All Posts in Category: Cognitive Behavioral Therapy

Adult ADHD

Attention Deficit Hyperactive Disorder or ADHD is a medical disorder involving abnormalities in brain function. Often, this disorder can be passed genetically through families from one generation to the next. The condition is generally diagnosed in childhood, however we now know that ADHD commonly continues into adulthood. Although the hyperactivity component usually subsides in adults, attention and concentration problems often persist. If not caught in childhood, adults often become suspicious they may have adult ADHD when their children is diagnosed, and they recognize the same set of symptoms in themselves.

The Centers for Disease Control (CDC) estimates that approximately four percent of adults have the disorder. The risk increases in those people who have close blood relatives (parents, siblings, etc) who also have ADHD, in people who were born prematurely or were exposed to environmental toxins, or those who were born to mothers who smoked, drank alcohol, or abused drugs during their pregnancy.

Signs of ADHD in Adults

The following can be warning signs of adult ADHD:

  • Reckless driving or frequent traffic tickets or accidents
  • Problems paying bills on time
  • Job hopping or habitual unemployment, being late to work frequently, trouble staying on task if you’re distracted by emails or phone calls
  • Alcohol or substance abuse problems
  • Some marital troubles, especially if your partner grumbles that you don’t listen to them or that you don’t honor promises you made to them
  • Frequently forgetting appointments, forgetting to run errands or do things like getting gas or picking up something from the grocery store on the way home
  • Underestimating the amount of time it will take to complete a task
  • Making impulsive or irrational decisions
  • Having trouble starting or completing projects at work or at home
  • Being tense or edgy or being prone to angry outbursts, even over minor problems

ADHD Symptoms in Adults

The signs that are so telling for ADHD in children are often more subtle when you reach adulthood. The Centers for Disease Control (CDC) has a comprehensive list of criteria for adult ADHD symptoms. If five or more of the symptoms on each list are present now and were noticeable before the age of twelve, if they have persisted for more than six months, and if you are age 17 or older, you may have adult ADHD:

  1. Inattention: Five or more symptoms of inattention for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
    • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
    • Often has trouble holding attention on tasks or play activities.
    • Often does not seem to listen when spoken to directly.
    • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
    • Often has trouble organizing tasks and activities.
    • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
    • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
    • Is often easily distracted
    • Is often forgetful in daily activities.
  2. Hyperactivity and Impulsivity: Five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
    • Often fidgets with or taps hands or feet, or squirms in seat.
    • Often leaves seat in situations when remaining seated is expected.
    • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
    • Often unable to play or take part in leisure activities quietly.
    • Is often “on the go” acting as if “driven by a motor”.
    • Often talks excessively.
    • Often blurts out an answer before a question has been completed.
    • Often has trouble waiting his/her turn.
    • Often interrupts or intrudes on others (e.g., butts into conversations or games)

In addition, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more setting, (such as at home, school or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.

Adult ADHD Treatment

Since the focus of attention deficit hyperactive disorder is normally on children and helping them learn to function through their challenges, if you’ve reached adulthood without an ADHD diagnosis, it may seem silly to consider treatment. However, it is still very important that you address your condition. As noted above, untreated adult ADHD can cause ongoing disruptions in your life, such as workplace or relationship problems, and alcohol or substance abuse.

Adult ADHD treatment can be very effective and can help turn your life around. A combined approach works best. This includes prescribing appropriate ADHD medications to help balance and boost the brain’s neurotransmitters, as well as psychotherapies like Cognitive Behavioral Therapy. CBT teaches life skills in time management and organizational development and provides aids that may allow some people to eventually discontinue their medication. Additionally, couples therapies can be used to help improve communication skills and teach your significant other ways to understand and help with your Adult ADHD condition.

Help for Adult ADHD

It is challenging to have adult ADHD, so don’t go through it alone. The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are here to help. For more information, contact us or call us today at 561-496-1094.

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Sex Avoidance and Anxiety Disorders

Most people are somewhat familiar with the term “sex addiction”, particularly because they’ve heard about the occasional movie star or entertainer who seeks treatment for their compulsion. But, while sex addiction is recognized and there are rehab centers and support groups that can provide help, its polar opposite – sex avoidance – is hardly ever discussed. And yet, sex avoidance is just as shattering – perhaps even more so, because a person with sex avoidance shuns intimacy and the enjoyment that comes with having a sincere connection to a loving partner.

Additionally, while sexual avoidance can be troubling on its own, it is also often a side effect of having an anxiety disorder. Things like performance fears, being distressed and upset, and low libido can make people even more anxious and can lead to the avoidance of sex.

What is Sex Avoidance?

In general, the aversion toward sex is a defense mechanism. When thinking of intimacy or engaging in sex, the person with sexual avoidance feels emotional distress and physical symptoms, such as nausea and tensed muscles, or they may have panic attacks. They may also experience humiliation, shame, and low self-esteem for rejecting their partner.

As with any condition, there are people who fall on either end of the spectrum. Sex avoidance can come in the form of sexual anorexia, which happens when sex and intimacy are obsessively evaded in the same way anorexics shun food. In some cases, the sexual anorexic may enjoy physical intimacy once it has been initiated, but may not be able to instigate sex. Or, they may take it a step further and turn down their spouse or partner’s desire for physical closeness more often than not.

On the other extreme, the American Psychological Association has classified an actual disorder called Sexual Aversion Disorder. With this disorder, the individual actively seeks to avoid genital sexual contact with a sexual partner. Often, the person will even avoid genital contact related to a gynecological exam or procedure. Sexual Aversion Disorder can be so traumatic that the person won’t allow any physical touch or kissing.

Reasons for Sex Avoidance

There are various reasons for avoiding sex. The most obvious is the case of a person who has suffered childhood sexual abuse and now dodges anything that brings the trauma back up in their mind. However, not everyone who has been abused will avoid sex, just as not every person who shuns physical intimacy has been abused.

In some cases, people with anxiety disorders also shun sexual encounters. When a person has an anxiety disorder, they suffer physical effects along with their mental stress. Physically, the Mayo Clinic reports people with an anxiety disorder may experience the symptoms of:

  • Insomnia, trouble falling asleep or problems with staying asleep
  • Fatigue, particularly if they aren’t sleeping well
  • Heart palpitations
  • Headaches
  • Vomiting, nausea
  • Irritable bowel syndrome
  • May be easily startled
  • Muscles aches, tense or clenched muscles
  • Twitching or trembling
  • Sweating

But, why would these symptoms cause someone to avoid the comfort of a physical relationship? One reason is that the act of intimacy raises your heart rate, induces heavier breathing, and makes you sweat. These bodily reactions mimic the physical “fight or flight” responses people experience during a panic attack, so much so that some individuals will go to great lengths to avoid feeling them at all.

Additionally, people who already suffer anxiety may choose to forego sexual encounters so they don’t have to add more fears to their list of concerns. Engaging in sexual activity can bring up worries about their attractiveness, their ability to perform, or may increase feelings of shame or guilt.

Sex Avoidance Treatment

Depending on its root cause, sex avoidance can be effectively treated either on its own or as part of an anxiety disorder therapy.

  • Cognitive behavioral therapy and psychodynamic therapy can help reduce anxiety, fear, and negative emotions. These therapies can be conducted on a one to one basis, in group therapy, or online depending on the particular preference of the client.
  • Sexual function can often be improved with the use of certain medications. For example, SSRIs may have the side effect of delaying orgasm and can often help men who suffer from premature ejaculation.
  • If you are already on anxiety disorder medications, talk to your doctor about adjusting your medicine so it has less effect on or can help with your condition.

A Place to Turn for Help

If your anxiety disorders are leading to sex avoidance, turn to the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, contact us or call us today at 561-496-1094.

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Can Men Get Postpartum Depression, Too?

Almost everyone knows that new mothers can sometimes go through postpartum depression after the birth of a baby. There are plenty of articles about the subject online and daytime talk shows often discuss the topic. In women, anxiety and depression can be the result of many factors – sleeplessness, a new routine, feeling like you’re losing control, and radical swings in hormone levels all contribute to the “baby blues.” But, while new moms are the usual focus of postnatal depression, what about the new dad? Can men get postpartum depression, too?

While it would seem unlikely, it is not uncommon for new dads to also go through a period of depression after the birth of their child. In fact, in 2010, American Medical Association (AMA) researchers reported that slightly more than 10 percent of new fathers experience paternal postpartum depression (PPND). That figure is roughly twice as high as “regular” depression rates in the general male population.

Postpartum Depression in Men

In February, 2017 JAMA Psychiatry published the results of a New Zealand study of more than 3,500 men who were about to become fathers. These study participants filled out questionnaires when their partners were in their third trimester of pregnancy and answered follow-up questions nine months after the birth of their child.

The researchers found that while some of the new fathers showed signs of depression, this mental disorder was most likely to be present in the men who reported being in fair-to-poor health or under stress during the pregnancy. All in all, about 2.3 percent of the study’s expectant fathers exhibited signs of depression before the birth of the baby.

When the study follow-up was done nine months after the birth of their child, postpartum depression in the new fathers had increased. At this point, 4.3 percent of the men who were participating reported symptoms of PPND. This postpartum depression in men was not only associated with stress during the actual pregnancy, but had risen due to other factors that happened after the birth, such as becoming unemployed, having a prior depression history, or no longer being in a relationship with the child’s mother. It was also no surprise that the men’s risk increased if the baby had health concerns, was colicky and not sleeping well, or if the pregnancy was unplanned.

The AMA study done in 2010 showed that the men’s postpartum depression was highest in the 3 to 6 months after the child’s birth. Interestingly, researchers also noted a correlation to the depression severity within the family. It seems that the new fathers were more likely to experience paternal postnatal depression if the child’s mother also went through postpartum depression.

New Father Depression Symptoms

The indicators of postpartum depression in men are similar to those experienced by women. New father depression symptoms can include some or most of the following:

  • Anger, frustration, mood swings
  • Withdrawal from social activities
  • Poor memory, unable to concentrate
  • Fear that you can’t take care of yourself, your baby, or your baby’s mother
  • Low energy, diminished libido
  • Changes in appetite
  • Sleeping too much or insomnia
  • Feelings of guilt or inability to bond with your child
  • Feeling helpless, sad, or hopeless
  • Physical pain, such as gastrointestinal problems or headaches
  • Lack of interest in your normal activities
  • Poor hygiene, unmotivated to perform personal care routines

Don’t Ignore Paternal Postpartum Depression

Your depression can have a long-term effect on your marriage or relationship, and on your child. There is research that shows the children of men with postpartum depression can have a reduced vocabulary at age two and can have behavioral and emotional issues, as well. Additionally, men with postpartum depression are less apt to spend time playing with or reading to their kids and are more likely to spank their child.

As with women, untreated PPND can last for a long time. Treatment for this type of depression is most likely to involve cognitive behavioral therapy or talk therapy. If needed, it may also include anti-depressant medications.

Even though much is not yet known about paternal postpartum depression, it helps to know there is such a disorder and that you are not alone. It is normal for men to need time to adjust to a new baby, just the same as it is for the new mother. Because men are not as likely as women to seek help, if you or your partner are experiencing some of the new father depression symptoms listed above, it would be wise to speak with a licensed mental health professional who works with men. Remember: it is not a weakness to seek help. Instead, it shows the strength of your commitment to yourself and your family.

Let Us Help

If you are a new father and are going through the symptoms of paternal postnatal depression, the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

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ADHD and Anxiety – Is There a Relationship?

Do ADHD and anxiety go hand in hand?

If you have been diagnosed with Attention Deficit Hyperactive Disorder, you may also be experiencing challenges with anxiety. But, what is it about these conditions that causes them to occur together?

ADHD Facts

By now nearly everyone has heard of Attention Deficit Hyperactive Disorder (ADHA). ADHD is a mental illness that is thought to be biological in nature. ADHA is the same as Attention Deficit Disorder (ADD) – the name that was originally used when people first became aware of the disorder. Although the names are often used interchangeably, the most current name is ADHD.

ADHD symptoms include:

  • an inability to focus
  • restlessness
  • disorganization
  • difficulty completing tasks
  • impulsive behavior
  • hyperactivity in children, although this behavior tends to diminish in adulthood

You do not have to experience all of these symptoms to have Attention Deficit Hyperactive Disorder.

How common is ADHD? Statistics show that about 11 million adults (about 5% of the USA’s population) have the condition. However, less than 20% of adults who have the disorder have actually been diagnosed and, of those identified adults, only about 25% have pursued treatment. People who were diagnosed in childhood often continue to experience symptoms in adulthood – about two thirds of children with the condition will continue to require some form of treatment in their adult life. Additionally, while we used to think the disorder only affected males, we now know females can have ADHD.

Can You Have Both ADHD and Anxiety?

Experiencing ADHD and anxiety is more common than you may think. Somewhere between 30% and 50% of adults with ADHD will also have some type of anxiety disorder. These disorders can range anywhere from generalized anxiety or social anxiety to panic disorder, phobias, and obsessive compulsive disorder (OCD).

The reason anxiety is so common in conjunction with ADHD is twofold. First, there is a theory that both ADD and anxiety disorders may carry a genetic component. Having a close relative with either condition can increase your chances of being diagnosed with their same disorder. Additionally, research is being conducted to find out if there is an environmental component that triggers both conditions, such as exposure to lead or toxins.

The second reason is that having the disorder is stressful and can lead to feeling overwhelmed and vulnerable. When you worry about things like possibly forgetting a work deadline or when your symptoms affect your relationships or daily activities, you may feel angry or disappointed. Being upset and anxious can make it more difficult to seek help and may cause people to stay in their comfortable but potentially ineffective patterns.

Anxiety and ADHD Treatment

Because ADHD is a brain-based disorder, it is generally treated with medication to help normalize brain function. The challenge to treatment with medicine, however, is that some ADHD prescriptions can worsen the symptoms of anxiety in some patients.

Ideally, a combined approach to anxiety and ADHD treatment works best. This should include Cognitive Behavioral Therapy (CBT) or another form of mindfulness based therapy, in addition to medication. These therapies provide coping techniques: learning these skills can be an invaluable tool to help you stay positive about change.

Undergoing CBT can help you improve productivity, learn to be accountable, and can aid in identifying and achieving goals. Additionally, support groups and talk therapy can help you come to terms with the interpersonal effects the disorder can bring. Feelings of shame, guilt, failure, and their resulting stress can be reduced by processing them in a friendly, compassionate setting.

There also are some steps you can take at home to help improve your symptoms:

  • Exercise regularly (30 minutes per day) to decrease anxiety.
  • Create schedules to help stay on task.
  • Get seven to eight hours of sleep per night. Being well-rested helps reduce anxiety.
  • Identify your triggers and work with your therapist to learn coping strategies.
  • Practice relaxation techniques, such as meditation or deep breathing.
  • Decrease your stress and surround yourself with positive, supportive people.
  • Try to minimize worry and negative thinking.

If You Have Questions, We Can Help

If you have questions or need help managing your ADHD and anxiety, the therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are there to help. For more information, contact us or call us today at 561-496-1094.

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Using Virtual Reality Therapy for Phobias

 

What would you think if you had a phobia about something (example: a fear of flying) and you could overcome your fear just by sitting in your therapist’s office and watching a movie? We think you’d sign up for that! Okay, it’s not entirely that simple (although it almost is), but virtual reality therapy for phobias is now giving patients a high-tech, cutting-edge solution for helping them get past their fears so they can live a better life.

How Does Virtual Reality Exposure Therapy Work?

Many types of phobias can be overcome or greatly reduced when the sufferer goes through cognitive behavioral therapy. In this type of therapy, a patient learns to recognize the thoughts causing the negative feelings surrounding their fears. Once these thoughts are identified, the patient learns how to replace those undesirable beliefs with more positive ones.

In-vivo exposure therapy goes hand in hand with cognitive behavioral therapy. With in-vivo exposure, the patient experiences what they fear in a controlled way and in small doses. By taking small steps, they can confront and gradually conquer their phobia.

Virtual reality exposure therapy combines the best of cognitive behavior therapy and in-vivo exposure. It allows people to work through their fears in a realistic environment without actually leaving the comfort and safety of their therapist’s office.

Virtual Reality Therapy

In the case of the fear of flying phobia mentioned above, a patient comes to our office, sits in a comfortable chair, and puts on a pair of virtual reality therapy goggles. In conjunction with coaching from their therapist, they view a simulation of the inside of an airplane’s passenger compartment and can look around to see all aspects of the interior.

The patient not only sees the plane, they also hear the same sounds they would experience if they were really on a flight, such as the flight attendant’s announcement or the rumble of airplane engines. Additionally, our virtual reality therapy chair vibrates with the motion of the plane “taking off” or “flying” to provide an even more convincing simulation.

Even if a person knows the virtual reality program isn’t completely realistic, there is enough realism in it to trigger their emotional responses to their phobia. And, by working through these reactions, in some types of phobias or traumas, nearly 83 percent of people who have tried virtual reality therapy have managed to put their fears behind them.

Virtual Reality Therapy Benefits

Some of the benefits of virtual reality therapy include:

  • Allowing the patient to try the therapy without as much anxiety. For example: in the case of a phobia about flying, it is much easier for someone to agree to try working through their fears in an office than to have to force themselves to physically go to the place they know will bring an emotional reaction.
  • Experiencing the phobia and/or its triggers without taking the time to travel to an actual location. For the fear of flying phobia, you simply sit in a chair, rather than going to the airport numerous times for several small exposures to your triggers.
  • Confidentiality for the patient: you don’t have to face potential embarrassment by running into someone you know or possibly becoming upset in a public area.
  • The therapist can carefully control the situation, meaning if you are afraid of elevators or airplanes, you don’t have to get in one. Virtual reality exposure therapy allows you to feel as if you are in a location, but the therapist can stop the program if you become truly upset.
  • The therapy is more realistic, in that you can go places or experience things you wouldn’t ordinarily be able to (you can’t get on and off an airplane as part of your flying phobia therapy, for instance). That being said, it is much safer than the real-life setting and minimizes any risk involved.
  • Virtual reality exposure therapy sessions are shorter than those that require you to visit an actual site for therapy (so, there is no travel time from the therapist’s office to the airport for our fear of flying scenario.)
  • Sessions can be repeated several times until the patient has conquered that portion of their phobia and is ready to move on to another phase.

Studies show this treatment has a powerful real-life impact and a great track record, over time. Virtual reality therapy has been successful in treating both children and adults for PTSD (post-traumatic stress disorder), social anxiety, panic disorder, anxiety disorder, OCD (obsessive compulsive disorder), and phobias. It is also a very effective tool for treating children who suffer from phobias such as school phobia or sleep fears.

Do You Have Questions About Virtual Reality Therapy?

Virtual Reality Therapy is coming to our practice very soon. For more information or to find out when it becomes available, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

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Complex PTSD

 

The majority of us have heard about PTSD (Post-Traumatic Stress Disorder), the condition that can occur when someone is exposed to a situation over which they had little or no control and from which there was little or no hope of escape. It is often associated with members of the military who have witnessed the horrors of battle, or with people who have endured an extreme physical or emotional trauma. PTSD can occur after experiencing even just one threatening situation, such as being involved in a car accident. But, what about those who have gone through long-term exposure to a continuing, intense level of stress?

Recently, mental health experts have begun to realize there are more layers to the emotional suffering experienced by people who have been through long-lasting stressors like childhood sexual abuse, for example, or years of domestic violence. In cases like these, a PTSD diagnosis partly addresses their condition, but doesn’t adequately define the severe psychological harm that has resulted from the trauma. Therefore, some mental health professionals now believe there should be a new category added to the PTSD diagnosis – one that will encompass this emotional scarring from long-term, chronic trauma: Complex PTSD (C-PTSD).

Even with this new classification, it is important to note that the victims of chronic trauma can have both PTSD and Complex PTSD simultaneously. Here is an easy way to see the differences between the two conditions:

  • A child witnessing the death of a friend in an accident may show some symptoms of PTSD
  • A child who has lived with years of sexual or physical abuse may have symptoms of C-PTSD in addition to PTSD.

CPTSD Symptoms

People who have gone through a long-standing, extremely traumatic situation may exhibit both physical and emotional symptoms related to their ordeal.

Emotional symptoms may include:

  • Rage displayed through violence, destruction of property, or theft
  • Depression, denial, fear of abandonment, thoughts of suicide, anger issues
  • Low self-esteem, panic attacks, self-loathing
  • Perfectionism, blaming others instead of dealing with a situation, selective memory
  • Loss of faith in humanity, distrust, isolation, inability to form close personal relationships
  • Shame, guilt, focusing on wanting revenge
  • Flashbacks, memory repression, dissociation

Victims of C-PTSD may also have physical symptoms, such as:

  • Eating disorders, substance abuse, alcoholism, promiscuity
  • Chronic pain
  • Cardiovascular problems
  • Gastrointestinal problems.
  • Migraines

Help for Complex PTSD

With Complex PTSD, healing cannot happen on its own because the survivor keeps reliving the trauma through flashbacks and dreams. People who suffer from C-PTSD may go for years before making the connection between their symptoms and the chronic stress and trauma they have been trying to cope with. Once they do, healing can begin and many people have been able to overcome their past to find a more meaningful and healthy present.

Cognitive Behavioral Therapy (CBT) has been shown to be highly effective in treating both PTSD and Complex PTSD. This therapy works to change unhelpful thinking and behaviors. It challenges deep-seated patterns and beliefs. CBT therapy helps replace “errors in thinking” (for example: magnifying negatives, minimizing positives, and overthinking) with more realistic and effective thoughts. This serves to decrease both emotional distress and self-defeating behaviors.

EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder/CPTSD. It has been shown to help trauma survivors heal faster than through traditional therapy. In fact, EMDR can be successful in as few as 3-12 treatment sessions. This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time.

We Can Help

Complex PTSD can be debilitating. Those who suffer from CPTSD may be at greater risk of substance abuse or of deliberate self-harm in order to cope with their emotional pain. We can help! To learn more, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.

 

 

 

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Postpartum Depression

Welcoming a new family member into your household is an exciting and joyous event. There is so much anticipation about the new baby and women often go through their pregnancy daydreaming about happy things: who will the baby will look like, what will their first words be? Understandably, the knowledge that you’re going to have a baby can also give rise to a certain level of concern and anxiety – there will be sleepless nights, adjustments in your daily life, and possible financial concerns to face.

It’s perfectly normal to feel both anxious and excited after the birth of a new baby and it’s also quite common for new mothers to experience the “baby blues” as they adjust to the arrival of their child. In fact, research shows the symptoms of the baby blues (mood swings, difficulty sleeping, crying, and anxiety) can affect up to 80% of new moms. These symptoms usually begin somewhere in the first few days after giving birth and generally last for about two weeks.

For some new mothers, however, the birth of their baby can trigger a long-lasting and more severe episode of depression, called postpartum depression or postnatal depression. Additionally, and rarely, a new mother can go also through postpartum psychosis – an extreme and dangerous mood disorder.

What is Postpartum Depression?

First, whether you are experiencing “just” the baby blues or an actual incidence of postpartum depression, understand that it is not a sign of weakness on your part and it doesn’t mean you are “a bad mom”! There is plenty of evidence showing that this mood disorder can actually be a complication of the birth process for some women.

After giving birth, many physical and emotional changes take place: hormone levels drop dramatically, you’re sleep-deprived, you may feel overwhelmed, and you may feel like you’re losing control of your life. Researchers think these changes may contribute to the development of postpartum depression. Furthermore, studies have shown that women who have a past history of depression and anxiety or those with a thyroid imbalance may be at higher risk for postnatal depression.

At first, postpartum depression can be mistaken for the baby blues, but the symptoms of postnatal depression last longer than the typical week or two in the case of the baby blues and are more profound. And, while the symptoms of post partum depression generally begin within the first few weeks after having a baby, they can even start anywhere from six months to a year after giving birth. Left untreated, postnatal depression can last a long time, ranging from several months to several years.

Postpartum Depression Symptoms

The Mayo Clinic  lists postpartum depression symptoms that may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Postpartum Psychosis

As mentioned above, postpartum psychosis is rare, occurring in about .1% of births or about 1 to 2 out of every 1,000 deliveries. Postpartum psychosis is severe and usually comes on suddenly – most often within the first two weeks after giving birth. The women most at risk have had a prior psychotic episode or are those with a personal or family history of bipolar disorder.

Postpartum psychosis can include:

  • Hallucinations
  • Paranoia
  • Delusions
  • Bizarre beliefs
  • Irrational judgements

Research shows that, in women undergoing postpartum psychosis, there is a suicide rate of about 5% and a rate of infanticide of approximately 4%. Because of the woman’s psychotic state, her delusions and beliefs feel very real, make total sense to her, and may cause her to act on them.

It is imperative that a woman going through postpartum psychosis get immediate help. This condition is treatable, but it is an emergency condition. Call your doctor or an emergency helpline to get the assistance you need as soon as possible!

Getting Help for Postpartum Depression

If you suspect you may have postpartum depression, the sooner you seek help, the better for both your baby and yourself. Call your doctor or a mental health professional right away if the signs and symptoms of your depression:

  • Don’t lessen or go away after two weeks
  • Seem to be getting worse
  • Are making it hard for you to care for yourself and/or your baby
  • Are making it difficult to carry out everyday tasks
  • Include thoughts of harming yourself or your baby

Treatment for postpartum depression may include counseling and talk therapy via Cognitive Behavioral Therapy, as well as the use of antidepressant medications.

Learn More

Without treatment, postpartum depression can last for months or years. If you think you or a loved one may be suffering from postnatal depression, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.

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Mood Disorders: Bipolar Disorder

Bipolar Disorder

We’ve all had “those days” at work or at home – days when we feel exhausted, irritable, or out of sorts and when nothing seems to go our way. Conversely, we’ve all also experienced days when we are chock full of energy, when we feel like we can take on the world, when ideas seems to flow effortlessly, and we feel joyful and optimistic. For most of us, those feelings of the “blues” or of being happy will ebb and flow from one day to another and they don’t really change our daily lives. But, for people with bipolar disorder (also known as manic depression), the swings between emotional highs and lows are chronic and can fluctuate broadly from extreme euphoria, overconfidence, and boundless energy, to the other end of the spectrum and despair, anger, and deep depression. People can also experience a mixture of the two extremes.

Bipolar Definition

About 1% of people (or 1 in 100) will develop bipolar disorder. The National Institute of Mental Health’s bipolar definition states that, “Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.”

Bipolar Disorder Symptoms

One of the worrisome things about the disorder is that it is often hard for people to pin down and identify. In fact, family and friends of the individual may recognize the need for evaluation long before the person does. This is because bipolar disorder symptoms can sometimes be subtle and are often dismissed by the person who has the condition. After all, if you have troubles at work or have been moody, why would that indicate that anything else might be wrong?

The main bipolar disorder symptom is mania. While a mania episode can be extreme enough that some people can lose sight of reality, hypomania (a milder form of mania) is subclinical and produces a state of more energy and activity, but lasts for less than the bipolar threshold of four days. Because this shortened state doesn’t really impact a person’s life, they can easily deny it as being a symptom of anything.

Other bipolar disorder mania symptoms may include:

  • Feeling euphoric, overly happy, extremely optimistic
  • Inability to sleep, sleeping fitfully, racing thoughts
  • Easy to anger, irritability, aggressive behavior
  • Poor judgment, reckless behavior, high risk behavior
  • Inability to concentrate, easily distracted
  • Rapid speech (the person may just “talk right over you” in a conversation)

On the other end of the spectrum, the depressive state of bipolar disorder symptoms can be where some people spend an overly long period of time. These symptoms may include:

  • Losing interest in activities you once enjoyed
  • Having trouble making decisions, being easily distracted, having problems remembering or concentrating
  • Loss of energy, loss of appetite
  • Feeling guilty, worthless, or helpless
  • Feeling very tired, sleeping more than usual
  • Chronic pain that can’t be accounted for through injury or illness
  • Thoughts of suicide or death

To make this disorder even more confusing, some people can be in a depressive state, yet have a lot of energy or they may feel hopeless and agitated at the same time.

Diagnosis and Treatment

If you are worried whether you or someone you know may have bipolar disorder, the red flag is when the person does things that are out of character for them. Are they normally careful with their money, but suddenly go on a reckless spending spree or take up gambling? Are they engaging in uncharacteristic behaviors (drinking too much, engaging in substance abuse, having one-night-stands or frequent sexual encounters)? Maybe they aren’t interested in their hobbies or are sleeping all the time. If you spot atypical behaviors, encourage the person to see their health provider to rule out possible medical conditions. If everything checks out and the symptoms aren’t caused by injury or illness, they can provide a referral to a mental health professional.

A mental health professional will discuss family history to see if there may be a genetic component to the disorder. In some cases, medications may be prescribed to help with severe symptoms. Cognitive Behavioral Therapy is also used in treating bipolar disorder to change harmful behavior patterns and reduce negative thought patterns. Additionally, family focused therapy can provide coping strategies to help family members learn to recognize an impending episode and to improve communication between the person and their family members.

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Bipolar disorder can worsen if left undiagnosed and untreated. If you know someone who may be suffering from bipolar disorder, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to help – online or in the office.  To find our more, contact them at 561-496-1094 or email The Center today.

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Loneliness: A Public Health Concern?

Loneliness is an emotion that can be difficult to pin down because it often means different things to different people. It can be a perception of isolation because we feel that we aren’t being heard and valued. It can be caused by feeling that there is no one we can turn to for emotional support. Also, in many instances, a lonely person is actually physically alone through the loss of a spouse or loved one. Regardless of how we define loneliness, however, researchers have concluded that feeling so alone can affect not just our mental and emotional well being, but our physical health, as well. And, they are finding that loneliness can be as contagious as a virus.

Feeling Lonely is Becoming a Public Health Concern

It may be hard to believe, but loneliness is also becoming a public health issue in the United States. When people were asked how many close confidants they had during a poll taken back in 1984, the average answer was three. When a follow-up poll was taken again in 2004, however, the average response from people was that they had no close confidants: zero!

Not only is loneliness on the upswing, but studies are now suggesting that loneliness can be contagious and can spread through groups of people via negative social interactions. One such study asked more than 5,000 people to complete a loneliness questionnaire. Participants were also asked to supply researchers with a medical history and go through a physical examination every two years to four years over the ten year study period. The participants also listed relatives and friends and referred them to the study: many of these referrals also took part in the study. By looking at the social networks of the participants and the number of lonely days they experienced each year, scientists were able to see how loneliness spread throughout the groups.

Additionally, researchers are finding that social isolation actually changes human DNA. In 2015, a study done by UCLA School of Medicine psychologist Steve Cole and his colleagues revealed that complex immune system responses are at work in lonely people. Their investigation found that feelings of loneliness or actually being socially isolated created more activity in the genes responsible for inflammation and reduced the activity of genes that produce antibodies to fight infection. They found that monocytes, a type of white blood cell that forms the first line of the body’s infection response system, are dramatically changed in people who are socially isolated.

Even if you overlook this change in infection-fighting cells, we know that “lonely adults consume more alcohol and get less exercise than those who are not lonely,” says John Cacioppo, co-author of the book Loneliness: Human Nature and the Need for Social Connection in an interview with U.S. News and World Report. “Their diet is higher in fat, their sleep is less efficient, and they report more day time fatigue. Loneliness also disrupts the regulation of cellular processes deep within the body, predisposing us to premature aging.” Their study showed that the cellular damage that can be caused by these genetic changes appears to be similar to that which comes from smoking, diabetes, and obesity.

Coping With Loneliness

So, how do you cope with being lonely? First, understand that loneliness is a normal part of being human, but it can make you feel like you are abnormal. Second, move forward by trying these suggestions:

  • Get a pet – they provide companionship and unconditional love and can be a way to meet other people through activities that get you up and out of the house. Dog-walking in the park is a good example of this type of activity.
  • Volunteer – helping others is often done as group. Volunteering can give you a new sense of purpose, can make you feel more positive about yourself, and will allow you to meet others who are working toward the same goal.
  • Take a class – classes also allow you to join a group of people with at least one common interest of yours. Additionally, classes give you something to look forward to and can provide you with the sense of ‘belonging’ that comes from being in a group.
  • Try to strengthen your existing connections and relationships with family and friends by calling them more or going out with them more often. Take the initiative to ask the person out, be yourself, and be a good listener.
  • Consider joining an online community because it can be easier to connect with people online than connecting with them in person if your loneliness comes from being shy or socially anxious. Do keep in mind, however, that online interaction is not a substitute for connecting face-to-face.
  • If you have tried some of the ideas above and are still having difficulty with feelings of loneliness, it might be time to try Cognitive Behavioral Therapy (CBT). CBT can give you the power to cope with your situation and can help you take action to deal with feeling lonely. Past studies have shown that changing how a person perceives and thinks about themselves and their social interactions with others was the most effective intervention for loneliness.

Learn More

It may be hard to figure out why you feel lonely and how to move past those feelings. A licensed mental health professional at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help you to understand and work through your loneliness. For more information, call them at 561-496-1094 or email The Center today.

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