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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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Physician Burnout

There is no denying the fact that physician burnout is a growing problem in the United States. The statistics that support this trend are appalling:

  • Approximately 1 in 3 doctors experience physician burnout at any given time
  • Doctors are 15 times more likely to experience burnout than other types of professionals
  • 45% of primary care physicians report that, if finances allowed, they would quit their jobs
  • There are approximately 300 to 400 physician-suicide deaths every year

These numbers make a strong case that physician burnout is a major issue that needs to be addressed and addressed quickly.

Physician Burnout Symptoms

The symptoms of physician burnout bear a strong resemblance to those typically seen in other stress disorders, but there are also distinct differences. Dr. Dike Drummond, author of the blog, “The Happy MD“, hits the nail on the head by identifying that physician burnout occurs when stress is present and a doctor is unable to recover from it in their free time. He pinpoints three distinct burnout symptoms:

1. Physical and emotional exhaustion that leaves you worn out and unable to recover during down time.
2. The development of a cynical and negative attitude with regard to your work and your patients.
3. A reduced sense of purpose and a feeling that your work is meaningless and without value.

The Factors

A variety of factors in a doctor’s work life combine to explain why burnout has become so prevalent. The most common factors that lead to this syndrome include:

  • The inherent stress that comes with the job. Any profession that includes high responsibility and a small amount of control over outcomes is bound to be stressful. Adding to this stress are the kinds of outcomes that can occur as a result of physician decisions. It’s no wonder that stress levels are high.
  • The extreme lack of work-life balance. Doctors are expected to be available 24/7. This expectation, combined with long hours and shifting schedules, can have a negative impact on physicians in numerous ways, including:
    • Poor sleep patterns
    • Interference with family relationships (doctors tend to have a divorce rate that is 10 – 20 percent higher than the general population)
    • Physical and emotional exhaustion
  • Overwhelming administrative hassles. Being a physician in today’s medical world is rarely as simple as just being able to treat illness. Navigating the mazes of insurance paperwork and the new burdens of healthcare reform has added extra administrative work to a doctor’s duties. They must keep up with it if they want to get paid for their services and remain compliant with government regulations.

An Even Greater Challenge

It’s easy to see how the everyday challenges of being a doctor can continuously build up until the physician hits the burnout stage. The real difficulty lies in understanding how we can improve those statistics. The unfortunate reality is that many doctors will not seek assistance for physician burnout even when they realize there is a problem. There are several reasons for this:

  • Fear: licenses have the potential of being denied if a doctor is under treatment for substance abuse or depression and many physicians are afraid to take that risk.
  • Pride: in comparison to other professions, the world of physicians is pretty small. This means that a doctor seeking treatment would most likely be getting help from a colleague. Since doctor’s careers are built on reputation, it can be difficult for a physician to let a colleague see their perceived weaknesses, even in light of patient privacy laws.
  • Poor self-care: the combination of all the stressors mentioned above often lead to a doctor not taking care of themselves simply because they don’t have the time or energy to do so.

Where to Go from Here

If you or someone you know is showing signs of physician burnout, it’s important to seek help. Don’t let yourself become part of the growing statistics related to this trend. Recognizing and acknowledging this is a concern can be the biggest stepping stone toward finding a resolution.

For more information about easing the effects of physician burnout, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders at 561-496-1094.  Also, you can email The Center at their Delray Beach, Florida location.

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EMDR Therapy Helps Trauma Recovery

Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder (PTSD). PTSD is a disorder that often develops after exposure to a terrifying event or ordeal – one in which intense physical harm occurred or was threatened. PTSD can also result after someone has witnessed an event that is disturbing, distressing, or dangerous. Sufferers of this disorder have persistent, frightening thoughts and memories of their ordeal.

PTSD can be triggered by events such as:

  • Military combat
  • Violent personal assaults
  • Natural or human-caused disasters
  • Car accidents, plane crashes

To understand EMDR therapy, it’s important to first understand how PTSD can impact people. People who have developed this type of disorder often have ‘re-experiencing symptoms’ or exhibit avoidance symptoms, which can include:

  • Flashbacks of the event
  • Nightmares and bad dreams
  • Uncontrollable and frightening thoughts about the event
  • Avoidance of people, activities, or places that remind them of the traumatic experience
  • Severe emotional distress or physical reactions to something that makes them think of the event
  • Irritability, aggressive behavior, angry outbursts
  • Feeling guilt, shame, or worry about the event

What is EMDR?

A great way to understand EMDR is to think through the body’s normal healing process. When you cut yourself, your body works on its own to heal the injury. If the wound is irritated by a foreign object, the abrasion festers and the body is unable to close the wound until the object is removed.

There is evidence to support the theory that the mind works in much the same way. With post traumatic stress disorder, healing cannot happen because the survivor keeps reliving the trauma through their flashbacks and dreams. Those memories are the “foreign objects” that fight the healing process.

Effective EMDR therapy includes some important elements:

  • Processing of the traumatic memory and disturbing feelings
  • Transformation of the painful events on an emotional level
  • Empowerment of the person dealing with PTSD

EMDR therapy also involves using bilateral (both sides of the body) stimulation, such as:

  • Eye movements
  • Physical hand tapping or toe tapping
  • Musical tones

These bilateral stimuli and the guidance of the therapist allow the survivor to tap into the biological mechanisms that come into play during Rapid Eye Movement (REM) sleep. It is believed that this allows the individual to naturally process their memories – effectively removing those “foreign objects” so their mind can heal.

What Does EMDR Therapy Include?

Eye movement desensitization and reprocessing therapy consists of eight therapy phases that are focused around three specific time periods:

  • The past – the event(s) that created or intensified the trauma is identified
  • The present – attention is given to the current situations that are causing distress
  • The future – action is taken to develop the skills and attitudes needed for positive progress

Phase 1: The therapist works with the individual to uncover the incident or trigger event from the survivor’s past that might be relevant for the therapy. This may include not only the traumatic event, but also other incidents from the person’s past. The treatment plan is developed during this stage.

Phase 2: The therapist teaches the individual a variety of stress reduction and imagery techniques that can be used during and between sessions to help them handle their emotional distress.

Phases 3-6: A target memory is chosen and processed using EMDR therapy techniques. In order to start this procedure, the individual must identify the following:

  1. Emotions and physical sensations related to the memory
  2. Visual imagery related to the memory
  3. A negative belief about themselves that is related to their distress
  4. A positive belief they’d like to have

The therapist asks the individual to rate the strength of the negative and positive beliefs they choose. Then, the person is instructed to focus on the imagery, negative thoughts, and body sensations they relate to the target memory while the therapist directs them in performing the bilateral stimulation that is the hallmark of EMDR therapy. These steps are done repetitively in ‘sets’, with the survivor rating the strength of the negative beliefs after each set. Once the person no longer reports distress related to the memory, the therapist will repeat the process while focusing on the positive belief previously identified.

Phase 7: This is the closure phase, where the trauma survivor keeps a log of any lingering negative thoughts or emotions that come up throughout the week. By reviewing the person’s journal of their negative emotions or thoughts, the therapist gains information to help the individual continue to work through their pain while reminding them of self-calming techniques learned during therapy.

Phase 8: In this final phase, the therapist and patient examine the progress made during previous sessions.

How to Get Help

One of the benefits of EMDR is that it has been shown to help trauma survivors with post traumatic stress disorder heal faster than through traditional therapy. Look at these amazing results:

  • One study revealed 84%-90% of single-trauma victims no longer had PTSD after only three 90-minute sessions
  • Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after six 50-minute sessions
  • A third study showed that 77% of combat veterans were free of PTSD in 12 sessions

This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time. If you or someone you know is suffering from PTSD, seeking professional help can be the most direct path to reclaiming your life.

Learn More

For more information about EMDR and how EMDR therapy can help you or a loved one overcome trauma and PTSD, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us at 561-496-1094.

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Children and the Benefits of Mindfulness Training

 

These days, children often have stressors that come at them from all directions. Schools are sending more homework and projects home with children, kids are busy after school with extra-curricular sports and activities, and there are video games, social media, and cell phones all competing for their attention. In addition, they may have to deal with being picked on at school or may be coping with the pressures of divorcing parents or the arrival of a new sibling in the home. With all that kids have to contend with, it’s no wonder that children who engage in mindfulness exercises tend to be happier kids who are more able to self-regulate and calm themselves during periods of stress.

What is Mindfulness?

What is mindfulness, anyway? According to experts in the field, mindfulness is defined as “paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally” (Kabat-Zinn, 2003).

Mindfulness helps with emotional regulation and cognitive focus. It allows children to choose a calmer, practiced response to stressors instead of throwing a tantrum or losing control. It teaches them to be conscious of how their emotions “show up” in their bodies (in the form of headaches, stomachaches, nightmares etc), and helps them understand that their thoughts are “just thoughts.” Children who undergo mindfulness training become adept at recognizing when their attention has wandered and learn to implement tools for impulse control.

How Can Mindfulness Training Help Your Child?

There is a growing body of research that indicates mindfulness training can help children improve their ability to calm down when they are stressed or upset, learn to pay attention and become more focused, increase their ability to concentrate, and learn to make better decisions.

Mindfulness activities for children can also help with:

  • Anxiety and depression
  • Sleep difficulties
  • Anger issues and separation anxiety
  • Coping with increased life stressors
  • Anxiety at school (for example: test taking or athletic performance)
  • Chronic medical conditions
  • Learning compassion and acceptance for themselves and others
  • Breaking the cycle of worry before it turns into full-blown anxiety or panic attacks

Mindfulness Activities for Children

If you would like to help your children learn to become more mindful, there are a few things to take into account when teaching them. First, remember to take the age of the child into consideration and keep the mindfulness sessions short until they get used to practicing it. Also, make the practice times age appropriate – limit them to about five minutes or less, particularly for younger children. Praise your child for the effort they put into their mindfulness exercises and reward them with hugs and cuddles or by doing something they want to do together afterward.

Try these exercises to help your child practice being more mindful:

  • Belly breathing – Have your child put one hand on their tummy and one hand on their heart. Have them take a deep breath in for a slow count of 3 and then breathe out again to another slow count of 3. They should repeat this deep breathing exercise at least three to five times to feel calmer in times of stress. For younger children, it can be helpful to have them lie down and place a small stuffed animal on their stomach while breathing in and out during the exercise. As they focus on watching the stuffed animal rise and fall with their breathing, they learn how to breathe from their belly.
  • “Cool Your Food” breathing – Have your child breathe in through their nose and blow their breath out of their mouth as if they were trying to cool down hot food. Repeat this 5-10 times, very slowly.
  • Listen to the sounds around you – An easy way for children to practice mindfulness is to focus on paying attention to what they can hear. Take a walk and listen to the birds chirping, lawn mowers mowing, or the wind blowing. You can also download phone apps that have calming waterfalls or nature sounds and have your child listen to see what they can hear (for example: are there frogs croaking or birds chirping in the background?)
  • Mindful Playtime – Finger paints or coloring books offer great ways for children to be mindful. As they color, ask your child how the crayons smell or how the finger paint feels against their hands. What do the colors they are using mean to them? Can they hear the crayon or pencil scratching against the paper or the paint swishing as they swirl it across the paper?
  • Ring a bell – or chimes or perhaps strike a note on a piano (or use a phone app that has these sounds on it) and have your child listen carefully to the sound of the tone until it gradually fades away and stops.
  • Practice gratitude – Have your child tell you one or two things they were grateful for today. You can have them do this at dinner time or just before they go to bed. Tell them what you are grateful for, as well!

Learn More

We have mindfulness programs for both adults and children at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To find out more about these programs, call us 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.

Learn More

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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How to Beat the Post-Holiday Blues

The holidays have come and gone and a new year has begun. You should be feeling inspired and happy to start working on your New Year’s resolutions and doing what you can to make this year better than the last…right? Maybe not.

Even though many people do greet the new year with excitement, there are also many who find themselves suffering from the post-holiday blues. This is understandable: the holiday season is a time of family gatherings and festive parties, which all comes to an abrupt halt right after the calendar page turns to the next year. Instead of all the merriment, we have to deal with fatigue, going back to work after taking time off, taking down those cheerful decorations, and stress from paying for all the gifts we’ve given. Additionally, the long, cold, dark days of winter, can lead some people to experience seasonal affective disorder (SAD). If you think about it, it’s no wonder many of us experience some depression after the holidays!

Symptoms of Post-Holiday Depression

The symptoms of the post-holiday blues period are similar to those of “regular” depression – headaches, insomnia and trouble sleeping, anxiety, weight gain or loss, and agitation. In general, depression related to the holidays is short-lived, though, lasting just a few weeks into the new year. For some people, however, it can be long-lasting and overwhelming: in these cases, counseling and support groups can help immensely.

Tips for Getting Over Depression after the Holidays

In order to help avoid (or climb out of) that post-Christmas depression period, many mental health professionals recommend taking a pro-active approach to the New Year. You might try:

  • Reflecting on the good times you had over the holidays. Spending some time to remember the enjoyable things that happened during the holiday season can help you focus more on the blessings you have in your life. Keeping a gratitude journal can also be helpful.
  • Getting some rest: things always look bleaker when you are tired. If you can, take some time to relax and do something just for yourself: reading the book you’ve been wanting to finish, watching a movie or two, or indulging in some “me time” can all give you a brighter perspective.
  • Starting a hobby or picking up one that you’ve enjoyed in the past. Activities you delight in will help take the focus off the end of the holiday season.
  • Starting to plan your next vacation or what you’ll do on your next long holiday weekend. There are holidays in January (Martin Luther King, Jr’s birthday) and February (President’s Day) that you can start looking forward to. Even something as simple as planning a dinner with friends over those weekends can help you refocus your thoughts away from the holidays.
  • Volunteering: if you are lonely and missing those gatherings with family and friends, this can be a great way to get out and be around people.
  • Phototherapy: If your depression is more related to the dark days of winter, phototherapy can help immensely. Seasonal affective disorder generally responds well to light therapy, in which patients are regularly exposed to bright light. In particular, fluorescent lights have been shown to significantly improve depression. People with SAD can purchase “light boxes” which are used for approximately 30 minutes daily in the morning and evening.
  • Setting realistic New Year’s resolutions. Don’t aim so high that your goals are unattainable or you may end up disappointed in yourself for breaking them.

Above all, expect to enjoy the year ahead of you. Look forward to the coming months: plan some of the things you’d like to do this year, make a list of things you’d like to accomplish, stop looking backwards at the past. Put your goals for the year down in writing or tell them to a friend, so you’ll be more likely to make them happen.

Learn More

If you’ve tried some of these tips and are finding that you’re still having a hard time kicking the post-holiday blues, it might be helpful to speak with a mental health professional. Dr. Andrew Rosen and the therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. For more information, call them at 561-496-1094 or Contact Dr. Rosen and The Center today.

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Fear of Public Speaking

We’ve all experienced it: you have to give a presentation and you’re stressing about getting up in front of a room full of people. What’s the first thing everyone always says? “Just picture your audience naked,” they’ll tell you with a chuckle. While that can work for a few people, for many, a fear of public speaking is no laughing matter. Studies have shown that some speakers can’t even calm down after beginning their speech: instead, they become increasingly more nervous as their lecture goes on. For these people, even presenting their ideas to a small group in a workplace meeting can be a harrowing experience.

It’s no secret that glossophobia or fear of public speaking is the number one fear reported by people in the United States. This anxiety comes from a worry about being judged and often has origins in social anxiety. Speech anxiety has increased in today’s cyber-world of communication where we are often “faceless” and can remain relatively anonymous by sending emails or texting instead of speaking directly to people.

Tips for Overcoming Speech Anxiety

For many people, a fear of public speaking can often be helped by learning a few skills:

  • Know your topic: the more you know about your topic, the less you will stress if you accidentally lose your train of thought or make a mistake.
  • Practice your speech: go over (and over) your presentation in front of a supportive friend or coworker (videoing yourself can also be helpful). Have them ask questions about your topic so you are prepared to give answers. Also, ask them for feedback and consider making any changes they might suggest.
  • Visualize a successful outcome. Mentally picture yourself being announced, approaching the lectern or stage, smiling at your audience, presenting your slides or PowerPoint images. See yourself being congratulated for your ideas and shaking hands with the admiring people you’ve spoken in front of.
  • Be prepared – organize your slides or handouts, listen to any audio clips, and run through your presentation from start to finish so you can see how it “flows.”
  • Bring water with you to the podium in case your mouth gets dry or you need to take a quick pause to regroup.
  • Clasp your hands together or stand with your knees slightly flexed to help keep them from trembling if you are nervous and shaky.
  • Take a few deep breaths and smile (even though smiling is probably the last thing you’ll want to do!). Deep breathing helps you relax and studies have shown that smiling can help lower your heart rate and aid in physiological recovery after stressful situations.
  • Focus on your material instead of your audience.
  • Keep in mind that audiences will generally sympathize with a nervous speaker, so try not to worry about appearing uneasy or anxious.
  • After your speech, mentally congratulate yourself for putting yourself up there in front of everyone! Write down some of the positive aspects of your lecture (did you remember to make eye contact with your audience or toss out statistics without a mistake?). Focusing on the positives will help keep you from over-analyzing any slip-ups you made (even world-class speakers make mistakes!).

Cognitive Behavioral Therapy for Public Speaking Anxiety

In many cases, the apprehension we experience before giving a speech can be used as a way to focus: in our nervousness, we go over and over the points we want to make and read through our notes repeatedly which helps ingrain them in our memory. For some individuals, however, instead of focusing on the details of the presentation they are about to give, they will zero in on their own physical symptoms and won’t be able to settle in once they’ve begun to talk. They’ll turn their attention to how their hands are shaking or how nauseous they are and they’ll become progressively more anxious as their lecture goes on.

Often, they end up carrying that anxiety over after the speech ends, too, so they stay keyed up instead of relaxing – even to the point of becoming physically ill. For these people, cognitive behavioral therapy (CBT) done through a licensed mental health professional can help quickly identify and challenge inaccurate or negative thinking. CBT can often provide coping mechanisms that can help them gain confidence and overcome their public speaking anxiety.

Keep in mind that not everyone who benefits from cognitive behavioral therapy has a mental health condition. In the case of “stage fright”, CBT simply gives you the power you need to cope with a public speaking situation in a more effective and healthier way. Because CBT utilizes a goal-effective approach, it can be an effective tool to help you learn how to better manage the stress of speech anxiety.

Learn More

If these tips and tricks don’t help you when it’s time for your next public lecture, it might be helpful to speak with a mental health professional like Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, call them at 561-496-1094 or Contact Dr. Rosen and The Center today.

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Resilience Training

Why is it that some people seem to take life’s challenges in stride, while others fall apart at the least little thing? Haven’t you noticed that some people just ooze grit and determination and others give up after the tiniest failure? You might think this is because certain people have more dominant personalities or may be emotionally stronger than others, and you may be correct in some cases. Some people who seem so strong, however, have gotten that way because they have actually been taught to use coping tactics that allow them to better handle depression, stress, and anxiety. These people have gone through resilience training.

Resilience Definition

According to the Mayo Clinic, “Resilience is your ability to adapt well and recover quickly after stress, adversity, trauma or tragedy. If you have a resilient disposition, you are better able to maintain poise and a healthy level of physical and psychological wellness in the face of life’s challenges.”

When you have emotional resilience, you can look at problems as being temporary and something that can be changed. You can also perceive adversity not as catastrophic, but as something that can have positive aspects: resiliency means you “look on the bright side” of a problem. For those who don’t come by this mental fortitude easily, resilience training can be used to minimize negative thoughts and help you learn ways to bounce back effectively from life’s setbacks.

One thing to keep in mind – being resilient does not mean that you will go through your life without experiencing grief, loss, and painful events. Instead, understand that suffering and personal growth can exist side by side when you learn to work through the emotional effects of adversity.

Besides thorough training, emotional resilience can come from:

  • Having close relationships with family and friends
  • Feeling like you are in control of a situation
  • Having confidence in yourself, knowing your strengths
  • Keeping a positive outlook – looking for the positives, in spite of your difficulties
  • Not seeing yourself as a victim
  • Good problem-solving skills
  • The ability to manage strong feelings and impulses
  • Being able to let others help you and being able to help others
  • Being able to look for and use resources
  • Coping with stress in healthy ways and avoiding harmful coping strategies, such as substance abuse

What Will You Learn in Resilience Training?

If you would like to learn to be more emotionally resilient, resilience training programs can help you:

  • Identify ways to respond positively to the pressures and demands of work, finances, and other stressors
  • Learn techniques to manage risks
  • Gain tips for developing your natural strengths
  • Find ways to identify the opportunities that can come from challenges and setbacks
  • See the relationship between performance, work pressure, personal well-being, and resilience
  • Practice techniques for promoting long-term behavior and attitude for developing resilience
  • Develop creativity and problem solving methods
  • Learn relaxation and stress management techniques

Resilience training can help you learn how to have a more positive outlook in the face of adversity. It can teach you methods for doping in a healthy way when life throws you a curve ball. Without these skills, there can be a tendency to feel overwhelmed by challenges or to dwell on problems, which could lead to anxiety or depression.

For example, resilience training has recently been implemented by the United States military to help soldiers learn to analyze and overcome their emotions and beliefs about failure so they can become tough in mind, as well as body. The military program helps participants learn to look more positively at situations and not to jump to conclusions or judge others too quickly.

In other programs, humanitarian aid workers across the globe have learned to cope with the chronic stress of living in conflict or disaster zones and caring for those in traumatic situations. Aid workers often work under unique pressures and can suffer from post-traumatic stress disorder (PTSD), depression, and anxiety. Resilience training helps them build coping skills so they can better manage their stress.

Have Questions? We Can Help!

If you are someone who often dwells on problems, tends to assume the worst, or feels overwhelmed much of the time, resilience training can help you decrease your stress and give you a better quality of life. For more information, call Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or contact Dr. Rosen and The Center today.

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Insomnia and Anxiety/Depression

Most all of us have had the occasional sleeplessness night for one reason or another. Maybe you have a work project on your mind or it could be that you are worried about a family issue and can’t seem to fall asleep or stay asleep. Whatever the reason, having more than a few nights of less than quality sleep can make anyone feel fatigued and more than a little depressed. That stands to reason: after all, who wouldn’t be depressed when they are totally exhausted?

But, the combination of insomnia, depression, and anxiety may mean more than just a lack of sleep. In fact, studies have shown that at least 80% of people who suffer from anxiety and depression also have chronic insomnia. This is so prevalent that researchers are now saying that chronic insomnia may actually be a predictor of the onset of depression and/or anxiety.

Insomnia Symptoms

Chronic insomnia is defined as having trouble falling asleep or having problems staying asleep most nights during the month. Insomnia symptoms may include some or all of the following:

  • Difficulty falling asleep
  • Waking too early or waking up throughout the night
  • Being sleepy or tired during the day
  • Feeling irritable, anxious, or depressed
  • Loss of interested in social activities
  • Loss of libido
  • Difficulty in completing tasks or staying focused
  • An increase in accidents or errors
  • Physical symptoms of insomnia may include headaches, stomach or GI distress, or not feeling well, in general

Is There a Link Between Insomnia and Depression/Anxiety?

If you can’t get to sleep or can’t stay asleep, it’s easy to see why you’d become depressed from fatigue or become so tired that you might become anxious about things that might not normally bother you. Current sleep research has found, however, that “insomnia and depression are two distinct but overlapping disorders,” says Michael Perlis, Ph.D., associate professor of psychiatry at the University of Pennsylvania and director of their behavioral sleep medicine program.

“Until recently, insomnia was typically seen as a symptom of depression,” says Perlis. “Treat the underlying depression, the thinking went, and sleep problems would go away.” But, recent findings show that insomnia often shows up or gets worse just before a bout of depression. “Insomnia may serve as a trigger for depression,” Perlis says. “But it also appears to perpetuate depression.”

Treating Insomnia and Depression or Anxiety

In our practice, we find that Cognitive Behavior Therapy, used in conjunction with Mindfulness Meditation, often helps the most to relieve the anxiety experienced by having insomnia. CBT teaches people healthier behaviors and helps them gain more positive and realistic thought processes regarding their sleep. This therapy encourages better sleep habits and helps reduce the fears and replace the negative thoughts that can keep them from falling asleep or staying asleep.

Research has shown that Cognitive Behavioral Therapy has longer-lasting, more sustainable effects on insomnia and depression. This is because it teaches you a skill set that you can use for the rest of your life. CBT gives you the power to cope with your situation in a healthy way and feel better about yourself and your world.

Mindfulness Meditation is also used to help the patient learn self-awareness. It teaches that our inaccurate view of the world is what triggers our negative emotions. Through practicing Mindfulness Meditation, the person trains their mind to overcome their worries and painful emotions, so they can be free of their suffering.

Other Ways to Treat Insomnia

There are also other schools of thought about ways to treat both insomnia and depression or anxiety. One idea is to specifically treat the insomnia by itself: research indicates that the treatment of sleep problems can help relieve and prevent a recurrence of depression and anxiety. In fact, several studies have found that depressed people who also had insomnia and were treated with both an antidepressant and a sleep medication did much better than those who were treated just with antidepressants. They slept better and their depression scores improved significantly over people who were just taking antidepressants alone.

Another method for treating insomnia is to actually wake a depressed insomniac early. This boosted mood in 30-60% of cases, but the cure is short-lived: the sufferer often becomes depressed again after they sleep once more.

Chronotherapy has also been used – in this type of therapy, those who have trouble falling asleep reset their internal circadian rhythm by adjusting the time they go to sleep over a period of days. Light therapy can also help: it exposes the insomniac to bright lights to help change their sleep cycles.

We Can Help

Are you or a loved one fighting chronic insomnia? It may be time to talk to a professional to see if there is an underlying condition that is contributing to your sleep problems. Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to take your call and make getting help easier. Contact Dr. Rosen at 561-496-1094 or email Dr. Rosen and The Center today.

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