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  1. Last week
  2. Ferring Pharmaceuticals Inc. today announced that the U.S. Food and Drug Administration has approved ZOMACTON for injection in four additional pediatric indications View the full article
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  4. I didn’t engage in behaviors like calling or texting multiple times—if anything, I did the opposite, out of fear of being perceived as needy—but the thoughts alone, their irrationality and all-consuming anxiety, caused me a lot of pain. Fear of abandonment, jealousy, and general insecurity in romantic relationships leads many in the dating scene to be labeled the dreaded “needy.” It’s a pejorative that’s especially used to describe women, an insult that dismisses someone as being “crazy” for simply needing reassurance and consistent contact. Of course, men can suffer from the “needy” label too, but they often fall into the “unavailable” camp—aloof, distant, indifferent, and detached, which can quickly earn them the title “asshole.” Sadly, most folks don’t know the roots of these behaviors, so we’re left throwing insults at fellow daters rather than understanding that these traits date back to childhood. For years I thought I didn’t fall into the “needy” camp. Many of my past relationships were with men who bordered on needy themselves, so I never needed to feel insecure—if anything, they were the insecure ones, always vying for my time and attention. There was little reason to fear abandonment. It wasn’t until this past year that I discovered that if I’m invested in someone who is a bit more independent, my anxiety and fear of rejection can become nearly intolerable. Enter the man who is now my partner, Matthew*. The day after our first date, he sent me a very sweet text complimenting both my personality and appearance while adding that he would love to see me again, and soon. Just a few days later, we had our second date, and a few days after that, our third, and by that time I realized I could really fall for him. After our fourth date, I was officially hooked, and that’s when the anxiety hit. Now I was invested, and that meant that if a few days passed and I didn’t hear from him, I assumed he was over it. And I was so terrified of seeming needy that I rarely initiated a text. When I did, it would sometimes take hours for him to respond; that’s just his nature, being a very busy person, but when he didn’t respond right away, I’d once again assume he was over it. Despite all the fear, I’d always hear from him, often with a “Sorry, hun, wish I could have gotten back to you sooner!” text. At the time, I thought I was going slightly crazy. Part of me knew I was just being paranoid, and part of me kept buying into the irrational thoughts telling me that he was going to drop me. I knew that ghosters—people who vanish from seemingly stable dating scenarios for no reason whatsoever—were everywhere. But Matthew hadn’t given me any reason to think he might leave; all of his words and actions displayed evidence that he wasn’t going anywhere. Still, I worried and worried—every day waiting for the other shoe to drop—for Matthew to show some sign of disinterest. I comforted myself with thoughts like “Once we’re exclusive, this anxiety will go away.” Well, we became exclusive, and the anxiety did not go away… So what did Tracy do when the anxiety didn’t go away? Find out in the original article How I Conquered My Relationship Insecurity at The Fix. View the full article
  5. As an advocate for OCD awareness, I get lots of emails from people. One of the most frequent questions I receive is some form of “How can I get rid of this terrible anxiety that is ruining my life?” While I’m not a therapist, I have learned a lot in the eleven years since my son was diagnosed with obsessive-compulsive disorder, and one thing I know for sure is that is not the question any of us should be asking. The reason? Well, for one thing, a life without anxiety is not only an unattainable goal but an unhealthy one. Anxiety serves a purpose and a few of the ways it can benefit us include: Our bodies instinctive fight-or-flight response related to anxiety can propel us into action and protect us from danger. An example might be gathering your family as quickly as possible to escape a house fire. Anxiety might be a warning sign to pay closer attention to whatever it is that is making you anxious. For example, if you are extremely stressed and anxious when coming home after work every day, maybe that’s a sign that there are issues in your marriage or home life that need to be addressed. Anxiety can motivate you to get things done. For instance, if you’re a student, feeling anxious about getting a good grade on a final exam can motivate you to study hard and do well. These are some of the more common benefits to anxiety, though there are certainly others. But what if you suffer from unrelenting, severe anxiety and are dealing with a brain disorder such as obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, post-traumatic stress disorder, or social anxiety disorder? What if you’re paralyzed with so much fear and anxiety that you can’t enjoy life, or even leave the house? Then, by all means, you need help. But the question to ask isn’t, “How do I get rid of my anxiety?” but rather, “How do I learn to live with my anxiety?” There’s a big difference. Using OCD as an example, I know of many people who begin therapy thinking they will get rid of their obsessions and become anxiety free. What they quickly learn, however, is that exposure and response prevention (ERP) therapy, the evidence-based cognitive therapy used to treat OCD, actually initially raises anxiety as the person with OCD is asked not to perform any compulsions. Over time, the anxiety will become less intense and subside quicker, but there will still be times in their lives when they will become anxious. None of us, whether we have OCD or not, can control our thoughts or our anxiety, but we can learn the best ways to react to them. Professional help might include some therapies such as Cognitive Behavioral Therapy (CBT), mindfulness, Acceptance and Commitment Therapy (ACT) and possibly medication, those who have been totally controlled by anxiety can absolutely get their lives back. They can learn to accept the uncertainty of life, as well as the anxiety that often goes along with that acceptance. Perhaps most importantly, they can shift from lives dictated by fear to lives where they’re free to honor their values, pursue their goals, and follow their dreams. View the full article
  6. A virtual reality (VR) coach can effectively deliver psychotherapy to help overcome a fear of heights in people with this phobia. View the full article
  7. There is tremendous social and cultural hype around the joys, excitement, and wonder of pregnancy, birth, and raising children. Baby showers, parenting classes, and the array of pre-birth activities often convey the implicit and explicit message to parents-to-be that having kids is exclusively a magical albeit stressful experience. This mythology does us a grave disservice by creating the sense that there is something shameful or abnormal about postpartum depression and/or anxiety. The truth is, negative emotional postpartum experiences are very common and tragically underreported as new mothers in particular often feel they should be nothing but glowing and ecstatic. The Mommy Wars, a competition amongst women to excel at being new mothers, have created a disturbing dynamic in which women often feel afraid to admit they need help, are overwhelmed, or are struggling. Women in particular — and men as well — may feel obligated to “put on a good face” or “act like” they are doing well when they are in fact not. Many fear judgement from friends who are parents or from family members. The Centers for Disease Control estimates that in the United States, the prevalence of postpartum depression and anxiety is as high as 1 in 5 women in some states. Postpartum depression and anxiety affects women regardless of age, race, ethnicity, number of pregnancies, or prior mental health issues. These feelings can arise days, weeks, and months after birth, and may last years. Stress, anxiety, sleeplessness, hormonal changes, and the emotional intensity of pregnancy, childbirth, and bringing home an infant are all significant influences on postpartum mood issues, and feeling sad, anxious, and overwhelmed is by no means a sign that a new parent is somehow failing to rise to the task. Postpartum depression and anxiety can range from mild to severe. Symptoms include feeling sad, anxious, nervous, weepy, blue, angry, and lonely — among others. Severe symptoms may include thoughts of harming oneself or the child. If you or someone you know is at risk for harming themselves or their child, immediately contact your local crisis support hotline or 911. Getting help for postpartum mood difficulties like depression and anxiety is important for the health and wellness of families. Recognizing and accepting that one is feeling overwhelmed is the first step on the long road of parenting in which eventually, parents are ultimately supported by many other people when it comes to their children and parenting … family, teachers, coaches, counselors, and clergy, to name a few. Initially reaching out is often the hardest part of asking for help when it comes to being an overwhelmed parent, whether it’s your first time or your fourth. If you’re having difficulty asking your support system for what you need (and maybe you’re even having a difficult time identifying what it is that would be helpful to you) try the Third Person Test. This is when you imagine what you would want a friend to say to you to ask for help if they needed it and were struggling to ask. Sometimes, imagining that the situation isn’t our own frees us up from the harsh self-judgements we tend to levy on ourselves but that we wouldn’t dream of when it comes to someone else. Your medical professionals can be tremendously helpful when it comes to accessing the resources you need. Obstetricians, pediatricians, and even your family Primary Care Provider all have extensive experience supporting families through postpartum mood disturbances, and they can direct you to reputable, reliable, professional organizations and service providers to address your families’ specific needs. Postpartum Support International or PSI for example is a trusted organization for the education and support of new moms and their families surrounding the entire perinatal period. There are also compassionate, specialty counselors available to help new parents navigate these difficult feelings while engaging in this important new journey. These counselors can support you with practical skills and strategies for addressing the challenges that arise. Faith organizations and hospital systems frequently offer a wide variety of emotional and practical support services, including educational forums, support groups, peer groups, and links to other ancillary services that help new parents feel less overwhelmed by their exhaustive new responsibilities. If you’re having difficulty getting the kind of support you need from your partner, friends, or family members, a counselor specifically trained in perinatal mental health can offer you practical advice for getting these important individuals on board in ways that are meaningful to you. Counselors often are excellent at providing communication training so that the individual can more successfully convey what it is they are needing to those who are in a position to provide it. Having children can be a remarkably rewarding experience, but more often than not, it also comes with real anxieties about the infinite questions surrounding parenting. Give yourself, your child, and your family the gift of helping you through postpartum depression and anxiety by seeking and accessing the support you need. View the full article
  8. There is tremendous social and cultural hype around the joys, excitement, and wonder of pregnancy, birth, and raising children. Baby showers, parenting classes, and the array of pre-birth activities often convey the implicit and explicit message to parents-to-be that having kids is exclusively a magical albeit stressful experience. This mythology does us a grave disservice by creating the sense that there is something shameful or abnormal about postpartum depression and/or anxiety. The truth is, negative emotional postpartum experiences are very common and tragically underreported as new mothers in particular often feel they should be nothing but glowing and ecstatic. The Mommy Wars, a competition amongst women to excel at being new mothers, have created a disturbing dynamic in which women often feel afraid to admit they need help, are overwhelmed, or are struggling. Women in particular — and men as well — may feel obligated to “put on a good face” or “act like” they are doing well when they are in fact not. Many fear judgement from friends who are parents or from family members. The Centers for Disease Control estimates that in the United States, the prevalence of postpartum depression and anxiety is as high as 1 in 5 women in some states. Postpartum depression and anxiety affects women regardless of age, race, ethnicity, number of pregnancies, or prior mental health issues. These feelings can arise days, weeks, and months after birth, and may last years. Stress, anxiety, sleeplessness, hormonal changes, and the emotional intensity of pregnancy, childbirth, and bringing home an infant are all significant influences on postpartum mood issues, and feeling sad, anxious, and overwhelmed is by no means a sign that a new parent is somehow failing to rise to the task. Postpartum depression and anxiety can range from mild to severe. Symptoms include feeling sad, anxious, nervous, weepy, blue, angry, and lonely — among others. Severe symptoms may include thoughts of harming oneself or the child. If you or someone you know is at risk for harming themselves or their child, immediately contact your local crisis support hotline or 911. Getting help for postpartum mood difficulties like depression and anxiety is important for the health and wellness of families. Recognizing and accepting that one is feeling overwhelmed is the first step on the long road of parenting in which eventually, parents are ultimately supported by many other people when it comes to their children and parenting … family, teachers, coaches, counselors, and clergy, to name a few. Initially reaching out is often the hardest part of asking for help when it comes to being an overwhelmed parent, whether it’s your first time or your fourth. If you’re having difficulty asking your support system for what you need (and maybe you’re even having a difficult time identifying what it is that would be helpful to you) try the Third Person Test. This is when you imagine what you would want a friend to say to you to ask for help if they needed it and were struggling to ask. Sometimes, imagining that the situation isn’t our own frees us up from the harsh self-judgements we tend to levy on ourselves but that we wouldn’t dream of when it comes to someone else. Your medical professionals can be tremendously helpful when it comes to accessing the resources you need. Obstetricians, pediatricians, and even your family Primary Care Provider all have extensive experience supporting families through postpartum mood disturbances, and they can direct you to reputable, reliable, professional organizations and service providers to address your families’ specific needs. Postpartum Support International or PSI for example is a trusted organization for the education and support of new moms and their families surrounding the entire perinatal period. There are also compassionate, specialty counselors available to help new parents navigate these difficult feelings while engaging in this important new journey. These counselors can support you with practical skills and strategies for addressing the challenges that arise. Faith organizations and hospital systems frequently offer a wide variety of emotional and practical support services, including educational forums, support groups, peer groups, and links to other ancillary services that help new parents feel less overwhelmed by their exhaustive new responsibilities. If you’re having difficulty getting the kind of support you need from your partner, friends, or family members, a counselor specifically trained in perinatal mental health can offer you practical advice for getting these important individuals on board in ways that are meaningful to you. Counselors often are excellent at providing communication training so that the individual can more successfully convey what it is they are needing to those who are in a position to provide it. Having children can be a remarkably rewarding experience, but more often than not, it also comes with real anxieties about the infinite questions surrounding parenting. Give yourself, your child, and your family the gift of helping you through postpartum depression and anxiety by seeking and accessing the support you need. View the full article
  9. Most people know the telltale signs of depression: a deep, sinking sadness, loss of hope, a bleak outlook on life, and weight and appetite changes. As psychologist Deborah Serani, Psy.D, said, most people also picture a slow-moving individual with sloped shoulders who’s unable to get out of bed. While for some people the above is absolutely true, for others, different signs are more prominent and indicative of depression—signs that might surprise you. Below are six symptoms to watch out for. You have a super short fuse. Irritability is a common sign of depression in men, but it also shows up in women. For example, a client came to psychotherapist Rachel Dubrow, LCSW, to work on her short fuse at work. She’d get so frustrated that she’d cry in front of coworkers, and cause conflict—which made them not want to work with her. She also was exhausted and overwhelmed. She’d start projects but didn’t have the energy to finish them. (She had other symptoms, too, including insomnia, hopelessness, helplessness, low self-esteem and loss of interest.) Janina Scarlet, Ph.D, a clinical psychologist and founder of Superhero Therapy, worked with a client who had just broken up with her boyfriend because of his cheating. She told Scarlet that she was happy to be rid of him and felt “fine.” A week later she mentioned feeling irritable around her friends. Little things that normally didn’t bother her—a friend chewing gum, a friend texting while talking to her—made her absolutely furious. She started finding people “too annoying” to be with, so she started isolating herself. She also snapped at her parents, stopped working on a school project and lost interest in activities she used to enjoy. As she and Scarlet dug deeper, it turned out that beneath the client’s anger were feelings of grief, hurt and rejection. Teens at risk for depression also are more likely to be irritable than sad, said Serani, who specializes in treating patients with mood disorders and has authored several books on depression. For instance, Serani worked with a high school senior who was getting into trouble at school and fighting with his parents, who were concerned about his disruptive, disrespectful behavior. He wasn’t completing assignments, and was missing a lot of school. But when Serani met him, she saw that his restlessness, agitation and irritability were less about being a rude teen, and more about an undiagnosed depressive disorder. In addition to these symptoms, he was struggling with sadness, helplessness, negative thoughts, low confidence, and worries about the future. But “those symptoms weren’t detected because his others were so noticeable,” she said. Your concentration is shaky. You simply can’t focus like you used to. That’s because depression also affects cognition, leading to forgetfulness and distractibility, Serani said. Dubrow’s depressed clients tend to notice their difficulty concentrating in two areas: reading and completing tasks. For instance, her clients are unable to finish a chapter or an entire book, which seems to take them much longer than it used to. Because of this, they no longer want to read, even though it was an activity they loved. In the second scenario, clients try to complete tasks but instead find themselves staring at the computer screen, losing their train of thought or getting distracted in other ways, she said. You can’t make up your mind. “The cognitive slowness of depression makes thinking and problem solving more difficult than for those who do not have depression,” Serani said. For some of her clients the indecision is intense. They tell Serani that they feel “stuck.” Stuck about what to eat for lunch. Stuck about what to wear. Stuck about what show to watch. In addition to seemingly small decisions, other clients struggle with major life decisions, she said, such as: “Should I take this job? Should I date this girl? Should I go back to school?” It becomes a “tennis game of should I, or shouldn’t I? It becomes a ruminating style of thinking that interferes with daily life.” You strive for perfection. Which is related to anxiety. That is, anxiety may serve as a protective emotion against depression, said Scarlet, also author of several books, including Superhero Therapy: Mindfulness Skills to Help Teens and Young Adults Deal with Anxiety, Depression and Trauma. “Sometimes people with depression may feel as if their emotions are ‘out of control’ and therefore may look for things and behaviors they can control, such as cleaning, organizing, or perfecting their work.” Sometimes, you might even struggle with severe anxiety, including panic attacks. For example, Scarlet was working with a client who had debilitating panic attacks. Together they used mindfulness and cognitive behavioral techniques, including exposure (“helping the client to face their fears in a safe and gradual manner”). Her anxiety subsided. But her depression surged. “We uncovered that her depression began after her father passed away and that in order to avoid her depression, she started trying to keep things ‘organized’ and ‘perfect.’” Getting to the root of this client’s depression and grief, and processing it significantly reduced her depression. You have random aches or chronic pain. Sometimes, people with depression struggle with headaches or stomachaches. Other times, Serani said, they have full-blown migraines, back or neck pain or chronic pain in their knees or chest. “The key here is if you’ve been checked out physically and there is no ‘origin’ for your pain, like a slipped disc, a torn ligament, allergies that lead to migraines or gastrointestinal issues.” Inflammation may actually play a pivotal role in depression, and trigger your pain. You feel utterly empty. Many people with depression experience apathy, “which means not caring about things,” Scarlet said. They may feel like nothing gives them joy or pleasure. In fact, they might not feel anything at all. As Rosy Saenz-Sierzega, Ph.D, told me in this piece, the lack of feeling is downright terrifying and isolating for her clients. They’re “fearful that they will never again be able to feel.” They “feel as though there is a wall or barrier between them and other people—it’s very lonely behind that wall.” Author Graeme Cowan called it “terminal numbness”: “I couldn’t laugh, I couldn’t cry, I couldn’t think clearly. My head was in a black cloud and nothing in the outside world had any impact…” Depression affects all individuals differently. As Serani said, “Depression is not a one-size-fits-all illness.” Again, some struggle with unrelenting sadness, while others feel empty. Some feel angry with everyone, while others fixate on perfection. Depression also lies on a continuum, from mild to severe, Serani said. If you’re struggling with similar signs and symptoms or simply feel off, seek professional help. Both Dubrow and Serani stressed the importance of getting a medical workup to rule out any underlying medical causes and getting a comprehensive evaluation from a mental health practitioner. “What I always say is that it is better to get ahead of the symptoms, than be chasing them—especially with depression because the symptoms can be persistent or long standing,” Dubrow said. Depression is highly treatable. Please don’t hesitate to get help. View the full article
  10. Phobiasupportforum

    How to Communicate Suicidal Feelings

    Unfortunately, I know this subject all too well. When I was 19 years old I my dad died by suicide, and I have had an almost fatal attempt myself in my early 20s, along with very regular ideation of wanting to end my life. One thing I have learned through the years, is that if you are suicidal, it is incredibly important to reach out for help in a way that is supportive for all involved. It is not easy for anyone, and there is a very big difference between using suicide as a means to manipulate people in an abusive way as opposed to using it as a means to ask for support to get the help you need. As I said, I know this issue well and unfortunately I didn’t learn how to communicate suicidal feelings in a way that was healthy for both myself and others. And let’s be honest. Not many people even want you to mention the word suicide, let alone hear you feel like you want to end your life. Unfortunately, I learned these behavior patterns from my dad. As my dad told me many times, if X happens, I am going to kill myself. So I thought that was normal. And my dad lost his sister at a young age to suicide, so maybe he thought that was normal as well. So when my dad’s untreated depression got the best of him, and he lashed out in anger, he felt so much sadness after and didn’t know what do to do with it and why he could not control it. So he told me that he felt so bad he wanted to die. And I didn’t know what to do with it. So instead of setting boundaries and getting him into treatment, I tried to make him feel better, which resulted in a cycle of untreated mental health problems that ultimately destroyed him. What is so sad, is I know he didn’t want to die. He wanted to be a great dad and husband and meet his grandkids and not lash out in anger. He simply didn’t know how to control his emotions. So in the end, he drank a ton of alcohol to give him the courage to go to sleep in the garage in the car with a bible on his lap. And a late Valentine’s Day card to me, telling me our family was the most important thing in his life and he hoped I never felt the deep unhappiness, regret, and sadness that he felt. Little did he know that by leaving me that way, that is exactly what I would feel. I wish I had learned from that experience, but I was fairly deep in my own addictions and the pain from the loss and feeling of having failed to save him, so went through my own cycle with my first serious boyfriend where I would threaten self-harm. Yet it was always because of own bad choices or mistakes. What I was trying to say was “This feels terrible, please help me.” But what I was really saying was “Do this or else…”. The bottom line, is this is abusive and manipulative behavior, and not anything I am proud of doing. I just didn’t know better, or how to deal with the intensity of my emotions. And the ironic thing, is that when we do that to others, we end up just pushing them further away and not getting the help we need. As it is not about ‘them’, it is about learning how to deal with the curves we are presented in life, navigate through the pain of it, and maintain a hopeful mindset through it all. It took a lot of time and practice, but now when I feel seriously suicidal (as opposed to just suicidal thoughts), I’m able to say to my friends, family, and therapists I have identified in my Hope network — “I feel hopeless, any ideas for how I might get support? How I might fix this problem that feels overwhelming?” And when I say it that way, or ask it that way, I generally get the support I need that helps my internal healing and growth for making better, most positive choices. By threatening suicide, we don’t solve anything, anyway. We just fix a surface immediate problem, instead of getting to the root of the behaviors or limiting beliefs causing it in the first place. As it is easy to fix things short-term, but to create the kind of long-term healing we need to stay healthy and in positive relationships, we need to be able to get to the deeper root of why we don’t think we can remain in a hopeful state. When I went through a divorce, I remember feeling incredibly hopeless as I had significant challenges that felt completely insurmountable and I was sober so had to feel my way through the pain. I really didn’t know how I might recover, and how I was going to get through it. So I called my oldest brother, and instead of saying ‘I’m going to kill myself if you don’t help me’ I simply expressed how terrible I was feeling about my situation. So like the hero rockstar brother he is, he got a U-Haul, came and packed me up, and moved me to be by his family where I got to be an aunt to two of the coolest kids (now grown) I know. I got my medications modified, went into intensive therapy, practiced meditation, exercised regularly, practiced gratitude, focused on giving back, journaled, got closer to my spiritual guidance, and got my life back on track. And ironically enough, when I put my mental health before all of my other perceived emergencies and issues, the other issues slowly resolved themselves. I was in a recent relationship where someone was threatening suicide, and it was pretty devastating to me as it reminded me of my dad and all I went through with him. Yet it also reminded me that I can’t allow myself to be manipulated by those that are suicidal and refuse to get help. I simply cannot sacrifice my own mental health to keep others alive, nor is that my job. While it was hard and triggered a lot of my own trauma, it was positive as it led to a lot of my own healing from PTSD I covered with alcohol and drugs for many years. As I can do everything I can to connect people in pain to resources available, but people need to want to get treatment themselves. I can’t spend enough money, give enough love, or fix enough problems to help another heal. And while nothing hurts more to me than watching those I love suffer, when I abandon myself and stop helping myself, everyone loses. Thankfully, these days I’m feeling really good, off medications, have 14 years of sobriety and a close network of people I know I can turn to when I don’t see a way past an obstacle, including connecting to my higher power when nobody else seems to understanding. And using the power of surrender, a true gift. The reality is statistically speaking I have a very high chance of dying by suicide, so I need to be extra vigilant about sharing with others how I am feeling and reaching out for support when I need it. We all need networks for hope, to know we are not alone, and to be able to share authentically our health status, and that includes our mental health. And I think especially so when we are feeling that we don’t want to be alive, as that is a pretty clear indication we need help. Yet to be the kind of people we want to be, we need to do it in a way that is respectful not just of ourselves, but others, so we strengthen our relationship instead of tearing them apart. As that is the way we get to true healing and recovery. If you, or someone you know, is feeling suicidal please reach out to 1800-273-8255 (TALK) to find resources in your area. View the full article
  11. As I write this, sunlight glares off the pavement outside my window, the sky remains a plain of ceaseless blue, and the air is so bogged down with heat that the usual cheery birdcalls trilling through the neighborhood now sound shrill. It is summer; I am sad and annoyed — and there’s not a big overreaching reason why (not any more than all the other seasons, at least). I haven’t always been a “bummer in the summer” kind of person; in fact, it used to be my favorite time of year. All the way through childhood and even past my college years, I relished long days swimming in the ocean and countless nights sitting around bonfires with friends. When I became a parent, I still loved the summer season, planning seaside vacations with my family and reading to my kids under the canopy of the city park’s huge oak trees. But as my children turned into adults and I transformed into a middle-aged woman, I find that the long, light-filled days have grown increasingly challenging. One of my friends feels similarly, joking that maybe it’s because our skin has literally become thinner, making us more sensitive to sunlight and prone to sunburn. Although that may be true, our more delicate epidermis doesn’t account for the ever-thickening sadness. And… I also know a 26-year-old who also notices that she gets the summertime blues as well. So out of curiosity, I Googled “Seasonal Affective Disorder in the Summer,” not expecting any concrete results. I was surprised to find that it really is a “thing.” Even WebMD had an article on it titled “Tips for Summer Depression,” saying that about 10 percent of people with SAD get it in “the reverse” — that is instead of depression being triggered during the typical SAD season of winter, it creeps in during summer months instead. Symptoms of summertime SAD include loss of appetite, trouble sleeping, weight loss, insomnia, and anxiety — and, of course, sadness. According to this article, the director of the Depression Research Program at UCLA, Ian A. Cook, MD, says that some studies have shown that SAD is more common during the summer than winter in countries near the equator. Experts theorize that longer days and increasing heat plus humidity may play a role. So what can we “summer-bummer” folks do to help save ourselves from drowning in the summertime blues? Whether we are suffering from a clinical bout of summertime SAD or dealing with situational depression during these hot, sweaty months, below are a number of ways that can help us cruise through the dog days of summer. Dealing With the Extra Light. Staff writer Olga Khazan at The Atlantic wrote a piece about summertime SAD in which she cited a theory by Alfred Lewy, a professor of psychiatry at Oregon Health and Science University. Lewy theorizes that the intense light of summer may be just as disruptive as winter’s short days and long nights. Because people have a tendency, as well, to stay up later in the summer, we can further throw off our body clocks. Lewy suggests that people suffering from summertime SAD may be able to reset their clocks by taking melatonin and exposing themselves to early-morning light. Dealing With the Extra Heat. The simple fact that heat can also affect people in negative ways (irritability, anger, lethargy, etc.) can very well contribute to summertime SAD. According to the article posted in The Atlantic, Thomas Wehr, a scientist emeritus with the National Institute of Mental Health who first documented SAD, notes that when people with summertime depression were “wrapped in cooling blankets at night, their temperatures dropped and their symptoms disappeared. As soon as they went outside into the summer heat, their depression returned.” Dealing With the Extra “Fun.” Aside from the biological reasons behind summertime SAD, people often have to deal with extra stressors of the season, including body image issues (the thought of donning on shorts and bathing suits can make some people feel horribly self-conscious), disrupted routines (kids home from school and/or college, anyone?), even vacations can contribute to summer depression because they disrupt exercise, sleep, and eating habits. It’s important, therefore, to either find a way to work on body image issues and/or allow yourself the freedom to wear a nice, cool dress or loose pants and shirts, instead of shorts and tank tops and swimming trunks and t-shirts (rather than bikinis), plan summer camp activities for the kids and/or make sure that your college-aged kids know you’re not going to work as their personal maid, and lastly, try to maintain a healthy exercise routine (maybe an air-conditioned gym may be in order?), a steady sleep schedule, and try to eat as healthy of a diet as possible. And… you can also do what I do: By seven at night, I often shut all the blinds, curl up on the couch, and enjoy a good book or my current binge-worthy show, while ignoring the evening sun outside my front door as well as my neighbor’s beer-enhanced barbecues. Ah, how wonderful the mellow light of autumn will be! View the full article
  12. For the majority of affected youth, anxiety disorders are chronic, even after a successful course of evidence-based treatments, reports a study published in the July 2018 issue of the Journal of the American Academy of Child and Adolescent Psychiatry. View the full article
  13. Is your love life suffering because of your mood? Is it hard to have a healthy relationship when you’re depressed? Absolutely, yes! Mixing depression and relationships is tricky. I know because I’ve been there. I’ve struggled with depression for my whole life — 52 years. For a long time, I didn’t have a name for why I always felt so hopeless and full of despair. I just lived with it. And then I got married. And he had to live with it, too. Being in a healthy, loving relationship when you are depressed can be very difficult, but I am here to tell you that relationships don’t have to self-destruct because of your depression. Here are 5 ways for how to deal with your depression without letting it ruin your love relationship: 1. Recognize When You Are Depressed — and Let Your Partner Know, Too. Those of us who live with depression can usually tell when it hits. Simple tasks that just the day before was easy to do become difficult. Sleep is elusive. We are short-tempered and crabby. Each of us manifests depression differently but usually, we know when we are experiencing it. Keeping in touch with your depression and sharing its presence with your partner is very important. Don’t just expect your partner to guess that you are depressed. They might not recognize the signs and might not respond to your new mood and that could lead to some big problems between the two of you. When I was married, I didn’t tell my husband when I felt depressed. I was crabby and mean and not fun to be around. And I expected him to fight through all of that and make an effort to make me feel better. Of course, he didn’t. He thought I was just being mean and crabby and so he wanted nothing to do with me. If only I had told him what was going on. Perhaps he would have had some sympathy and given me what I needed. So, when depression hits, be clear about it. You and your partner have a bit of a battle ahead. Together. These Types of Depression Can Sneak Up On You 2. Talk to Your Partner about What Depression Feels Like. Even the most sympathetic of partners doesn’t really understand what depression is like unless they suffer from it themselves. Because of this, it’s important to try to teach them what depression looks like for you. When we talked, my message for my husband was: You didn’t cause this. You can’t fix it. I can’t just suck it up and feel better. For me, it was essential that he knew these three things to be true. Next, I explained to him what my depression looked like. That when I was depressed I felt like I had a gorilla on my back. Moving around, getting things done, communicating effectively, all required such a Herculean effort that I could barely manage. When I was depressed, I was exhausted, easily angered, and prone to long bouts of crying. Going to work, seeing his family, taking care of myself, all filled me with such an overwhelming sense of dread that I couldn’t bear it. So, when you ARE NOT depressed, take some time and share your experience with your partner. The better understanding they have of your depression the better they will be able to deal with and cope with it. 3. Plan Ahead for What to Do When Depression Hits. A key part of dealing with depression for me and for my husband was to have a plan in place for what I needed when I was depressed. I knew from past experience what I needed to get through my depression, but sharing it with my partner was the key. For me, when I get depressed I need four things: to get outside, to sleep, Pad Thai, and sex. I knew that those things would not cure my depression but that they made living with it easier. So, when I was NOT currently depressed and able to think and strategize more clearly, my husband and I made a plan for what to do when I was depressed. We would let me sleep in, go for a hike, get Pad Thai, have sex, and send me back to sleep. We would do that or some variation of that to stay connected while I was depressed, so he could help me get through it. What we also agreed was that he wouldn’t try to fix it. Many people want to fix things. You can’t fix depression. Accepting that was a great way for my husband to manage when I was depressed because he wasn’t constantly frustrated, searching for ways to help me. 4. Don’t Make Your Partner Suffer. So, you have talked to your partner about your depression and made a plan for what you need when you are in it. Both of those things are great. Proactive. Good for you. Sometimes, however, those things just don’t work and you are miserable. You are short-tempered and difficult and not fun to be with. At times like that, let your partner go. Let them go about their day, guilt-free. The last thing in the world you want to do is tether someone you love to your depression. Encourage your partner to go do something they love instead of hanging around being miserable with you. If you let them do this they will come home refreshed and better able to support you. (And they might even bring you some Pad Thai.) 10 Things to Do When You’re Ready to Overcome Your Depression and Anxiety 5. Agree to Seek Help. One of the hardest things for someone who loves someone with depression is their sense of helplessness. They know that there is nothing that they can do to help their partner get out of this dark place, and that sense of helplessness can tear relationships apart. So what can you do? You can agree to seek help for dealing with your depression. That help can be what you want it to be: medication, yoga, or therapy. Whatever works for you. It is important for both of you in the relationship to know that the depression isn’t something that will be ignored, but will be addressed head-on — together, as a couple. Get some help. Both for you and for the one you love. It can be difficult to have a healthy relationship when you’re depressed. Depression can have a devastating effect on relationships. It doesn’t have to be a death knell, however. Some relationships can actually thrive when couples tackle depression together. Share with your partner what your depression looks like, allow them to fully understand it and share with you the tools you have in place to manage it. Give them the freedom to escape from it for a bit if necessary. But be in it together. Because if together you can manage depression then there is nothing else that you can’t take on. Together. You can do this! This guest article originally appeared on YourTango.com: 5 Ways To Have A Loving, Healthy Relationship When You Have Depression. View the full article
  14. Phobiasupportforum

    Should You Try TMS (rTMS) for Depression?

    TMS refers to transcranial magnetic stimulation (TMS), a treatment method for clinical depression first developed in the 1980s. In the psychology research literature, TMS is often referred to as rTMS — the little ‘r’ is for repetitive, because the treatment needs to be delivered at regular intervals to be most effective. What exactly is it? TMS is a simple, safe, external outpatient treatment procedure that pulses very specific wavelengths of magnetic fields to specific areas of your brain through your skull. It is believed these magnetic pulses help to reduce depression symptoms when administered in a course of treatment lasting 20-30 sessions over a period of six weeks (depending upon the response of the patient and the severity of the depression). What’s a treatment session of TMS like? TMS treatment sessions typically last about 40 minutes after the initial consultation that determines whether TMS is right for the patient. The TMS procedure is painless and you remain fully conscious during it. Many people report feeling a tingling or tapping sensation on their head during the procedure. Ear plugs are typically worn to help reduce the noise made by the TMS machine. TMS is administered by a TMS technician who has been trained and certified in the treatment. A typical treatment of rTMS includes high-frequency (10 Hz) stimulation of your brain’s left-side dorsolateral prefrontal cortex. rTMS machines and procedures vary slightly, depending upon the manufacturer and the facility where you are receiving treatment.1 Some patients also benefit from maintenance treatment once the initial course of 20-30 sessions has been completed. This maintenance treatment may occur every 6 to 12 months, depending on the patient and whether their depressive mood reoccurs. Is TMS effective in the treatment of depression? TMS is an effective treatment method for depression, especially treatment-resistant depression (TRD), according to the research literature. In one recent review the researchers wrote, “The studies reviewed reported satisfactory responses to rTMS in acute depressive episodes, as measured using depressive symptom scales. Remission of symptoms was achieved in many cases” (Felipe et al., 2016). Research has produced thousands of studies examining the effectiveness of rTMS for depression. One meta-analysis — a systematic review of scientific studies designed to arrive at generalized conclusions — found that active rTMS was significantly superior to sham conditions (the equivalent of a placebo condition) in producing clinical response in subjects (Lam et al., 2008). A more recent meta-analysis examined 18 good- or fair-quality treatment-resistant depression studies that employed rTMS compared to placebo (or sham treatment) (Gaynes et al., 2014). In every one of those studies, rTMS was better than placebo, significantly reducing depression severity in the subjects studied (a reduction of 4 or more points on the Hamilton Depression Rating Scale, a typical measure for depression used in research). How will I know it’s working? Your therapist or clinician will regularly assess the treatment’s effectiveness by asking you a series of questions about your depression, or by having you take a short quiz asking you those same questions. You should always answer these questions as truthfully as possible, to give the clinician an accurate picture of your depressive symptoms.2 Research has shown that a patient’s initial response to TMS predicts that patient’s subsequent response and likelihood of relapse (Kelly et al., 2017). Therefore, if after a predetermined number of sessions your therapist determines that the treatment doesn’t seem to be helping your depressive symptoms, they may suggest discontinuing it. One thing to be aware of that just as in antidepressant therapy, research has demonstrated that the placebo effect is large in rTMS treatment (Razza et al., 2018). That simply means that some people benefit from a treatment that looks like rTMS, but doesn’t actually do anything. Just like some people would benefit from an “antidepressant” pill that is made from nothing but sugar. Placebo response was lowest in people with treatment-resistant depression (TRD), suggesting that is a group of people it is likely to work best with as well. Can I try TMS when I’m pregnant? TMS is one of the few treatments, other than psychotherapy, that also appears to be safe for pregnant women. In a review of a dozen studies conducted with women who were pregnant during TMS treatment, researchers found no harm to the fetus or that any additional pregnancy complications resulted (Felipe et al., 2016). They wrote, “The data available at this time support the efficacy and tolerability of rTMS for depression in pregnant women. Controlled studies should corroborate this conclusion.” What are the side effects of TMS? TMS appears to be safe for your brain (Tovar-Perdomo et al., 2017), or as the researchers put it, “cognitively safe.” Unlike electroconvulsive therapy (ECT), which has potentially significant cognitive and memory side effects in some people who undergo it, TMS has very few side effects in most people who try it. (Research suggests that while ECT may be more effective than rTMS, it is also among the least well-tolerated treatments available (Chen et al., 2017).) The primary side effect most people who try TMS experience is a mild headache that goes away on its own or with the help of an aspirin or Tylenol. Some people also experience scalp pain, that tends to also go away on its own after each treatment session. (Teenagers appear to experience more side effects than adults, perhaps owing to their still-developing brains.) Should I try TMS? Yes, especially if you have treatment-resistant depression and have already tried a combination of psychotherapy and antidepressant medications. TMS helps about one-third to one-half of the people who try it to become free of depression symptoms, and nowadays, is a treatment covered by most health insurance plans. The side effects of the treatment are minimal and well-tolerated by most people. References Blumberger, Daniel M.; Vila-Rodriguez, Fidel; Thorpe, Kevin E.; Feffer, Kfir; Noda, Yoshihiro; Giacobbe, Peter; Knyahnytska, Yuliya; Kennedy, Sidney H.; Lam, Raymond W.; Daskalakis, Zafiris J.; Downar, Jonathan. (2018). Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): A randomised non-inferiority trial. The Lancet, 391(10131), 1683-1692. Chen, Jian-jun; Zhao, Li-bo; Liu, Yi-yun; Fan, Song-hua; Xie, Peng. (2017). Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression: A systematic review and multiple-treatments meta-analysis. Behavioural Brain Research, 320, 30-36. Felipe, Renata de Melo & Ferrão, Ygor Arzeno. (2016). Transcranial magnetic stimulation for treatment of major depression during pregnancy: A review. Trends in Psychiatry and Psychotherapy, 38(4), 190-197. Gaynes, Bradley N.; Lloyd, Stacey W.; Lux, Linda; Gartlehner, Gerald; Hansen, Richard A.; Brode, Shannon; Jonas, Daniel E.; Evans, Tammeka Swinson; Viswanathan, Meera; Lohr, Kathleen N. (2014). Repetitive transcranial magnetic stimulation for treatment-resistant depression: A systematic review and meta-analysis. The Journal of Clinical Psychiatry, 75(5), 477-489. Kelly, Michael S.; Oliveira-Maia, Albino J.; Bernstein, Margo; Stern, Adam P.; Press, Daniel Z.; Pascual-Leone, Alvaro; Boes, Aaron D. (2017). Initial response to transcranial magnetic stimulation treatment for depression predicts subsequent response. The Journal of Neuropsychiatry and Clinical Neurosciences, 29(2), 179-182. Lam RW, Chan P, Wilkins-Ho M, Yatham LN. (2008). Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and metaanalysis. Can J Psychiatry, 53(9), 621-31. Razza, Laís B.; Moffa, Adriano H.; Moreno, Marina L.; Carvalho, Andre F.; Padberg, Frank; Fregni, Felipe; Brunoni, André R. (2018). A systematic review and meta-analysis on placebo response to repetitive transcranial magnetic stimulation for depression trials. Progress in Neuro-Psychopharmacology & Biological Psychiatry, Vol 81, Feb 2, 2018 pp. 105-113. Tovar-Perdomo, Santiago; McGirr, Alexander; Van den Eynde, Frederique; dos Santos, Nicole Rodrigues; Berlim, Marcelo T. (2017). High frequency repetitive transcranial magnetic stimulation treatment for major depression: Dissociated effects on psychopathology and neurocognition. Journal of Affective Disorders, 217, 112-117. Footnotes: A newer type of rTMS that researchers are also studying is called intermittent theta burst stimulation (iTBS) that can be delivered in 3 minutes, versus 37 minutes for a standard 10 Hz treatment session. Initial research suggests that iTBS may be just as effective as standard rTMS, but that self-reported pain associated with the treatment may be slightly higher (Blumberger et al., 2018). It’s not uncommon for patients to want to “please” their therapist by saying they are feeling less depressed, even when they feel no change in their mood. You should try and not do this, in order to give your therapist a clear picture as possible of how you’re feeling. View the full article
  15. Phobiasupportforum

    Real Event OCD

    As many of us are aware, one of the cornerstones of obsessive-compulsive disorder is doubt: Did I hit somebody while driving? Did I say or do or think the wrong thing? Did I shut off the stove, turn off the lights, and/or lock the doors? The list goes on and those with the disorder often find themselves obsessing over things that may or may not have happened. But what if you are fixated on an event in your life that actually did occur? What if you did “something terrible” a long time ago (or last week) and now you can’t stop thinking about it? You’re trying to remember all the details, you’re analyzing every aspect of the occurrence, and you’re wondering about how awful a person you must be to have done what you did. Then you could be dealing with real event OCD (sometimes called real life OCD). I think it’s safe to say that most of us, whether we have OCD or not, have done things in our lives that we wish we hadn’t. It’s all part of being human. We are not perfect, and sometimes we make mistakes — in how we choose to act, in which road we decide to take, in how we treat people. Many adults cringe at the thought of some of their behaviors as children or teenagers and would now behave very differently if they could go back in time. While people without OCD can certainly regret their actions and even be bothered throughout their lives by events they’re not proud of, it’s a whole different ball game for those with OCD. People with OCD just cannot let it go and likely feel a sense of urgency to figure it all out — quickly and thoroughly. As an example, let’s imagine someone with OCD who is a kind, caring person. She remembers that in middle school there was one girl who everyone teased, and on a few occasions she joined right in. She now thinks, “What kind of a horrible person bullies someone? Maybe I’m responsible for messing up this person’s life — scarring them forever?” She searches for this girl on Facebook so she can apologize, but can’t find her. Now of course she is thinking the worst: “Is this girl even still alive, and if not, I could be to blame …” See the difference? OCD is laced with cognitive distortions such as black and white thinking and catastrophizing. While whatever real life event OCD latches on to might not be the person’s proudest moment, it is highly unlikely to be nearly as bad as the person perceives. Actually the problem is not the event, or even how the person with OCD feels about what happened. The problem is their reaction to their thoughts and feelings. Instead of trying to “solve the problem,” thoughts, feelings and memories of the event should be observed, accepted, and allowed to come and go. No compulsions (which in real event OCD typically include reassurance seeking and mentally replaying the event) allowed! There are so many variations of OCD: hit-and-run OCD, harm OCD, and real event OCD, to name a few. The good news, however, is the treatment is the same no matter what type of OCD you have. If you think you might be dealing with real event OCD, exposure and response prevention (ERP) therapy can help you turn your tormenting obsession into nothing more than an event of the past. View the full article
  16. Phobiasupportforum

    When Suicide Summons

    This is not a pleasant article to write. But then how could it be pleasant when I am writing about suicide. Yet, it’s important for all of us to attempt to understand the suicidal mind. My interest in this topic began when I was in my mid-twenties, with the attempted suicide of my mother. My mother’s act of aggression did not come out of the blue. She was depressed; she was drinking; she demanded that life bend to her demands. When it seemed that life was going to do as it damn well pleased, she, in a fit of anger and despair, decided to take matters into her own hands. While she lived for many more years after her attempt, she never really got beyond her depression and all its many manifestations. Suicide once again touched me personally when I discovered the body of my twenty-something next-door neighbor who had planned and executed a carbon monoxide garage death. Just two evenings before, we had dinner in my home. I never had a clue that anything was wrong. He seemed happy with his new job, enjoyed playing with my three kids and appeared to be in the prime of his life. I can’t really say that I found out why he did it. But I did find out that he was being treated for depression and that he and his family kept it a secret. Maybe, I told myself, if I had known he was depressed, I might have become suspicious when he told me not to worry if I didn’t see his car around for a while. Maybe, if I had known he was depressed, I would have taken him aside and had a heart-to-heart talk with him that may have lifted his spirits. My reaction to his suicide was a myriad of intense emotions: Surprise: “OMG, I can’t believe it!” Anger: “How could you have done this?” Compassion: “You must have been in so much pain!” Sadness: Bursting into tears at any moment. Frustration: “Why didn’t you say anything?” Confusion: “Why did you pretend that everything was ok?” It’s important for all of us to understand what traits promote the belief that suicide is the only way out: Feeling hopeless, helpless, worthless, shamed. Feeling defeated and in despair. Feeling alone, lonely, isolated, abandoned. Feeling that I don’t belong, I’m different, nobody can understand. Attempting to escape the pain, via drugs, alcohol, isolation. Finally, a sense that nothing matters anymore. I can’t go on. My life’s not worth it. I’m better off dead. As time goes on, the suicidal mind develops a mind of its own, searching for signals that reinforce the belief that there’s no way out. It ignores reassurances from others; it takes as gospel that nobody cares; it negates that help is available, it refuses to believe that things may get better; it nullifies any hope; it paints a dark future. And so, I write this personal note to anyone who has been feeling suicidal: Though you may not see a way out right now, it’s not true that ending your life is the only escape. There are other ways out of your pain, loneliness, shame, hopelessness. So, I hope you’ll take a chance and trust someone enough to let them help you. If you speak to someone who doesn’t understand, minimizes your concerns or berates you for feeling as you do, don’t give up. You haven’t found the right person yet. Instead of giving up, it’s imperative that you believe that: there’s someone who will listen to you and truly understand what you’re feeling, someone will appreciate how difficult your journey has been and still is, someone will take you by the hand and guide you toward a better life, you will smile again, feel safe once more and truly know that your life is worth living. Please, don’t give up until you find that special someone. ©2018 View the full article
  17. Phobiasupportforum

    Sharing Hope: An Interview with Charles Minguez

    According to Merriam-Webster Dictionary, hope is: “a feeling of expectation and desire for a certain thing to happen,” “a feeling of trust,” “want something to happen or be the case.” When used to describe the sense of desire for recovery regarding mental health, it carries with it, the belief that some positive outcome can ensue, that things can improve and that symptoms can abate. When a person succumbs to the illness, often it is because he or she has relinquished the possibility of healing. This month the suicides of designer Kate Spade and chef Anthony Bourdain had many questioning whether they had given up hope. Often, when people are immersed in darkness, they can’t imagine coming through on the other side into the light, even if they have done so on multiple occasions. Call it psychological or spiritual amnesia that has them forgetting how resilient they can be. Because of the stigma attached to mental illness, many are not comfortable talking about their emotional turmoil and the impact it has on their daily lives. Charles Minguez, MA, has walked that path and emerged triumphant one day at a time. Struggling with depression and addiction, this resilient thriver has taken his experiences and used them to assist others in traversing the treacherous trails that can lead to a precipice. He has elected to remain on solid ground. His vulnerable sharing of his story is inspiring. When one has run out of hope, sometimes borrowing someone else’s is what is called for. Minguez has made it part of his purpose to do just that in his newsletter called Sharing Hope. What experiences shaped the person you are now? When I was about nine or ten, my parents split and shortly after, my mom began a long-term relationship with a man who was abusive. Having no real coping skills to deal with the violence in my home I turned towards alcohol and drugs. Before the age of eighteen, I had been hospitalized three times, dropped out of school, and found myself with a diagnosis of major depression and schizoaffective disorder. Then sometime in my early twenties I was introduced to yoga and had the opportunity to train with a fantastic teacher. The trajectory of my life changed. How do you live with depression as an aspect of your life without it being your entire focus? I’ve learned to befriend my depression as opposed to pushing it away. If I were to pretend that the illness was not there, I would probably be a much angrier person. Unless people know you well, could they tell that it is part of your experience? No. In fact, I’ve had conversations with people where mental illness/health has come up, and when I share my story with them, they’re often surprised, not only by my history but that depression is such a part of my day-to-day experience. During the darkest times, what let you know that the light was there as well? I’m not sure I have a great answer to this question. I just knew, deep down inside that, there had to be more to life than the pain I experienced in my youth. Now when I’m feeling down, I can look back on those experiences remembering a promise I’ve made to help others find their way through the dark. Who were your supports/cheerleaders who kept you afloat? Unfortunately, when I was younger, I didn’t have much support. When you’re deep into addiction and depression, you tend to hurt a lot of people and push friends away. Currently, my biggest cheerleaders are my wife and three children. I’m not sure that I could ever, indeed, convey just how powerful of a support system my family is and how they keep me motivated. What toolkit do you use to keep on keeping on? This is such a great question, and I love that you used the word “toolkit” because you need more than one tool to build a successful recovery. You can’t make a house with just a hammer. You’re going to need wrenches, drills, machinery and other raw materials to bring it all together. I focus on seven different tools and try to give each of the seven a little love every day to keep them useful. These seven tools are: Commit to open communication with a doctor Work with a counselor or therapist Exercise regularly Eat clean, fresh foods Get enough sleep Cultivate a meditation practice Join or build a community Is hope an essential ingredient in recovery? Hope is an essential ingredient in recovery. It sounds cliché, but without hope, it’s hard to believe that we can get out of the darkness to experience the light. Hope allows us to shift our mindset so that we can focus on, or look forward to, the good stuff. I believe hope works best when it’s tied to some goal(s). If we can shift our mindset and then have an action plan, we can transform many obstacles and avoid feeling a false sense of hope. How does your sense of spirituality assist you? As a Buddhist, spiritual practice and spirituality make up a big part of my life. I meditate and often pray, daily if I can, and the practice of mindfulness has been monumental in my recovery. Practicing meditation and mindfulness allows us to put some space between our thoughts and our self so that we can get a better understanding of how the mind works. Then when negative states of mind arise, it’s easier to understand how to dissolve them and cultivate a peaceful mind. Minguez is writing a book about his experiences growing up with addiction and depression, but in the meantime, you can read more of his story on his blog. View the full article
  18. According to Merriam-Webster Dictionary, hope is: “a feeling of expectation and desire for a certain thing to happen,” “a feeling of trust,” “want something to happen or be the case.” When used to describe the sense of desire for recovery regarding mental health, it carries with it, the belief that some positive outcome can ensue, that things can improve and that symptoms can abate. When a person succumbs to the illness, often it is because he or she has relinquished the possibility of healing. This month the suicides of designer Kate Spade and chef Anthony Bourdain had many questioning whether they had given up hope. Often, when people are immersed in darkness, they can’t imagine coming through on the other side into the light, even if they have done so on multiple occasions. Call it psychological or spiritual amnesia that has them forgetting how resilient they can be. Because of the stigma attached to mental illness, many are not comfortable talking about their emotional turmoil and the impact it has on their daily lives. Charles Minguez, MA, has walked that path and emerged triumphant one day at a time. Struggling with depression and addiction, this resilient thriver has taken his experiences and used them to assist others in traversing the treacherous trails that can lead to a precipice. He has elected to remain on solid ground. His vulnerable sharing of his story is inspiring. When one has run out of hope, sometimes borrowing someone else’s is what is called for. Minguez has made it part of his purpose to do just that in his newsletter called Sharing Hope. What experiences shaped the person you are now? When I was about nine or ten, my parents split and shortly after, my mom began a long-term relationship with a man who was abusive. Having no real coping skills to deal with the violence in my home I turned towards alcohol and drugs. Before the age of eighteen, I had been hospitalized three times, dropped out of school, and found myself with a diagnosis of major depression and schizoaffective disorder. Then sometime in my early twenties I was introduced to yoga and had the opportunity to train with a fantastic teacher. The trajectory of my life changed. How do you live with depression as an aspect of your life without it being your entire focus? I’ve learned to befriend my depression as opposed to pushing it away. If I were to pretend that the illness was not there, I would probably be a much angrier person. Unless people know you well, could they tell that it is part of your experience? No. In fact, I’ve had conversations with people where mental illness/health has come up, and when I share my story with them, they’re often surprised, not only by my history but that depression is such a part of my day-to-day experience. During the darkest times, what let you know that the light was there as well? I’m not sure I have a great answer to this question. I just knew, deep down inside that, there had to be more to life than the pain I experienced in my youth. Now when I’m feeling down, I can look back on those experiences remembering a promise I’ve made to help others find their way through the dark. Who were your supports/cheerleaders who kept you afloat? Unfortunately, when I was younger, I didn’t have much support. When you’re deep into addiction and depression, you tend to hurt a lot of people and push friends away. Currently, my biggest cheerleaders are my wife and three children. I’m not sure that I could ever, indeed, convey just how powerful of a support system my family is and how they keep me motivated. What toolkit do you use to keep on keeping on? This is such a great question, and I love that you used the word “toolkit” because you need more than one tool to build a successful recovery. You can’t make a house with just a hammer. You’re going to need wrenches, drills, machinery and other raw materials to bring it all together. I focus on seven different tools and try to give each of the seven a little love every day to keep them useful. These seven tools are: Commit to open communication with a doctor Work with a counselor or therapist Exercise regularly Eat clean, fresh foods Get enough sleep Cultivate a meditation practice Join or build a community Is hope an essential ingredient in recovery? Hope is an essential ingredient in recovery. It sounds cliché, but without hope, it’s hard to believe that we can get out of the darkness to experience the light. Hope allows us to shift our mindset so that we can focus on, or look forward to, the good stuff. I believe hope works best when it’s tied to some goal(s). If we can shift our mindset and then have an action plan, we can transform many obstacles and avoid feeling a false sense of hope. How does your sense of spirituality assist you? As a Buddhist, spiritual practice and spirituality make up a big part of my life. I meditate and often pray, daily if I can, and the practice of mindfulness has been monumental in my recovery. Practicing meditation and mindfulness allows us to put some space between our thoughts and our self so that we can get a better understanding of how the mind works. Then when negative states of mind arise, it’s easier to understand how to dissolve them and cultivate a peaceful mind. Minguez is writing a book about his experiences growing up with addiction and depression, but in the meantime, you can read more of his story on his blog. View the full article
  19. Anxiety can stymie our lives in so many ways. Whether it’s a debilitating panic attack, constant worry or an all pervading fear, anxiety is often an unwanted companion that seemingly only wants the worst for us. However with the right help, guidance and support, there are a variety of techniques that can help. Of course it’s important to note that we’re all different, and what works for one person may not be as effective on another, but from personal experience, my own road to recovery led me, thankfully, to yoga therapy. After years of struggling with depression and anxiety, I moved to to South East Asia and embarked on an intense meditative practice that lasted for three years, training as a yoga teacher and becoming deeply interested in mind-body therapies. During my own personal journey, I learned that one of the challenges that so many people living with anxiety face, is the often extreme physiological response to a threat; regardless of if that threat is real, or simply perceived. We may rationally understand that there’s nothing inherently dangerous about a given situation, and that our panic and rolling fear is just our brain’s “flight or fight” response misfiring, telling us that we’re in imminent danger — but none of this knowledge makes the fear any less real. In the middle of a panic attack applying any kind of rationality is nearly impossible, and our fear response is incredibly powerful and hard to overcome without support. While my own recovery led me to yoga therapy, it’s by no means a cure-all. It would be unrealistic to expect to feel constantly blissful all of the time, but both science and individuals have given credence to yoga’s efficacy as a method for reducing and managing anxiety, and with the right guidance, yoga therapy is a tool we can all use as part of a wider strategy to combat our anxiety. However as with most things in life, a little bit of research can go a long way, and there are some areas to consider before exploring yoga therapy further. Choosing a Yoga Therapist Yoga is, in and of itself, a therapeutic practice. However, if you suffer from anxiety you may benefit from the specialized advice and teaching that a yoga therapist can offer you. Yoga therapists are trained across a variety of disciplines, blending the wisdom of the Yogic and Buddhist traditions with detailed medical knowledge, neuroscience and psychology. It’s this foundation and multidisciplinary approach that can be used to successfully apply the principles of yoga therapy to anxiety, but it’s also important you choose a yoga therapist that you feel comfortable with. Typically, a yoga therapist will discuss your unique circumstances with you, and it’s important that you feel an affinity with them. Compassion and empathy are two very important considerations, and as with talking therapy, you may even need to see a few yoga therapists before you find someone you feel is most able to help you. In the initial discussion, don’t be afraid to assert your boundaries and explain the full extent of your anxiety. Many of us can feel like we need to put on a public face, even downplaying our symptoms to doctors and healthcare practitioners — but the point of yoga therapy is that it is designed around you. We’re all beautifully complex and unique, and being open and honest about your own challenges is often the first step towards a successful outcome. Using Yoga Alongside Other Treatment Complementary and alternative medicine is nothing new, and has been in practice in some parts of the world, such as China and India, for hundreds of years. As a complimentary form of treatment, yoga therapy does not have to be used in isolation — in fact, it works well in conjunction with a variety of other treatments. For example, medication and pharmaceuticals are valuable treatment paths in particular circumstances, and can be especially helpful in extreme situations. In more recent times you may have also heard the term “Integrative medicine”, a term recently adopted by a number of government and educational organizations, intended to highlight the use of multiple therapy and treatment approaches in order to achieve the best outcomes for mind-body wellbeing. From a very simplistic perspective, this could be viewed as the combination of Eastern and Western medical practices, and both can, and arguably should, be used in tandem whenever necessary. Who Is Yoga Therapy Suitable For? Put simply, yoga therapy is suitable for everyone. Yoga therapy is therapeutic in nature, and importantly, designed uniquely for the individual in question. For example, with lower back pain, there are very specific yoga positions and postures for strengthening and supporting the back. Similarly, with post-traumatic stress disorder (PTSD), there are gentle, specialized ways of regulating the nervous system, and in autism spectrum disorders, specific yoga postures can be used to reduce heightened sensory arousal and promote emotional regulation. For anyone suffering from anxiety, this is an important point. Yoga therapy is never about who’s the strongest or most flexible, but what’s best for you. If that involves sitting in a chair conducting simple yoga postures, then there’s absolutely nothing wrong with that. Everything should be conducted in a supportive and therapeutic environment where compassion and understanding become the core tenants. Whatever your age, body shape or fitness level, you can apply yoga therapy to your own self-care routine, addressing mind, body and soul in order to help manage and treat the symptoms of anxiety. Recovery from anxiety isn’t an easy task, and we often experience setbacks, but incorporating yoga therapy into our daily lives can give us the tools we need to manage our anxiety — and maybe, one day, overcome it. View the full article
  20. Dealing with increased expectations, social pressures both in-person and online and astronomical education costs, all while simultaneously facing major life choices and changes has led to a dangerous epidemic of mental, emotional and behavioral health issues in America’s youth. During college, a majority of students are living on their own for the first time, possibly in an entirely new state or area where they don’t know anyone. They spend nearly half of the time that they are awake on classwork, and the school day never really ends until breaks for holidays and in between semesters. Struggling to keep up with the workload and these significant lifestyle adjustments has become the norm. While they may frequently be surrounded by a lot of people, many students often feel quietly isolated and lack meaningful connection with others. Compounding the problem, the pressures to succeed and fit in make these feelings hard to express, and life becomes even more confusing and discouraging. This is causing record rates of anxiety and depression that greatly impact students’ quality of life. As an adolescent or young adult goes through these challenges, parents may write off symptoms of mental disorders as “growing pains” or “going through a phase.” However, when developing mental health disorders are left untreated, they can result in dire consequences that impact the entire family in the long run. According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death among young people between the ages of 10 to 24. In 2015, the suicide rate among teens reached a 40-year high. In addition, only 20 percent of children with diagnosable mental or behavioral disorders ever receive treatment, which leaves about 12 million who don’t. Similar research amongst higher education students done by the Center for Collegiate Mental Health revealed that nearly 1 in 5 college students experience anxiety or depression. Others may turn to unhealthy coping mechanisms, leading to problems like drug abuse and addiction or eating disorders. With mental health issues peaking at alarming rates for the younger generation, there needs to be a serious, concerted effort to curve this epidemic. Unfortunately, the growing demand for mental health care on campuses is not being met with adequate services. With only about 13 percent of colleges offering full-time, in-house mental health services, students can often go weeks waiting for an initial consultation with a therapist. Schools across the country are simply struggling to keep up. In Florida, only 10 out of the 12 state schools meet the recommendation of at least one therapist per 1,000 students. That is already an absurd and unsustainable ratio, and we’re failing to meet even that. But Florida’s situation is not an anomaly, it’s the norm and indicative of the widespread lack of access that is keeping students from quality mental health services across the country. At the same time, corporate America is progressively recognizing the importance of mental wellness in the adult workforce and increasing mental health services, expanding employees’ insurance options to include therapy, and incorporating mental health into their core values. Colleges and universities should take note and follow suit. This growing emphasis on the value of mental health care should not be looked at as a trend — it is and should be seen as a necessity. As young people and parents begin to recognize the need for and demand these services, universities must offer them in order to keep up and remain competitive. New reports indicate that students are now taking into consideration what mental health service options will be available when choosing a college to attend. In fact, about 28 percent of parents of teenagers are also thinking more about mental health services on campus, when researching schools for their child. For teens who see a therapist in high school, the transition to college can be particularly difficult because it often means losing access to their therapist, in addition to the emotional support of family and friends. However, there is a devastating shortage of mental health care providers across the country. With the demand for therapy and the number therapists being incompatible, we must turn to alternative options to ensure that everyone gets the help they need. Relatively new to the scene, telemedicine provides a more flexible and often better solution that can assist students through challenging times. Instead of waiting weeks just to meet a therapist, remote therapy provided through modern technology can provide immediate, yet equally impactful mental health care. Many universities already use mobile apps to allow students to check their grades, contact professors and even see what’s on the menu in the cafeteria. Why not incorporate something as important as mental health services, as well? Telemedicine also provides a unique means for continuity of care. For the small percentage of students who are able to receive therapy on-site at school, they unfortunately lose access to these local therapists once they leave campus for summer break or to study abroad. But with apps that provide universal, mobile mental health services, students can still reach their therapists anywhere across the country or even the world. With adolescent suicide and mental illness rates skyrocketing, schools simply cannot afford to wait to address critical mental health needs. To ensure the future of the next generation, we must provide learning environments that are safe for students not only physically, but mentally as well. View the full article
  21. Dealing with increased expectations, social pressures both in-person and online and astronomical education costs, all while simultaneously facing major life choices and changes has led to a dangerous epidemic of mental, emotional and behavioral health issues in America’s youth. During college, a majority of students are living on their own for the first time, possibly in an entirely new state or area where they don’t know anyone. They spend nearly half of the time that they are awake on classwork, and the school day never really ends until breaks for holidays and in between semesters. Struggling to keep up with the workload and these significant lifestyle adjustments has become the norm. While they may frequently be surrounded by a lot of people, many students often feel quietly isolated and lack meaningful connection with others. Compounding the problem, the pressures to succeed and fit in make these feelings hard to express, and life becomes even more confusing and discouraging. This is causing record rates of anxiety and depression that greatly impact students’ quality of life. As an adolescent or young adult goes through these challenges, parents may write off symptoms of mental disorders as “growing pains” or “going through a phase.” However, when developing mental health disorders are left untreated, they can result in dire consequences that impact the entire family in the long run. According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death among young people between the ages of 10 to 24. In 2015, the suicide rate among teens reached a 40-year high. In addition, only 20 percent of children with diagnosable mental or behavioral disorders ever receive treatment, which leaves about 12 million who don’t. Similar research amongst higher education students done by the Center for Collegiate Mental Health revealed that nearly 1 in 5 college students experience anxiety or depression. Others may turn to unhealthy coping mechanisms, leading to problems like drug abuse and addiction or eating disorders. With mental health issues peaking at alarming rates for the younger generation, there needs to be a serious, concerted effort to curve this epidemic. Unfortunately, the growing demand for mental health care on campuses is not being met with adequate services. With only about 13 percent of colleges offering full-time, in-house mental health services, students can often go weeks waiting for an initial consultation with a therapist. Schools across the country are simply struggling to keep up. In Florida, only 10 out of the 12 state schools meet the recommendation of at least one therapist per 1,000 students. That is already an absurd and unsustainable ratio, and we’re failing to meet even that. But Florida’s situation is not an anomaly, it’s the norm and indicative of the widespread lack of access that is keeping students from quality mental health services across the country. At the same time, corporate America is progressively recognizing the importance of mental wellness in the adult workforce and increasing mental health services, expanding employees’ insurance options to include therapy, and incorporating mental health into their core values. Colleges and universities should take note and follow suit. This growing emphasis on the value of mental health care should not be looked at as a trend — it is and should be seen as a necessity. As young people and parents begin to recognize the need for and demand these services, universities must offer them in order to keep up and remain competitive. New reports indicate that students are now taking into consideration what mental health service options will be available when choosing a college to attend. In fact, about 28 percent of parents of teenagers are also thinking more about mental health services on campus, when researching schools for their child. For teens who see a therapist in high school, the transition to college can be particularly difficult because it often means losing access to their therapist, in addition to the emotional support of family and friends. However, there is a devastating shortage of mental health care providers across the country. With the demand for therapy and the number therapists being incompatible, we must turn to alternative options to ensure that everyone gets the help they need. Relatively new to the scene, telemedicine provides a more flexible and often better solution that can assist students through challenging times. Instead of waiting weeks just to meet a therapist, remote therapy provided through modern technology can provide immediate, yet equally impactful mental health care. Many universities already use mobile apps to allow students to check their grades, contact professors and even see what’s on the menu in the cafeteria. Why not incorporate something as important as mental health services, as well? Telemedicine also provides a unique means for continuity of care. For the small percentage of students who are able to receive therapy on-site at school, they unfortunately lose access to these local therapists once they leave campus for summer break or to study abroad. But with apps that provide universal, mobile mental health services, students can still reach their therapists anywhere across the country or even the world. With adolescent suicide and mental illness rates skyrocketing, schools simply cannot afford to wait to address critical mental health needs. To ensure the future of the next generation, we must provide learning environments that are safe for students not only physically, but mentally as well. View the full article
  22. You’re struggling with anxiety. Maybe you had your first panic attack when you were in high school while taking a final. Maybe you had a panic attack in college while driving or grocery shopping. Maybe since then you’ve been having panic attacks regularly. Maybe it’s not panic attacks at all. Instead you’re constantly on edge. If they gave out medals for worrying, you’d no doubt take first place. Everything makes you anxious and uncomfortable. And it’s absolutely exhausting. Whatever the specific circumstances surrounding your anxiety and how it manifests, you feel like a complete and utter loser. You feel like there’s absolutely something wrong with you. There must be. Many of Kira Hoffman’s clients assume their coworkers and friends don’t struggle with anxiety (or feelings of inadequacy). They also believe they should be able “to get over” or “push through” their anxiety. They believe they should be able to work harder and to cope better. Which is precisely what they think others do—and do with very little effort, said Hoffman, Psy.D, a licensed psychologist who provides psychotherapy services for young professionals in San Francisco. Lisa Richberg’s clients who have high anxiety, especially panic attacks, tell her that they feel embarrassed and ashamed. They also worry that they’ll be “found out as a fraud,” or seen as “out of control,” said Richberg, who specializes in co-morbid eating disorders and addictions, anxiety and depression in Miami. They yearn to be “normal,” to be like people who don’t sit with anxiety every single day. But here’s the truth: You’re not alone. For starters, “anxiety disorders are more common than any other mental health issues,” said Richberg. According to the Anxiety and Depression Association of America, anxiety disorders affect 40 million adults in the U.S., or 18.1 percent of the population every year. Also, anxiety in general (and feelings of deficiency) is part of the shared human experience, Hoffman said. “To suffer is to be human,” so, again, you are not alone—just like you’re not alone in your grief or sadness (or excitement or joy). Knowing you’re not alone is important. But it can be hard to dissipate our thoughts of deficiency. Sometimes, it seems like they’re simply part of who we are. I am anxious, and I am inadequate. But you can slowly chip away at your negative, hurtful self-perception, and adopt a more compassionate perspective. Below, Hoffman and Richberg share some tips on how. Share your heart with someone. Tell someone you trust that you’re struggling with anxiety. When Hoffman’s clients have had these discussions with loved ones they’ve reported feeling heard, understood and validated. You might even find out that the other person is struggling or has struggled, too. However, it’s OK if you’re not ready yet to share. If that’s the case, Hoffman suggested seeing a therapist that you feel is a good fit. In fact, seeing a therapist for your anxiety can be tremendously helpful. As Richberg noted, “Anxiety issues are highly treatable.” Turn to caring phrases. For many of us speaking to ourselves with kindness feels foreign and false. But you can create a phrase that feels “as authentic, genuine, and true to yourself as possible,” Hoffman said. For instance, you might use: “Everyone feels anxious sometimes,” or “It’s OK, you’re just having a really hard time today.” You also can create a phrase based on your responses to these questions from Hoffman: “What am I feeling in this moment? What isn’t helpful? What do I need?” You might come up with: “I can be gentle with myself, and provide myself with the comfort I need right now…I think I’ll take a walk to get some fresh air.” Address your inner critic. Even though it feels like the opposite, our inner critics actually have good intentions. They yearn to protect us and keep us safe. The problem is that they run on fear, and lash out. Sometimes, it can help to talk directly to your inner critic. For instance, Hoffman suggested saying something like: “I know you are trying to be helpful by motivating me to do better next time, but you are really just hurting me.” Recognize when your anxiety is talking. “Most of the time, the negative messages we tell ourselves are totally bogus,” Richberg said. That is, our critical thoughts are actually creations of our anxiety. In order to tell whether a thought is simply your anxiety is talking, Richberg suggested jotting down the negative messages as they arise, and reflecting on these questions: Are you catastrophizing? That is, are you creating a catastrophe out of a current or future situation? Are you stuck in all-or-nothing, black-and-white thinking? What are the reasons for and against these thoughts? Would others you know and respect agree with these thoughts? Are there alternate ways of viewing yourself? What are they? What would these more helpful views and thoughts look like? Tune into your tension. “Our experiences of anxiety and self-criticism almost always involve a somatic component,” Hoffman said. For instance, you might feel tightness in your chest or a pit in your stomach. She suggested closing your eyes; identifying the location of your tension; visualizing “softening the sharp edges around the physical pain or discomfort”; and giving yourself a gentle caress at that spot, while saying the phrase you picked (from above). Struggling with anxiety is hard enough. Then when we add our feelings of inadequacy, deficiency and shame, getting through the day may feel downright impossible. Again, know that you’re not alone in these feelings. You’re one of millions. Many millions. And remember that anxiety is treatable. Every day doesn’t have to feel like a mountain you must scale. Every day doesn’t have to feel like a hurdle. So if you’re not working with a therapist who specializes in anxiety, consider it. Maybe you think this only confirms how weak you really are; it only confirms how much of a mess you really are. But it’s actually one of the bravest things you can do. View the full article
  23. Phobiasupportforum

    Trigger-Induced Depression

    The last three to four weeks for me have been extremely hard. I found myself in the grips of a deep depression. I am fortunate enough to no longer suffer from the deep devastating suicidal depression that once came with my bipolar depression, I am blessed in that way. However, nonetheless it is still a devastatingly life-halting depression that really makes life difficult to tolerate for a few weeks and difficult to carry on with my daily activities. My normal, everyday personality is more along the lines of a bubbly, happy person, and I tend to have a larger than life, over-the-top personality. These last few weeks though I couldn’t find a way to enjoy even going out with my friends let alone smiling when we were out. It got to the point while we were out where they would ask many times over, “Tosha are you having a good time?” I would assure them I was, and honestly, I was trying to have a good time, however it was difficult to enjoy myself because the depression was so thick. Think of depression as a black thick tar, that is what it feels like you are trying to live your life going through. Each day you are struggling to survive by crawling along barely making it, because this thick black tar is holding you back as you are trying to move forward. Every time you move it almost feels as if it is drying up around you and it is getting harder to move all the time. People who have never experienced a true bipolar depression think that it is just feeling sad when we say we have depression but it is so much more than just feeling sad. It is a complete total fatigue of energy because it takes completely every ounce of what we have to just get out of bed some days. Which is why many days we just won’t even do that. I have anemia from having weight loss surgery, when my iron is low is when I will feel the most depressed. I figured this time my iron was low, but I had a doctor appointment this past Friday, and when I went in and saw the doctor my levels were perfect, better than perfect. This time my depression was all mood related and nothing is physically wrong with me. Which meant that I needed to make sure I was following my care plan to a T to make sure I was not letting any outside triggers influence my mood at all. The very next day I began. As I started to dissect my care plan to figure out what I was doing wrong. I thought what had I changed recently that could be making me depressed and triggering a depression? It all started 4 weeks ago when I started to cook full size meals for my family most nights, meaning that I would eat at 5 or 5:30 at night instead of 6:30 or 7 when I would take my meds for bed. When I did that I wouldn’t get to bed on time, and I would end up staying up way past my bedtime then and be up half the night. Being up half the night ended up triggering my depression. I was doomed. My depression creeped in quickly and it held on for dear life. By this past Monday I didn’t want to get out of bed. I went to see my favorite band this past weekend and I was there and trying to enjoy myself and I smiled and I danced, but I wasn’t truly enjoying myself. That was when I knew I had to do something and fast. This week I made some changes to my care plan that got me back on track. I am eating correctly again. Getting my meds on time. I got back to the gym, too. I had been slacking there as well, but if I take my meds on time and go to bed at the right time I have energy the next day. It doesn’t always have to be a huge trigger that messes up your care plan. It can be a subtle change that can throw you off. However, a simple change can make the difference in not having depression or having depression when you have bipolar disorder. Stability is a constant balancing act, but that is the ultimate goal. Stability! I know it is hard to find, but in mental health recovery the goal is to have more days stable, then depressed or manic. Everyone’s recovery looks different, but recovery in every form is wonderful. View the full article
  24. As hard as it may sound to pull out of this stress reaction cycle, it is possible. The first step in creating any positive change is always raising your awareness of what the cycle is, how you participate in it, and what pains the cycle creates. Why? Because you can’t change a habit you don’t know you have. And if you don’t recognize the pain the habit is creating, you won’t have the motivation you need to make new choices and break out of the cycle that has become familiar despite the fact that it is destructive. The practice of mindfulness is an incredibly powerful tool to help you find that awareness. Mindfulness teaches us to pay attention, non-judgmentally, to what is happening in the moment. Mindfulness not only counteracts stress, but also prevents it from happening in the first place, because when you practice mindfulness you can begin to observe your patterns and make new choices instead of compulsively acting them out over and over. Mindfulness helps you break the cycle. It also sets the stage for your parasympathetic nervous system to take over and to create the conditions your body needs in order to heal itself. Start to check in with yourself when you feel that old familiar feeling of stress creep in and try to observe the thoughts you have and actions you take in response to it. A foundational piece of mindfulness is to be non-judgmental about the thoughts and feelings you pay attention to, so resist the urge to beat yourself up for wanting a piece of cake to help you feel better or feel guilty about how much time you spent scrolling through your social media feed instead of working on the project or having the conversation that’s causing you so much stress. At this point, you simply want to raise awareness of how you react to stress. Another Thing to Become Aware of: Your Inherited Patterns Whether you realize it or not, you were born into a family with its own unique patterns of maladaptive coping mechanisms. Just as you inherit eye color, height, and talent from your parents, grandparents, and great-grandparents, you can also inherit an addictive personality, or a tendency to reach for sweets, or a quick temper. In your attempt to deal with the stresses that life has thrown your way, you have been repeating patterns that began even before you were born. Recognizing what those patterns are and how they have shown up in your own choices is such a relief. It’s empowering to know the truth so that you don’t have to blame yourself and feel shame for obstacles that you inherited. Choosing Better Coping Mechanisms Once you recognize your patterns, it is absolutely possible for you to break them and choose new coping mechanisms that actually support you instead of contributing to your breakdown. Just as your body has physiological mechanisms that help you respond to stressors, it has an equally powerful system that helps you relax. This is ruled by the parasympathetic nervous system. Spending more time in parasympathetic realm also cues deeper emotions, such as compassion, in what’s known as the “tend and befriend” response. This drive to connect with others is really what motivates you to wander in to the office kitchen during a hectic day — you’re looking for someone to talk to, even though you may think you’re there to see if there are any leftover pastries from the morning breakfast meeting! When you spend more time in the parasympathetic realm, you not only benefit your physical health, you tend to your emotional health, because it sets the stage for you to deepen your relationships, develop a support network, and exercise your compassion. This helps you find the support you need to start making changes in how you deal with your stressors. Heal the Body with Conscious Relaxation Now it’s time for a deeper dive into the pool of relaxation. Conscious relaxation is exactly what it sounds like — using your mental awareness to produce a relaxed state that is profound. The practice builds body awareness, focus, and empowerment — because once you know how to do it, you never need to feel trapped in a stress reaction again. I have included instructions below for a conscious relaxation practices called a body scan: Body Scan Time 20-40 minutes If you can, practice this three to five days a week for six to eight weeks, as research suggests people reap more benefits from this practice when they keep at it. How to practice: A body scan can be performed lying down or sitting. You can close your eyes if that feels comfortable for you. Once you are comfortable, begin by taking a few deep breath in through your nose and out through your mouth. Start noticing your body, feeling the weight of your body on the chair or on the floor. Notice where your body is in contact with the floor or chair, and where it isn’t. Now place your attention on your feet. Notice the sensations of your feet touching the floor—the weight, pressure, vibration, and temperature. Next, notice your legs against the floor — is there pressure, pulsing, heaviness, lightness? Move on to your back and see what sensations you can feel there. Now bring your attention into your stomach area. If your stomach is tense or tight, let it go and relax. Take a breath. Notice your hands. Are they tense or tight? See if you can allow them to let go and relax. Now pay attention to your arms. Feel any sensations happening there. Let your shoulders drop and let go of tension and tightness. Notice your neck and throat. Let go of tension and tightness. Relax. Relax your jaw. Let your face and facial muscles soften. Let go of any tension and tightness that may be there. Then expand your awareness to take in your whole body, feeling how it feels to be in your body in this moment. Take a breath. Be aware of your whole body as best you can. Take a breath. Bring your hands together rubbing them together to generate heat in your hands and place your hands over your eyes. Slowly open your eyes and come back to the room. Notice how you feel. Thank yourself for providing the space to connect to your mind, body, and spirit. Give yourself a gift of love and dedicate a space to practice this technique regularly. The body scan I am leaving you with is the best place to start in learning how to break the stress reaction cycle in your life. Conscious relaxation practices such as the body scan help by systematically placing your attention on each and every part of your body and inviting them to relax, one by one. Over the years I have learned this is the best place to start with my patients before covering more ground work using yoga, breathing techniques, more conscious relaxation exercises, and the power of positive affirmations. Starting with this basic body scan is the first step in uncovering how powerful it is to connect to your body, mind, and spirit. It’s such a beautiful mindfulness practice helping us accept and acknowledge our thoughts, feelings and bodily sensations without judgement, so we can start to listen more attentively to how our body feels and what it needs to HEAL! Reference: Center for Disease Control and Prevention, “Defining Adult Overweight and Obesity,” accessed on 9/19/17 at https://www.cdc.gov/obesity/adult/defining.html. View the full article
  25. It’s 9 AM Monday morning. You’ve just pulled into work and are ready to pitch your presentation to the senior management team. Your PowerPoint slides are damn near perfect and you’ve gone over the script dozens of times. You’ve got this. As everyone gathers in the room, you’re suddenly flooded with a hit of adrenaline. The bad kind. In a flash you become acutely aware of what your body is doing: beads of sweat forming on your brow, a dry mouth that no amount of water can fix, and a steadily increasing heart rate thumping inside your chest. This ability to perceive the signals of your body is known as interoceptive accuracy (IAc). There are, as the example demonstrated, different psychosomatic cues that you pick up within yourself during states of anxiety. But above all, a beating heart is the hardest one to ignore. It’s for this reason that heartbeat perception, as brain scientists call it, is a direct proxy for measuring people’s IAc and reported anxiety and stress levels. IAc and a Beating Heart Having the ability to accurately detect your own heartbeat is critical for reappraising your anxiety on a moment to moment basis. We know that anxiety is as much in the body as it is in the mind, and that a (mis)perception of a fast heart rate can easily contribute to the catastrophization of a panicked state. It’s why some of the most effective anxiety-related therapies, like progressive muscle relaxation and deep breathing, tend to focus on muting a physiological response followed by a cognitive reappraisal technique. Now in terms of IAc, the longstanding view was that it is an inherited trait, similar to eye color or height. Your IAc is immutable, unchanging. But now there’s new evidence suggesting that the situation matters just as much as the person: While some people may have inherently bad interoceptive ability, we can’t ignore the influence of the broader context. And this, if it turns out to be true, is a definite win for anyone looking to reverse a certain anxiety-based predisposition. The Study and Findings A team of researchers led by Martin F. Whittkamp out of the University of Luxembourg set out to investigate just how much of a role the environment plays in determining our ability to self-reflect on accurate biofeedback. The researchers relied on two methods to measure IAc via heartbeat perception. The first, called the counting task is simply a comparison between actual measures of your heartbeat with your self-reported measures. Another method, called the heartbeat discrimination task, measures how accurately you can rate whether or not your heartbeat is in sync with an external stimulus such as a blinking light on a computer screen. The team in this newest study compared the results of both a heartbeat counting task and discrimination task in two conditions: a resting state and a stress state. Mental stress was induced by having participants match the color of a flashing light bulb with a corresponding button as fast and accurately as possible. If this wasn’t stressful enough, the experimenter also chimed in with a few verbal cues urging the participant to perform better so as to not ruin the entire experiment. In addition to comparing stress state IAc with resting state IAc, the researchers also designed a number of computational models. These models aimed to measure how much of one’s interoceptive accuracy is owed to individual ability versus the situation. The results found that about 40% of a person’s IAc can be explained by his/her individual traits, while around 30% can be explained by the changing situation, leaving the remaining 30% to measurement error. What this says is that your ability to detect and therefore modulate your bodily responses during an anxious state is not fixed. These signals are amenable to change. You can learn to more accurately perceive your beating heart in a high-stress environment. You can apply reappraisal techniques in mitigating your anxiety. The findings of this study have the potential to inform research on stress and anxiety management. For example, having a general idea of how much your IAc is dependent on biological predisposition could provide leeway to pharmaceutical interventions to help combat debilitating responses to stressful situations. For now there’s therapeutic power in knowing you can improve your IAc and work towards minimizing your anxiety. References Feldman, G., Greeson, J., & Senville, J. (2010). Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. Behaviour Research And Therapy, 48(10), 1002-1011. doi: 10.1016/j.brat.2010.06.006 Knoll, J., & Hodapp, V. (1992). A Comparison between Two Methods for Assessing Heartbeat Perception. Psychophysiology, 29(2), 218-222. doi: 10.1111/j.1469-8986.1992.tb01689.x Richter, D., Manzke, T., Wilken, B., & Ponimaskin, E. (2003). Serotonin receptors: guardians of stable breathing. Trends In Molecular Medicine, 9(12), 542-548. doi: 10.1016/j.molmed.2003.10.010 Wittkamp, M., Bertsch, K., Vögele, C., & Schulz, A. (2018). A latent state-trait analysis of interoceptive accuracy. Psychophysiology, 55(6), e13055. doi: 10.1111/psyp.13055 This guest article originally appeared on the award-winning health and science blog and brain-themed community, BrainBlogger: How Misreading Bodily Signals Causes Anxiety. View the full article
  26. If you’re taking beta blockers, certain kinds of anxiety drugs, certain types of painkillers (including ibuprofen), proton pump inhibitors (PPIs) (used to treat acid reflux), ACE inhibitors (used to treat high blood pressure), or anti-convulsant drugs, you may be at greater risk for depression. That’s according to a new, large-scale study published earlier this week in JAMA. However, this was a correlational study, so it can’t say that these medications actually cause depression or not. It may be that people with greater health problems are more likely to take one of these medications and be depressed about their health condition. NPR has the story about the study that examined the prescription habits of 26,192 adults in the U.S. and their self-report of depression (as measured by the PHQ-9). More than a third of the people who took the survey were taking medications known to have depression or suicidal thoughts as potential side effects. Olfson and his collaborators wanted to determine whether those participants were more or less likely to be depressed, compared to participants who didn’t take any of these medications. “What we found is that, in fact, they’re more likely,” [study author] Olfson says. And they found that people who took three or more of the medications were three times as likely to be depressed. This is a fairly common sense finding, insomuch that the researchers found that medications that listed “depression” as a possible side effect found a greater incidence of depression in people taking one or more of such drugs. That is exactly what one would expect to find, just as if the researchers had looked at drugs that listed “nausea” as a side effect and found more people experienced nausea on those drugs. The thing is that most people who are taking these drugs don’t realize that depression is a possible side effect of the drug. Their doctors fly through the possible side effects (if they cover them at all), and it would be easy to miss this when listening to a litany of possible side effects. Here is the list of medications of concern: Antihypertensives Metoprolol Atenolol Enalapril Quinapril Antidepressants Sertraline Citalopram Bupropion Fluoxetine Trazodone Venlafaxine Escitalopram Duloxetine Paroxetine Amitriptyline Hormones/hormone modifiers Ethinyl estradiol Estradiol Finasteride Anxiolytics, hypnotics and sedatives Alprazolam Zolpidem Clonazepam Lorazepam Analgesics Hydrocodone Tramadold Ibuprofen Cyclobenzaprine Gastrointestinal agents Omeprazole Ranitidine Esomeprazole Famotidine Respiratory agents Montelukast Cetirizine Anticonvulsants Gabapentin Diazepamd Lamotrigine Topiramate Corticosteroids What to do if you’re on one of these medications? A psychiatrist not associated with the study offers sound advice if you suddenly find that depression is bothering you after starting one of these medications: “People who don’t have a history of depression and then, suddenly, start to have symptoms of depression should be concerned that it’s potentially due to a side effect, or potentially, an interaction,” [psychiatrist Don] Mordecai says. If you have no history of depression in you or your family, then it would be perhaps telling that you began to experience symptoms of depression a week or two after you started taking a new medication. Especially one where depression is a possible side effect. While depression can strike anyone, at any time, with or without some sort of event preceding its onset, such a correlation should not be ignored. At that point, it would be wise to speak to your doctor who prescribed the medication. It may be that another medication could be tried that doesn’t have depression as a side effect. Or that the depression symptoms can be managed in some other way if the medication is vitally important for your health. Reference Dima Mazen Qato, Katharine Ozenberger, Mark Olfson. (2018). Prevalence of Prescription Medications With Depression as a Potential Adverse Effect Among Adults in the United States. JAMA, 319(22):2289-2298. doi:10.1001/jama.2018.6741 View the full article
  27. Phobiasupportforum

    Recognizing Depression in Your Partner

    Depression is a difficult illness in any circumstance. The repercussions for untreated, long-term depression can be wide ranging and potentially dangerous. And when you are dealing with a depressed spouse the problems affect every aspect of the relationship and family, and can have devastating consequences on everyone involved. How do you know if your partner is depressed? One of the biggest problems with depression is that it can be hard to recognize even for the person suffering with it. Chances are that if someone is struggling with depression they will understand that something is wrong, but not know how to define it. That can make it especially tricky for a partner to recognize, too. It may seem at first like your partner is simply moody and maybe lazy. They may seem down or sad, or frustrated with life. They don’t want to do things they used to, and perhaps you even feel like they have fallen out of love with you. These behaviors can be symptomatic of many things, from a midlife crisis to genuine marital issues. So how can you tell if it is actually depression? Depression is different from passing sadness or temporary frustration with life’s issues. There are number of common signs for depression and they tend to be persistent. Among them are the following: Withdrawal. If your partner shows an increasing withdrawal from social situations and possibly from you, this can be a sign of depression. Depression is isolating. When you are depressed it can feel exhausting or overwhelming to connect with others in even a basic way. Disengagement. As with the withdrawal from social life, you may see your partner begin to remove themselves from hobbies or interests they once enjoyed. It may now feel like too much work. Or, where they once had the motivation and drive to accomplish tasks like household chores, work projects or exercise, they now no longer do, opting instead to watch TV or sleep. Exhaustion/Fatigue. Depression is exhausting to the person suffering from it. Just accomplishing the bare minimum can seem like too much work. If your partner is sleeping more or tired all the time, this could be a sign of depression. Anger/Moodiness. When a once easy-going spouse gets angry or sad at the drop of a hat they may be dealing with depression. Anger is a particular sign in men. Changes in the bedroom. It is not surprising that along with the other symptoms of depression you may also see changes in the bedroom. In a relationship where an active intimate life has been the norm, this may be one of the most glaring indications of a problem. If your sex life has taken a downturn, and you see some of the other symptoms listed, you may be dealing with a partner suffering from depression. These are just a few of the most common symptoms of depression. The combination can vary, as can the severity of each. However, you are seeing these signs in your partner it is worth considering depression as a possible cause. What should you do if you suspect your partner is depressed? Clinical depression is not likely to go away on its own. It is not a passing phase, nor is it your fault. The longer it goes on the more problems it will cause for your partner, for you and for your relationship. Left untreated it can lead to erratic behavior, substance abuse, or, at its most devastating, suicide. If you believe that your partner may be depressed you need to take action and seek a professional diagnosis. As mentioned, someone suffering depression may know that there is something wrong or different going on. They are not likely to proclaim themselves depressed, however, or be overly receptive to being labeled by you. Rather than dealing with things on your own, work toward getting him/her into see a doctor. There are some physical ailments that have similar symptoms and should be ruled out as well. With the help of a physician’s opinion your partner should be more willing to get the mental health help they need. Another option is to get the advice of a mental health professional. With help your partner can be on the road to relief and recovery more quickly. And so can your relationship. View the full article
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