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  1. Back in 2008 — a decade ago — we noted that the good folks who oversee the Golden Gate Bridge finally approved a suicide barrier for this iconic landmark. Every year, 30 to 50 people jump from the bridge. With a 98 percent fatality rate, the chances of survival are poor. Six years later in 2014, we noted that a specific barrier type was approved for the Golden Gate Bridge — a wire-mesh netting that would be mostly out-of-sight tucked underneath the bridge. Construction was expected to be completed by 2018. Here it is August 2018, and still no suicide barrier has been erected at the Golden Gate Bridge. What’s going on? Suicide barriers — whether they be a net like this one, or a higher fence — are very effective in reducing the number of people contemplating or attempting to jump to their death (and in some cases, completely effective). Because of its iconic, beautiful nature, the Golden Gate Bridge has long attracted hundreds of suicidal people to it. Each year, somewhere between 150 and 300 people attempt to jump from the bridge. Thankfully, most are saved by trained crisis workers. But dozens more sadly are still successful in jumping to their death. In 2016, for instance, there 184 successful interventions and only 39 confirmed suicide deaths. In 2017, there were 245 successful interventions, and only 33 confirmed suicide deaths, according to the Golden Gate Bridge Highway and Transportation District. Since the suicide barrier was first approved in 2008, it is estimated that more than 300 people have lost their lives jumping off of the bridge. With the updated completion date now set for 2021, the three-year delay will add more than 100 more souls to the bridge’s gruesome death count. Work has finally begun on the Golden Gate Bridge suicide barrier. Last week, the construction crew began delivering crates of equipment and tools to the worksite on the bridge deck. After constructing platforms for the builders, work will begin adding brackets to the bridge that will support architectural struts. Those struts, in turn, will support the stainless-steel, marine-grade netting that will jut out from underneath the bridge deck. The netting will be painted gray to better blend in with the water, and will be nearly invisible to the naked eye when viewing the bridge from a distance. The only clear view of the netting will be when standing on the sidewalk, looking straight down toward the water. When someone jumps, they will fall onto the net. Bridge crisis workers will be notified in order to pull the individual off of the net. Most people who jump and land on a suicide net don’t actually crawl to the edge to continue their jump. Instead, most people just wait to be rescued from the netting, which has just saved their life. Most people are thankful to be given a second chance at being alive. According to research, suicide barriers like netting or raised fencing are very effective in reducing the number of people using a bridge as a suicide method. At some bridges, after such barriers were erected, the number of suicide attempts have been reduced to zero. Sadly, the cost of the project has ballooned from an initial projection of $66 million to more than $204 million since it was first conceived and budgeted. Just six years ago, the project’s estimated cost was $76 million.1 What has accounted for the ballooning cost estimates? According to a spokesperson from the Golden Gate Bridge Highway and Transportation District: Due to the complexity and difficulty of the work to be performed, construction bids on the project came in above what the District originally estimated and the budget was amended to meet the new estimates for what it would take to complete the work. It also took several years to secure funding for the project — which includes federal, state, and regional sources — including a change to federal transportation funding policy to make the project eligible for federal funds. Countless families and mental health advocates around the country will be thankful when the bridge’s suicide barrier is finally completed in three more years. We expect the suicide rate at the bridge will drop to less than a dozen per year once the barrier is installed, saving dozens of lives annually. No matter what the cost, the lives saved by the barrier will be worth the cost and the wait. Footnotes: When we first started covering the suicide barrier for the Golden Gate Bridge in 2006, the estimated cost of the barrier was between $15 and $20 million. View the full article
  2.  The rate of depression in children and adolescents continues to grow, leaving many parents clueless on what to do. What is driving this increase? Are things truly different for young people today, compared to twenty or thirty years ago? This episode welcomes a child psychologist to address these issues and more, including: how and why kids today are overloaded with activities, the different ways depression expresses itself in youth versus adults, how to tell when kids are “just being kids” versus dealing with depression, how to recognize the various signs of depression in young people, and how parents can stop feeling like failures. Subscribe to Our Show! And Remember to Review Us! Youth Depression Show Highlights: “Parents often have some kind of intuition that something doesn’t feel right, and because we don’t want to admit that something’s wrong, we’ll override that.” ~ Luana Colman Cook [3:57] Are we expecting too much of kids, today? [5:49] Why are we overloading children? [8:03] How do we slow down? [17:56] What does depression look like in young people? [23:40] how can parents tell when kids are depressed, rather than just “kids being kids”? [29:56] What about parents who think they’re failures? About Our Guest Luana Coloma Cook, PsyD is a licensed psychologist and mother of three who has specialized in supporting youth and families for the past fifteen years. She is an experienced supervisor and trainer of new psychologists, and previously served as the Consortial Director for the Kaiser Permanente Central Valley Consortium Postdoctoral Residency Training Program. She currently works with children, teens, couples, and families in her private practice in Sacramento, California. It is her belief that in order to successfully move through the therapeutic process, the therapist must be open to learning about the perspective of the family and must recognize the strengths and wisdom in each individual and in the family as a whole. Luana utilizes mindfulness and attachment-based therapy to assist with this process. Luana is a certified Emotionally Focused Couples Therapist (EFT) and has advanced training in Emotionally Focused Family Therapy (EFFT). About The Psych Central Show Hosts Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. In addition to hosting The Psych Central Show, Gabe is an associate editor for PsychCentral.com. He also runs an online Facebook community, The Positive Depression/Bipolar Happy Place, and invites you to join. To work with Gabe, please visit his website, gabehoward.com. Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. In addition to co-hosting The Psych Central Show, Vincent is the author of several award-winning novels and the creator of costumed hero Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com. View the full article
  3. Phobiasupportforum

    OCD and Showering

    When my son Dan was in the throes of severe obsessive-compulsive disorder in 2008, he would sit in his “safe chair” for eight hours at a time. He was literally “stuck.” While I didn’t realize it at the time, getting stuck, or more accurately, becoming a slave to OCD’s demands, is part of what severe OCD is all about. Never-ending compulsions take over your life as you try to achieve <certainty that all is well. I’ve always found it particularly heartbreaking when OCD latches on to our most basic needs such as loving relationships, eating, and physically caring for ourselves. One of the more common compulsions that is often used as an “example of OCD” is hand washing, which can indeed be so severe that scarring, bleeding, or infections occur. The person with OCD cannot stop washing until their doubt and anxiety subside. What perhaps is less known to people who are not directly affected by OCD is that showering is also a common compulsion. While those with obsessive-compulsive disorder might believe they are just trying to get clean, showering as a compulsion serves the same purpose as all compulsions — to reduce anxiety and uncertainty. Some people will insist on using scalding hot water, while others will have rituals that need to be done in a certain manner. If something is done “incorrectly,” the person with OCD feels the need to start all over again. At the very least it is tiring and draining, and in the worst-case scenarios it is completely debilitating. I personally know of a young woman who got “stuck” in the shower for ten hours and had to be physically removed. As I said — heartbreaking. A basic activity of daily living turned into a nightmare. What leads to this nightmare? How and why do things get that bad? Well, as with all types of OCD, it starts with an obsession. In those with shower compulsions, obsessions typically include contamination fears or germ phobias, but that isn’t always the case. OCD has an impressive imagination and can latch on to anything. For example, someone with OCD might fear harm coming to someone they love if they don’t wash each body part ten times in the shower. While the person with OCD typically realizes this makes no sense, there is always that doubt, and the compulsions are then carried out. Unfortunately, that’s never the end of it. The reassurance that compulsions provide is addictive and just as with drugs, tolerance rises and more and more compulsions are needed to feel that sense of relief. Before you know it, you’re in the shower, unable to get yourself out. I know that even with this explanation, it is hard for those of us without obsessive-compulsive disorder to understand. Why can’t our loved ones just get out of the shower? Shut the water and get out!? It is difficult for us to comprehend the level of fear and anxiety they are dealing with. But there truly is good news. Obsessive-compulsive disorder, no matter how severe, is treatable. The frontline psychological therapy for the treatment of the disorder is exposure and response prevention (ERP) therapy, and it works. Remember the young woman who was stuck in the shower for ten hours? After two months of intensive ERP therapy, she now easily takes fifteen-minute showers. She is in charge of her showers, and her life, now. Not OCD. View the full article
  4. Phobiasupportforum

    Psychology Around the Net: July 28, 2018

    This week’s Psychology Around the Net dives into a new online program that helps people with mental health issues better handle money, how you can know someone’s personality by their eye movements, why psychology courses are important for business owners, and more. Enjoy! Banks’ 360-Degree View of Customers Could Include Their Mental Health: Silver Cloud Health has created an online mental health program, Space from Money Worries, to help people who have financial problems related to mental health issues. The program is designed to help those with a link between finances and mental health learn how to manage negative thoughts about finances, reduce impulse spending, feel confident about money issues, and more. Scientists Just Found the Neurological Link Between Poor Sleep and Depression: We’ve known for a while that poor sleep and an increased risk of depression are bed fellows; however, now scientists have identified why they’re so cozy and that discovery could lead to better depression treatments and sleep quality improvement. The Damaging Way We Talk About Celebrities and Mental Health: “As someone who lives with mental illness (specifically, a well-managed case of obsessive-compulsive disorder, or OCD), it’s frustrating to watch when the behavior of celebrities grappling with their mental health is treated as fodder for the celebrity gossip mill. Few outlets show any consideration for how their coverage contributes to misunderstandings and misinformation about mental illness, let alone how it affects the lives of the people who are the subjects of the articles.” — Lux Alptraum To Know Someone’s Personality, Watch Their Eye Movements: I feel like there’s a meme out there just waiting to be Instagrammed. U.S. Psychology Group Set to Modify Rules On Interactions With Military Detainees: Next month, the American Psychological Association will get a chance to modify its policy that prevents military psychologists from conducting interrogations at Guantanamo Bay and other national security facilities. 5 Ways Psychology Courses Can Help Small Business Owners: Thinking about starting a business? Already own a business? You might want to brush up on your understanding of psychology. Not only can it help you better provide support and motivation to your employees, but it can help you gain a better understanding consumers’ wants versus needs, personalize your products and services, and more. View the full article
  5. Phobiasupportforum

    The Effects of Sunlight on OCD Symptoms

    When my son Dan was dealing with severe OCD, he would often be awake all night, pacing throughout the house. It was not unusual for me to get up in the morning and find him fast asleep on the living room floor, or wherever else he happened to finally collapse from exhaustion. Even when his symptoms began to improve, he still could not seem to fall asleep at a normal hour and would be awake until 4:00 am or so. Not surprisingly he’d then sleep half the day away. His sleep cycle was all out of whack. It turns out that this abnormal sleep pattern is not unusual in those with OCD and has warranted the attention of researchers. In this July 2018 article published in the Journal of Obsessive-Compulsive and Related Disorders, scientists determined that living at higher latitudes, where there is less sunlight, appears to result in an increased prevalence of OCD. In regards to the delayed sleep-wake pattern similar to what my son Dan experienced, Professor Meredith Coles, first author of the study, explains: “This delayed sleep-wake pattern may reduce exposure to morning light, thereby potentially contributing to a misalignment between our internal biology and the external light-dark cycle. People who live in areas with less sunlight may have less opportunities to synchronize their circadian clock, leading to increased OCD symptoms.” In other words, if you sleep through the morning hours of sunlight, you have less chance of “catching up” with your sun exposure if you live in areas with less sun. Professor Coles finds the results of this project exciting as they provide a new way of thinking about OCD. She says, “Specifically, they [the results] show that living in areas with more sunlight is related to lower rates of OCD.” I find the results of this research quite interesting, though not particularly shocking. We already know that lack of exposure to sunshine can affect our mental health — those with Seasonal Affective Disorder (SAD) can certainly attest to that. As is often the case, results of studies leave us with more questions than answers. Why do those with OCD often have abnormal sleep cycles to begin with? Is it anxiety keeping them awake, or is it something else? Professor Coles wants answers to these questions as well and says that future studies are in the works including testing a variety of treatment options that address sleep and circadian rhythm disruptions. She says: “First, we are looking at relations between sleep timing and OCD symptoms repeatedly over time in order to begin to think about causal relationships,” said Coles. “Second, we are measuring circadian rhythms directly by measuring levels of melatonin and having people wear watches that track their activity and rest periods. Finally, we are conducting research to better understand how sleep timing and OCD are related.” Obsessive-compulsive disorder can be such a complex disorder — it is always encouraging to hear of research being done on different aspects of it. Who knows? Maybe these studies will somehow lead to better treatment options, or even a cure, for OCD. Surely that would help us all sleep soundly! View the full article
  6. 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
  7. 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
  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
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    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
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    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