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Get Out of the Rat Race!
2007-02-10 18:51:00
Feeling overwhelmed with the daily rat race? Is career, gathering material goods, consuming more time than you want, taking time from your personal time, your family time, your life? Have you noticed that every time you reach a material or career goal, you find little sense of achievement, just an emptiness that can only be replaced with a new goal? Then perhaps you need to rethink your values. More and more people are redefining the "American Dream". The traditional goals of money and consumption does not bring us happiness. Anxiety, Addiction and Depression Treatments According to economic and psychological experts across the board, more money almost always brings with it more stress and leads to decreases in the quality of an individual's physical and mental health. Popular philosophy reasons that money grants one greater opportunity to live the life he or she wants. But independent studies have ironically found that, the more money people earn, the more stress they incur wh...
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The Emotional Roots of Rationality
2007-02-04 05:21:00
Perhaps the most common problem I see in my clients is pervasive avoidance of emotion. I suspect that the American culture encourages us to value rationality above all else and hide our emotional "weakness". I recall as a teen hearing guy talk about girls and their intuition about things how irrational and erratic that process made them. My Norwegian extended family certainly modeled stoicism, but paradoxically also demonstrated in a grand fashion why emotion was perceived as a problem of dramatic excess. Indeed, most people who find themselves persistently avoiding and suppressing emotions are those who have experienced emotional excess at it's worst and been traumatized as a result. All human beings share a neurological system that produces the manifestations of rational thought and florid emotion. We have all experienced how often our thoughts and feelings contradict. Perhaps we can recall times of particularly lucid convergence of emotion and thought that provided us with a de...
More About: Roots , Root , Emotion , Ality , Emotional

Antidepressants and Suicide
2007-01-20 19:03:00
Anyone taking or contemplating anti-depressants for treatment of depression have been concerned about the blackbox warnings from the FDA. The FDA has issued blanket warnings to anyone considering or taking anti-depressants that they may actually induce suicidal thinking. The truth is that there is still very little and conflicting information about the risks. Highlighting the risks in the way the FDA did by issuing a blackbox warning has been controversial. The problem is that the risks have been assessed in only a few studies and it is not clear what is happening. The other problem is that anti-depressants also treat and prevent suicidal behavior. Not taking an anti-depressant when you need one can also be a grave risk. There is concern within the psychiatric and advocate community that the FDA is driven more by politics than science these days. A coalition of psychiatry and advocate organizations has issued an open letter to the FDA pointing to the life and death consequences o...
More About: Suicide , Anti , Antidepressant , Sant , Antidepressants

Prescription for Resilience
2007-01-20 04:10:00
Ever wondered why some people survive a major stress or trauma better than others? There really is no magic. People who in general have healthy lifestyles and attitudes survive trauma better than others. People who in particular have unhealthy attitudes about stress, themselves and life in general are much more likely to suffer stress related symptoms. Here are a list of ten traits of healthy POWs from the Vietnam War. This information is not just for soldiers, it's for all of us. Psychiatry News Charney and Steven Southwick, M.D., a professor of psychiatry at Yale University, identified personality traits associated with resilience in 250 American POWs during the Vietnam War who were held captive for up to eight years and subjected to torture and solitary confinement. Remarkably, years after their release, they had a lower-than-expected incidence of depression and PTSD. To determine how these men, mostly pilots, handled such a dire experience yet in many cases came out stronge...
More About: Resilience , Prescription

The Truth About Drug Abuse
2007-01-09 15:16:00
There is a secret that is just not talked about in a lot of circles. Drug abuse is not solely the scourge of poverty. In fact, drug abuse among poor minorities is dropping. Drug abuse among educated white middle aged women is higher than it's ever been and growing. Along with it, aging baby boomers are well represented in the latest crime wave. New York Times When releasing last week?s Monitoring the Future survey on drug use, John P. Walters, the director of the Office of National Drug Control Policy, boasted that ?broad? declines in teenage drug use promise ?enormous beneficial consequences not only for our children now, but for the rest of their lives.? Actually, anybody who has looked carefully at the report and other recent federal studies would see a dramatically different picture: skyrocketing illicit drug abuse and related deaths among teenagers and adults alike. ...According to the Centers for Disease Control and Prevention, the number of Americans dying from the abu...
More About: Truth , Abuse , Ruth , The Truth

Medical Blog Awards
2007-01-03 20:02:00
Vote for Dare To Dream.. in the Medical Blog Awards ! The polls are open today at http://www.medgadget.com/2006bestclinical .php. Here is the announcement. Polls will be open from Wednesday, January 3, 2007 and will close at midnight on Sunday, January 14, 2007 (PST).announcement. Thanks for your vote!
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Problems with the Medical Model
2006-12-23 16:59:00
Mental illness is less understood than most people think. Common sense would have it that good parenting makes all the difference. It's just not that simple. The NY Times has a great series on "Troubled Children" that is well worth the read. The articles include some good background on the nature of mental illness and it's development. Today six million American children have been diagnosed with a serious mental disorders, a number that has tripled since the early 1990's. But that doesn't mean that the rates of illness have increased in the past few decades. Rather, it is the decease in stigma of seeking help and that more professionals and parents are willing to attribute problems with children to mental illness. ADHD and Bipolar illness is diagnosed with alarming frequency these days, clearly an indication of misdiagnosis in both the past and the present. From the NY Times series: Still, many psychiatrists believe that, although childhood bipolar disorder may be real in ...
More About: Parenting , Medical , Model , Problems , Psychotherapy

When Countertransference Becomes Stigma
2006-12-19 00:50:00
Mental Nurse posted a wake up call for caregivers today. Please note she writes with tongue firmly inserted in cheek. Service users are time-wasters. They want to be in hospital, are happy to be dependent on professional carers and are ready, willing and eager to become institutionalised as soon as they fall into our grasping hands. Sound familiar to anyone out there? ?probably not, but now replace the general with the specific, and I wonder how many staff have either heard these words uttered from the mouths of colleagues?or even, dare I say it, have said it themselves: ?Patient x shouldn?t be here, s/he?s just wasting our time?..not mad, but bad. S/he really likes being in hospital/getting a community service, and (the final convincer for anyone who thinks this is just prejudiced opinion??..) we need to discharge him/her before they get institutionalised/too dependent on us.? The last comment of course refers to the mystical processes of institutionalisation and dependence th...
More About: Stigma , Count , Counter , Ferenc , Tran

Eating Disorders Contagious?
2006-12-12 01:12:00
Sort of contagious. You see, there are a lot of symptomatic behaviors that are subject to imitation. Drug abuse, cutting, suicidal behavior and eating disorders are just a few examples. When like minded people get together, they inspire imitative behavior in each other. It is unlikely that they are sharing the behavior in each other's presence, but they are seruptitiously comparing notes. Therapists are very much aware of this potential for contagion. They do what they can to minimize the chance it will happen. If you know of such imitation going on in a therapy experience, be sure you let the therapist know immediately. Thanks to the heads up and link from The Corpus Callosum. Here is a excerpt from his blog. There is also a link to the study abstract. According to a study published in the medical journal, Pediatrics, girls and young women who visit eating disorder oriented websites may be harmed by the activity. The funny thing is, is does not matter if the sites encourage ea...
More About: Eating Disorders , Order , Disorders , Eating , Orders

Eating Disorders: Without a Consensus Treatment
2006-12-04 05:37:00
Eating Disorders include Anorexia, Bulimia, and Binging Disorder. Unfortunately, most often, eating disorders, even with rigorous studies, have been studied as if they are related disorders. While there appears to be some relationship, between them, there are important differences. Anorexia is one of the most deadly forms of mental illness. The mortality rate is about 10%. Stice (2002) Eating disorders are one of the most common psychiatric problems faced by women and girls and are characterized by chronicity and relapse. Anorexia nervosa involves emaciation, fear of becoming fat, disturbed perception of body shape, undue influence of shape on self-evaluation, denial of the seriousness of low body weight, and amenorrhea. Bulimia nervosa is marked by uncontrollable binge eating, compensatory behavior to prevent weight gain (e.g., vomiting), and undue influence of shape on self-evaluation. Binge eating disorder entails uncontrollable binge eating in the absence of compensatory b...
More About: Treatment , Eating Disorders , Order , Sens

Are New Drugs Really Better?
2006-12-01 19:24:00
Tripped over a blog I hadn't seen before. While the author is apparently anonymous, he makes a good point here. Clients can best ensure they are receiving quality care by being informed of ALL of the options. Seldom have I seen doctors give a second thought to the cost of the medicine their prescribe and the hardship the client may face. A study supports my viewpoint. It's not that they are without compassion, it's that they simply were not trained that way. They will make their best judgment of the medication for you. I do believe in general, doctors could do a better job of informing you of the consequences of his choice, including cost and side effects and alternative treatments. So be informed, ask if you doctor doesn't volunteer the information. Clinical Psychology and Psychiatry I'll join many others, including the study authors, who have stated that this doesn't mean everyone should switch from atypical antipsychotics to older antipsychotic meds. Treatment should of c...
More About: Drugs , Medications , Bett , Really , Ally

Halucinations and Odd Ideas More Common Than Believed
2006-11-28 19:24:00
Hallucinations and odd ideas are much more common than the psychosis the text books would have us believe. For too long, Some of us may have suspected this all along. I've seen well meaning psychiatrists diagnose as schizophrenic, and medicate with powerful anti-psychotics, people who were experiencing one or both. Sometimes these experiences are signs of a history of abuse, neglect or trauma. Sometimes it's a product of odd beliefs within a family where such experiences are common and expected. Mind Hacks Psychosis is the mental state in which delusions and hallucinations are prominent, and is usually linked to diagnoses such as schizophrenia or bipolar disorder. ...Recent research has indicated that the experiences previously thought to be diagnostic of madness, actually occur in many people who never become distressed or impaired. It may be the extent and impact of these experiences, rather than just their presence, that is important. Weight is something which is distribu...
More About: Ideas , Common , Cina , Comm , Luci

The Importance of Early and Effective Treatment Response in Schizophrenia
2006-11-14 02:46:00
There is an important new research study on treatment of schizophrenia. They have found delayed or interrupted treatment is associated with permanent lost brain function and less success in recovery. That is indeed my clinical experience with schizophrenia and bipolar disorder. Any kind of chronic brain dysfunction makes permanent changes to brain structures and functioning. PTSD has been associated with permenent changes in emotion intensity and increased difficulty in emotion regulation. Chemical abuse has been associated with brain changes as well. When the brain is involved, respond quickly, ask for help and persist to be sure the treatment is effective. Anything less will cost you in brain function. This applies to any serious mental health or neurological problem. Psychiatric Weekly In summary, it appears that there are benefits to be gained by identifying psychotic exacerbations early and bringing effective treatment to bear quickly (Table).11 If patients do not respond wi...
More About: Treatment , Early , Effective , Import , Earl

Mental Health Problems From Katrina Persist
2006-11-09 15:08:00
The tragedy of Katrina continues in resources stretched beyond capacity with no relief in sight. This nation needs to take another look at relief efforts on the Gulf coast. washingtonpost.com Hurricane Katrina left more than gutted houses and empty streets along the Gulf Coast. The most devastating impact of the storm, which killed thousands of people and destroyed entire towns, can be seen in the desperate faces of people more than a year later, survivors and rescue workers said in a panel discussion Wednesday. ...The panel was part of an annual Carter Center symposium on mental health policy. This year's focus is on the psychological effects of Hurricane Katrina. Panelists said mentally ill patients are still unable to get treatment and medicine because so few services are available in New Orleans and other damaged cities. But the storm also triggered mental problems -- most commonly depression and anxiety -- in people who had never before had them. Wellborn's unit handles...
More About: Health , Mental , Mental Health , Problems

Cognitive Behavior Therapy Again in the News
2006-11-04 21:56:00
The National Health Service in Britain has adopted Cognitive Behavior Therapy (CBT) as the first choice treatment for depression and anxiety. Collective experience is that medication is very expensive and has disappointing results. The article from Times Online argues that CBT has trouble maintaining results in the long run. However, the issue isn't what therapy works best, it's about what therapy works best for whom. Anti-depressant medications and CBT has the most impressive outcomes, but these measurements seldom look at long-term outcomes. Anti-depressants in my experience take the edge off of depressive symptoms for most people. CBT offers a good set of skills for clients to learn that enable them to redirect their thoughts and change their feelings on a moment to moment basis. These are critically important skills that everyone can benefit from. Some depression and anxiety have deeper causes. A history of abuse, neglect, or signficant or repeated trauma can very much c...
More About: News , In the News , The News , Psychotherapy

Suicide Rates for Oldest and Youngest Dropping
2006-11-04 01:25:00
The American Journal of Public Health published a study showing suicide rates from 1970 to 2002 by age group. Suicide rates have been dropping in all age groups. But there have been some changes, increases and decreases in rates during this time that suggest age specific pressures. Perhaps the most significant finding is that suicide rates in the youngest group, under 18 has been consistently dropping through the time that use of anti-depressant use have doubled, and the new generation anti-depressants called SSRIs have been associated with a greater risk of suicide. That appears to be unlikely given the population statistics. Psychiatric News Suicide rates among teens and young adults have been on the decline since the mid-1990s. In addition, suicide rates among elderly Americans have been dropping since peaks in the late 1980s. Researchers reporting their findings in the October Journal of Public Health said they don't have enough information to determine what may be leadi...
More About: Rates , Ping , Rate , Cide

Depression Related to Inaccurate Perceptions of Peer Relations
2006-11-01 03:13:00
Thanks to PsychCentral.com, I found facinating article from the Los Angeles Times. A recent study has found that depression is related more to misperceptions of peer interactions, especially during puberty. Truth sometimes hurts. But for children closing in on adolescence, a firm grasp on the truth about one's standing with classmates and peers can be healthy, even when it does hurt a bit. A new study has found that children who can accurately assess how much ? or little ? their peers like them are less likely to develop symptoms of depression, including sadness and difficulties concentrating or sleeping. By comparison, children with unrealistically rosy or unfoundedly gloomy views of their standing appear more likely to be headed toward depression. Many psychologists have speculated that the smiling child who believes she is the glowing sun in her classmates' universe will be protected from depression by that belief. They also surmised that the child who holds a negative view ...
More About: Parenting , Depression , Peer , Relations , Late

What Every Girl Should Know
2006-10-23 06:13:00
Isn't it sad that our most effective and pervasive education sources (TV) and other media is full of images that are not real, raise expectations for ourselves and others, and sets us up to feel inadequate. Those feelings help create in some girls a frenzied obsession with appearance that sometimes leads to eating disorders, some of which are deadly. And they make a few people rich. Thanks to Dr. Deb Serani for the link.
More About: Girl , Child Development

Public-Education Campaign Battles Depression Myths
2006-10-23 04:42:00
A group of physician, patient and constituency groups concerned about confusing messages in popular culture suggesting that depression is "just the blues" or worse, a "made-up disease." Although they don't say so, I suspect this movement intends at least in part, to counter the very well organized and highly funded lobbying effort by Tom Cruise and his Scientology friends to debunk psychiatry and depression. Instead they want us all to believe that depression is best alleviated by removing the sufferer's covering of tiny disembodied souls of aliens dispersed by the Galactic Federation leader Xenu. And to learn that technique, you must send thousands of dollars to the "Church" of Scientology. In the process you will learn all about the delusional beliefs of founder L. Ron Hubbard. For whatever reason, they have put together a nice website and are pursuing a worthwhile educational program. Psychiatric News The initiative will spread science-based information to counteract "made...
More About: Education , Depression , Public , Myths , Campaign

Latest Schizophrenia Study: Interesting Science, Bad Policy
2006-10-19 05:06:00
Anti-psychotic medication has gotten very expensive, especially when compared to long standing generics. Now research is finding the generics work just as well as the new "atypicals". But the fact is, medication has to be subscribed one client at a time. While on average, some of the generics work as well with low side effects, some individuals have extreme side effects from the generics or don't benefit from them any where near as effectively as the new "atypicals". In particular, the worse permanent side effect, tardive dyskinesia appears less likely with new atypicals in individuals prone to that problem. So when we have journal articles pointing out the excesses of the pharmeceutical industry, we need to be sure we don't eliminate the best option for the minority of persons who need the new "atypical" anti-psychotic medications. Archives of General Psychiatry In people with schizophrenia whose medication is changed for clinical reasons, there is no disadvantage across 1 ye...
More About: Science , Interesting , Study , Policy , Late

Mental Illness Awareness Week October 1-7
2006-10-05 04:33:00
It's Mental Illness Awareness Week ! There is all kinds of information and materials to lead your own media campaign at NAMI.org Since 1990, mental health advocates across the country have joined together during the first week of October to celebrate Mental Illness Awareness Week (MIAW). What is Mental Illness Awareness Week? Established in 1990 by Congress, the first week of October is designated as "Mental Illness Awareness Week" (MIAW) in recognition of NAMI?s efforts to raise mental illness awareness. "Bipolar Disorder Awareness Day" (BDAD) is held each year on the Thursday of MIAW to encourage further understanding and promote early intervention and treatment for this mental illness. MIAW and BDAD are NAMI?s premiere public awareness and public education campaigns that link the organization nationally to the organization?s over 1100 local affiliates across the country. Over the past 16 years, MIAW has become a tradition in NAMI. It presents an opportunity for all three le...
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Can Chat Room Support and Phone Counseling Be Effective?
2006-10-02 05:26:00
On-line education with chat room support for eating disorders, on-line self-help support for depression, on-line treatment for panic disorder, on-line and phone-based help for sexual problems, and phone therapy with miscarriage sufferers have been recently studied as reported in recent journal articles. While this is exciting and concerning at the same time, these studies is only a beginning of a new area of research in providing mental health services. I'm committed to having some part in this process and hope you will join me in this effort by visiting ePsyQ.com supporting our efforts in whatever way you can. If you can only join Top Health Sites and display our banner on your site that's great! If you want to list your health service and/or spread the word about the FREE listing at ePsyQ.com Health Directory, fabulous! If you can join in the discussion and development of this project, all the better. Hope to see you soon on ePsyQ.com! Mental health counseling given over the ...
More About: Chat , Phone , Support , Psychotherapy , Room

Free Professional Health Services Directory, Research and Service Delivery
2006-09-21 01:56:00
UPDATE for 9/25/06: The Directory crashed on Friday, but it's rebuilt, with better reliable software and a new address and a more reliable host provider. Links are updated below! I'm very excited about a new venture I'm hosting at ePsyQ.com. I've had an interest in research for a long time, but my work in direct practice and management always came first. Now I've found a passion for online building, and frankly find it far more entertaining than television. My interest was piqued by an article from NIMH I tripped over a couple weeks ago. A long-term, large-scale study has found that an Internet-based intervention program may prevent some high risk, college-age women from developing an eating disorder. The study, funded by the National Institutes of Health 's (NIH) National Institute of Mental Health (NIMH), was published in the August 2006 issue of the Archives of General Psychiatry. The researchers conducted a randomized, controlled trial of 480 college-age women in the ...
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Assessing Risk of Suicide
2006-09-18 19:03:00
Today, I tripped over an interesting article on assessing suicide potential. Psychiatric Weekly America bears witness to 30,000 deaths by suicide per year. Although clinicians have a fairly good grasp of long-term risk factors, possible short term indicators of risk have been largely overlooked. Dr. Jan Fawcett believes that, to make real headway in combating suicide, doctors need to identify patients at acute, not just chronic, risk of suicide and treat their symptoms aggressively. ...?We have plenty of clinical associations, and even quite a few social and epidemiological associations, for suicide risk,? Dr. Fawcett says. ?However, when it comes to a clinician evaluating an individual patient, things can get difficult. Most of the associations we have predict long-term risk for suicide, but clinicians needs to know what?s going to happen tomorrow. When it comes to predicting acute risk, we?re very deficient.? Dr. Fawcett?s work has suggested that the standard risk factors ...
More About: Suicide , Risk , Cide

The New Asylums Redux
2006-09-08 03:33:00
There is news today of a new study about mental health problems in prison and jails. The information shows a much bigger problem than previously reported. MSNBC.com More than half of America's prison and jail inmates have symptoms of a mental health problem, the Justice Department estimated Wednesday. But fewer than one-third of those with problems are getting treatment behind bars. The study by the department's Bureau of Justice Statistics also found the incidence of symptoms much higher among women than men. Compared to inmates without symptoms, these mentally troubled prisoners were more likely to have been jailed before, to get into a fight behind bars, to have been physically or sexually abused in the past and to have drug problems, the bureau said. But troubled inmates were no more likely to have used a weapon during their offense (37 percent for troubled and nontroubled state prisoners) and only slightly more likely to have committed a violent offense (49 percent of st...
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Many Vets Suffering Recurance of PTSD
2006-08-30 05:00:00
Post traumatic stress disorder is an anxiety disorder caused by experiencing intense trauma where life is threatened in terrifying ways. This disorder has life long consequences as I've talked about before. AP Wire reported on a former Senator who is a Vietnam vet who has had a recurence of PTSD because of repeated exposure to images of war in Iraq. Former U.S. Sen. Max Cleland, who has battled bouts of depression since losing three limbs in Vietnam, is being treated for post-traumatic stress disorder. Cleland, who represented Georgia in the Senate from 1997 to 2003, said he believes the condition - cases of which are increasing rapidly among Vietnam war veterans - was in part triggered by the ongoing violence in Iraq. "I realize my symptoms are avoidance, not wanting to connect with anything dealing with the (Iraq) war, tremendous sadness over the casualties that are taken, a real identification with that. ... I've tried to disconnect and disassociate from the media. I don't w...
More About: Suffering , Post Traumatic Stress Disorder , Erin

New Orleans Mental Health Infrastructure Is Overwhelmed
2006-08-29 06:39:00
New Orleans was a social service nightmare before Katrina. It's mental health infrastructure was likely underfunded like many other inner city services. But the results of the devastating trauma of Katrina spawned flood, people are stressed beyond their ability to cope. Psychiatric beds have shrunk by 80% while many professionals have abandoned the city along with half it it's residents. It's often those without alternatives who are left to return, to conditions worse than they ever were. New Orleans needs licensed mental health professionals. Looking for meaningful work? Here is your opportunity. Newsweek ...the state-funded Central City Mental Health Center has chosen a more practical way to mark the anniversary of the nation?s biggest natural disaster?one that may well be the most fitting. Free testing for depression and post-traumatic stress disorder (PTSD) will be conducted all day on Aug. 29, punctuated by a lunch at which overburdened staff members will reminisce abou...
More About: New Orleans , Infrastructure , Mental Health

You Are What You Believe
2006-08-14 03:20:00
MindBlog quotes from pp 348-352 of Wayward Mind by Guy Claxton: What we call our ?self? is an agglomeration of both conscious and unconscious ingredients: cans, needs, dos, oughts, thinks?.these constructions hold out an overwhelming temptation: to assume that the ?I? is the same in all of them? so that instead of having an intricate web of things that make me Me, I have to create a single imaginary hub around which they all revolve, to which they all refer?the attempt to keep this fiction going, to ?hold it together? can become quite tiring and bothersome? If ?I? am essentially reasonable, if I imagine that my zones of control ? over my own feelings for example ? are wider and more robust than they are, then I am going to get in a tangle trying to ?control myself.? If I have decided that who I am is clever, attractive, athletic, stable, creating the hub of ?I? locks everything together and prevents it moving. It stops Me expanding to include the unconscious, or graciously shrinkin...
More About: Wellness

Perceptions Have More to Do With Depression and Happiness
2006-08-05 19:06:00
From the outstanding site of Anxiety Insights, there is a summary of a recent research study that produces results questioning conventional wisdom about income, poverty and depression. None of the socio-economic indicators studied was found to be significantly associated with an episode of common mental disorder at follow-up, after baseline psychiatric illness was taken into account. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both groups. In other words, it's the subjective experience of stress rather than the experience of poverty that predicts a higher rate of depression. That is consistent with my own clinical and life experiences. I teach my clients that we control our reactions to whatever happens to us. While, we also have a lot of input on our successes, mainly by the persistence and willingness to make adjustments and keep going, but there are othe...
More About: Depression , Happiness , Wellness , To Do , Perception

A Higher Risk of Diabetes From Depression and/or Anti-depressants?
2006-08-05 09:19:00
Here is a heads up for everyone taking or considering anti-depressant medication. One study has found a higher incidence of diabetes in high risk pre-diabetic persons undergoing intensive preventative treatment. What is not clear is whether anti-depressant use was associated with previous serious depression. The results could indicate depression and/or anti-depressant use increases the risk of diabetes. Further study certainly is certainly indicated. Please note, there is NO reason to consider discontinuing your medication based on this study alone. Bring your concerns to your doctor, preferably a psychiatrist.
More About: Depression , Diabetes , Risk , Anti , Higher