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Phobiasupportforum

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  1. You’ve been to four psychiatrists and tried over a dozen medication combinations. You still wake up with that dreadful knot in your stomach and wonder if you will ever feel better. Some people enjoy a straight path to remission. They get diagnosed. They get a prescription. They feel better. Others’ road to recovery isn’t so linear. It’s full of winding bends and dead-ends. Sometimes it’s entirely blocked. By what? Here are a few impediments to treatment to consider if your symptoms aren’t improving. 1. The Wrong Care Take it from the Goldilocks of mental health. I worked with six physicians and tried 23 medication combinations before I found the right psychiatrist who has kept me (relatively) well for the last 13 years. If you have a complex disorder like I do, you can’t afford to work with the wrong doctor. I would highly recommend that you schedule a consultation with a mood disorders center at a teaching hospital near you. The National Network of Depression Centers lists 22 Centers of Excellence located across the country. Start there. 2. The Wrong Diagnosis According to the Johns Hopkins Depression & Anxiety Bulletin, the average patient with bipolar disorder takes approximately 10 years to receive the proper diagnosis. TEN YEARS. About 56 percent are first diagnosed incorrectly with major depressive disorder, leading to treatment with antidepressants alone, which can sometimes trigger mania. In a study published in the Archives of General Psychiatry, only 40 percent of participants were receiving appropriate medication. It’s pretty simple: if you’re not diagnosed correctly, you won’t get the proper treatment. 3. Non-adherence to Medication According to Kay Redfield Jamison, Ph.D., Professor of Psychiatry at Johns Hopkins University and author of An Unquiet Mind, “The major clinical problem in treating bipolar illness is not that we lack effective medications. It is that bipolar patients do not take these medications.” Approximately 40 to 45 percent of bipolar patients do not take their medications as prescribed. I’m guessing the numbers for other mood disorders are about that high. The primary reasons for non-adherence are living alone and substance abuse. Before you make any major changes in your treatment plan, ask yourself if you are taking your meds as prescribed. 4. Underlying Medical Conditions The physical and emotional toll of chronic illness can muddy the progress of treatment from a mood disorder. Some conditions like Parkinson’s disease or a stroke alter brain chemistry. Others like arthritis or diabetes impact sleep, appetite, and functionality. Certain conditions like hypothyroidism, low blood sugar, vitamin D deficiency, and dehydration feel like depression. To further complicate matters, some medications to treat chronic conditions interfere with psych meds. Sometimes you need to work with an internist or primary care physician to address the underlying condition in tandem with a mental health professional. 5. Substance Abuse and Addiction According to the National Institute on Drug Abuse (NIDA), people who are addicted to drugs are approximately twice as likely to have mood and anxiety disorders and vice versa. About 20 percent of Americans with an anxiety or mood disorder, such as depression, also have a substance abuse disorder, and about 20 percent of those with a substance abuse problem also have an anxiety or mood disorder. The depression-addiction link is both strong and detrimental because one condition often complicates and worsens the other. Some drugs and substances interfere with the absorption of psych meds, preventing proper treatment. 6. Lack of Sleep In a Johns Hopkins survey, 80 percent of people experiencing symptoms of depression also suffered from sleeplessness. The more severe the depression, the more likely the person will have sleep problems. The reverse is also true. Chronic insomnia creates a risk for developing depression and other mood disorders, including anxiety, and interferes with treatment. In persons with bipolar disorder, inadequate sleep can trigger a manic episode and mood cycling. Sleep is critical to healing. When we rest, the brain forms new pathways that promote emotional resilience. 7. Unresolved Trauma One theory of depression suggests that any major disruption early in life, like trauma, abuse, or neglect, may contribute to permanent changes in the brain. According to psychiatric geneticist James Potash, M.D., stress can trigger a cascade of steroid hormones that likely alters the hippocampus and leads to depression. Trauma partly explains why one-third of people with depression don’t respond to antidepressants. In a study recently published in Scientific Reports, researchers uncovered three subtypes of depression. Patients with increased functional connectivity between different brain regions who had also experienced childhood trauma were categorized with a subtype of depression that was unresponsive to selective serotonin reuptake inhibitors like Zoloft and Prozac. Sometimes, then, intensive psychotherapy needs to happen alongside medical treatment in order to reach remission. 8. Lack of Support A review of studies published in General Hospital Psychiatry assessed the link between peer support and depression and found that peer support helped reduce symptoms of depression. In another study published by Preventive Medicine, teens who had social support were significantly less likely to become depressed after experiencing work or financial stress in early adulthood than those without support. Depression was identified among conditions affected by loneliness in a paper published in the American Journal of Public Health. Persons without a support network may not heal as quickly or as completely as those with one. View the full article
  2.  Suicide is something that most people think they understand, but there are many misconceptions about it. We say it’s a serious problem, yet will mention it casually and insensitively in certain settings. In this episode, our hosts openly discuss suicide and their personal stories with trying to end their own lives. SUBSCRIBE & REVIEW “I thought about suicide every day for as far back as I can remember.” – Gabe Howard Highlights From ‘Suicide’ Episode [1:00] Frankly discussing suicide. [3:00] Don’t belittle a person’s suicide attempt. [7:00] Why did Michelle try to end her life? [10:00] Discussing families and suicide. [12:00] Why did Gabe try to end his life? [16:30] Michelle shares her suicide story. [23:00] Michelle can’t understand how her mom did not know she had a mental illness. [27:00] Gabe and Michelle agree that things get better. Computer Generated Transcript for ‘Talking Suicide with a Bipolar and a Schizophrenic’ Show Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Narrator: [00:00:05] For reasons that utterly escapes everyone involved. You’re listening to A Bipolar, A Schizophrenic and A Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Gabe: [00:00:19] Welcome to a bipolar a schizophrenic and a podcast. My name is Gabe Howard and I am bipolar. Michelle: [00:00:24] Hi I’m Michelle and I am schizophrenic. Gabe: [00:00:27] And today we are going to talk about suicide specifically. How are we still alive after having been suicidal for so long. And this is kind of a tricky one for us to cover because Michelle and I you know we kind of like to be bombastic. We kind of like to be funny. We kind of like to be out there and well we like to yell at each other. And suicide is a much it’s a scary topic. It’s something that sort of lends itself not to humor but to I don’t know it’s scary. Michelle: [00:01:00] It is a scary topic. It’s something that doesn’t really get spoken about. It’s kind of something that like is very hush hush. And if you’ve ever really attempted suicide you don’t talk about it because then people just really judge you very harshly and they would say why would you do that. Don’t you care about people around you? How is that going to affect people around you what you did was something selfish. Gabe: [00:01:23] There’s 80 billion reasons that this show should avoid suicide. Given how we talk about living with mental illness our mental illness and mental illness advocacy. But there’s one very big reason that we should cover it and that’s that we’re not afraid and we talk about everything The Good the Bad and The Ugly. But it’s gonna be a challenge for us. The first thing that we want to say immediately right out of the gate is Trigger Warning suicide. We are going to be talking about suicide and I’m not going to tell you that an inappropriate joke may or may not come up because hey we’re Gabe and Michelle. Michelle: [00:02:02] That’s right. Gabe: [00:02:03] This is what we do. If you are in danger right now if you are feeling suicidal please ask for help. Gabe: [00:02:12] Call 911 if you’re in America call the suicide hotline tell a trusted friend go to the emergency room. Most importantly Michelle and I are still alive because we got help because we talked about it openly. Michelle: [00:02:25] And I’m really bad at suicide. Gabe: [00:02:28] Oh and the first inappropriate joke is right out of the gate okay Michelle. We sort of we did some research we made a list of topics and stuff that we want to discuss. And the first question that I get asked a lot is it if you were suicidal why didn’t you just do it. So you must not have been suicidal because you didn’t die. So you’re a liar I have a million things I want to say to that. One of them is Fuck you. That’s not how mental illness works. Michelle: [00:02:57] Yeah. Yeah that’s a big fuck you like don’t belittle somebody whose suicide attempt because if they want to do it again . . . If you belittle somebody suicide attempt they’re going to think oh I didn’t really try to kill myself. So maybe next time I’ll try even harder and succeed. Gabe: [00:03:15] Well I love this whole idea of this. This if you try suicide or if you say you’re suicidal it’s just a dramatic cry for help. Gabe: [00:03:24] You want to hear some other dramatic cries for help I’m drowning. Help. My house is on fire. How I’m falling out of a helicopter. But the difference is when people yell those things people come to help. People come to help them. Michelle: [00:03:41] But when someone says they’re suicidal. Oh, you’re just being dramatic. What’s wrong. Did you have a bad conversation today? You’re not really suicidal. You know it’s just you’re so it’s really just stop being dramatic. You don’t actually feel that way like you don’t know what’s going on in my head. You don’t know my thoughts. You don’t know what I’m dealing with. Don’t tell me it’s all in my head. That’s not no. Gabe: [00:04:07] It this is really little thing that we have where society acknowledges that it’s a cry for help but then also says that the best thing to do is not help. I just I cannot stress enough that if somebody says that they are suicidal. If somebody says that they want to die. That is not drama. It is not. It’s none of those things. That person needs help and you’re saying well what if the person is lying and faking then that person is a jackass. Michelle: [00:04:37] Yeah. Gabe: [00:04:37] But to literally ignore every single person that asks for help because they’re fighting with their own brain because they’re mentally ill because they’re having suicidal thoughts because they’re so depressed they can’t take it anymore because some dickhead out there is being dramatic. That’s literally nonsense. Michelle: [00:04:57] Yeah after one suicide attempt my friend told me you weren’t really trying to kill yourself that time. You know what happened a month or two later. I then tried to kill myself again. Did that time count? Gabe: [00:05:11] Michelle How many times did you attempt suicide. Michelle: [00:05:14] Well I mean attempt. I mean like did I attempt but I attempted about attempted really it wrong. I didn’t know what I was doing but I would say maybe 7 times. Gabe: [00:05:24] That’s a lot and you’re very lucky that you’re still alive. I do appreciate your joke. You must be really bad at suicide. I for one am glad this this statistically holds up for whatever reason women do tend to suck at suicide. There’s a lot of research into this one of these is the methods we’re not going to give methods because that just well we’re trying to be mature. Michelle: [00:05:47] Something I did learn about women differently in women and men is that women like to be found looking like themselves. Gabe: [00:05:54] Yeah men don’t care. Michelle: [00:05:55] Yeah men are like you know find me find me all disgusting. I don’t care. Gabe: [00:06:00] Aren’t you glad that vanity saved your life. Michelle: [00:06:03] Yeah I guess so. I guess they saved my life. Gabe: [00:06:05] Yeah the our society really messes with us but when you’re feeling suicidal at all this is an example of your brain not working properly. We as humans are our bodies our minds are. Our consciousness is set up to defend ourselves. If you walk up to a stranger and you throw a tennis ball at their face and they see it they’ll duck. They don’t have to think about it. They don’t have to consider it. They don’t have to wonder what all they know is that an object is coming at them and they immediately take evasive action. It’s biological. It’s built into our brains. And yet when we’re feeling suicidal or when we try suicide it’s we’re overriding that. And that’s the illness process. Our bodies have decided to steer into danger rather than away from it. And that’s an unnatural state of being. So that this the first way that you know that something is wrong. Gabe: [00:07:01] Our bodies want to protect themselves. We just do. Michelle: [00:07:05] Every time I tried to kill myself I thought I had to kill myself. I thought it was something that was better for the future. I thought everyone would be better without me and everyone would be happier if I was gone. I would be less of a burden on everybody’s life. But thinking back now that I can really do retrospective kind of thoughts it would have ruined people’s lives. Gabe: [00:07:32] Oh yeah. Michelle: [00:07:33] It would have really ruined people’s lives. So, the thoughts I have of oh I’m a burden. You know I should be gone. Michelle: [00:07:39] I would have put horrible burdens on all of my friends and my family and they might still be thinking about me every day about what I did and how maybe they could have helped me and they couldn’t. And they might not be okay now because of what I did. Gabe: [00:07:57] There’s a quote out there and I really like it and I don’t know who to credit it to it is not ours but it says that suicide does not end the pain, it just transfers it to somebody else. And I believe that that is so true. Michelle: [00:08:09] Yes. Gabe: [00:08:10] When I was suicidal I convinced myself that my granny didn’t love me. And as everybody knows I am granny’s favorite. Michelle: [00:08:16] Yes. Gabe: [00:08:16] I convinced myself that my friends my family just even strangers would be happy if I were dead. And this is nonsense because it looks like strangers don’t give a shit if I’m alive or dead. So, to have convinced myself that strangers would be happy that I was dead. It literally they don’t care. That’s why they’re strangers. I’m not. I’m not saying this to be mean to strangers I’m just they wouldn’t be happy or sad they’d be indifferent. That’s just how life works. We’re not emotionally invested with every single person that we’d see you live in New York City. If you were emotionally invested in every single person that you laid eyes on you won’t have time to podcast. Michelle: [00:08:55] I wouldn’t I wouldn’t. I’m just kind of bringing at one thing this is about my mother that she is she of course she’s not going to like that I’m saying this but what I was in college you know her my grandparents were alive and my mom would call me and she would say “you know Michelle my mother’s sick my father’s crazy, can you just be OK, So I don’t have to worry about you.” What does that make me feel like? A huge burden. Gabe: [00:09:21] Yeah it does. And let’s take this from your mother’s perspective because you know we want to be fair our parents. Mine too. I don’t know how my mom and dad and grandma and grandpa and brother and sister and friends and family escape my anger these days because they did all of those things too. They said that I was being dramatic. They didn’t get me the help that I needed as long-term listeners of the show know a complete stranger took me to the hospital my friends and family were not absent. My parents are good parents but they didn’t know they didn’t do anything. Your mother was just like hey get a grip and don’t cause me problems because I have other things to worry about. If your mom would have understood that you were sick, she never would have told you hey don’t be sick from cancer. she never would have told you. Like if you’ve gotten like a traumatic accident and you were like you know like learning to walk again, she never would have said hey can you just like walk today so this doesn’t cause a problem. Your mom’s not an idiot. She was just ignorant about what was going on and that’s an extra burden to people like us because now their ignorance becomes our problem and we’re already sick. Michelle: [00:10:29] Yeah. How was I supposed to feel in that situation? Gabe: [00:10:32] You were supposed to feel shitty. Michelle: [00:10:34] What was her logic there like of her telling me. Can you just be better so I don’t have to worry about you? Gabe: [00:10:41] Her logic is that you had control because she hadn’t yet understood that you didn’t have control as so many people. I did the same thing as your mother to myself. I thought that I was just an asshole and I can’t say it any other way. My parents would sit me down and say you can’t behave this way you can’t skip school you can’t stay up all night you can’t talk to people like that you can’t behave this way. And then when I became an adult and started well, we all know what I did as an adult. These were not the values that my parents taught me. I thought that I had control. I didn’t realize I was sick. I thought that I was just making really shitty decisions and I kept doing it over and over and over again. Michelle: [00:11:22] Let’s pause and hear from our sponsor. Narrator: [00:11:24] This episode is sponsored by betterhelp.com secure convenient and affordable online counselling. All counselors are licensed accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to betterhelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. Betterhelp.com/PsychCentral. Gabe: [00:11:55] And we’re back. Michelle: [00:11:56] Do you think that the world would have just been better off if you weren’t gone? Gabe: [00:12:01] No. No. I thought it at the time I really did think it at the time. I thought that everybody would be relieved. I thought that they would be like oh we don’t have to worry about Gabe anymore. We don’t have to be concerned that Gabe is going to get fired or cause a problem or divorce his wife for cheat on his wife or yell at his wife or yell at us or we’ve all heard. Michelle: [00:12:20] The wrath of Gabe. Gabe: [00:12:22] Yeah. These things didn’t come out of nowhere. I kind of wish that I could escape that label because the wrath of Gabe hasn’t existed since you know treatment but I was a person with untreated bipolar disorder and you know bipolar rage is a thing as much as I hate the reminder that I used to be so out of control that I would just start screaming at people uncontrollably and non-stop like I was some sort of like Supreme Court justice candidate just bothers me. Michelle: [00:12:50] Did you always believe that you were in there right when you were screaming? Gabe: [00:12:55] Yeah. Gabe: [00:12:56] Who starts screaming because they think they’re wrong. I had no ability to consider another point of view. None whatsoever. And the more they wanted me to consider their point of view the angrier I became and the angrier I became the more I would yell and the more that I would I just sort of built on itself so you can see where when you’ve got that kind of emotion just railing at somebody they’re going to look at you like you’re just insane they’re going to look at you like you’re an asshole and those would be the faces that I would think about when I would be contemplating whether or not I want to live or die. Michelle: [00:13:33] So you 100% are glad you’re alive right now? Gabe: [00:13:37] Unequipped I have achieved it more than I ever thought possible. I don’t know I mean for like a dude with bipolar disorder I mean like just for a dude. Gabe: [00:13:48] I never thought I could get here. I had so many problems so many and I still have a lot of problems. Michelle: [00:13:56] I have a question. Michelle: [00:13:57] So how old were you when you first thought of suicide attempts and tried to almost make a suicide attempt. Gabe: [00:14:07] Zero. I was 0 years old. I thought about suicide every single day as far back as I can remember. 4 years old 5 years old 6 years. I thought that everybody was thinking about suicide. I really did and nobody ever knew. Nobody dissuaded me of this. Michelle: [00:14:26] Did you tell people? Gabe: [00:14:28] No. Why would I. I thought it was normal. I did. And listen you know I have never seen my mother go to the bathroom. Gabe: [00:14:37] I just I want to put that right out there for the general public. I have never seen my mother go to the bathroom but I do assume that she does. Michelle: [00:14:45] Yeah. Gabe: [00:14:45] It’s just an assumption. So, if my mother is the one person on the planet that never has to use the restroom she should tell me because there’s no way that I would know this. I thought about suicide every day but nobody walked up to me and said hey thinking about suicide is abnormal and I didn’t tell them because I thought they were all thinking about it too. This is just how it was. I just assumed that they were thinking about it and they just assumed that I wasn’t. Michelle: [00:15:11] Was anyone berating me with insults? Gabe: [00:15:14] I mean I wouldn’t say berating me with insults because that sounds like they were calling me like jerk face but there was a lot of negativity in my life that people didn’t realize was negative. Kind of like the example that you used of your mother like where she said look, I’ve just got way too much going on I need you to be okay because she’s going through the illness of her of her parents which is a real big deal to her. Michelle: [00:15:36] It is. Gabe: [00:15:37] But that put a lot of burden on you. Gabe: [00:15:40] So nobody was berating me with insults but my family was not understanding of what I was going through and I really thought that I was an asshole. I thought I was a bad kid. Gabe: [00:15:50] I thought that they didn’t love me and I carried this very day because I I cannot stress this enough. Michelle, my parents are good parents. They’re good parents. Gabe: [00:16:03] They’re fantastic parents. I don’t have a story about how my parents were awful or beat me or called me names or treated me like shit. Gabe: [00:16:12] They were good parents and they made all kinds of mistakes like tons of mistakes like every mistake they made just compounded and made my life even worse and worse and worse. But this isn’t because they were malicious or bad it’s because they were human and nobody taught them about mental illness either. Michelle: [00:16:29] Well I have a story in 11th grade, I walked out of my physics class. Gabe: [00:16:36] Your 11th grade was much different from my 11th grade. Michelle: [00:16:39] Yeah I walked in our home. I took the keys to the car when I had a permit and I drove to a drugstore. I found some like you know it was sleeping pills but obviously they were not like prescriptions sleeping pills. Went home took all the pills went to bed didn’t die but my eyes were all dilated. Couldn’t read a book. I was sitting next to my mom. And the day just went on. I tried to kill myself that day. It didn’t work. And the day we just went on like a regular day. Gabe: [00:17:16] And nobody noticed. Michelle: [00:17:18] Well I got in trouble because I was the teacher said that I just walked out of my physics class. But that was it. Gabe: [00:17:25] Yeah. Michelle: [00:17:25] Nothing nobody said. What did you do. Did you do anything after. Nobody questioned anything after. Nobody said why did you walk out of your physics class? Where did you go? What did you do? Michelle: [00:17:37] I remember I was home. My mom goes “Why are you home right now?” Michelle: [00:17:41] Because she came home from work and I go “Oh I wasn’t feeling good so I came home,” but really maybe I should have been honest and what I did. Gabe: [00:17:49] Right. Michelle: [00:17:50] But I didn’t. Michelle: [00:17:52] And there’s like so many things I would have wished I would have said to my younger self that like this. This is not the answer because just because you think you’re stupid and this physics class is so hard and you hate your life already this is not a reason to kill yourself. Gabe: [00:18:09] You know it’s an interesting thing that you brought up there like what would you tell your younger self. Gabe: [00:18:13] Like if today’s Michelle could call 20 year ago you know. Michelle: [00:18:17] Like physics was like not a reason, but I mean things I would have told to my younger self was, why would killing yourself now, what would that do for anyone? Michelle: [00:18:31] You’re in high school. Everyone’s going to like Oh that that’s the girl that killed herself. I don’t think anyone would have been like “Oh I’m so devastated.” I honestly didn’t wouldn’t even think that anyone would have even cared at that point in my life. I didn’t think anyone really liked me at that point in my life and I was definitely having schizophrenia symptoms. I remember sitting in the back of that physics class having a delusion cracking up laughing at nothing and a girl two seats ahead turns around and goes. “Are you okay.” And I’m like “Oh what.” Michelle: [00:19:04] She goes “You’re laughing it’s something.” I go “oh sorry” I didn’t even know. So, I was having schizophrenia hallucinations delusions in that class and had no idea I was schizophrenic but I obviously was. Gabe: [00:19:19] And nobody noticed. Michelle: [00:19:19] And that girl who sees ahead notice something was wrong. But I didn’t know what it was. Gabe: [00:19:27] It’s interesting to consider like what our families would have felt or what they would have done or how they would have reacted had we been successful at ending our lives. And as our listeners know we work as a speakers and writers and in addition to podcasting and we go to a lot of mental health conferences and I hear people’s stories all the time. Gabe: [00:19:53] I interview people about their stories and I mean no disrespect when I say this but when you hear a story from a thousand different people you sort of build up a thick skin to it and they don’t really affect me like they did in the beginning and this is good. This is this is I’m not saying this in any bad way I love hearing stories and I want people to tell their stories and I’m glad that we play a role in getting stories out to the greater public. But myself you know I tend to remain kind of emotionless by them one time I got hired to give a speech and the keynote speaker was a gentleman running for judge. He was going to be a judge. So, I went on before him because he was the keynote. So, I was like I was like the opening act. And I just had low 15-minute thing and I came up and I gave my speech it’s you know it’s condensed and beautiful and I talked about it. Michelle: [00:20:48] And I’m sure it was the greatest speech. The greatest speech Gabe Howard gives the greatest speeches. Gabe: [00:20:55] Yes I did get a standing ovation while you’re mocking me. Michelle: [00:20:58] Oh wow. Gabe: [00:21:01] Yeah yeah. Gabe: [00:21:02] I’ve only gotten 4 in my life but that’s not the point of the story. The point of the story is after I was done, I sat down. Gabe: [00:21:09] I plopped my ass and my seat and the next person got introduced. This was this gentleman running for judge he was about my parent’s age and he was very very dapper African-American gentleman. He was wearing a suit and his wife. You know same age and beautiful and when they called him up, he walked up with his wife and you know I don’t really think anything of this like I said I’m kind of bored like I have to say the next hour you know whatever. It’s not even my town. Gabe: [00:21:33] Like I can’t even vote for him for Judge if I wanted to. But he said we’re changing things up a little bit. And my wife wants to talk for a moment about why we’re mental health advocates and she talked for just like 5 minutes. Gabe: [00:21:48] And she told the story of their perfect beautiful son who died by suicide in his first or second year of college. Gabe: [00:22:00] And she said, “We did everything right. We lived in the best neighborhoods we sentence in the most expensive private school we could find. You know he went to Europe. He. He got into the finest college. We were so proud. You know my husband’s a judge were upper middle class. We both hold advanced degrees. We gave everything to our children.” Michelle: [00:22:22] That means nothing. Gabe: [00:22:23] Yeah. And that’s what she said. Except we did not understand mental illness. We did not understand that he was struggling we did not make a way for him to ask for help. He could not get out of whatever it was that made him do this. And now for the rest of our lives we don’t have a son. And I started to cry because as I was looking at them all I could think of as if I was successful would be my parents. These two, they did not set out to be mental health advocates. They didn’t want to be at a mental health conference. They didn’t know this guy was a lawyer that became a judge. I mean just they became mental health advocates because they missed it and because they were too late and because they don’t want this to happen to other people it could be my parents I’d be gone and my parents would just be standing there saying we don’t know what happened and we don’t want it to happen to other people. And that’s why we need to talk about this more. That’s why we need more mental health education. Gabe: [00:23:24] That’s why we need to understand suicidality and mental illness because me and you Michelle we’re lucky it’s not our parents. Michelle: [00:23:33] Yeah I believe in high school. My mom. Well when I was not doing my homework in high school it was more because I believed I would never graduate. I mean I believed I was going to die. But my thought. My mom. She believed it was a learning disability. Gabe: [00:23:49] Sure. Michelle: [00:23:49] Because she was really unaware of what mental mental health and mental illness was. So when she found out years later when I was in college that it was a mental illness. Michelle: [00:23:59] She was like “Oh I never even thought of that.” Michelle: [00:24:04] How could you not think of that? Gabe: [00:24:05] Because we didn’t think about it either Michelle. Michelle: [00:24:09] It’s just education and it’s just different because I think generations ago they didn’t do that. And even considering my mom never thought about mental illness when my mother’s grandmother lived in a psychiatric center from the moment my grandmother was born until she died and my mom has memories of going to visit her in the center where she spoke like a baby and was just just for lack of a better word she was looney tunes so to have that in our family and to not see anything like that in me. Michelle: [00:24:50] How could it have been such a shock if it runs in our family? Gabe: [00:24:54] Because nobody everybody thought that it was a one off that it was a one in a million that it was never going to happen. And just it’s like getting struck by lightning. You do. I have a family member that was struck by lightning. You know I don’t look up at the sky and try to avoid it right. I still go out in the rain. I just think here is a one in a million thing. Michelle: [00:25:11] There’s my dad’s first cousin Lori. She’s schizophrenic as well. Gabe: [00:25:15] Well there you go. Michelle: [00:25:16] My mom’s sister takes anti-depressants. Was it denial? Gabe: [00:25:22] Yeah probably. It was denial it was lack of understanding and it was ignorance and it was the ostrich. Michelle: [00:25:28] I mean I don’t know I don’t hold it against her. I don’t hold it against her. That she didn’t see it. Michelle: [00:25:35] I think maybe it was a denial thing. She didn’t look into it. She really thought it was a learning disability because she always said that I don’t read and if you don’t read, you’re not smart. Well I read some books but what was hard for me about reading is that I was so busy in my head all the time. It’s hard to read a book when your mind’s racing back and forth. Gabe: [00:25:56] It’s all over the place. Gabe: [00:25:57] Michelle what do we want to leave our listeners with. I mean because we’ve covered a lot. I mean this is this is you know this is not our normal. I hate Michelle, Michelle hates Gabe and then we start screaming at each other show and that’s for the best. But really is for the best. Michelle: [00:26:11] I mean just to leave listeners with…suicide is not an answer. And like I said I tried that 7 times and I failed 7 times. It’s not even an easy thing to do. And most likely you’ll end up in a psych ward where that’s not fun to be in. So really weigh your options and then just don’t do it. Michelle: [00:26:37] It’s not a good idea. You’re going to hurt more than just yourself. You’re going to hurt the people around you instead of the people that love you. And if you keep on going with your life things do get better. My life has just gone leaps and bounds better than I ever thought would ever happen in my life. I never thought I’d be recording a podcast with Mr. Gabe Howard and talking about mental health like I do now. I thought I’d be pathetic my entire life. I couldn’t I would never will. Gabe: [00:27:10] Oh well the two are not mutually exclusive. Gabe: [00:27:12] That’s going to be recording a podcast with me and still be pathetic. Michelle: [00:27:17] I guess but I never really envisioned a future because I never thought I would get there. I mean at that point I’m still it’s still hard for me to envision a future but that’s almost my own insecurity thinking nothing will ever really work out. Gabe: [00:27:29] Of course of course Michelle there’s. I want to leave our listeners with just a couple of quick things one. Gabe: [00:27:36] As we said before suicide it doesn’t end the pain. It just transfers it to somebody else. There’s another quote that I really like that is suicide is a permanent solution to a temporary problem. Michelle: [00:27:48] Yes. Gabe: [00:27:48] But the thing that I keep in my head probably fourth most of all after where I can find Diet Coke at 2:00 a.m. is at looking back now I realize that I didn’t want to die. Gabe: [00:28:03] I never wanted to die. I wanted the pain to stop and I didn’t know how to make the pain stop. I just didn’t. And the only thing that my battered bewildered disease the brain could come up with was suicide. That is not a good option and it’s far from the only option. And once I got treatment, I found all of these better ways to make the pain stop. And that’s all I ever wanted. I never wanted to die. I just didn’t want to suffer anymore. And I would say to anybody who’s thinking about contemplating it has in the past or maybe in the future you don’t want to die. You want the pain to stop. There are much better ways to make the pain stop. Please invest in yourself and look into them. Ask everybody that you know for help. Go to the emergency room call the suicide hotline. Talk to your general practitioner. Gabe: [00:28:58] Go to the local urgent care. I hear that you can go to the drugstore and Wal-Mart and see a doctor now do whatever it takes. Michelle: [00:29:07] Your life is valuable and we want you in the world. Gabe: [00:29:12] Completely agree. Thank you everybody for listening to this week’s episode of a bipolar, a schizophrenic and a podcast. Please review rank. Share us everywhere Facebook algorithm has gone I don’t know schizophrenic. Can we say that? Michelle: [00:29:26] Sure. Gabe: [00:29:26] Because it just it just pushes everything down. So at this point I think you’re gonna have to like share our Website via a smoke signal maybe like tattoo it on your arm and show people. I don’t know but whatever you do it for Michelle and I to maintain our high luxury standard of living. We’re just we’re gonna need you to be there. Gabe: [00:29:47] We’ll see everybody next week. Michelle: [00:29:49] We love you! Narrator: [00:29:51] You’ve been listening to a bipolar a schizophrenic and a podcast. If you love this episode don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe rate and review to work with Gabe go to GabeHoward.com. To work with Michelle, go to Schizophrenic.NYC. For free mental health resources and online support groups. Head over to PsychCentral.com Show’s official Web site PsychCentrald.com/bsp you can e-mail us at show@PsychCentral.com. Thank you for listening and share widely. Meet Your Bipolar and Schizophrenic Hosts GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com. MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC. View the full article
  3. Phobiasupportforum

    Psychology Around the Net: March 9, 2019

    Happy Saturday (or whatever day you’re reading this) sweet readers! This week’s Psychology Around the Net covers a personal account of how running helped one author’s anxiety and fear, how green spaces work to boost your well-being and social connections, why “hip” office settings aren’t benefiting employees the way employers would like them to, and more. Enjoy! Moving the Body, Boosting the Mind: Running Your Way to Better Mental Health: Bella Mackie, author of Jog On: How Running Saved My Life, weighs in on how physical activity (specifically, running) helped release her from a life of anxiety, fear, and intrusive thoughts. Hyperhidrosis Associated with Higher Anxiety, Depression, ADD: New research shows patients who have primary hyperhidrosis — “a rare disorder characterized by excessive sweating on the palms of the hands, the soles of the feet, in the armpits (axillary), in the groin area, and/or under the breasts” — are significantly more likely to develop mental health conditions such as attention deficit disorder (ADD), anxiety, and depression. Green Spaces Can Help You Trust Strangers: Last week I directed you to research about how growing up in an area lacking in green spaces can contribute to depression in adult years; now, we learn from a new case study about how green spaces and other colorful urban design elements can increase the well-being and social connections among the city’s residents. Physician Mental Health: The Role of Self-Compassion and Detachment: Finding the professional balance between showing compassion to and engaging emotionally with their patients can leave medical providers suppressing their feelings, doing a disservice to their own mental health and well-being. Enter REVAMP. Hip Offices Are Part of Our Mental Health Crisis. Here’s Why: Taking the occasional mental health day has become the corporate cure-all for employees experiencing burnout, but now offices are trying to create “hip,” “cool” workplace environments in an attempt to prevent burnout and even help employee mental health. According to one entrepreneur, these aren’t effective methods. Motivation Through Appreciation: The Science Behind a Happy Workplace: On that note, here’s a look at how something as seemingly simple as employee appreciation can boost happiness and motivation. So, what are some super basic yet super effective ways employers can show appreciation to their employees? View the full article
  4. Obsessive-compulsive disorder (OCD) is an often misunderstood and complicated illness. It can latch on to anything that is important to us, and has the potential to totally devastate lives. Still, so many people believe it is nothing more than excessive hand washing and the desire to keep things tidy. This could not be further from the truth. For the purpose of this post, I’ll be referring specifically to OCD in children. When OCD makes an appearance in a family, it often brings about fear and confusion. For one thing, obsessive-compulsive disorder manifests itself differently in everyone. Truly, there is no end to the ways it can present itself in addition to the stereotypical compulsions mentioned above. A few examples include eating issues, refusal to leave the house, irrational fears of certain people, places, or things, and the inability to complete previously easy homework assignments. You name it, it just might be OCD. Which leads us to the next issue that faces parents of children with OCD — getting a proper diagnosis. Misdiagnosis is common, which of course leads to the wrong treatment. Even when OCD is properly diagnosed, the right therapy, exposure and response prevention (ERP) therapy is often elusive. What’s a family to do? For those lucky enough to receive a proper diagnosis and referral to good treatment, you’d think the children would be on their way to recovery. However, that is not always the case – I’m hearing from more people than ever who are in this situation. While various forms of intensive treatment (intensive outpatient, partial hospitalization programs, or residential treatment centers) are often recommended for their child, many parents are concerned that a commitment to intensive treatment will disrupt their child’s life. For example, Kate loves dance and she’ll miss some classes and the recital, Jake will miss a good chunk of fourth grade if he does a particular ERP program, and Ashley will miss a few social events and have to tell her friends what’s going on (or lie).* Obviously, the children discussed in the above paragraph are not totally debilitated by OCD. Not yet, anyway. And it very well could be that they are balking at the idea of treatment. For children who can’t leave the house, or are not able to function to any extent in their daily lives, the decision to seek treatment is typically easier — they have already hit bottom. But many parents of children who are teetering on the edge don’t seem to want to take away the few things that still make their children happy, or “normal.” As an advocate for OCD awareness and proper treatment for over ten years, I cannot stress the importance of getting the right help for obsessive-compulsive disorder sooner rather than later. OCD rarely gets better on its own, and once entrenched, is harder to treat. So, for all those out there who might be in this situation, please get your child the right help as soon as possible. Friends and activities will come and go. Even missing a significant amount of time in school can be made up. But a child who grows into a young adult with untreated OCD might very well be so disabled by the disorder that he or she can’t even hold down an entry-level job. Getting good treatment now will free your child from the grips of OCD and allow him or her to go on to have a wonderful life. *These are not their real names. View the full article
  5.  Life is tough. Life with mental illness is tougher. Life with mental illness on top of other conditions and life experiences can seem too tough. Today’s guest shares how she dealt with Tourette Syndrome, OCD, anxiety, depression, and many other things, by tapping into her own super powers. Perhaps you can, too. Subscribe to Our Show! And Remember to Review Us! About Our Guest Everyone has challenges but some people have more than others. Brett Francis knows this from personal experience. Only now she turns those challenges—her own and other people’s—into assets. Her mantra is “no one is broken” and she means it when she says “our struggles are not our fault.” Her Not Broken® Radio show is heard on hundreds of stations throughout the globe; she is the bestselling author of Not Broken: How to Overcome Mental Health Challenges and Unlock Your Full Potential. In addition, she hosts the TV series Breaking the Barriers. Some of the challenges that have made Brett a stronger person include Tourette’s syndrome, ADHD, childhood bullying, anxiety, panic disorder, OCD, an abusive relationship, a miscarriage and depression. Brett’s mission is to educate individuals and society at large about mental health and why having mental health issues or a family member with them is a lot more normal than most people think. She wants to eradicate the stigma associated with mental health and disabilities so that those who are coping with such issues realize they are no different than having diabetes or some other common physical ailment. She advocates for greater education and awareness of these common problems. mentalhealthspeaks.com @brettspeaksnow SUPER POWERS SHOW TRANSCRIPT Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health – with host Gabe Howard and co-host Vincent M. Wales. Gabe Howard: Hello everyone and welcome to this week’s episode of the Psych Central Show podcast. My name is Gabe Howard and with me as always is Vincent M. Wales. And today Vince and I will be talking with Brett Francis. Brett’s mission is to educate individuals and society at large about mental health and why having mental health issues or a family member with them is a lot more normal than people think. Brett. welcome to the show. Brett Francis: Thank you for having me. I really appreciate you guys having me on. Gabe Howard: Oh it’s our pleasure. Vincent M. Wales: Definitely glad to have you. Brett, my first question is this: how did this become your mission? What happened in your life to push you in this direction? Brett Francis: Yeah well, it was a long road, I’ll tell you that for sure. When I was 16, I was diagnosed with Tourette’s Syndrome and severe ADHD. And then of course, 17, I was rediagnosed with the same, but in addition, anxiety, OCD, panic disorder. Now that doesn’t mean that I only had anxiety when I was 17. Since I can remember. I’ve been struggling with anxiety and panic and mental health, mood regulation, all those kinds of things. And I think a lot of it was from being bullied when I was in high school. I was bullied very badly. I was shoved in lockers every day. And that really was the big start of it. You know, when I was seven years old, my parents said, Oh, just tell everybody that you’ve got Tourette’s Syndrome. Well, as you guys know, mental health is mis-educated or maybe not known a lot about, sometimes, or it’s a taboo topic, which we’re all working at bringing more awareness to it and making it less taboo and more of normal conversation. But Tourette’s is still one of those things that is very misunderstood. And so people would think, oh she’s going to be swearing like the girl on the movie or like the person in the movie. And so I got really ridiculed and bullied for my Tourette’s Syndrome for a very long time, shoved in lockers every day, and then when I was 15 years old, I was raped for my first time. And then, through that I did a lot of substance abuse and I really was starting to fail in school after my rape. And so I had a lot of mercy passing because the teachers felt sorry that I was being bullied. And at this time there wasn’t a lot of education about not only Tourette’s Syndrome, about mental illness. Parents did the best that they could, but it was still a really really big struggle for me. And so, when I turned 18 years old, very shortly after I turned 18, I actually got pregnant unexpectedly with my high school sweetheart and then at 19 I had a miscarriage at about four months. And then I hit rock bottom, and through all of this, after my rape, after some traumatic events in my life,and then again after my miscarriage, was the last attempt that I had on my own life, to take my own life. And so I’ve struggled through my whole life and still to this very day I have bad days. And I just want to bring… my mission has become that because I want to bring awareness to mental health and help people understand that it is normal, it’s just like having diabetes or you get a broken leg you get a cast. If you have mental illness, you try medication. You know, really working at normalizing that because I would’ve done anything for somebody to be able to relate to me and say, hey that doesn’t make you a screw up, like I felt a lot of my life, I felt very broken for a very big portion of my life. And that’s why I do what I do, not only because I’m passionate about it but I just know I love every minute of it. And that’s become my life’s mission. Gabe Howard: I love that and I also love the way that Vin asked the question. It’s like we see that you’re a mental health advocate. What happened to you? And I say that to be a little bit funny but it really is true. I’ve noticed that people in the mental health advocacy space are either people like like me, I live with bipolar disorder, or people like you with Tourette’s Syndrome and anxiety and everything that we just learned about you; Vin, of course, has persistent depressive disorder and it really seems like either you or somebody that you love suffers from a mental illness in order to really occupy this space. And I’m hoping that some day I will walk up to somebody and say, Oh my God, you’re a mental illness advocate. Why? And they’ll say, because mental illness is serious. And I’ll be like well but you have it, right? No. A loved one? No, mental illness is serious. We need to help out. And that will just be like a great day – a great day. Vincent M. Wales: That would be nice. Brett Francis: I really look forward to that day, too. I mean just to hear, yeah I’m passionate about it… You know, you hear people, kids talk about being an astronaut, a geologist, a trained person. Or a veterinarian or six foot tall blond model. That’s what I want to be when I grew up, still, by the way, guys. [laughter] And where is the, oh I’m passionate about mental illness a I want to stop the stigma, just because I can. Instead of being an astronaut or whatever, I look forward to that day as well. Vincent M. Wales: So earlier you mentioned Tourette’s Syndrome and how it’s so misunderstood, because as you pointed, out most people just think of it as the stereotypical swearing without any kind of restraint sort of thing. But it takes many other forms. Can you share some of those with our audience? Brett Francis: So the swearing is actually called coprolalia and it only happens of 4 to 7 percent of people with Tourette’s Syndrome. So Tourette’s Syndrome is divided into a couple of different things. You have motor tics and then you have verbal tics. And then out of those each of those there’s simple and then there’s complex tics. Simple ones would be like hand jerks, sniffing, snorting, blinking your eyes, lip smacking, things like that. Those are really a lot of the common simple ones. And now when we get into the complex ones, that can be anything from, like I’ve had these where my tics are so bad that I feel like I need to echo the sounds on an action movie or something, or some people feel the need to bark like a dog or repeat themselves saying something, and they have to say it in just the right way and just the tone of voice. That one I actually know, like I said, from the sound effects in movies, or yell at the screen, or things like that. So it’s a lot of different, uncontrollable… and sometimes, I’m like, wow I didn’t know that my Tourette’s would want me to do that. You know, like you just have these new tics, they’re ever changing. So when I was younger I did have quite a bit of prominent verbal tics and I was yelling. I never swore, but in the middle of my sentences… they were… my sentences were like 100 different volumes. I’d be from screaming at the top of my lungs to like hardly mumbling. I had this one where I had to breathe all of my air out and I had to go, [heavy exhale] and breathe it all out to the point where I had nothing left in my lungs. And as you age and mature into it, you can either grow out of it or you can continue on with it. And it’s fairly mild because it’s worse than your hormonal years when you’re going through puberty and all that stuff. But as you mature into it, your tics kind of get solidified. There’s a few small ones and then there’s a few ones that are like moving, and so it’s sometimes every six months I’ll be surprised I’ll be like, Oh this one’s fun, you know? So it’s changing. And so sometimes it’s new but it’s also frustrating sometimes because you’re like, oh I just got used to the one that I was the new one that I had six months ago, now I have another tick. So and sometimes you go three years and you don’t have a new one. Vincent M. Wales: Very interesting. Gabe Howard: I did not know that either. Thank you. Thank you for sharing. Brett Francis: You’re welcome. Gabe Howard: You are the host of the Not Broken radio show, which is heard on many different radio stations throughout America. Can you tell us why did you name it Not Broken? Brett Francis: Well, it actually followed my book. So my book is called Not Broken and that’s where I came up with “not broken,” because I spent a large portion of my life feeling very broken and going into psychologists, psychiatrists, counselor’s appointments, and even people in the general population, with the stigma I felt like a screw up and like I couldn’t do anything right. And I’m sure that you guys have felt like that before with your mental illness. Gabe Howard: Many times, many times. Brett Francis: And that’s not a good feeling to have like you don’t fit anywhere. And so the book and the Not Broken name was inspired by feeling like that for a lot of my life. So I say, whenever I talk about mental health, my slogan is “not broken,” because people with mental health challenges and disabilities are not broken. And they don’t need to be stereotypically fixed. That doesn’t mean that they won’t need to learn to manage or doesn’t mean that they don’t need help, but they’re not broken. You know, we don’t look at a person with diabetes as broken. We look at them as somebody who needs to manage that disease. And I think we should look at mental illness the same. Gabe Howard: I couldn’t agree more. Thank you so much. I love that. I love that. Brett Francis: Thank you. Vincent M. Wales: Let’s talk about how mental health and physical health are linked. It’s something that Gabe and I have brought up several times over the course of our show. But I don’t think it’s ever been spoken about enough. Do you have any input on that? Brett Francis: I’ll share a personal story. Recently on my spouse’s side, his nephew is 15 years old and he was hearing voices and he was scared that he was going to harm himself and other people. And so he said, like, I need I need help in voicing this. And we took him into the hospital and the hospital said, oh he’s hearing voices, but the mental health worker, crisis worker comes in and says, oh, he told me that he’s not worried about harming anybody, that he also promised that he wouldn’t harm himself or others. And we said, he’s 15 years old like he’s impulsive and he’s worried about that impulse may strike and that’s what it’s going to happen. It’s not like it’s premeditated. And so we really struggled because they wanted to see somebody for chest pains or a broken leg or there was a person in there that also they were treating for an overdose. They want to see the physical stuff. And I don’t think that it’s that they don’t take it seriously, I think it’s not 100 percent sure what to do in the hospital because there’s a lack resources. And so anyways, I basically sat down and I plunked my butt down in the chair and I said, look, we’re not leaving here until this gets taken seriously. He’s got a younger brother at home and he’s worried he’s going to hurt somebody or himself. And he’s hearing voices. And I said, he needs to be seen. He needs to be treated. And he needs to be admitted. And I said, we’re not signing any kind of liability release or self care plan or non self harm plan. So they get you to sign the papers and they tried to get him to sign them without anybody being present. And I felt like it was really not… like he wasn’t being taken seriously. Like I said, not at the fault of the people who work in the hospital because the nurses and doctors are amazing and they’re great at what they do and they care for people. And that’s incredible. But I just think that they really didn’t know what to do especially because it was a northern rural community. It was very difficult for them to know like they had to call the mental health crisis team and then the crisis team had to call the psychiatrist and then the psychiatrist finally said, Okay admit this 15 year old boy. And so I think that we really need to work at it and I was reading an article as well and in many states and provinces in the US, Canada, everywhere and all over the world, people that go into emergency rooms for mental illness are often discharged and those are the people that are back and they continue to come back because they continue to struggle. And so sometimes people know that they’re struggling mentally and sometimes they don’t. They go and talk like with me when I was panic disorder I would go into the hospital when I was younger for chest pains, thinking I was having a heart attack. Well it wasn’t a heart attack. It was my panic disorder. And so being a person that’s been dismissed in the hospital without things like that being taken seriously and then having to wait after you’ve been there four times because you’re having chest pains, then then waiting for 16 hours this is just a really frustrating thing. So having been in those shoes before in the emergency room for mental illness and with the lack of resources and education and the lack of the link that we’re talking about for mental health and physical health when the two go hand-in-hand. I mean if you’re depressed, the first thing I do when I’m depressed is I put on sweats and sit on the couch. Your personal hygiene goes, your mental health directly affects your physical health and vice versa. If I’m not feeling well physically, I’m not having a good day mentally, either, and I’m sure that you guys with your diagnoses, see the same thing. Gabe Howard: Oh yeah it’s fascinating to me. You know physical health is your body and mental health is your brain. But of course your brain is IN your body. It’s fascinating. Brett Francis: Yeah exactly. Gabe Howard: You know we don’t have mental health, physical health, and then a separate stage for heart health, because we understand that the heart is in the body. It’s like everything is combined except for the way that we think and feel. And you’re right, it absolutely drives everything. People who are depressed are more likely to smoke, they’re more likely to overeat, they’re less likely to exercise, they’re less likely to build sustainable friendships or relationships. So that’s a support system. Everything just sort of spirals out of control from these thoughts and feelings that definitely have, a massive impact on our physical safety and surroundings and potentially – I always like to say potentially – the safety of those around us. And the fact that you knew what you were looking for and came in and said it and you still had some pushback is obviously something that we want to change. I like how you said we’re not trying to throw people under the bus or blame them. We’re just saying that we have to do better. Brett Francis: Exactly. And those nurses and doctors were amazing and once he was admitted, they were great. But a lot of times the nurses on the E.R., ‘cuz he was put in a pediatric ward, they are not 100 percent sure how to handle it. He had a suicide watch nurse that was at his side 24/7 and they’re not entirely sure like what to say to him. They have to either do the steps of calling a mental health crisis team, well they were only in Monday to Friday 9 to 4, and then the psychiatrist wasn’t in until Monday and he worked Monday to Friday as well. So when you really have an emergency on a Saturday night, essentially that system -like I said no fault of anybody involved – but that system is… you gotta be in the hospital for two days or get discharged and come back on Monday or wait six months or a year to get referred to a psychiatrist and specialist. So it’s really frustrating being on the other end of that, being the person who’s experiencing it for themselves or for a loved one, being able to say, look I know that this is happening, especially even when I went and said like, I know what’s happening, still being kind of unintentionally given time to the dismissive and the runaround. I don’t think people were intentionally trying to brush it off. I just think they didn’t know what to do with it. So finally the psychiatrist was called after four hours in emergency. Vincent M. Wales: Well, I think you’re experienced too also speaks to the tragic shortness of psychiatrists that we have right now. And you said it was in a rural area, which just adds to the problem there. Brett Francis: Yeah, and then there’s less resources for counseling and stuff in the rural areas where people aren’t in the main center. Vincent M. Wales: Exactly. Exactly. Gabe Howard: We will see in a moment after we hear from our sponsor. Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Vincent M. Wales: Welcome back everyone. We’re here with Brett Francis, author of the book Not Broken. So what are, as you put it, mental illness superpowers? Brett Francis: Well, mental illness superpowers, I actually kind of came up with that through building my career and speaking and things like that, where I realized I can actually use my mental illness to to an advantage here, like it doesn’t have to be always something that cripples me, it doesn’t have to be always something that makes me feel like garbage. It doesn’t have to be always something that I’m judging myself for or other people, I feel like other people are judging me for, it doesn’t have to be a downfall and it doesn’t have to be, so to speak, a fault that I look at. You know we all look at ourselves in the mirror and point out our own imperfections. People with mental illness look into their own minds and point out the flaws that they think they have and they judge themselves for it and we’re out own self-critics. So a big part of what I do is really embracing that mental illness and figuring out what has it brought your life. And initially people say to me like, what? Like what are you talking about? Like I live with depression I’m chronically depressed, how has that brought any benefit to my life? And one of my friends that has chronic depression, I said to her, I said, think of something that it’s brought, like who do you think you wouldn’t be, or what has it brought to your life? Well, it took her hours. So she finally called me back and said, You know, Brett, I’m a paramedic and I care for people for living and I don’t think that I’d be doing that without depression. And I’m really empathetic. So I’m really in tune as well with other people feelings, and I can provide empathy, I can be a good wife, and I can really understand where people are coming from and empathize with how they’re feeling and also pick up on it. And I said, Well what’s not great about that? So for me, one of the first things was, well, if I didn’t have OCD, I wouldn’t be organized enough to do my own thing. I’d be so scatterbrained, I wouldn’t be organized enough to be in business, to run a business, to write a book. You know I’m not saying I don’t struggle with those things. And that I don’t have bad days. But without the OCD, I wouldn’t be a business owner, without my ADHD, I wouldn’t be as creative, without my anxiety, I wouldn’t have the amount of energy that I do and the amount of passion that I do, without my Tourette’s Syndrome, I wouldn’t be who I am or what I am today and doing what I do today. If I hadn’t had the past of my bullying, my substance abuse, if I hadn’t had all those… I mean don’t get me wrong, I wouldn’t wish those things on my worst enemy… But those things are what made me the person that I am today, sharing my story, the person that loves to change people’s lives, the person that loves to bring awareness to mental health and fight for the advocacy. I would not be that person had I not had my diagnoses. So that’s what mental health superpowers are. Gabe Howard: I really appreciate that. Thank you so much. I like the way that you worded it and tried to tie it together. You know, sometimes I go the other way, where I say that there’s no superpower in mental illness. These are just innate skills that a person has that they’re able to use. And when I talk to people that say no no no no I’m turning my mental illness as negatives into positives… On one hand, I want to be like, No there’s no positive about mental illness, but on the other hand, I really appreciate the reframing. And this is why I am so glad that there are multiple voices out there because the reality is I’m kind of a realist, I’m kind of a pessimistic guy and that’s how I choose to deal with my symptoms and mental illness. But other people are more optimistic and they see things differently and they’re going to completely agree with you. And this is why I feel that all voices are important, because if you were the only voice, you’d never connect to me and if I was the only voice, I’d never connect to you. But thankfully, multiple voices allows everybody to feel connected and we’re all on the same side. So, so thank you. Brett Francis: Thank you. I mean thank you for sharing as well. I would say I’m more on the optimist scale of that. However, my anxiety and I’m sure you guys experience that with your mental health as well, it’s almost like a Jekyll and Hyde type thing where one minute… Gabe Howard: Oh yes! Brett Francis: I’m an optimist. And then in a split-second and the snap of a finger, I can be the worst pessimist in the world and all life is going down the drain and I’m a failure and I’m always a waste of time and blah blah blah. You guys know the drill, right? It’s the snap of a finger and it can change in a split second. I can be the pessimist. Gabe Howard: Dr. Jekyll and Mr. Hyde. Brett Francis: I could be Mr. Hyde, and it could just switch in a flash and it’s very frustrating sometimes. But I’m still back and forth and I yo-yo so much with my mood, with anxiety, that I know that there’s gonna be some sort of snap of a flash and I’m gonna be optimist Brett again in like the next millisecond or half an hour or the next day. You know, I know that that’s coming. So, that kind of gives me a little bit of hope because I’m like well I know that the optimist, resilient, stubborn Brett is in there somewhere, she’s gotta come out eventually. Just poke it a little bit, you know? Gabe Howard: That is very cool, and I think this is a nice segue into self stigma. Because you talk about self stigma a lot and the different ways that it affects us. So can you talk about that a little bit? Brett Francis: A lot of people really undervalue what they say to themselves and then they mean anxiety and all mental illnesses like it puts those doubts in your head where it’s like, I’m a failure, I’m not good enough, and it’s continuing to tell you everything that you can’t and won’t, or should haves and could haves. My counselor says, focus on the can dos and the have dones. But that’s not anxiety. So anxiety’s like this pestering… you know the angel and the devil sitting on your shoulder? It’s like the devil is there all of the time, just whispering in your ear that you’re not good enough. And so that’s a big part of stigma. And sometimes it’s easier to control and other times it’s not easy to control at all. You have this way that you feel you should be, and I think as human beings naturally, with or without mental illness, we have that self critic, where we try to make ourselves feel like we should be this or we should be that or we should have more money or we should have a better job or we should be married by now or all these things that we say the should haves. We naturally are programmed to think of that as human beings, like our society seems to always focus on, oh I’m not skinny enough, I’m not, I’m not well-off enough. And so we focus on the negatives naturally as a society. Throw mental health in the mix and we’re really giving ourselves a hard time. And so it’s just this continuing negative Nancy in your head. And so we give ourselves the self stigma where it’s almost turning into a double depression. So I don’t know if you guys have that or not, but like when you’re depressed, you’re like, oh crud, like why am I depressed? I shouldn’t be depressed right now. You get depressed about being depressed. Gabe Howard: Yeah, guilt. Brett Francis: I get anxiety about having anxiety. I’m like, why am I anxious right now? And then I start to overthink like why am I just anxious? So it’s anxiety about having anxiety depression or having depression. And it’s really this spiral. If you don’t stop it, it can get out of hand really really fast with that self stigma. So we give ourselves anxiety about having everything or it’s just a double negative. And so that’s a really big role that that my anxiety tried to play in my own mental health is it’s tried to give me anxiety about being anxious or feeling depressed about being depressed. And it just really gets us nowhere. And so we also undervalue the self care in that as well. So we forget to take care of our minds and our bodies while we’re going through that. Vincent M. Wales: Yeah, sounds about right to me. Gabe Howard: Not wrong at all. Vincent M. Wales: Now that you’ve mentioned self care… There are misconceptions about self care out there. Self care, emotional well-being, all of these things. Can you talk about some of those misconceptions? Brett Francis: I think one of the biggest misconceptions about self care is that it’s selfish. We hear this, you can’t take care of somebody to the best of your ability until you’re taken care of. I mean, why do you think when you go on a plane, the safety demonstration says put your own air mask on first and then help others. So when you are breathing properly your brain is more clear and therefore you can help other people put their mask on, such as children, other people that may need help, somebody that you’re with. But as soon as you have that breath of air and you get that oxygen flowing in into your body, you’re thinking more clearly because you’re taken care of. So that’s exactly the same reason why they tell you to put that mask on first for yourself and then help others. Because if we don’t take care of ourselves, we can’t give others our everything. We can’t take care of our spouses, our children, our friends, and be there for them as much as we could be with our own self care, so we’re giving ourselves or I guess losing not only to self care and all of its benefits but we’re also losing possible potential to be something more to somebody else that we love. Another common misconception would be that, I don’t need self care. I’m good. Everybody needs self care. People with or without mental illness. People with mental illness. We have to find out really what we’re. I mean the value money everybody. No one will be that it’s an on that important one. Another one would be that it’s not that important. Well it really is. And then the one along with selfish is that people think I need to take care of everybody else first and then I can take care of me. And then the last one I guess that I think is most common is that it takes a lot of time. Well no it actually doesn’t. You know talking about meditation, you can do that twice a day for 10 minutes. It’s literally the amount of time that you would spend going and freshening up and brushing your hair or something. So you go and you brush your hair. So instead of going to brush your hair or maybe you need to brush your hair, too, spend five minutes just meditating and breathing, people really think that it takes, oh I’ve got to invest three hours a day into going to the gym, eating right, all this stuff. And so people get very overwhelmed because they’re like, oh I have to start with three hours of self care in order get anywhere. It can start with like five minutes a day. So people really have that big misconception, as well. That’s how I felt, initially when I started reading self help books. After my miscarriage and my depression and suicide attempt, I started reading books. And I went, boy do I have a lot to do. Like, if I want to turn my life around, holy man, like am I ever gonna get there? And sometimes I still feel like that. I’ll go to see my counselor and I’ll be like, oh boy, I just wrote down 18 things that I think that I have to do. And so I’ll take that back to my counselor next time and she’ll be like, Brett, what are you doing? Like, these are not 18 things you have to do. The stuff we talked about is the things you need to check off your list and improve on yourself. There are things where we can eventually get to. Like, that doesn’t need to happen right now. And I’m like, well I’ve got a plan. And she’s like, that’s going to take you like half a working day to get them today. And I”m like, OK. Right. So let’s do the five or ten minute thing. Right. So we all I think do that when you get overwhelmed like, holy man, do I ever have a lot to work on before my mental health improves. Or do I ever have a lot to work on before I lose weight. And people just think that it’s going to be this long, drawn out, tedious task and it’s really not. Vincent M. Wales: You’re absolutely right. Gabe Howard: Makes sense completely. Brett, the time just flies by. Before we close out the show, can you tell folks where we can find you? Brett Francis: They can go to my website at mentalhealthspeaks.com. I’m also on Facebook and Twitter, handle would be @brettspeaksnow. Gabe Howard: Brett, thank you so much you were a great guest. We look forward to having you on the show again. It was absolutely wonderful. Thank you for being here. Brett Francis: Thank you so much for having you guys and also for sharing your own personal lives with me. Gabe Howard: You’re very welcome and thank you everyone for tuning in. And remember, you can get one week of free, convenient, affordable, private, online counselling anytime, anywhere just by visiting betterhelp.com/psychcentral. We will see everybody next week. Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email talkback@psychcentral.com. About The Psych Central Show Podcast Hosts Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. 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. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com. View the full article
  6. Phobiasupportforum

    8 Health Risks of Untreated Depression

    Medication side-effects can seem unbearable at times: dry mouth, nausea, dizziness, constipation. Certain prescriptions can also increase our risks for developing chronic conditions like thyroid disease and diabetes. Three years ago, I decided that the pills’ side-effects weren’t worth the relief they brought, so I slowly weaned off all my medication. I then plummeted into a severe depression that ended up taking a far greater toll on my health than the nuisance of my drugs. You may be justifiably concerned about how your mood stabilizer and antidepressant are altering your biochemistry, but also consider the grave consequences of untreated depression. A 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses, and conditions of the nervous system. In other words, the side-effects of untreated depression are more threatening than those of our meds. Here are eight health risks of untreated depression: 1. Cognitive Decline Left untreated, major depressive disorder (MDD) literally changes your brain. A study published online in The Lancet Psychiatry measured brain inflammation in 25 people with more than a decade of MDD and 30 people without depression. The depressed group had inflammation levels of approximately 30 percent higher in certain brain regions including the prefrontal cortex, responsible for reasoning, concentration, and other executive functions. Given this data, researchers argue that depression is not unlike other degenerative disorders, like Alzheimer’s, that are progressive if not treated. 2. Diabetes Depression is associated with a significantly increased risk for diabetes. In a meta-analysis of 23 studies published in the Journal of Clinical Psychiatry, there was a higher incidence of diabetes in the depressed participants (72 percent) versus the non-depressed subjects (47 percent). Researchers speculate that the underlying cause for the elevated risks lies in the challenge for depressed persons to adopt and maintain healthy lifestyle behaviors such as exercising and eating right, causing higher cortisol levels and inflammation. 3. Chronic Pain In a study published in Dialogues in Clinical Neuroscience, 69 percent of persons who met the criteria for depression consulted a doctor for aches and pains. Mood disorders can show up in surprising symptoms — like bloating, backaches, or joint pain. According to a one review in Pain Research and Treatment, there is compelling evidence to link fibromyalgia and depression. They co-occur and share a similar pathophysiology and pharmacological treatments. Approximately 40 percent of persons with fibromyalgia experience depressive symptoms. According to the abstract, “these similarities support the concept that depression and fibromyalgia are differential symptom presentations of a single underlying condition.” 4. Heart Disease The connection between heart disease and depression is well established. Depression and anxiety affect heart rhythms, increase blood pressure, elevate insulin and cholesterol levels, and raise levels of stress hormones. According to the National Institute of Mental Health, three in 20 Americans with heart disease experience depression compared to the one in 20 average of people without heart disease. A study published in the journal Circulation found that people with heart failure who are moderately or severely depressed have four times the risk for early death and double the risk for being hospitalized, compared to those who are not depressed. Just as persons with coronary heart disease are at risk for depression, those with depression are at risk for coronary heart disease. In a study published in the Archives of Internal Medicine, for example, the men who reported clinical depression were at significantly greater risk for subsequent coronary heart disease and myocardial infarction even 10 years after the onset of the first depressive episode. 5. Autoimmune Disorders Depression and autoimmune disorders share the common denominators of inflammation and stress. According to a review in Nature Reviews Immunology, “patients with major depressive disorder exhibit all the cardinal features of an inflammatory response, including increased expression of pro-inflammatory cytokines and their receptors and increased levels of acute-phase reactants.” Inflammation in the body impacts every biological system, including our immune system, increasing our risk for developing autoimmune disorders. Because of this shared inflammation, depression and autoimmune disease are beginning to share the same treatments protocols. 6. Gastrointestinal Problems People with depression often report stomach or digestion problems, such as diarrhea, vomiting, nausea, or constipation. Some people with depression also have chronic conditions, including IBS. According to research published in 2016, this may be because depression changes the brain’s response to stress by suppressing activity in the hypothalamus, pituitary gland, and adrenal glands. According to the review, there are significant associations between GI symptoms and abnormally low cortisol levels post a low dose dexamethasone suppression test (DST). In plain speech, this means depression affects a range of organs and glands that help us to absorb and digest food. Depressive symptoms interrupt their progress and cause discomfort and potentially significant disorders. 7. Osteoporosis and Lower Bone Density According to research from Harvard University of Jerusalem, depressed people have a substantially lower bone density than non-depressed people and depression is associated with an elevated activity of cells that breakdown bone (osteoclasts). This association was stronger in women than men, and especially in younger women during the end of their period. According to Harvard Women’s Health Watch, depression is a risk factor for osteoporosis. Researchers found that depression triggers the release of noradrenaline, which interferes with bone-building cells. 8. Migraines Migraine and depression happen together. According to a study published in the International Review of Psychiatry, patients with migraine are two to four times more likely to develop lifetime major depressive disorder, due to similar underlying pathophysiological and genetic mechanisms. And people who leave their depression untreated increase their risk of going from episodic migraines (fewer than 15 per month) to chronic (more than 15 a month). Having one puts you at a higher risk for the other. Because low serotonin levels have been linked to both conditions and SSRIs and tricylics are used to treat both disorders, some researchers hypothesize that the link between migraine and depression lies with a person’s inability to produce serotonin and other neurotransmitters. View the full article
  7. Phobiasupportforum

    When Your Teen is Struggling with Anxiety

    Since she was 10 years old, Sophie Riegel felt like something was off. “My friends all seemed so carefree. And I had the weight of the world holding me down.” Riegel writes these words in her beautiful, invaluable new book, Don’t Tell Me to Relax: One Teens’ Journey to Survive Anxiety (And How You Can Too). Shortly after, in middle school, Riegel was diagnosed with obsessive-compulsive disorder (OCD), trichotillomania, generalized anxiety disorder and panic disorder. As a parent, you also think that something is off with your teen. They haven’t said anything, but you can feel the difference in their demeanor or behavior. Maybe your teen has become more avoidant, and refuses to participate in activities they usually enjoy. Maybe they’re having stomach pain, nausea, headaches and/or heart palpitations, which aren’t related to a medical issue. According to OCD and anxiety specialist Natasha Daniels, LCSW, these could be signs that your teen is struggling with anxiety.* Maybe your teen has told you directly that they’re struggling. Either way, you’re not sure what to do. These tips can help. Don’t be dismissive. When trying to support your teen, you might unwittingly minimize and dismiss their struggles, which can create distance and disconnection. “When we as parents try to normalize a teen’s anxiety, they may get the message that we don’t understand. This can shut down any further openness about their true struggles,” said Daniels, author of Anxiety Sucks: A Teen Survival Guide. In Don’t Tell Me to Relax, Riegel (and her mom) share examples of what not to say to your teen: “Maybe this is just a phase.” “Just smile” (“This is the equivalent of telling someone who just got shot to put on a bandage.”) “In a few days, you won’t even remember this.” “You always get over this. You are fine.” “You just need to get out more. Maybe if you exercise more, you will feel better.” “You are overreacting.” “Do you know how bad you make me feel when you won’t talk to me?” “There is nothing to worry about.” “That doesn’t make any sense.” “Relax.” Daniels stressed the importance of validating your teen’s experience and empathizing with how hard it must be. Below are examples of what is helpful to say from Riegel’s book: “Is there something that I am doing that is contributing to your feeling this way?” (“This is a great alternative to ‘What am I doing wrong? I didn’t raise you to be mentally ill,’ or ‘Why are you so screwed up? Was it something I did?’”) “I’m here for you.” “I don’t understand what you are going through, but I would love to hear how you are feeling. Maybe we could learn about this together.” Empower your teen to problem solve. Perspective is key in helping teens reduce their anxiety (and knowing how to problem solve is a critical lifelong skill). But “instead of telling your teen why they should think differently, ask them questions like, ‘What’s the worst that can happen?’ and ‘If that happened what could you do?’” said Daniels. She noted that this is important to do when your child isn’t in a state of panic. Share valuable resources. Let your teen know that there are many ways to effectively navigate and reduce their anxiety. This includes seeing a therapist, attending group therapy, taking online courses and reading books about anxiety, Daniels said. In addition to Anxiety Sucks, she recommended Lisa Schab’s The Anxiety Workbook for Teens. Daniels offers an online class for teens (and adults) with social anxiety called Crush Social Anxiety. She noted that CBT School by Kimberley Quinlan also is a great resource. Involve your teen in the decision-making process. “If you make all the decisions for [your teen] or force them to seek help, they’ll be closed off and resentful,” Daniels said. “And even the best therapist will have a hard time making progress with an angry teen.” A better approach, she said, is to tell your teen that it’s critical to “build their skills and get help in some capacity.” Then “offer them several books, several classes and several therapists and have them choose which will work best for them.” Today, Riegel is a high school senior. She still experiences anxiety before taking a test, speaking and doing interviews, but it’s not as debilitating. Her panic attacks also have decreased. When her anxiety is at its peak, she can’t feel her legs, and therefore can’t walk. She feels like she’s “in a fog,” and her “mind goes blank.” Her hands “go numb,” and her “tongue feels like it’s swelling,” which makes her slur her words. However, the difference is that now she knows what to do. Riegel has “an amazing support system,” which includes her parents and twin brother. She attends therapy several times a month. She takes medication and regularly checks in with her psychiatrist. She works out, and cares for her rescue dog, Nash—which has been especially transformative. “Getting Nash changed my life. Having her near me keeps me grounded. [Caring for her] is a responsibility that I take very seriously and makes me realize that my worries aren’t my biggest priority. Nash and I walk together when I feel anxious. She cuddles up next to me when I panic, reminding me that I am not alone. Nash doesn’t let me ruminate or obsess, as she is always distracting me with her needs.” When Riegel was in middle school, she gave a presentation about OCD to her class because she wanted mental illness to be taken seriously. “But it only made things worse. I was still bullied, and my mental health started to deteriorate.” However, years later, a fellow student reached out to Riegel to tell her that because of that presentation, she started going to therapy. This helped Riegel realize that being open about her mental illness could help others feel less alone and seek help, which inspired her to write her book. “I am living, breathing proof that it is possible to have an anxiety disorder and be successful,” Riegel said. “I am successful not despite having a mental illness, but because of it.” Riegel uses her anxiety as fuel to accomplish her goals. She’s a straight-A student, All-American athlete, and the president of the board of directors of Here.Now., a Jewish mental health advocacy organization. She’s attending Duke University in the fall. Riegel said that her anxiety has made her a much better listener and friend. She’s learned what helps her when she’s feeling anxious, and she tries to do the same for others. Riegel understands that her anxiety doesn’t define her, but “it is important. Without my mental illness, I wouldn’t be who I am today. If I could go back in time and prevent my mental illness, I wouldn’t.” Help your teen learn to manage their anxiety and channel it. Teach them to empower themselves. They’ll be better for it. *These are other signs of anxiety in teens. View the full article
  8. Approximately 25 percent of patients with major depressive disorder (MDD) experience a recurrent depressive episode while on an adequate maintenance dose of antidepressant medications, according to a 2014 metanalysis published in Innovations in Clinical Neuroscience. The clinical term for this medication poop-out or antidepressant tolerance is antidepressant treatment (ADT) tachyphylaxis. While psychiatrists and neuroscientists don’t know exactly why this happens, it could be due to a tolerance effect from chronic exposure to a medication. I address this topic because I have experienced antidepressant poop-outs myself, but also because I often hear this concern from persons in my depression communities: What do I do when my antidepressant stops working? The following strategies are a blend of clinical suggestions from the metanalysis mentioned above and other medical reports I’ve read, as well as my own insights on recovering from a relapse. 1. Consider all reasons for your relapse. It’s logical to blame the return of your depressive symptoms on the ineffectiveness of a drug; however, I would also consider all other potential reasons for a relapse. Are you in the midst of any life changes? Are your hormones in flux (perimenopause or menopause)? Are you experiencing loss of any kind? Are you under increased stress?Did you just start therapy or any kind of introspective exercise? I say this because I experienced a relapse recently when I starting intensive psychotherapy. While I am confident it will lead to long-term emotional resiliency, our initial sessions triggered all kinds of anxiety and sadness. I was tempted initially to blame the crying and emotional outbursts on ineffective medication, but soon realized that my pills had nothing to do with the pain. Watch out especially for increased levels of stress, which will commonly drive symptoms. 2. Rule out other medical conditions. Another medical condition can complicate your response to medications or contribute to a worsening mood. Some conditions that are associated with depression include: vitamin D deficiency, hypothyroidism, low blood sugar, dehydration, diabetes, dementia, hypertension, low testosterone, sleep apnea, asthma, arthritis, Parkinson’s disease, heart disease, stroke, and multiple sclerosis. Get a thorough check up with a primary care physician to rule out any underlying condition. Make sure to test for a MTHFR gene mutation, how you process folate, which can definitely affect antidepressant results. If you experience any elevation of mood with your symptoms of depression, be sure to discuss those with your doctor. More than half of people with bipolar disorder are misdiagnosed as clinically depressed and don’t receive the proper treatment they need, including a mood stabilizer. 3. Take your medication as prescribed. Before I list some of the clinical suggestions, it’s worth mentioning that many people don’t take their medication as prescribed. I would like to plead innocent here, however, I acknowledge that there are too many evenings when I forget to take my pills. ccording to a 2016 review in the World Journal of Psychiatry, about half of the patients diagnosed with bipolar disorder become non-adherent during long-term treatment, a rate similar to other chronic illnesses. Some psychiatrists assert that the real problem isn’t so much the effectiveness of medications as much as it is getting patients to take medications as prescribed. Before switching up your medication, ask yourself: Am I really taking my meds as prescribed? 4. Increase the current antidepressant dose. Increasing the dose of an antidepressant is a logical next course of action if you and your doctor determine that your relapse has more to do with a medication poop-out than anything else. Many patients take too little medication for too short period of time to achieve a response that can last. In a 2002 review in Psychotherapy and Psychosomatic, doubling the dose of Prozac (fluoxetine) from 20 to 40mg daily was effective in 57 percent of patients, and doubling the 90mg from once weekly to twice weekly was effective in 72 percent of patients. 5. Experiment with a drug holiday or lowering the antidepressant dose. Since some medication poop outs are a result of a tolerance built up from chronic exposure, the metanalysis recommends a drug holiday among its strategies for tachyphylaxis, however this needs to be done very carefully and under close observation. In some patients where the symptoms are severe, this is not a feasible option. The length is of a drug holiday varies, however the minimum interval required to restore receptor sensitivity is typically three to four weeks. This all seems counterintuitive, however, in some studies, like the one by Byrne and Rothschild published in Clinical Journal of Psychology, decreasing the dosage of an antidepressant led to positive results. 6. Change your drug. Your doctor might want to switch medications, either to another drug in the same class or to another class. You may need to try several medications to find one that works for you, according to the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study, the largest and longest study ever conducted to evaluate depression funded by the National Institute of Mental Health (NIMH). If the first choice of medication does not provide adequate symptom relief, switching to a new drug is effective about 25 percent of the time. It might make sense to introduce a drug that has an entirely different mechanism of action in order to regain the response blunted by the drug tolerance of the one you’re on. The transition between meds needs to be handled carefully. Typically it’s better to introduce the new drug while tapering off the old, not to quit it abruptly. 7. Add an augmentation drug. According to the STAR*D study, only one in three patients in the first sequence of monotherapy (that is, taking one drug) achieved remission. Meta-analyses of antidepressant trials of nonchronic patients with major depressive disorder report remission rates of 30 to 45 percent on monotherapy alone. Augmentation drugs considered include dopaminergic agonists (i.e. bupropion), tricyclic antidepressants, buspirone, mood stabilizers (lithium and lamotrigine), antipsychotic medications, SAMe or methylfolate, and thyroid supplementation. According to STAR*D, adding a new drug while continuing to take the first medication is effective in about one-third of people. 8. Try psychotherapy. According to a 2013 Canadian Psychology Association report, mild to moderate depression can respond to psychotherapy alone, without medication. They found that psychotherapy is as effective as medication in treating some kinds of depression and is more effective than medication in preventing relapse in some cases. Also, for some patients, the combination of psychotherapy and medication was more beneficial than either treatment on its own. According to a study published in the Archives of General Psychiatry, adding cognitive therapy to medication for bipolar disorder reduced relapse rates. This study examined 103 patients with bipolar 1 disorder who, despite taking a mood stabilizer, experienced frequent relapses. During a 12-month period, the group receiving cognitive therapy had significantly fewer bipolar episodes and reported less mood symptoms on the monthly mood questionnaires. They also had less fluctuation in manic symptoms. It’s normal to panic in the days and weeks your symptoms return; however, as you can see, there are many options to pursue. If the first approach doesn’t work, try another. Persevere until you achieve full remission and feel like yourself again. It will happen. Trust me on that. View the full article
  9. Phobiasupportforum

    How Hard Should You Try with Depression?

    With depression we are told to “fake it til we make it,” to “act as if,” to go through the motions until we can feel again. But what if doing so sabotages your health? What if you push yourself straight into a wall of debilitating symptoms? Conversely, what if efforts to baby yourself keep you where you are? This issue of knowing when to push yourself and when to coddle is undoubtedly one of the most challenging aspects of recovery from depression. I ask myself this question a few times a day. When trying too hard backfires. It turns out that trying too hard to reverse depressive ruminations can definitely backfire. A study published in August 2007 in The Journal of Neuroscience showed that there was a breakdown in normal patterns of emotional processing that prevented depressed and anxious people from suppressing negative emotions. In fact, the more they tried, the more they activated the fear center of their brain — the amygdala — which fed them more negative messages. In the study, researchers examined depressed and non-depressed adults. Participants were asked to view a series of emotionally positive and negative images and then specify their reaction to each one. After the presentation of each picture, participants were asked to either increase their emotional response, to decrease it, or simply to continue watching the image. The results showed distinctive patterns of activity in the ventromedial prefrontal cortex (vmPFC) and the right prefrontal cortex (PFC), areas that regulate the emotional output generated from the amygdala. It’s much like exercise. While regular and moderate exercise can boost longevity, cardiovascular health, and mood, long-term endurance exercise and working out too hard can actually harm our health. What are your pressure points? In pushing ourselves with depression, we need always be mindful of our pressure points, or vulnerabilities. For example, I know that when I work more than 50 hours a week for more than a month, my mood becomes fragile and the self-loathing tapes return. Stress is the ultimate pressure point. It compromises almost every biological system in our bodies. So when deciding if you should push harder or not, evaluate your stress levels and the pressure points triggered (fragility and self-loathing, in my case). Rather than quitting or taking six months of medical leave, I first start with scaling back my hours. You might look for a compromise in your situation, a temporary arrangement that allows you to remain active while giving you the time and care you need. Why flexibility is key. Some days you may have the energy and determination to complete your responsibilities as if you don’t have symptoms. And other days you can hardly get out of bed. What’s really difficult is that you don’t know which day you’re getting until you open your eyes. That’s why it is really critical to be as flexible as you can, knowing that even though pushing made sense yesterday it might not today. Trust yourself as much as possible. Don’t force progress if it doesn’t feel right. Instead, step aside and enjoy the view until you can get back into the race. A cold or the flu? Several months ago I attended a mental health conference. I was tempted to cancel, as I was having severe symptoms of depression. Even though I couldn’t quiet my ruminations, I made myself participate and found that the interaction with other people helped me. However, in the hotel room afterward, my symptoms returned. I couldn’t stop crying. I went to the airport seven hours early, hoping to catch an earlier flight. During the cab ride there, I beat myself up mercilessly for not being able to enjoy a new city. Shouldn’t this be a time when I push myself? As soon as I arrived at the terminal I started to feel physically sick, with flu symptoms. Suddenly the self-bashing stopped, and I was able to be gentle with myself. I then thought about the trying harder versus coddling dilemma. When I have a cold, I push through and go to work. When I’m sick with the flu, I stay in bed and rest. Might it be the same with depression? Once we assess the severity of our symptoms we can determine if we have a cold or the flu. In everything, self-compassion. Self-compassion should be the ultimate compass behind your decision to call in sick or press on. In all situations, ask yourself, “What is the kinder act?” For example, some days self-compassion for me means swimming for an hour and other days it means going to the woods to have a good cry. Being kind to yourself can mean tackling the first item on your to-do list, or it could mean slashing that list in half. Self-compassion is most challenging for me when I decide to rest because I undoubtedly start to obsess about copping out and giving in. That’s when you need to be extra compassionate and remind yourself that you have the flu. Unfortunately, there’s no set rule on when to try harder and when to go easy with depression. Each situation requires careful discernment, assessing the severity of our symptoms. Sometimes faking it and pushing through delivers us to a better place. Other times trying too hard sabotages our health. One thing is for sure, though. We need always treat ourselves with kindness and compassion. View the full article
  10. In a new pilot study, autistic adults showed real-life, functional improvement after a combination treatment approach that included graded exposure to fear and anxiety-producing experiences in a virtual reality environment. View the full article
  11. Last week a committee of the U.S. Food and Drug Administration (FDA) recommended in a 14-2 vote that the agency approve the use of a nasal spray form of esketamine (a specific type of ketamine) for the treatment of treatment-resistant depression and certain other types of depression. Treatment-resistant depression is when clinical depression fails to respond to multiple (at least two) attempts to treat it with at least two different types of medications or psychotherapy over the course of a year or longer. If the FDA ends up approving the drug — and we believe it will — the nasal spray will offer new hope for people with depression. Ketamine has more recently been prescribed off-label for the treatment of depression at high-priced “ketamine clinics.” Such clinics regularly charge people $650 – $1,200 per treatment, with most people needing six to eight treatments to get started. Most insurance won’t cover the cost of this treatment, since depression is not a condition that ketamine is currently approved to treat. The Good News The new drug is named Spravato, an intranasal form of esketamine, and is made by Janssen, a division of Johnson & Johnson. Eventual FDA approval of this type of ketamine treatment would make such treatment far more affordable to more people. The committee determined that Spravato has a favorable benefit-risk profile, after analyzing the safety and efficacy data from five different research studies conducted in patients with treatment-resistant depression. The research showed that esketamine delivered through a nasal spray, alongside a traditional oral antidepressant, provided statistically significant improvement of symptoms associated with depression. Historically the FDA rarely goes against the advice of its Psychopharmacologic Drug Advisory Committee. A source within the FDA has suggested to me that the FDA will approve the drug for these specific conditions. The FDA fast-tracked approval of this drug, because it is already approved for use for other medical needs as an anesthetic. Therefore, its safety profile is also well understood. The FDA calls this fast-track process a “breakthrough therapy” designation. The FDA committee has also approved Spravato for the indication of major depressive disorder in people who are at an imminent risk for suicide. The Bad News In its typically paternalistic manner, the FDA committee didn’t think patients could be entrusted to take the drug as directed on their own. One of the side effects after administration of Spravato is dissociation and sedation. Obviously you wouldn’t want someone to take a dose of this drug, and then go and operate heavy machinery. So the committee is recommending that the FDA not let patients take the nasal spray at home, according to Vantage: The agency has proposed a risk-evaluation and mitigation strategy that requires self-administration in a healthcare facility that can monitor patients for two hours, until dissociative and sedation side effects have subsided, as well as a patient registry that could help characterize the project’s risk. That means for every treatment, patients are still going to need to make an appointment with their medication provider and hang around the office (?) for two hours (??!) after they’ve taken the drug. This is a weird recommendation and could dampen people’s desire to give the drug a try. I hope the final FDA approval makes the program more flexible and takes into consideration the diverse set of people who suffer from depression, since these requirements would impact low-income people the most. But this is in keeping with how ketamine clinics currently operate. There, ketamine is delivered as an intravenous infusion (IV) directly into the blood stream. Patient get the infusion, then they need to stick around for approximately an hour to ensure they can be monitored for negative side effects. Infusions also allow the drug to bypass processing by the liver and other organs. Intranasal sprays allow for the same kind of bypass, making it easier to offer the drug at lower doses while maintaining its efficacy. Additionally, because no IV is needed, it is expected that Spravato will be offered at a more affordable price than current ketamine treatments for depression do. I hope Janssen prices this drug affordably enough that most ordinary Americans can have access to it. Today, most Americans cannot afford the price of admission at ketamine clinics. I also urge health insurance companies to immediately approve coverage of this drug on all of their offered health plans for the specific approved conditions, because it may be a game-changer in terms of helping people feel better from severe depressive symptoms. The FDA is set to make its decision by March 4, 2019. We hope the agency does right by the million+ Americans who suffer from treatment-resistant and other kinds of difficult depression. We also hope that the agency minimizes treatment barriers — such as requiring a doctor’s office visit — to obtain this important treatment for depression. For more information From Vantage: Esketamine floats past adcom vote From The Pharma Letter: J&J nasal spray set to win first approval in ketamine-based depression research View the full article
  12. Phobiasupportforum

    Psychology Around the Net: February 16, 2019

    Are you ready to get all the latest on whether or not talking to bots is good for your mental health, how your occupation can affect how effective your depression treatments are, and the difference between shameful secrets and guilty secrets (and which ones hurt us more)? We hope so, because we have all that and more in this week’s Psychology Around the Net! Can Talking to a Bot Help You Feel Better? Maybe…but at what cost? Says psychologist and MIT professor Sherry Turkle: “We expect more from technology and less from each other. Technology appeals to us most where we are most vulnerable. We’re lonely but we are afraid of intimacy. We are designing technologies that will give us the illusion of companionship without the demands of friendship […] We have come to a point where we are willing to talk to machines about our problems — I call this the robotic moment. But it is odd to celebrate this as an achievement. Because in these exchanges, no one is listening to us. What kind of achievement is this? I think it is a sad landmark.” How to Get Motivated to Work on Your Sex Life: When you and your partner hit a rut, sometimes it’s easier to ignore the rut (and hope it resolves itself on its own) than to work on the problem. Or, sometimes you wait so long to admit you’ve hit rut (or wait so long to address the issue) that enough time has passed you actually feel uncomfortable approaching it — or even thinking about it. Use this little how-to guide to help you not only get motivated to work on your self life, but also actually start working on your sex life. Self-Care & Earth-Care Collide In These 3 Simple Rituals: Self-care has always been important, but it’s finally getting the attention it needs these days. Now, you can combines your self-care rituals with earth-care practices so we all win. Does ASMR Affect Mental Health? Here’s What the Research Shows: ASMR (short for Autonomous Sensory Meridian Response) is defined in a recent study as “the sensation experienced by some people in response to specific sights and sounds, described as a warm, tingling and pleasant sensation starting at the crown of the head and spreading down the body […] typically accompanied by feelings of calm and relaxation,” is a relatively new area of exploration, and not experienced by everyone. However, growing (though still limited) research and professional opinions believe even those who don’t automatically experience the full effects of ASMR can still enjoy its benefits such as reduced anxiety and depression symptoms and better sleep. High Occupational Status Linked to Poor Response to Depression Treatment: A new study provides research that provides additional evidence that the type of employment we have is associated with the outcome of our depression treatments; specifically, people who struggle with depression and have higher positions at work often respond less well to depression treatments. Psychologists Believe Shameful Secrets Worry Us More Than Guilty Secrets: According to Columbia University’s Dr. Michael L. Slepian, the lead author of what’s thought to be the first study diving into how the emotions that motivate us to keep secrets change our experience of the secrecy: “Almost everyone keeps secrets, and they may be harmful to our well-being, our relationships and our health […] How secrecy brings such harm, however, is highly understudied.” The study focuses on shame and guilt because they are “the two most highly studied self-conscious emotions” and “center on the self,” unlike other basic emotions such as fear and anger which generally relate to something outside of ourselves. View the full article
  13. Phobiasupportforum

    Unwanted Thoughts? Don’t Try to Suppress Them

    We all do it. We try to wish our thoughts away. When our mind turns to a stressful work situation, a craving for a cigarette, or a fantasy we shouldn’t be having, we immediately try to remove the thought from the gray matter of our brains. We start a random conversation with the person next to us, we concentrate harder on a work assignment, or we put our index fingers in our ears, and sing, “La la la la, I can’t hear you!” Consider every long song you hear on the radio. How many begin or end with the lyrics, “I can’t get you out of mind”? The human brain is conditioned to obsess — its negative bias makes us worry and fret. Despite our valiant efforts to shift our thoughts, they follow us into the shower and to work meetings. The Untamed Thought It’s time to accept the good/bad news: Thought suppression doesn’t work. The harder you try to eliminate something from your mind, the more likely it will stalk you. A 1943 study published in the Social Science Research Council Bulletin, for example, found that people instructed to avoid making color associations with stimulus words were unable to stop the associations, even when threatened with shock for doing so. More recently, Gordan Logan and Carol Barber published a study in the Bulletin of the Psychonomic Society, detailing an experiment to determine whether a stop-signal procedure is sensitive enough to detect the presence of inhibited thoughts. Their results showed that the stop-signal can, in fact, pick up on inhibited thoughts, even when a person is immersed in a complex task. The White Bear Study By far the most famous and fascinating study on thought suppression was the one led by Daniel Wegner in 1987, published in the Journal of Personality & Social Psychology. Wegner, a social psychologist, wanted to test a quote he came across in Fyodor Dostoevsky’s “Winter Notes on Summer Suppression,” which said, “Try to pose for yourself this task: not to think of a polar bear, and you will see that the cursed thing will come to mind every minute.” Wegner conducted an experiment where he asked participants to verbalize their stream of consciousness for five minutes, while not thinking of a white bear. Every time a white bear popped into their thoughts, they were to ring a bell. How many times did the participants ring a bell? On average more than once per minute. That’s a lot of bears. They then did the same exercise but were asked to think of a white bear. Interestingly enough the group that was originally told not to think of a white bear had far more white-bear thoughts than the group that was never given the first instructions. Apparently the act of suppressing the thought in the first exercise stimulated the brains of the folks in the first group to think of white bears even more often. Strategies for Unwanted Thoughts From that study, Wegner went on to develop his theory of “ironic processes” that explains why it’s so hard to tame unwanted thoughts. He conceded that when we try not to think of something, part of our brain cooperates while the other part ensures the thought won’t surface, thereby causing the thought to be even more prominent. While presenting his theory to audiences across the country, people would ask him, “Then what do we do?” In response, he compiled a few strategies to tame unwanted thoughts. Among them: Choose a distractor and focus on that. If you’re given two things to think about, your concentration is fractured, and will give your brain a small break from focusing on the unwanted thought. For example, think of a white bear and a zebra at the same time and see what happens. Postpone the thought. Set aside an “obsession time,” whereby you allow yourself to think about the forbidden thought all you want. Theoretically, this frees up your other minutes. I found the strategy helpful for mild-to-moderate ruminations, but not with severe. Cut back on multitasking. Studies consistently show that multitaskers make more mistakes. However, Wegner asserts that multitasking also leads to more unwanted thoughts. More specifically, his studies show that an increased mental load increases thoughts of death. Think about it. Like the “postpone the thought” strategy, this is a form of exposure therapy where you allow yourself to face your fear in a controlled way. According to Wegner, when you allow yourself the freedom to think the thought, your brain doesn’t feel obligated to check in on removing it, and therefore doesn’t send it to your consciousness. Meditation and mindfulness. Whenever possible stay in the present moment, connect with your breath, and try to calm yourself. However, don’t make the white bear angry by forcing meditation and mindfulness. The next time a white bear or any other unwanted thought pops into your noggin, don’t fight it. Consider its soft fur, sharp claws, or clumsy run. Thought suppression doesn’t work. May this truth set you free. View the full article
  14. Phobiasupportforum

    12 Ways to Keep Going with Depression

    About once a week I hear the same question from a reader, “What keeps you going?” The short answer is lots of things. I use a variety of tools to persevere through my struggle with depression because what works on one day doesn’t the next. I have to break some hours into 15-minute intervals and simply put one foot in front of another, doing the thing that is right in front of me and nothing else. I write this post for the person who is experiencing debilitating symptoms of depression. The following are some things that help me fight for sanity and keep me going, when the gravity of my mood disorder threatens to stop all forward movement. Find a good doctor and therapist. I have tried to beat my depression without the help of mental health professionals and discovered just how life-threatening the illness can be. Not only do you need to get help, you need to get the RIGHT help. A reporter once referred to me as the Depression Goldilocks of Annapolis because I have seen practically all of the psychiatrists in my town. Call me picky, but I am glad I didn’t stop my search after the third or fourth or fifth physician because I did not get better until I found the right one at Johns Hopkins Mood Disorders Center. If you have a severe, complicated mood disorder, it is worth going to a teaching hospital to get a consultation. Be just as choosy with your therapist. I have sat on therapy couches on and off for 30 years, and while the cognitive behavioral exercises were helpful, I didn’t begin making real progress until I started working with my current therapist. Rely on your faith — or some higher power. When everything else has failed, my faith sustains me. In my hours of desperation, I will read from the Book of Psalms, listen to inspirational music, or simply yell at God. I look to the saints for courage and resolve since many of them have experienced dark nights of the soul — Teresa of Avila, John of the Cross, Mother Teresa. It is of great consolation to know that God knows each hair on my head and loves me unconditionally despite my imperfections, that He is with me in my anguish and confusion. A substantial amount of research points to the benefits of faith to mitigate symptoms of depression. In a 2013 study, for example, researchers at McLean Hospital in Belmont, Massachusetts, found that belief in God was associated with better treatment outcomes. Be kind and gentle with yourself. The stigma attached to depression is still, unfortunately, very thick. Maybe you have one or two people in your life who can offer you the kind of compassion that you deserve. However, until the general public offers persons with mood disorders the same compassion that is conferred on people with breast cancer or any other socially acceptable illness, it is your job to be kind and gentle with yourself. Instead of pushing yourself harder and telling yourself it’s all in your head, you need to speak to yourself as a sensitive, fragile child with a painful wound that is invisible to the world. You need to put your arms around her and love her. Most importantly, you need to believe her suffering and give it validation. In her book Self-Compassion, Kristin Neff, Ph.D., documents some of the research that demonstrates that self-compassion is a powerful way to achieve emotional well-being. Reduce your stress. You don’t want to give into your depression, I get that. You want to do everything on your to-do list and part of tomorrow’s. But pushing yourself is going to worsen your condition. Saying no to responsibilities because your symptoms are flaring up isn’t a defeat. It is act of empowerment. Stress mucks up all your biological systems, from your thyroid to your digestive tract, making you more vulnerable to mood swings. Rat studies show that stress reduces the brain’s ability to keep itself healthy. In particular, the hippocampus shrinks, impacting short-term memory and learning abilities. Try your best to minimize stress with deep-breathing exercises, muscle-relaxation meditations, and simply saying no to anything you don’t absolutely have to do. Get regular sleep. Businessman and author E. Joseph Cossman once said, “The best bridge between despair and hope is a good night’s sleep.” It is one of the most critical pieces to emotional resiliency. Practicing good sleep hygiene — going to bed at the same time at night and waking up at a regular hour — can be challenging for persons with depression because, according to J. Raymond DePaulo, Jr., M.D., co-director of the Johns Hopkins Mood Disorders Center, that’s when people often feel better. They want to stay up and write or listen to music or work. Do that too many nights, and your lack of sleep becomes the Brussels sprout on the floor of the produce aisle that you trip over. Before you know it, you’re on your back, incapable of doing much of anything. Although pleasing our circadian rhythm — our body’s internal clock — can feel really boring, remember that consistent, regular sleep is one of the strongest allies in the fight against depression. Serve others. Five years ago, I read Man’s Search for Meaning by Holocaust survivor and Austrian psychiatrist Viktor Frankl and was profoundly moved by his message that suffering has meaning, especially when we can turn our pain into service of others. Frankl’s “logotherapy” is based on the belief that human nature is motivated by the search for a life purpose. If we devote our time and energy toward finding and pursuing the ultimate meaning of our life, we are able to transcend some of our suffering. It doesn’t mean that we don’t feel it. However, the meaning holds our hurt in a context that gives us peace. His chapters expound on Friedrich Nietzsche’s words, “He who has a why can bear almost any how.” I have found this to be true in my life. When I turn my gaze outward, I see that suffering is universal, and that relieves some of the sting. The seeds of hope and healing are found in the shared experience of pain. Look backwards. Our perspective is, without doubt, skewed during a depressive episode. We view the world from a dark basement of human emotions, interpreting events through the lens of that experience. We are certain that we have always been depressed and are convinced that our future will be chock full of more misery. By looking backwards, I am reminded that my track record for getting through depressive episodes is 100 percent. Sometimes the symptoms didn’t wane for 18 months or more, but I did eventually make my way into the light. I call to mind all those times I persevered through difficulty and emerged to the other side. Sometimes I’ll take out old photos as proof that I wasn’t always sad and panicked. Take a moment to recall the moments that you are most proud of, where you triumphed over obstacles. Because you will do it again. And then again. Plan something fun. Filling my calendar with meaningful events forces me to move forward when I’m stuck in a negative groove. It can be as simple as having coffee with a friend or calling my sister. Maybe it’s signing up for a pottery or cooking class. If you’re feeling ambitious, plan an adventure that takes you out of your comfort zone. In May, I’m walking Camino de Santiago, or The Way of Saint James, a famous pilgrimage that stretches 778 kilometers from St. Jean Port de Pied in France to Santiago de Compostela in Spain. The anticipation of the trip has fueled me with energy and excitement during a hard stretch of my life. You need not backpack through Europe, of course, to keep moving forward. Organizing a day trip to a museum or some local art exhibit could serve the same purpose. Just be sure to have something on your calendar other than therapy and work meetings. Be in nature. According to Elaine Aron, Ph.D., in her bestseller The Highly Sensitive Person, approximately 15 to 20 percent of the population is easily overwhelmed by loud noises, crowds, smells, bright lights, and other stimulation. These types have rich interior lives, but tend to feel things very deeply and absorb people’s emotions. Many people who struggle with chronic depression are highly sensitive. They need a pacifier. Nature serves that purpose. The water and woods are mine. When I get overstimulated by this Chuck E. Cheese world of ours, I retreat to either the creek down the street or the hiking trail a few miles away. Among the gentle waves of the water or the strong oak trees in the woods, I touch ground and access a stillness that is needed to navigate difficult emotions. Even a few minutes a day provide a sense of calm that helps me to harness panic and depression when they arise. Connect with other warriors. Rarely can a person battle chronic depression on her own. She needs a tribe of fellow warriors on the frontline of sanity, remembering her that she is not alone and equipping her with insights with which to persevere. Five years ago, I felt very discouraged by the lack of understanding and compassion associated with depression so I created two forums: Group Beyond Blue on Facebook and Project Hope & Beyond. I have been humbled by the level of intimacy formed between members of the group. There is power in shared experience. There is hope and healing in knowing we are in this together. Laugh You may think there’s nothing funny about your depression or wanting to die. After all, this is a serious, life-threatening condition. However, if you can manage to add a dose of levity to your situation, you’ll find that humor is one of the most powerful tools to fight off hopelessness. G.K. Chesterton once said, “Angels can fly because they take themselves lightly.” That’s what laughter does. It lightens the burden of suffering. That’s why nurses use comedy skits in small group sessions in inpatient psychiatric units as part of their healing efforts. Humor forces some much-needed space between you and your pain, providing you a truer perspective of your struggle. Dance in the rain. Vivian Greene once said, “Life isn’t about waiting for the storm to pass, it’s about learning to dance in the rain.” When I was first diagnosed with depression, I was sure that the right medication or supplement or acupuncture session would cure my condition. Ten years ago, when nothing seemed to work, I shifted to a philosophy of managing my symptoms versus curing them. Although nothing substantial changed in my recovery, this new attitude made all the difference in the world. I was no longer stuck in the waiting room of my life. I was living to the fullest, as best I could. I was dancing in the rain. References Rosmarin, D.H., Bigda-Peyton, J.S., Kertz, S.J., Smith, N., Rauch, S.L., & Björgvinsson, T. (2013). A test of faith in God and treatment: The relationship of belief in God to psychiatric treatment outcomes. Journal of Affective Disorders, 146(3): 441-446. Retrieved from https://www.sciencedirect.com/science/article/pii/S016503271200599X Hildebrandt, S. (2012, February 6). How stress can cause depression [blog post]. Retrieved from http://sciencenordic.com/how-stress-can-cause-depression Frankl, V.E. (1959). Man’s Search for Meaning. Cutchogue, NY: Buccaneer Books. Aron, E. (1996). The Highly Sensitive Person. New York, NY: Carol Publishing. View the full article
  15.  We all know that addiction, severe depression, and other conditions change our personality. What few know, however, is just how deeply ingrained that change can be, and how difficult (and scary) it can be to try to become “ourselves” again. In this episode, we examine such changes through the experiences of our guest, who overcame depression and addiction, and now helps others do the same. Subscribe to Our Show! And Remember to Review Us! About Our Guest David Essel, MS, OM, is a number one best-selling author (10), counselor, master life coach, international speaker and minister whose mission is to positively affect 2 million people or more every day, in every area of life, regardless of their current circumstances. His latest #1 best seller, FOCUS! SLAY YOUR GOALS…THE PROVEN GUIDE TO HUGE SUCCESS, A POWERFUL ATTITUDE AND PROFOUND LOVE, was selected by the influential blog “FUPPING” as one of the top 25 books that will make you a better person! David’s work of 38 years is also highly endorsed by the late Wayne Dyer, “Chicken Soup for the Soul” author Mark Victor Hansen, as well as many other celebrities and radio and television networks from around the world. He is verified through Psychology Today as one of the top counselors and life coaches in the USA, and is verified through Marriage.com as one of the top relationship counselors and coaches in the world. David accepts new clients every week into his 1-on-1 programs from around the world at www.davidessel.com PSYCHOLOGICAL IDENTITY SHOW TRANSCRIPT Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you. Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health – with host Gabe Howard and co-host Vincent M. Wales. Gabe Howard: Hello everyone and welcome to this week’s episode of the Psych Central Show podcast. My name is Gabe Howard and with me as always is Vincent M. Wales. And today Vince and I will be talking with David Essel. David is a number one best selling author, counselor, master life coach, international speaker and minister whose mission it is to positively affect 2 million people or more every day in every area of life, regardless of their current circumstances. David, welcome to the show. David Essel: Oh gosh, it’s great to be with you, Gabe and Vince. Looking forward to our conversation today. Gabe Howard: This is wonderful. And just to clarify real quick before we get going… Two million people every day. David Essel: You know, we don’t believe in tiny goals, do we? Gabe Howard: No we don’t. Thank you so much for being here. Vincent M. Wales: That’s a lot of people. So let me ask you… you know there are an awful lot of people out there who do similar things to what you do. And you’ve been helping people for what 30 years? Something like that? That’s that’s a long time. What makes your story about your healing different from the others? David Essel: The reason in the world of personal growth and mental health addiction recovery and more… the reason why there are 700 million authors, basically, in this industry is the same reason why there’s so many authors in the auto repair industry, and you know personal growth industry in general is massive, but people need to hear different voices and I may be saying the same thing the late Wayne Dyer said and people, X percentage of people would grab Wayne’s words and change their lives and then there’s other people that may not connect and Wayne and I were very good friends when he was alive. And then there are people that may not quite connect with him but they might connect with the way that I talk or the way that I write or the videos we do, so I don’t know if it’s as much “What’s the big difference?” as we need to have different voices out there with different experiences. I know one of the advantages in the world of mental health that I have is that in my background I came from extreme alcoholism and cocaine addiction for years, which was caused or the underlying cause of many addictions is depression and an inability to deal with emotions in life. I went through a severe clinical depression, suicidal, to the point where that I had to get extreme medical care and you know all these things, guys, happened while I’m doing the same work I’m doing today. So not only is my energy different than a lot of other people that do the same work, the words I use might be a little different, but unlike some people that write about these topics that we’re going to talk about that have not experienced extreme mental illness or challenges or anything else, addiction, that I’ve gone through, I think that’s one of the advantages that I bring, too. Because I’ve been on those sides of the fence that are very daunting, extremely scary, and have come back and I think that’s an advantage that our work has that some other people may not be able to go that deep or as deep as we go because they’ve never personally experienced these things,which I don’t wish on anyone, but the end result is is that the empathy and compassion that I can have for people in the world struggling with mental health or addiction is is incredible because I was there. I’m very grateful for the work that I’ve done to remove myself from some of these challenges and also extremely interested in helping as many other people as we can work their way through this stuff. Vincent M. Wales: Fantastic. Gabe Howard: When we’re doing research for the show, one of the things that came up a few times that I thought was interesting is that you said it’s scary at first to heal from depression. And I wanted to know what you meant by that. Can you explain that a little more? David Essel: Well you know when we have some type of a mental health challenge like a depression, we create an identity around it and that that identity is very powerful. We… it’s scary to let go of something you’re comfortable with, even if it isn’t healthy. In other words, let’s say that, during the depression, we create an identity well when we talk to our loved ones or our family, it’s always based on how we’re not feeling that great today, how we don’t have the motivation to go to the gym, how we don’t don’t don’t don’t don’t. When you repeat those phrases either vocally to the outside world or in your head, over the course of months and years we create an identity. The identity says, this is who I am. I’m a depressed person. So to walk away from that identity and then not have people saying to you on a daily basis, Oh my gosh, I’m so sorry, this is such a hard day. Or, come on, we know you can move through this or have you tried this or have you tried that? When we’re doing all these things, thinking we’re helping the depressed person, we’re actually deepening their identity. We are… the compassion and empathy that I think we should all have in the beginning turns into this thing where the depressed person actually looks and will latch on to certain individuals who will also deepen their identity as a depressed person. So when I say it’s scary. it’s like. if we’ve been in a depressed state for a number of years. we don’t know what it’s like to live with a little bit of lightness. a little bit of inner peace. a little bit of joy. and while lightness. inner peace and joy. guys, sounds like three really great things… to the depressed person, it’s like moving to Afghanistan. We don’t know what it’s like. We don’t know the terrain. We don’t know the customs. We don’t know anything other than our identity as a depressed person. So that is frightening. And it’s the same thing with the world of addiction. You know, coming from a serious addiction background, myself, I didn’t know what it was like to go out to dinner without having drinks before I left my house. I didn’t know what it was like to go to sleep at night without multiple drinks to put me to sleep. So it’s scary to walk away from an identity that you’ve held on to for years and to walk into a new life. And that depressed person, of course, at the core wants to be happy and healthy, is so comfortable in their little zone that getting outside of it can seem unbelievably threatening. And we’ve worked with some people that, once they’ve overcome, quote unquote, their depression and started to feel better, missed all of the accolades of people saying, how are you today and we hope you’re getting better and have you tried this. Some people will slip back into the old identity just to get the attention. so it can be scary. Healing on any level can be scary for people that have long term identity based on some condition. Vincent M. Wales: We get comfortable, even if it’s something that should be uncomfortable. It’s familiar to us. So, you know, you’re right, it is hard to leave it. And that’s that’s pretty sad when you think about it. Gabe Howard: Well especially if it’s all you’ve ever known. Vincent M. Wales: Right. Gabe Howard: As longtime listeners know, I thought about suicide from a very young age. In fact, I don’t remember ever not thinking about suicide and I thought that everybody did. I thought that weighing the pros and cons of life and death was just like a normal thing to do because there’s no mental health education, nobody challenged this belief in me, and then of course that’s not OK. Eventually, I went to a psychiatric hospital, was diagnosed with bipolar disorder and I learned about mental health and mental illness and and that all got fixed. So that was wonderful except, here I am at 26 years old, and for the first time ever, it occurred to me that I could die. And I didn’t want to die. So that was a scary thing. And I just became ultra paranoid about everything. So even though this led to greater potential for my future and you know now I’m 42 and everything is wonderful. You know for a couple of years, it was just really hard. My entire identity was wrapped up in this way of thinking. I knew no other way to think. And it sounds like that’s what you’re describing there. David Essel: Oh it’s exactly. Gabe. what I’m describing. And you know it doesn’t even have to be from birth. I mean someone could hit a real challenging mental health crisis in their 20s, 30s, 60s, 70s, 80s. It doesn’t take more than about six months of something very extreme of PTSD, high anxiety, bipolar, schizophrenic disorder… It doesn’t take more than six months for the subconscious mind to create an identity that says, this is who I am. To our listeners that maybe have loved ones that struggle with depression, but they haven’t, to hear what we’re talking about, that it’s scary to not be a depressed person, doesn’t make sense. But a lot of conditions in this world – addiction and mental health disorders – don’t make sense. So if you’re listening because you have loved ones that are struggling and we’re talking about people that who are depressed, they create an identity, and they want to stay in their identity, even if it doesn’t sound logical, it’s very true. So understand that when you’re dealing with your loved ones that they may be trying to hold on at some unconscious or subconscious level to their title, to their identity as a depressed person in order just to survive, because they have nothing that they can even compare it to. And let me make this differentiation between the conscious and the subconscious mind. So the conscious mind that the mind says, you know, I’ve been feeling down, I’m always blue, I’ve lost my joy for life, nothing sounds good to eat or to drink and no activities that I used to do sound good anymore. And it’s dragging myself out of bed in the morning and so many of the symptoms of clinical depression that I just mentioned. Wen we have all those things going down and we live with ourselves on a daily basis, that subconscious mind picks up the pattern. We’ll never get out of this. Life is too hard. It’s too challenging. No one understands me. No one could possibly understand me. There is nothing that works. I’ve tried several medications, the side effects are worse than… And it’ll go on and the subconscious will grab that identity that we are a depressed person, and because we’ve rethought it so many times and talked about it so many times and gotten that validation from the outside world – I’m so sorry you’re struggling – that the subconscious then, because it’s so powerful, will hold on and fight like heck for that person to stay in that depressed identity. You know, we work with people that, in the beginning, they were on the correct medication, they were doing the correct coping mechanism skills that we gave them, we have them doing all kinds of exercises on emotion for depression. We believe in our experience in the world of depression that about 90 percent of it is caused by unexplored or submerged emotions like rage and anger, resentments, shame, guilt, like we really believe about 90 percent of depression is caused by emotions that have not been vented, that haven’t had no place to escape. So the subconscious continues to grab onto these thoughts and as that person starts to feel better, they start to see the world open up. There is a percentage that will actually try to retreat back into that depressed identity to get the validation and the feedback from the outside world that they are used to. So again, while it may not make sense to the person that’s never personally struggled with anything we’re discussing tonight, it doesn’t have to make sense to be real and hopefully some of this information that we’re sharing will make it easier for us to understand that person struggling without having to judge them or without having to placate them and keep them in that stuck identity. Gabe Howard: We’ll be right back after these words from our sponsor. Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral. Vincent M. Wales: Welcome back everyone. We’re here talking with David Essel. You’re not the first that I’ve heard talk about depression being caused by unexpressed emotions, specifically anger is what I’ve heard in the past, so I’ve always found that pretty interesting. I never considered myself an angry person. It takes a lot to get me angry, as Gabe can attest. But when I when I stopped to think about it, I did have a lot of repressed anger, just unexpressed, and that I just would fight down and everything. And it often was that way because there was no target. It was just general, you know, free floating kind of anger with nothing to aim it at. So that was an interesting thing. So you talked a lot about the subconscious versus the conscious mind here, and of course, a lot of us have always heard things like well, you know, subconsciously, yada yada yada. We’re responsible for this and this is what’s causing that. The subconscious, in other words, just sounds like a negative thing but is there a positive aspect to it? David Essel: Oh gosh, Vince, that’s that’s a great question. And you know, we believe in life that whole concept of yin yang is is absolute perfection. There is an opposite to everything. So if the subconscious that we’re talking about tonight from a negative point of view, keeping us stuck in an identity as a depressed person, then it must also be, there must also be a powerful side of the subconscious. And and there is. Thank God. Because the subconscious works on patterns, whatever you feed it or whatever you’re around listening to or whatever you’re watching or the people you’re hanging out with, they’re all sending messages to the subconscious constantly about someone’s right, someone’s wrong, conspiracy theories, you know, your weight gain is genetics and all this other kind of stuff. When a depressed person can break the chains of an identity based on being depressed and they can start to heal, if they’ll stay with the daily exercises and the possible medication that they may be on that they can stay with the program long enough, they can turn that subconscious mind from battling to hold onto an identity that I am a depressed person or I am a suicidal person. We can actually turn that around, guys, that you can use the subconscious as your greatest ally in the world. Now when I say subconscious, I want to make something else clear, too. We look at subconscious responses and a term that we always use is a subconscious response is a knee jerk reaction. That’s the easiest way to describe it. So someone is talking to you about your mental illness and they say, hey you know I just read the story about this person in some other city that used this new therapy and it was incredible. Now, to most people who are struggling with depression, the immediate response is, well it might work for them, it would never work for me, I’ve tried everything. That happens so fast that it’s not a conscious decision to reply like that to this person. It’s a knee jerk reaction. It’s a defense mechanism, and it happens instantaneously without us even thinking about it. Now the cool thing is, and I’ll sort of jump tracks here over to the world of addiction, for twenty-five plus years, I knew myself as a raging alcoholic, but I was in denial, so I didn’t call myself a raging alcoholic… a cocaine addict, and I was in denial with that, too. For twenty-five plus years, my identity was all about addiction, but I didn’t use the word addiction on myself. I said, this is the way I relax. This is what successful men do. So I created a subconscious identity to protect my addiction so I never had to end it. Now when I ended it, guys, there were three parts of my recovery that were the scariest… It was like living a nightmare. The first was going to a treatment center and knowing that, as of noon when I checked in, I would not have access to any alcohol or drugs. And it scared the hell out of me. The next time I was extremely afraid was the day that I came home, thirty-two days later. And now I was free. I had the freedom. I could go to the store. I could go to my local dealer. I could do whatever I wanted to and that was outrageously scary. And then the third scariest time was basically the next year. When I was changing my identity. I wasn’t drinking. I was doing really heavy duty emotional work with several counselors. But I was still afraid to go to dinners or to go anywhere… I was based in fear. And over time and a lot of work – and that was a number of years ago – the fear totally was gone. The subconscious mind we turned around to be an ally where I am a completely recovered person. We don’t even talk about the word addiction, anymore. I don’t believe that I’m a “recovering” alcoholic. I believe I have fully recovered, which is a pretty strong statement, but we can back it with tons of information, if needed. But the subconscious, now, I go to parties, I go out to dinner, I’ll go to funerals, I’ll go to weddings, I’ll officiate weddings and funerals, and where in the past, it was just really normal for me to look for a glass of wine or someone to offer it right away, now the subconscious has turned around so much, guys, that there’s not even an interest. When the last great depression hit, in 2006, 2007, and I was sober back then, I lost everything. And I over-bet on the real estate industry, I had everything on the real estate industry, and I lost my shirt, as they say. In that time of going through those years, of accumulating all of this wealth and losing it in a matter of a year, completely losing everything… It would have been a great opportunity, if the subconscious hadn’t been so wholly turned around, for me to drink or to do cocaine or do something to get out of the pain. But when you learn the correct coping mechanisms, and the subconscious is turned around, the thought of having a drink never even enters your mind. And that’s the beauty of the subconscious, is that if you’re willing to do the work – which about 90 percent of people in this world (now listen to this) are not willing to do – you can go ahead and take wherever you are with your addictions, with your challenges and with the correct help, and in some cases, as you guys know, the correct medication – which can be really hard to get that correct dosage and the correct medication – but if you’re willing to do the work, we can heal so deeply and turn that subconscious mind that used to have an identity as a depressed person or I can’t do this because I have this other mental health issue or I have an addiction… we can turn that around and find out what freedom truly feels like. Gabe Howard: I think I understand what you’re saying because, for example, when I work with doctors, social workers, psychologists, people that work with people with, you know, severe and persistent mental illness, you know, bipolar, schizophrenia, major depression… I always ask them what are their goals for their patients. And, oftentimes I get pretty stereotypical answers. They want them to be med compliant, they want them to stop pushing back in therapy, they want them to be on time, they want them to not complain about the wait of the waiting room, they want them to pay the bills on time. You know, a lot of stuff like that, that is all very good things. I mean, I understand why they want them to, you know, take their medicine as prescribed and be on time and not cause a problem in the waiting room, but I pointed out that there’s a disconnect there because their patient’s goal is to go to Hawaii. Their patient’s goal was to get married, is to have a job. They’re not going to see you to be compliant with the treatment that you prescribe. They want the treatment so they can get on with the rest of their life. And it seems like what you’re saying is if the doctors sort of subconsciously believe that the goal is to be compliant, they’re going to subconsciously push that compliance onto their patients. That’s going to make their patients unhappy because they don’t feel that their medical staff understands that their goal isn’t to be compliant. Their goal is to go to Hawaii. And the doctors don’t realize they’re doing this, the medical staff, they don’t realize they’re doing it, they’re not bad people. So yeah, if your knee jerk reaction every time something bad happens is to drink, that is in fact problematic… or however it fits into, you know, anxiety, depression, etc. David Essel: Yeah. Interesting comment that you just made, too, Gabe, about, you know, do we as professionals, do we understand what someone’s going through? And again I’ll say it’s probably one of the edges that counselors, therapists, psychiatrists who have struggled themselves have. A number of years ago, I started working with a young schizophrenic man, and I still work with them to this day. And when… you know, our traditional sessions for 18 and up is an hour, 17 and lower is a 30 minute session. So, you know, he was they were really struggling with finding the right medication. He would be in the session with me but not there present for about 80 percent of the session. He would be drifting off and, you know, the voices were coming and thoughts were coming and he couldn’t stay… he couldn’t concentrate, just could not concentrate. So I said to his parents one time, I said, hey listen, I love your son, by the way. I’ve worked with him. We do great work together. But I want to make a recommendation, and this is going against all protocol that we’ve been trained with, but I want to do 15 minute sessions. That’s it. I can see that this is a strain on him. I can see that this isn’t what he wants. Now, he walks out of the sessions telling you, mom and dad, that you know he wants to continue to work with David. But I said in the sessions it’s different. So if you’re willing, and thank God they were… guys, we went to 15 minute sessions. This young man blossomed. Right now – and I’m getting shows as I say this – the last time I saw him was three weeks ago because his family went on a vacation. He is now in his… I think he’s 24. He’s in college. He’s going to get an associates degree. Now, it’s going to take him… I think he’s been at it for about three years. I think it’s going to take him another year. Now, he will never live outside of the house, he’ll always live with mom and dad, but for this kid, this young man… and it goes right to what you’re saying, Gabe, it’s like, you know, when we asked him what was his goal, his goal was to finish school. Now according to everyone else that had worked with him, that was an impossibility. He couldn’t go to college, for all the different challenges that he had. And yet, in a year he’s going to graduate. When I saw him just before the Christmas break, the last time I saw him, he was ecstatic. Now he doesn’t show ecstasy like I might or someone else might. But you could see it in his face and his eyes how proud he was that he was able to do this, you know, and able to accomplish something that everyone had told him he couldn’t do. And I think it’s because we modified, extremely modified the program to fit him, not what statistically programs are supposed to be like. Does that make sense? Vincent M. Wales: Yeah yeah. And that’s that’s a great story. Great story. Thank you. Thank you. Let’s talk about anxiety for a second. What kind of things have you got to say about that? David Essel: First let’s look at the volume. You know, 40 million people on a daily basis in the U.S. alone struggle with depression and/or anxiety. It’s an interesting topic because we’ve heard over the years that there’s been a continual increase in anxiety in our society and people are blaming social media, and it definitely has a role in it for sure. When we talk about anxiety, and I just had a brand new client this week start, and he came in and he’s filled with anxiety. Now he has a high pressured sales position, so everyone who has always told him, all the counselors he’s worked with,you know, it’s genetically based or it’s something, it’s just you put so much pressure, you’re so competitive, you’re so you’re this, you’re so that… and I just met with him one time, we had our first session, and I asked him – because this is, I think, a missing link with anxiety – I asked him was his grandmother, grandfather, mom, dad, sister, brothers, aunts or uncles… Was there anyone in his life when he grew up that couldn’t relax? That was always on the move. That was always trying to accomplish the next ABCDE. And he looked at me and he started laughing and I said, What’s so funny? He goes, You just called my mother out. I said, Well let me tell you something. In our opinion, and we’re just one opinion of 40 years in the personal growth industry, 30 years in counseling and coaching, he said we see anxiety being created by the core family element between the age of zero and 18 much more so than a genetic link. And what we mean by that is… we’ll go back to the subconscious mind. From zero to 18, we’re in an environment where mom can’t sit down. She’s always up and moving. She can’t relax. She’s always doing that. It might seem productive, you know, that she’s dusting now and she’s sweeping next and she’s picking up this next and she’s got TV’s on one room and and a radio on and another room. That might seem like a productive use of time. Actually it’s an example of a full-blown anxiety episode. So this young man was raised in an environment where it was normal to not relax. It was normal to be hyper-competitive. It was normal that, when friends or relatives were coming over, that that house was freaking spotless. It was normal that all of this anxiety that was produced, not on purpose, but by mom, and she’d probably modeled her mom or dad… he took on because of the environment he was raised in. And right away when I see… when I can when I can pull someone out of, you know, this must be genetic, and everyone wants to use those words, genetic. So with anxiety, a large percentage we see that people – just like almost everything we’re talking about tonight, guys, is that people, when we’re not taught how to deal with emotions, when we’re not asked to go deeper, when we’re not exploring what could be the cause of this depression or anxiety other than the fact that it could be genetically related, that we’re losing out on helping millions of people a day to heal. So anxiety is real. The condition is real. A huge number of people are affected by it. But we have seen in our practice so many people heal from it, get off of their medications, live super productive lives when they learn how to deal with underlying emotions that they didn’t even know were there. Or they can start to see constructively that, oh my god, I’m repeating my dad’s alcoholism or I’m repeating my uncle’s whatever it might be. There are so many conditions that are created in this incubator called zero to 18 and I think that information is crucial to get out because, once again, going back to what I talked about a little while ago, this gentleman that came in the other day, he said, I’ve been diagnosed with full-blown anxiety attacks, panic attacks. I have them once a week. And now we’re going to get to the core and find out what is causing them. And a big part of it could be he’s just repeating the way his mom reacted to life, and if he continues doing that, it’s going to get worse. But we’re gonna help him break through it, for sure. Gabe Howard: That is wonderful. Thank you so much. We’ve only got a couple of minutes left, is there any final thoughts that you want to leave us with? Where can we find you? Obviously the show notes will have your web page and all of that stuff. But, you know, there’s just so much that we didn’t get a chance to talk about. Can you give us the 30 to 60 second overview of of everything that we can know about you? David Essel: Absolutely, Gabe. First of all I want to thank you and Vince for having me on, and for our listeners… you know, we offer a lot of free stuff. And that’s – again, how do you reach 2 million people a day, is that you’ve got to be creative, so – if your listeners want to get on our daily video e-mail list – it’s called David Essel’s Daily Video Boost – where we talk about these type of topics, where we talk about what causes depression and what are some of the potential cures and everything else that we’ve discussed today… All they have to do is go to the Web site, which is TalkDavid.com and sign up for the Daily Boost, it’s free. They’ll also find our link for our YouTube videos. Thirteen hundred videos, there’s a lot of videos on depression anxiety et cetera there. So if they just go to TalkDavid.com, they can find out where they can get all the free information, and then if they wanted to do something with the work that we do, they could let us know with an e-mail. Gabe Howard: That would be wonderful. Thank you so much. And thank you, everybody, for tuning in this week. And remember you can get one week of free, convenient, affordable, private, online counseling anytime, anywhere by visiting betterhelp.com/psychcentral. We will see you all next week. Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email talkback@psychcentral.com. About The Psych Central Show Podcast Hosts Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. 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. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com. View the full article
  16. Phobiasupportforum

    Psychology Around the Net: January 26, 2019

    This week’s Psychology Around the Net takes a look at children taking mental health days, the definition of relationship cycling and what it can do to your mental health, career advice for having not only a successful but also a happy career, and more. Enjoy! Women Urged to Put Mental Health On Pre–Conception Checklist: Just like a healthy diet and exercise routine, maintaining a healthy weight, and avoiding smoking and alcohol, addressing her mental health should be on a woman’s pre-conception checklist. Researchers have found that women who have depression before conception are more likely to experience depression after giving birth, which can, according to Dr. Katrina Moss of the University of Queensland School of Public Health, “have a negative influence on parenting” and affect children’s psychosocial outcomes. I Will Always Let My Kids Take Mental Health Days: Speaking of parenting, here’s one momma’s story about how she discovered that children — just like adults — can benefit from mental health days. Having Stressed Out Ancestors Improves Immune Response to Stress: A new study suggests that having ancestors who were regularly exposed to stressors could improve your own immune response to stressors, and these results suggest we should consider family history when trying to predict or understand the health implications of stress. I Felt Something After KonMari-ing My Home—But It Wasn’t Joy: She might not have felt joy, but what she did feel was definitely positive and something we can all benefit from feeling — especially when it doesn’t seem like there’s much else in life giving us that feeling at the moment. ‘Relationship Cycling’ Is Messing With Your Mental Health: According to new research published in the journal Family Relations, people who engage in “relationship cycling” — repeatedly breaking up and getting back together — aren’t doing their mental health any favors. While it might make for entertaining television, movie, or book plots, in real life it causes and/or increases stress, anxiety, and depression and according to the study’s co-author Kale Monk of the University of Missouri-Columbia, the highs and lows aren’t even worth it in the end as relationship cycling was “linked to poor relationship quality, including impairment in satisfaction, commitment and communication.” What’s the Best Career Advice You’ve Received? Check out some advice these students, employees, and other career professionals have received — and have to give — to help guide you toward a career that brings happiness and fulfillment. View the full article
  17. Phobiasupportforum

    Does Crying Help or Hurt Depression?

    Tears. I liken them to numinous mist or emotional sign language. “They’re considered a release, a psychological tonic, and to many a glimpse of something deeper: the heart’s own sign language, emotional perspiration from the well of common humanity,” writes Benedict Carey in his New York Times piece “The Muddled Track of All Those Tears.” The Healing Property of Tears Tears heal us in several ways. They remove toxins from our body that build up from stress, like the endorphin leucine-enkaphalin and prolactin, the hormone that causes aggression. They lower manganese levels — which triggers anxiety, nervousness, and aggression — and therefore elevate mood. Emotional tears contain more toxic byproducts than tears of irritation. In his article “The Miracle of Tears,” Dr. Jerry Bergman writes, “Suppressing tears increases stress levels, and contributes to diseases aggravated by stress, such as high blood pressure, heart problems, and peptic ulcers.” I’ve always been a crier. During deep depressions, a veritable Niagara Falls streams down my face. Tears help me release my emotions. Sometimes they express feelings that I am unable to articulate in word or in body language. As my heart’s translator, they tell stories that enlighten and embolden me. Cry Carefully Though cathartic and healing, crying isn’t always beneficial. If I weep whenever the instinct arises, tears can keep me stuck in a pattern of illness. I have to carefully assess the thoughts and beliefs that are generating the wetness. If they are attitudes hopelessness or futility, I have to be careful not to indulge in those feelings and resist reaching for the Kleenex. My mixed assessment toward tears seems to be fairly typical among persons with chronic depression. Awhile back, I posed the questions to members of my depression community: “Does crying help? Does crying hurt?” Most said crying was a helpful release of emotions. They often felt much lighter after a session of tears. However, there were those that said once they started to cry, they had difficulty stopping. When the crying persists for days on end, they end up feeling worse. To Cry or Not to Cry The research on tears is conflicting, as you may guess. The Journal of Research in Personality published a study in 2011 that found that shedding tears had no effect on mood for nearly two-thirds of women who kept daily journals. Jonathan Rottenberg, lead author of the study and an associate professor of psychology at the University of South Florida, said, “Crying is not nearly as beneficial as people think it is. Only a minority of crying episodes were associated with mood improvement – against conventional wisdom.” In another study published in the journal Motivation and Emotion, researchers from the University of Tilburg in the Netherlands videotaped a group of participants while watching the films “Life Is Beautiful” and “Hachi: A Dog’s Tale.” The participants were assessed before, immediately afterward, and then 20 minutes and 90 minutes afterward. Of the participants who cried during the films (approximately half), most claimed they felt worse immediately after. Twenty minutes later, those who cried said that their moods were the same as before they the film began. However, an hour and a half after the credits rolled, the criers were in better moods than before the movie. According to lead author Asmir Gračanin, “After the initial deterioration of mood following crying, it takes some time for the mood not only to recover but also to be lifted above the levels at which it had been before the emotional event.” The researchers didn’t explain the reasons behind the mood change, but previous studies document the release of toxins through tears, as mentioned before, and also the release of feel-good endorphins. Borders around Niagara Falls I have decided to let myself wail, sob, and weep, but to erect borders around my Niagara Falls so that my outbursts don’t interfere with my daily responsibilities. Those boundaries include trying my best not to cry in front of my two kids, as I know my tears have been unsettling for them in the past. Whenever possible, I also try keep my crying sessions under a half hour. American writer Washington Irving said, “There is a sacredness in tears. They are not a mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contribution and of unspeakable love.” I believe that. Tears are the purest expression of human emotion. They are our heart’s sign language. They connect us deeply to ourselves and to others. And they tell our story long before we are ready to share it. Tears are loving messengers. Tears are cleansing perspiration. Tears are healing mist. Reference Carey, B. (2009, February 2). The Muddled Tracks of All Those Tears. The New York Times. Retrieved from https://www.nytimes.com/2009/02/03/health/03mind.html Bergman, J. (1993). The Miracle of Tears. Retrieved from https://answersingenesis.org/human-body/the-miracle-of-tears/ Bylsmaa, L.M., Croon, M.A.,Vingerhoets, Ad.J.J.M.,Rottenberg, J. (2011). When and for whom does crying improve mood? A daily diary study of 1004 crying episodes Author links open overlay panel. Journal of Research in Personality, 45(4): 385-392. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0092656611000778 Melnick, M. (2011, August 1). Study: Crying won’t make you feel better. TIME. Retrieved from http://healthland.time.com/2011/08/01/study-crying-wont-make-you-feel-better/ Springer. (2015, August 24). Crying has its perks: Effect of crying on one’s mood. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2015/08/150824101829.htm View the full article
  18. You’re trying to find a job, and after way too many interviews, you’re still unemployed. You’ve had a string of awful dates, and you’re convinced that you’ll never find your person. You’ve repeatedly asked your spouse to work less or spend less or drink less and after promising to make a change, they still haven’t. You have depression, and nothing seems to be helping. And, so, you feel hopeless. And you assume that this feeling of hopelessness carries with it some significant truth: your circumstances won’t improve, you should just stop trying, you might as well give up. “Clients who are feeling hopeless often view their situation in a polarized, black and white way,” said Chris Boyd, a psychotherapist in Vancouver, Canada. His clients tell him things like, “Nothing I do is making a difference,” “My circumstances will never improve,” “What’s the point of even trying?” “The pain is never going to improve,” “I’m in a dark place and can’t get out,” “I’ll never be happy,” “I’ll never find love.” Maybe these statements sound all-too familiar. But these hopeless sentiments couldn’t be further from the truth. According to Kate Allan in her uplifting book, You Can Do All Things: Drawings, Affirmations and Mindfulness to Help With Anxiety and Depression, hopelessness is simply “a misbehaving brain doing misbehaving brain stuff. It’s like a bug, a glitch.” Allan, who has anxiety and depression, understands first-hand what it’s like to deal with a sinking sense of hope. When she feels hopeless, she instantly tells herself, “You are depressed. This is depression.” After many years of therapy, Allan has realized that her feelings of hopelessness are a sign—not “that life is bad or that my problems are impossible,” but “a weirdly dramatic notification from my brain that I am not keeping up on my self-care, and that I need to reach out and connect with somebody.” This is when Allan turns to her mental health checklist, and asks herself: Did I sleep well? Have I eaten? Did I connect with anyone today? “If the answers to any of these are ‘no,’ I know I then need to be more careful with myself. It’s a signal that my defenses are down, and it takes little for my mental health to spiral into severe depression.” You, too, can use your feelings of hopelessness to check in with yourself. What do I need? Am I meeting those needs? What am I telling myself? California psychologist Ryan Howes, Ph.D, noted that hopelessness can point to a real limit or an irrational self-limiting belief. Maybe the reason you feel so hopeless isn’t rooted in reality, but instead in a false narrative about your abilities or circumstances. Maybe you tell yourself that you don’t really deserve a raise, or loving friends. Maybe you tell yourself that you’re not that smart or creative or capable. These kinds of stories not only hamper your sense of hope, but they create situations that make it seem like you’re hopeless and can’t do anything right. They lead you to take actions that aren’t helpful. Which is why another strategy for bolstering your hope lies in revising your self-limiting beliefs (these tips and insights may help.) Below, you’ll find other expert suggestions for building hope. Ask for help. Howes frequently tells his clients that “hopelessness is often just a powerful reminder that we can’t do it all by ourselves. Many situations that feel or truly are hopeless to an individual suddenly becomes doable when other people get involved.” Maybe you can ask your loved ones for help or a different perspective. Maybe you can talk to members of your church or synagogue. Maybe you can join an online or in-person support group. Change the goal. “If the situation is truly unchangeable, is there a way to change the goal?” said Howes, co-creator of the Mental Health Boot Camp, a 25-day online program that helps to strengthen your well-being. Howes gave these examples: If you can’t leave your job, your goal becomes to make it enjoyable and meaningful for you. If your spouse won’t change their ways, your goal becomes to change yourself, your routines and/or your friendships so you can meet more of your needs. If you can’t change a life-altering diagnosis, your goal becomes to face it with dignity, self-compassion and strength. Focus on purpose. Boyd, also co-creator of the Mental Health Boot Camp, stressed the importance of focusing on what gives you meaning and purpose in these four areas: connection, passion, cause and spirituality. That is, how can you connect to your partner, friends, family and colleagues? What creativity-fostering hobby or interest can you pursue? How can you help others? How might you ease their suffering? What fulfills you spiritually? Is it praying, meditating or spending time in nature or doing something else? Think in moments. Maybe you feel hopeless about the future, about a year from now or a month from now. So focus on this very moment. Focus on this very minute. As Therese Borchard beautifully writes for readers with depression, “All you have to do is persevere for 15 minutes at a time and be as gentle with yourself as you would a scared child in the middle of a thunderstorm.” Remember change takes time (and many steps). For instance, an illness like depression doesn’t dissipate with one or two changes, Howes said. Rather, you might need to change your sleep habits. You might need to start moving your body. You might need to take medication and to see a therapist. You might need to do these things for some time before you see significant results. “If you can take things one-by-one, day-by-day, and stay patient, you’ll gradually begin to see change,” Howes said. Seek therapy (or a different therapist). You can go to therapy at any time, Howes said, and it’s especially important when your hopelessness is affecting your ability to work, to appreciate things you’ve always appreciated or to spend time with your loved ones. (Your hopelessness might be a sign of depression.) Maybe you’re already working with a therapist, but it feels like you’re not getting anywhere. Voice your concerns. Always be upfront in therapy about how you’re feeling, and what is and isn’t working. (Here’s some insight into red flags that a therapist isn’t right for you.) And maybe you need to work with someone else. If you’re taking medication that seems ineffective, maybe you need a different dose. Maybe you need a different medication, or a different combination of medication. Maybe you’d like to work with a different doctor. And “if hopelessness has led you to start thinking about harming yourself or ending your life, please make seeking help your top priority,” Howes said. “This includes calling 911, if your impulse or wish to harm yourself feels beyond your control.” Or you might contact the National Suicide Prevention Lifeline at 1-800-273-8255, or the Crisis Text Line and text HOME to 741741. It’s vital to also remember that hopelessness is a feeling, not an ultimate reality, Howes said. And feelings are fleeting, he said. Plus, just because you think change isn’t possible, that doesn’t make it true. Boyd noted that all of us have the ability to rewire our brains. “How we choose to focus our minds and act can change the pathways within the brain and help improve our mental and physical health.” As Boyd added, “This is a profound message of hope, rooted in sound science.” Sometimes, it feels like your sense of hope is so shaky, so fragile. But this shakiness, this fragility may be pointing to a false story you need to revise. It might be pointing to a change you need to make or a goal you need to adjust. It might be pointing to an unmet need. In other words, that hopelessness isn’t a sign that you need to give up. It’s a sign that you need to pivot or redirect—which is something you can absolutely do. And there’s real, tangible hope in that. View the full article
  19. Phobiasupportforum

    9 Ways to Free Yourself from Ruminations

    Of all my symptoms of depression, stuck thoughts are by far the most painful and debilitating for me. The harder I try to move the needle from the broken record in my brain, the louder the song becomes. Ruminations are like a gaggle of politicians campaigning in your head. Try as you might to detach from their agenda, their slogans are forefront in your mind, ready to thrust you down the rabbit hole of depression. Logic tells you they are full of bull, but that doesn’t keep you from believing what they have to say. Ever since the fourth grade, I have been fighting obsessive thoughts. So for four decades, I have been acquiring tools for living around them, continuously trying out strategies that will deliver them to the back of my noggin. Sometimes I am more successful than others. The more severe my depression, the more pervasive the thoughts. I don’t promise you tips to get rid of them forever, but here are some ways you lessen their hold over you. 1. Distract Yourself Distraction is an appropriate first line of defense against ruminations. If you can, divert your attention to a word puzzle, a movie, a novel, or a conversation with a friend, in order to tune out what your brain is shouting. Even a five-minute reprieve from the broken record will help your mood and energy level, allowing you to focus on the here and now. However, if you simply can’t distract yourself — and I fully realize there are times when you can’t — don’t force it. That’s only going to make you feel more defeated. 2. Analyze the Thought Obsessions usually contain a kernel of truth, but they are almost always about something else. Understanding the root of the thought and placing it in its context can often help you to let go of it, or at least minimize the panic over what you think it’s about. For example, a friend of mine was obsessing about the size of his backyard fence. A few times a day, he knelt beside the fence with a measuring stick, fretting that it wasn’t tall enough. The obsession was never really about the fence. It was about his wife who had just been diagnosed with dementia. Scared of losing her, he exercised what control he did have over the fence. My recent ruminations are similar. I was obsessing about a mistake I made, or a decision I made that had consequences I didn’t consider. Once I realized that my obsession was really about something that happened 30 years ago, I breathed a sigh of relief. 3. Use Other Brains It can be extremely difficult to be objective when you’re in the heat of ruminations. The politicians are incredibly convincing. That’s why you need the help of other brains to think for you — to remind you that your rumination isn’t based in reality. If you can, call on friends who have experienced obsessive thoughts themselves. They will get it. If you don’t have any, consider joining Group Beyond Blue on Facebook. This online depression support group is full of wise people who have guided me out of ruminations many times. 4. Use Your Mantras I have ten mantras that I repeat to myself over and over again when cursed with obsessive thoughts. First, I channel Elsa in Disney’s “Frozen” and say or sing “Let it go.” I also repeat “I am enough,” since most of my ruminations are based on some negative self-assessment — usually how I handled a certain situation. The most powerful mantra for ruminations is “There is no danger.” Panic is what drives the obsessive thoughts and makes them so disconcerting. You believe you are literally going to die. In his book Mental Health Through Will Training psychiatrist Abraham Low writes, “You will realize that the idea of danger created by your imagination can easily disrupt any of your functions … If behavior is to be adjusted imagination must interpret events in such a fashion that the sense of security … overbalances the sentence of insecurity.” In other words, there really is no danger. 5. Schedule Rumination Time Sometimes a rumination is like a tantruming 2-year-old who just wants a little attention. So give it to him. Some parenting experts say by acknowledging the kid, you provoke more tantrums. However, my experience with tantruming toddlers and with ruminations is that sometimes if you turn your attention to the kid or the thought, the screaming ends. You don’t want to stay indefinitely with the thought, but sometimes you might get a reprieve by setting aside a certain amount of time for your brain to go wherever it wants. Let it tell you that you are a despicable human being and that you screwed everything up once again. When the time is up, say, “Thank you for your contribution. I need to do other things now.” 6. Lessen Your Stress Like most people I know, the severity of my ruminations are directly proportional to the amount of stress in my life. Recently, when the stress at work and at home were off the charts, so, too, were my ruminations. My brain was literally on fire, and no technique could quiet the thoughts. Be proactive about lessening your stress. You might not have to make the dramatic changes that I did — resigning from a job. A little tweak in your schedule to allow for some relaxation may be all you need. 7. Do a Thought Log Take a sheet of paper and draw three columns. In the first column, record your thought and assign a percentage of how strongly you believe it. For example, “I’m never going to recover from that mistake,” 90 percent. In the second column, list the cognitive distortions associated with that thought. For example, the above example involves “mental filtering,” “all or nothing thinking,” “jumping to conclusions,” “overgeneralization” and “catastrophizing.” In the third column, write a compassionate response to the thought THAT YOU BELIEVE and a percentage. For example, “My decision may or may not have been a mistake, but it surely isn’t the end of me, and chances are that I can learn a lesson from it that will improve my life in the future,” 90 percent. If your percentage of the compassionate statement is lower than the original thought, tweak the compassionate response until the percentage is equal or higher than the original thought. 8. Be Kind to Yourself The most important thing you can do to relieve the anguish of these thoughts is to be kind and gentle with yourself. In her book Self-Compassion Kristin Neff, Ph.D., offers a beautiful mantra she developed to help her deal with negative emotions, a reminder to treat herself with self-compassion when discomfort arises: “This is a moment of suffering. Suffering is part of life. May I be kind to myself in this moment. May I give myself the compassion I need.” Ruminations are, without doubt, moments of suffering. Self-compassion is your most powerful antidote. 9. Admit Powerlessness If I have tried every technique I can think of and am still tormented by the voices inside my head, I simply cry Uncle and concede to the stuck thoughts. I get on my knees and admit powerlessness to my wonderful brain biochemistry. I stop my efforts to free myself from the obsessions’ hold and allow the ruminations to be as loud as they want and to stay as long as they want because, here’s the thing, they do eventually go away. View the full article
  20. Phobiasupportforum

    7 Winter Depression Busters

    We’ve entered the “dark ages” as the midshipmen at the Naval Academy say — the weeks between Christmas break and Spring break when everyone turns a pasty white and the sidewalks are full of ugly slush. The lack of sunlight and the shorter days don’t help the pursuit of sanity. However, if you approach this time of year with a dose of creativity and enthusiasm, you need not fall down the rabbit hole of depression. Here are some ideas to keep your mood sunny when the weather is anything but. 1. Go to the light. I start using my light lamp in October. However, in January, this fixture becomes my best friend. Bright-light therapy — involving sitting in front of a fluorescent light box that delivers an intensity of 10,000 lux — can be as effective as antidepressant medication for mild and moderate depression and can yield substantial relief for Seasonal Affective Disorder. Technically, we are moving towards more light every day in January, which is great news. But my circadian rhythm — the body’s internal biological clock that governs brain wave activity and hormone production — gets really out of whack following the holidays. I think it’s the cumulative lack of sunlight since September. So bright light therapy becomes an important part of every January and February day. 2. Clean and Declutter I always feel like a massive hypocrite when I talk about decluttering and cleaning, but the evidence is in: messy environments affect your psyche. A 2011 study conducted by researches at the Princeton University Neuroscience Institute found that, when your surroundings are cluttered, multiple stimuli in your visual field compete for your attention, making it difficult for you to focus and limiting your brain’s ability to process information.1 Another study conducted through UCLA’s Center on Everyday Lives and Families showed that clutter affects our mood and mental health.2 January and February present perfect opportunities to at least start the process. Whenever I muster up the courage to begin to declutter, I feel the therapeutic effects. I think it has something to do with detaching yourself from the past and moving forward. 3. Get Creative The winter months are also a good time to try a craft, whether that be pottery or painting or woodworking. Like cleaning, there are studies that have documented the therapeutic value of art therapy. For starters, in a 2016 study published in the journal Art Therapy, 39 participants made art using collage material, modeling clay, and/or markers. After they completed their work, they were invited to share any aspect of their work or their experiences verbally with the group. They were also asked to share a brief written description of their experience. Researchers measured cortisol levels before and after making art and found a significant reduction in cortisol after making art.3 In the last year, I’ve tried my hand at a variety of art forms to express my feelings, and I can attest to the power of art to access and heal difficult emotions. 4. Give Back Ghandi once wrote that “the best way to find yourself is to lose yourself in the service of others.” Positive psychologists like University of Pennsylvania’s Martin Seligman and Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, believe that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression. You need not associate yourself with a specific cause or foundation. Sometimes a dollar and a kind word to a homeless person can make a great impact. So can calling up a friend you know is going through a rough patch. Anything we do that turns our gaze outward is going to help bolster our mood. 5. Be Around People Winter weather gives you a great excuse to isolate yourself. Of course you don’t want to go out. It’s nasty outside. But isolation is only going to worsen your symptoms of depression and anxiety. Take it from the Queen of Isolation. “We have all known the long loneliness,” writes Dorothy Day, “and we have found that the answer is community.” When we surround ourselves with others, there is a chance that we will forget about our problems for a few seconds and hear what someone else is saying. There’s also a possibility that we will discover that we are not alone in our struggle. On some days, that is enough to lessen our suffering. 6. Don’t Forget the Omega-3’s During the winter, I’m religious about stocking a Noah’s-Ark-supply of Omega-3 capsules in my medicine cabinet because leading physicians at Harvard Medical School confirmed the positive effects of this natural, anti-inflammatory molecule on emotional health. I treat my brain like royalty — hoping that it will be kind to me in return — so I fork over about $30 a month for the Mac Daddy of the Omega-3s, capsules that contain 70 percent EPA (Eicosapentaenoic acid). One 500mg softgel capsule meets the doctor-formulated 7:1 EPA to DHA ratio, needed to elevate and stabilize mood. 7. Move Your Body We’ve known for decades that exercise can decrease depression symptoms,4 but in a 2016 study by the University of California Davis Medical Center found that exercise increased the level of the neurotransmitters glutamate and GABA, both of which are depleted in the brains of people with depression and anxiety. The researchers evaluated 38 healthy volunteers who rode stationary bikes at a vigorous rate — about 85 percent of their maximum heart rate — for up to 20 minutes in three sessions, measuring GABA and glutamate levels in the brain immediately before and after the workouts. Post-exercise scans showed significant neurotransmitter increases in parts of the brain that regulate emotions and cognitive functions. Participants who had exercised three or four times in the week leading up to the study had longer lasting effects. The study showed that aerobic exercise activates the pathways that replenish these neurotransmitters, allowing the brain to communicate with the body.5 Don’t worry about hiking 10 miles in the snow. Simply put on some groovy tunes and climb up and down your stairs for 15 minutes. The important thing is to move. Footnotes: McMains, S., & Kastner, S. (2011, January 11). Interactions of Top-Down and Bottom-Up Mechanisms in Human Visual Cortex. Journal of Neuroscience, 31(2): 587-597. Retrieved from http://www.jneurosci.org/content/31/2/587.long Feuer, J. (2012, July 1). The Clutter Culture. UCLA Magazine. Retrieved from http://magazine.ucla.edu/features/the-clutter-culture/ Kaimal, G., Ray, K., & Muniz, J. (2016, April 2). Reduction of Cortisol Levels and Participants’ Responses Following Art Making. Art Therapy, 33(2): 74-80. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004743/ Stathopoulou, G., Powers, M.B., Berry, A.C., Smits, J.A.J., & Otto, M.W. (2006, May 30). Clinical Psychology Science and Practice., 13(2): Exercise Interventions for Mental Health: A Quantitative and Qualitative Review. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-2850.2006.00021.x Maddock, R.J., Casazza, G.A., Fernandez, D.H., & Maddock, M.I. (2016, February 24). Acute Modulation of Cortical Glutamate and GABA Content by Physical Activity. Journal of Neuroscience, 36(8): 2449-2457. Retrieved from: http://www.jneurosci.org/content/36/8/2449.short View the full article
  21. Phobiasupportforum

    Distinguishing Between OCD and GAD in Children

    As many parents of children with obsessive-compulsive disorder (OCD) will tell you, getting the right diagnosis is half the battle. Getting the right treatment is the other half. It’s true that OCD can be tough to diagnose, especially in children. Rituals are an important part of a healthy childhood, and it’s often difficult to know when they should be a cause for concern. This article can help you sort out “normal” rituals from behaviors that should raise a red flag. Even if you and your healthcare providers recognize that your child is dealing with anxiety issues, it’s not always easy to differentiate between OCD and Generalized Anxiety Disorder (GAD). Both can be characterized by rumination, increased vigilance, and an intolerance of uncertainty. Experts in OCD and anxiety disorders should be able to distinguish between the two, but for others it can be quite difficult. To make matters even more confusing, the two disorders can also occur together. A study published online in October 2018 in Depression & Anxiety aims to make it easier to properly diagnose these two disorders. The study looked at participants’ abilities in certain cognitive domains to determine if this information might be helpful in diagnosing OCD and GAD. The children involved in the study had either been diagnosed with OCD, GAD, or neither (control group). None were diagnosed with both OCD and GAD. The breakdown included 28 study participants diagnosed with OCD only, 34 diagnosed with GAD only, and 65 diagnosed with neither. This last group of children were the typically-developing controls (TDC). Cambridge Neuropsychological Automated Battery (CANTAB) tests were administered to compare the following cognitive performances: Working memory Visuospatial memory Planning ability and efficiency Cognitive flexibility The results were interesting. The participants with obsessive-compulsive disorder required more turns overall to complete multi-step problems than the other two groups, while those with Generalized Anxiety Disorder were more likely to make reversal errors than those with OCD or the control group. Those with GAD also took longer to identify visual patterns. Although those with OCD and those with GAD demonstrated significantly worse cognitive functioning compared with the control group, the children’s cognitive impairments and difficulties with specific skills depended on which disorder they’d been diagnosed with. Children with generalized anxiety disorder struggled more with mental flexibility and visual processing, and those with obsessive-compulsive disorder displayed poorer planning abilities. These results show promise in helping to diagnose OCD and GAD in children. More research is needed, however. For future research, the study authors suggested the use of parent-reporting forms as well as self-reporting forms. Neuroimaging and other types of assessments measuring the same cognitive skills examined in the study discussed here would be helpful as well. One of the reasons I find this research so interesting is the fact that, as many of us know, the earlier obsessive-compulsive disorder is diagnosed, the sooner it can be properly treated — before it becomes deeply entrenched. The same is true for Generalized Anxiety Disorder — the sooner the better. The more we can differentiate between these two disorders, the better chance we have for more timely diagnoses. View the full article
  22. Studies show there is a major link between personality traits and personal body image, but the relationship between personality and attitudes toward others' bodies has gone largely unexplored. View the full article
  23. Phobiasupportforum

    6 Life Lessons I Learned Last Year

    Danish philosopher and theologian Søren Kierkegaard once wrote, “Life can only be understood backwards; but it must be lived forwards.” The beginning of a new year is an appropriate time to look back over the lessons learned from the mistakes and experiences of previous months. In 2018, I wrote two letters of resignation, grieved the ending of two significant relationships, and spent several weeks on a hospital waiting list for severe depression and weight loss. I fumbled, got lost, and confronted demons that I had been running from my entire life. The result is that I came away with a set of invaluable lessons that I take into the new year. Here are six of them. 1. Don’t measure your self-worth by your job performance or title. Once was not enough for me to learn this important lesson. I had to make the same mistake twice to appreciate why you should never measure your self-worth by the status of your occupation. In my first job, I lost myself in the pursuit of approval and acceptance of my co-workers. In placing too much of my self-identity into my work, constructive criticism felt more and more personal. I got turned around and forgot what I loved about the job. Trying to make up for the insecurity I felt at the first job, I arrived at my second job as an overly ambitious employee, setting an unrealistic pace I couldn’t sustain. As soon as I woke up to my limitations as a human being without superpowers, my self-esteem crumbled. Both experiences taught me that you absolutely must fill up your tank of self-love with things other than job performance and job title if you want a good shot at serenity. 2. Stress kills. Not investing too much of your self-identity into your job was the first of two lessons I learned at my second job, where I worked as an editor for a health website. The second lesson was this: stress kills. In my time editing hundreds of articles on a variety of chronic health conditions, I noticed that the one common denominator among all of them was stress. Every piece I produced on flare ups — in dementia, psoriatic arthritis, or eczema — included stress as a powerful trigger. Stress not only complicates diseases, it can make any condition life-threatening. Stress is what pushed my painful depressive ruminations of last year into intense suicidal thoughts that had me on the verge of hospitalization. Not until I made the necessary changes in my life at work and at home to reduce that stress did my ruminations become manageable. 3. Self-compassion is the path to healing. Some of us learned a message early on that the way to an improved self is to beat ourselves to death. We bash ourselves for every mistake we make; we push ourselves beyond our threshold; and we fixate on a picture of a successful self that is unrealistic and unattainable. The result is that there is nothing to catch the broken pieces of ourselves when we fall apart. I’ll never forget the doctor’s appointment last year when my physician told me that if I didn’t start to show myself some self-compassion I would end up in the hospital. Self-compassion was and is the most difficult and the most important lesson I will ever learn. Being okay with my imperfect self feels horribly awkward and uncomfortable. Relaxing into the truth that “I am enough” runs counter to the overachieving agenda that has pushed me for 48 years. However, my first steps toward this new mindset have already planted seeds of peace that I didn’t know was possible. 4. By identifying old tapes, you can rewrite your narrative. “There is no coming to consciousness without pain,” remarked the Swiss psychiatrist and psychoanalyst Carl Jung. “People will do anything, no matter how absurd, in order to avoid facing their own Soul. One does not become enlightened by imagining figures of light, but by making the darkness conscious.” I have sat on many therapy couches over the course of 30 years, but not until this year did I dig deep enough to uncover the source of the painful tapes that have played over and over again in my subconscious brain my entire life, driving much of my depression, anxiety, and dysfunctional behavior. In the safe sanctuary of psychotherapy, I was able to begin replacing the damaging and hurtful narrative that has become automatic with a message of loving kindness. It is never too late to try to identify the source of your damaging tapes and rework the narrative. 5. Marriage is an organic, evolving relationship. “All living relationships are in the process of change, of expansion, and must perpetually be building themselves in new forms,” Ann Morrow Lindbergh explains in her classic Gift From the Sea. “There is no holding of a relationship to a single form.” I used to be proud of the fact that my husband and I never fought. Friends and families put our marriage on a pedestal. This year I realized it had more to do with our fear of the kind of candid communication that is uncomfortable and at times hurtful. While we have always been loving toward each other, our relationship needed a dose of the brutal honesty that results in yelling and slammed doors. Such disruption is not a sign of demise. It’s an indication of growth. In marriage therapy, we pressed through the boundaries that had kept us safe, frozen in a single form, as Lindbergh describes. Now we are moving through the awkwardness of growth to a deeper intimacy. 6. Being yourself takes tremendous courage. “To be nobody-but-yourself in a world which is doing its best, night and day, to make you everybody but yourself-means to fight the hardest battle which any human being can fight—and never stop fighting,” wrote E. E. Cummings. Ralph Waldo Emerson’s version is this: “To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.” Last year I ran up against the temptation over and over again to become an imitation or a version of myself that I thought was more acceptable or likable to the world. As I wrestled with whether or not I should return to writing and work as a mental health advocate, I experienced many colors and patterns of fear. I didn’t know if I was brave enough to be me. Ultimately I decided to pursue my passion. I enter into this year with a renewed conviction to be myself, as uncomfortable as that feels on some days. View the full article
  24. I am a friend. Therefore, these words are my own stories, opinions, impressions, and thoughts on having a friend with depression in this moment. They are not concrete or bible or forever — they are my truth right now. I am a friend. I think a damn good one. That is all, but sometimes it is a lot. As I think back, depression was always a part of our relationship. But at 18, 21, 24 we didn’t call it that. We didn’t know it was that. It was “caving” or “winter blues” or just, “I need a break”. And as fast as our friendship began and as strong as it was, it ended — a couple of times over again. When we reconnected again as full-fledged adults, the “D” word was introduced. It was discussed, visible and fierce. There was no denying it and the impact it had on his relationships, his career — his life overall. It lived in him and therefore, it lived in our close friendship. Let me preface by saying that I screwed up dozens, if not hundreds, of times. At first, I was unaware of the magnitude of this condition and the effect it has on relationships. There was a learning curve that smashed me in the face numerous times. But somewhere along the way I decided I was not going to let mental illness define or destroy this friendship. I began to change my mindset and my ideas. I think of a yoga meditation, “Devote yourself to seeing, not being seen.” In hindsight that’s what I tried to do — see, really SEE what was going on for him. And now I realize that I have learned to see myself as well. My approach and strategy for dealing with his depression took on various forms and there was definitely a progression and evolution over time. I decided to learn more about how those on the outside and from afar (mind you, I live hundreds of miles away) can help. My initial thought is that talking about it is, and was, paramount. I remember countless text and phone conversations that were icky, but oh so real, about how being depressed really feels in the moment. He talks about it, and therefore, it gives me permission to talk about it too. Even when he can’t name it because he is too far in it, over time he has given me the language and the power to do it for him. With that came the hard part: I challenged myself with listening. I listen to understand, empathize, problem-solve, validate and encourage. In that moment, I am there. And after, I am thinking, processing, and replaying it all over again, so I can be more cognizant of it next time. Often I stop and ask myself: is this my real friend or is this the depressed version of my friend? I almost equate it to someone who drinks — while there’s certainly some truth in the words of a drunk, the tone and delivery are inevitably damaged and therefore, damaging. This was by no means easy to work through, especially at the beginning of the process. It doesn’t mean I ignore it and can move on instantly, but it has become a check that I issue after I am done processing the yuckiness. Also, I educate myself, and I allow him (when not all in it) to educate me too. I read articles (metaphors comparing depression to regular things in life, like snowstorms, make the most sense to me), I watch videos (the Black Dog series was one of our favorites), I peruse blogs and follow mental health organizations. But most importantly, after I read/listen/watch/learn, I share it with him and ask, “So what do you think about this?” so I can gauge if it resonates with him as well. This learning is new and scary and so very personal in that it affects someone I’m close to. But that is why it is so important for me to do. Lastly, I’ve learned to give space. Often he will say to me, “I’m sorry, but this is not about you,” and while it may feel like a rejection, it’s the truth. There are times when he needs to shut me down, and although I can get pissed, I understand that talking is not always the best option. We can come back to it another time — or not, and that’s ok too. I am not a perfect friend. And I will never truly understand what someone with depression deals with on a regular basis. But I’ve found from personal experience that by doing some of the strategies above to SEE what’s in front of me, we can work together to tackle this goddamn Black Dog one bark at a time. *NOTE: I have had my friend’s permission, blessing and assistance with this piece from the beginning. He is fully aware I have written it and has read it in its entirety. View the full article
  25. Phobiasupportforum

    I Was Dumped Over My Depression

    He found out by Googling me. I’ve been writing candidly about my life for as long as I can remember. I’ve never been able to pull off fiction, because my brain doesn’t work that way, but I’ve been able to, as Hemingway put it, “sit down at a typewriter and bleed.” Or, since it is the 21st Century, sit down at a computer and just let it all out. Maybe I’m a product of my 21st Century over-sharing generation, or maybe I just want others to feel less alone in their own struggles; some days, I’m not quite sure. But either way, the topics in which I choose to cover never fail to evoke a strong response, and I would never want it any other way. One such topic, from which I’ll never steer, is my depression. The 3 Best (and Worst) Things to Say to Someone With Depression I’ve been very open in many pieces I’ve written about my struggles dealing with depression, as well as being honest about my suicide attempt about nine years ago. That particular subject, I can say for sure, isn’t about over-sharing at all, and absolutely about providing a sense of comfort and solace to those who are learning how to deal with depression and possible thoughts of suicide. It has taken me a long time to get to where I am on the matter, to be free of shame, embarrassment, and judgment of myself, but since I’m still here, alive and kicking, I feel it’s a story worth telling. When I first started writing about that specific part of my life and my person, I was still single. I wasn’t an avid dater, as that’s hard to pull off in New York City, because — breaking news — this isn’t Sex and the City, but I did meet new people here and there, and sometimes, if the stars were aligned, a first date would lead to a second date, but it was rare. Dating in New York City has to be one of the most difficult things in the world. Despite this rarity, I actually met someone great, and not only did it lead to a second date, but a third and fourth one, too. I wouldn’t say we were “dating,” exactly, because no one likes to use that term too fast, but we were on our way there and it felt good. He was charming and funny, and we connected over things that are important to me like politics, religion, and of course, music. We had both been raised in New England and, thanks to that, we were extremely skilled in our Boston accent impressions. We weren’t soulmates or anything like that, but I could definitely see us heading into the direction of the whole boyfriend/girlfriend label, as much as I’m not really keen on labels of any kind. But then something happened a couple months into our seeing each other: He Googled me. When I first meet someone I almost always Google them, or at least try to find them on Facebook. I don’t do this because I automatically assume everyone out there is like Patrick Bateman from American Psycho (Or do I?!), but mostly because I’m curious. I also tend to meet lots of people in my field and like to see links to their work and read their writings. So when, let’s call him Jay, told me partway through dinner one night that he had Googled me, I wasn’t really surprised. Don’t most people Google? I mean, the majority of us are online all day long, so why wouldn’t we? At least as a means to procrastinate, if nothing else. But instead of singing my praises, as he should (I kid!), he decided to ever so slightly inquire about my depression and suicide attempt. I kindly explained that the attempt was securely in my past and that, yes, my depression is a very real part of my life, but it’s as under control as it can be — at least for the moment. It was then that he told me, in not so many words, that he “couldn’t deal” and “wasn’t up for the drama.” I thought this was a strange response since I know more people than not who are medicated, and about 50 percent of my friends also suffer from some form of depression and/or anxiety. Had this been 1950, I could have sort have understood, considering the stigma that was attached to mental illness then, but now, in this century? It seemed absurd. We continued to talk about it through the rest of dinner, a dinner we both barely touched, and by the time the waiter came to ask if we wanted coffee or dessert, it was quite clear that we were not going to be able to find a common ground on the topic. In his eyes, I was a drama laden woman who had no hope at being “normal” enough for him, and in my eyes, he was both an ignorant and smug twit, who probably should have taken at least one basic psychology class in college so he wouldn’t sound so clueless. I’ve long lived with the idea that I am broken. Although I have come to grips with who I am and the chemical imbalance in my brain, the fact that it’s still very much a part of my daily life, I still can’t help but think of myself as being flawed. Yes, no one is flawless and I think that’s a beautiful thing, but to be flawed in your brain, to have zero control over your thoughts and feelings, and to be completely dependent on drugs just to keep you alive and to prevent you from seriously hurting yourself, is an entirely different thing. Quotes That Perfectly Explain What Depression Really Feels Like My depression is what I hate about myself the most, even if I have learned to deal with it. Never before and never since that night has any man, or anyone for that matter, taken issue with my depression. I’m not saying the other men in my life were excited to be with a woman who suffers so deeply and so often, but their tolerance and understanding were in a completely different ballpark than that of Jay. Although we never got into the particulars as to why he felt the way he did, I could only surmise that perhaps he had lost someone he really loved to the disease. Maybe it was a past girlfriend, a sibling, or a parent whom he watched struggle, up close and personal, and he just couldn’t stomach doing it again. If that were the case, I would have been more than understanding. I would not wish on anyone the turmoil I have put my loved ones through when dealing with depression. But since I don’t know the reasons, all I can do now is look back and think ill thoughts about him. It pains me that someone could be so obtuse about the subject and not even willing to budge an inch, despite me having shown him just how great and healthy I was then. This guest article originally appeared on YourTango.com: My Depression Was A Dealbreaker For Him. View the full article
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