All Posts in Category: General Mental Health

sad woman looking out the window

Pandemic Fatigue: How To Stay Mentally Healthy In The Covid Era

As 2020 draws to a close, many of us are experiencing pandemic fatigue. We’re all tired of wearing masks and social distancing. Most of us just want to go back to traveling, enjoying time with family and friends, and the normal world we used to know. This is the time when it is so important for our mental health that we keep a positive outlook and not allow boredom and pessimism to creep in.

Often, when we get closer to the end of a trying period in our lives, there is the temptation to give up. After all, going through long stretches of a challenge can make it seem as if we are not making progress. In the case of the pandemic, isolation from our friends and family coupled with fear of getting sick and concern for loved ones just adds to our anxiety and stress.

Signs Of Pandemic Fatigue

Our emotions have been running on high alert for months now. Living under this elevated level of awareness without a break means we’re always in fight-or-flight made, resulting in pandemic fatigue.

Signs of pandemic fatigue can take several forms, including:

  • No motivation
  • Feeling hopeless
  • Not sleeping well or sleeping too much
  • Feeling irritable or on edge
  • Overindulging in unhealthy foods or skipping meals altogether
  • Substance abuse or increased use of alcohol, recreational drugs, etc.

What Can I Do To Feel Better If I Am Anxious And Scared About Covid-19?

If you feel like you are constantly on edge or overly worried about the pandemic, know that you are not alone. The Centers for Disease Control and Prevention (CDC) reports that, “Symptoms of anxiety disorder and depressive disorder increased considerably in the United States during April–June of 2020, compared with the same period in 2019.”

This pandemic has not only brought disease to our front doors, it has given us other things to cope with, as well. Many of us are dealing with job loss and/or grieving the loss of loved ones. We may have new or worsening relationship challenges or financial concerns. Dealing with a pandemic is one thing, but adding these other stressors makes it much more difficult to cope. Be kind to yourself during this time.

One of the most helpful things you can do is to disconnect or limit your social media feeds and news reports. The constant news coverage of death tolls and illness can be demoralizing and social media posts can drive those fears to new levels. It’s enough to make us despair of ever getting our old lives back.

We recommend that you set a time limit for watching the news or reading news stories. In addition, set a goal that you’ll only check them once a day.

Likewise, we suggest backing off on your social media time and limiting your interaction to once a day for a reasonable amount of time. You may feel more anxious at first due to fear of missing out, but stick with it and you’ll soon see the positive results.

Another important thing to do is to stay connected to loved ones and friends, particularly those whom you trust with your concerns. Video chats and phone calls can help reduce feelings of isolation and loneliness. They can also be great distractions.

Set a routine. Keeping to schedule sounds boring, but the structure it provides can help keep us from sliding further into our fears and depression. For example, if you maintain a meal schedule, you are less likely to skip a meal, which can add to your depression.

Try to distract yourself. Activities like meditation, mindfulness, and other relaxation techniques or writing in a gratitude journal can help to keep negative thoughts at bay. Likewise, scheduling time to exercise or get outdoors will contribute to positive emotions.

Now is a great time to learn a new skill, start a new hobby (or work on a current one) or take up a musical instrument. Indulging in something you enjoy takes you out of fear-based thoughts and provides a more meaningful outlook.

Covid Era Depression? We Are Here For You

If you are experiencing pandemic fatigue and covid-era depression, we are here to help. Contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Andrew Rosen and The Center today.

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hands holding a smartphone with newspapers in the background

Is It Okay To Take A Break From The News?

The further we go through 2020, the crazier the year seems to get! The coronavirus pandemic is ramping up (again) and there are worries about more potential layoffs and job losses amid the new surge. Top these concerns off with the back-and-forth sniping over the presidential election’s disputed results and many people have begun asking is it okay to take a break from the news?

You bet it is! In fact, we highly recommend it, particularly to those who have already been experiencing heightened stress and anxiety due to the pandemic.

Does Watching The News Cause Anxiety?

In a word, yes. While you may feel that tuning in to the latest headlines keeps you informed, in reality, doing so causes information overload. There’s even a term for it – headline stress disorder. Although not an actual medical term, the phrase was coined by psychologist Dr Steven Stosny to define the high emotional responses one has after viewing endless media reports.

You see, by checking in and reading (or watching) the gloom and doom headlines, we begin to feel as if the world is on a roller coaster we can’t escape from. One minute we hear there may be a vaccine forthcoming, the next we hear that it may not be as effective as we’d hoped. Or we hear that the election has been called by the media, then we hear that the results are suspect and a recount is happening.

This rise of hope, followed by having it taken away only increases our anxiety and the feeling that the world is out of control.

On top of that, for those who have obsessive compulsive disorder, this constant checking of headlines and news stories can become a new ritual. They feel better while scrutinizing the news, which can reduce their anxiety if nothing has changed over the course of the day. But, it also triggers a cycle of compulsive checking just to be sure there isn’t some new disaster lurking.

Psychological Effects Of The News

In a 2019 article by Hoog and Verboon, published in the British Journal Of Psychology, the authors pointed to several studies that showed a direct relationship between negative news exposure and negative emotional states.

They report that “After being exposed to negative news reports, positive affect decreased, whereas negative affect, sadness, worries, and anxiety increased. Other studies have found indirect effects on psychological distress and negative affect through an increase in stress levels and irrational beliefs.”

Although researchers aren’t sure exactly what is at play that causes adverse reactions like depression or anxiety after habitually viewing negative media stories, they theorize that it has a lot to do with personal relevance.

To support this, Hoog and Verboon, pointed to studies of people’s stress levels as they related to the 9/11 attacks and also the Boston Marathon bombings. In both cases, people’s anxiety and PTSD levels were actually higher four weeks after these incidents than they were immediately after the attacks.

This is likely because of personal relevance. The authors noted that “…people who are anxious or depressed are more likely to focus on negative information or information that corresponds with their mental state (Davey & Wells, 2006), which in turn only increases their anxiousness or depression.”

How Do You Deal With News Anxiety?

Here are some self-care tips that can help you reduce your anxiety by giving you a way to regain control:

First, stop watching news coverage and limit your time on social media. As we’ve discussed, when something grips us with fear, it is sometimes hard to break away from the catastrophic thoughts that come along with it. By endlessly checking headlines and reading social media posts about current events, you don’t give your mind a chance to gain some mental distance from it.

Also remember that news coverage is written in a way that makes us tense and concerned. A fearful headline makes us click on it – and it’s what keeps the reporters or news channels in business.

Do some stress reducing activities: Meditate, take a walk, sit on your patio in the sunshine, or try an online yoga class. Or take one of the endless online classes and virtual museum tours that have popped up during this time of social distancing. Being active lessens the stress hormone, cortisol, and also serves as a distraction.

Additionally, you might focus on doing something you’ve been meaning to do. Now is the time to get organized, clean out that cabinet, or try a new recipe or hobby. Staying active means your mind will be engaged by something pleasant, which will help to reframe negative emotions in a more positive way.

Therapy In A Safe Environment

Sometimes self-care is not enough to get relief from anxiety. If your symptoms seem to be getting worse or if you find that a couple of weeks have gone by and you are still feeling more anxious than you think you should about current events, you may have developed an anxiety disorder. In that case, it’s best to turn to a professional.

Often, just talking through your concerns may be enough to reduce them, however speaking to a therapist can benefit you in many other ways by helping you sort out your fears and allowing you to gain a new perspective.

If you are concerned about exposure to the coronavirus during therapy, most mental health practitioners now have tele therapy options available. With tele therapy, you can talk to your therapist from your home, so there is no need to go into the office.

We Are Here For You

To get more information and help for headline news anxiety, contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

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Telehealth

A Message About Telehealth Amidst COVID-19

We hope that you, your children and families are doing well in the midst of this unprecedented time. After carefully considering the CDC guidelines, we at The Center for Treatment of Anxiety & Mood Disorders have decided that we will no longer be conducting therapy in our office at this time.

In good news, we have the capability to conduct appointments either over the phone or via Telehealth. We are happy to keep all appointments during this time. If you already have a scheduled appointment but you would prefer to postpone your to a later date or an alternate time, we are happy to do that as well.

We greatly appreciate your understanding during this difficult time. Please do not hesitate to contact us with any questions or to schedule an appointment at (561) 496-1094.

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How Meditation Benefits Mental Health

Meditation has been practiced for thousands of years by cultures across the globe. It is only recently that Western medicine has discovered that the practice actually has physical and mental benefits, aside from just making you feel less stressed.

Studies done on meditation have shown that, physically, it can:

  • Aid your quality of sleep
  • Help you better cope with the emotional effects of chronic pain
  • Possibly reduce age-related memory loss
  • Manage or reduce symptoms of high blood pressure, heart disease, irritable bowel syndrome, and tension headaches, among other things.

In fact, a 2014 meta-analysis done by Goyal, MD, et al., looked at over 18,000 meditation studies, eventually finding 47 that met their criteria for studies that were well designed, had good controls, and were  not based solely on participants who already felt that meditation had a positive benefit.

The results of this meta-analysis showed that the 3,515 participants experienced improvement in anxiety, depression, and pain, especially in those who practiced daily mindfulness meditation.

Meditation is also great for an individual’s well being and emotional intelligence. In fact, studies are showing that this ancient practice can have a positive impact on your mental health by actually changing the structure of your brain.

How Does Meditation Change The Brain?

In the brain, the amygdala controls the “fear centers” and triggers the body’s fight or flight response.

To find out if meditation changes the brain or if it only affects a person while they are meditating, a 2012 study by Debordes, et al, used magnetic resonance imaging (MRIs) to look at the brains of study participants. The researchers wanted to see “how 8 weeks of training in meditation affects amygdala responses to emotional stimuli in subjects when in a non-meditative state.”

The subjects underwent an MRI at the start of the study, so the researchers had a baseline to compare to. They then took part in an 8 week session of “either Mindful Attention Training (MAT), Cognitively-Based Compassion Training (CBCT; a program based on Tibetan Buddhist compassion meditation practices), or an active control intervention.”

At the completion of the study, the participants underwent another MRI to look at their amygdala responses. While there was no effect in the control group, the researchers found:

  • A reduction in right amygdala activation when viewing positive images for those in the MAT sessions.
  • An increase in right amygdala response to negative images in the CBCT participants, which is associated with a decrease in depression.

The researchers stated that, “This finding suggests that the effects of meditation training on emotional processing might transfer to non-meditative states. This is consistent with the hypothesis that meditation training may induce learning that is not stimulus- or task-specific, but process-specific, and thereby may result in enduring changes in mental function.”

Can Meditation Help With Anxiety?

Anxiety begins with our fears about the future or our worries about our relationships and our daily lives.

One way that meditation can help with anxiety is by allowing you to stop focusing on the past or the future and permitting you to concentrate on the immediate present. In fact, being present in the here and now is the basis of mindfulness meditation.

By being mindful, we can learn to calm the emotion behind our worries and fearful thoughts and begin to stop reacting to them.

  • To begin a mindfulness meditation, focus on your breathing.
  • Take notice of the sensations you feel. Be aware of your breath flowing through your nose and into your lungs as you inhale and exhale. Feel your chest expand and contract as you breathe.
  • Take note of the room’s temperature, listen to the sounds humming around you, notice the smells or fragrances in the room, and your physical reactions (sweating, pulse rate, etc).
  • If you have an anxious thought, give it a name, but don’t focus on it. Instead, think “that is a fearful thought” or “that is a sad thought,” then take three deep breaths.
  • After releasing the last breath, try to gain perspective about the anxious thought. Was the worry or fear valid or was it actually something you might be making more of than it deserves? Could you possibly be jumping to conclusions with that thought? 
  • As you gain perspective, you’ll have a few seconds of calm that will allow you to release the anxious thought, so simply let it go and focus on your next breath.
  • Don’t judge yourself for having anxious thoughts. Once you notice them, gently return your attention to your breathing and repeat these mindfulness steps.

Each time you focus solely on the present, your mind gets a chance to relax so you can see things from a new perspective.

Although it’s likely that you won’t experience a total release of anxiety the first time you try mindfulness, you should get some relief from your worries. If you keep practicing, you will improve over time.

Is Meditation Good For Depression?

Depression is triggered by stress and anxiety and how we react to them, so anything that can help reduce these conditions should also help ward off depression.

Since even a short meditation can help prepare you to face a stressful situation (example: by closing your eyes and taking a few deep breaths to calm yourself before going into a business meeting), it can also be helpful for tamping down the anxiety and stress that can lead to depression.

In an article from Harvard Men’s Health Watch, published by Harvard Medical School, Dr. John W. Denninger, director of research at the Benson-Henry Institute for Mind Body Medicine at Harvard-affiliated Massachusetts General Hospital said, “Meditation trains the brain to achieve sustained focus, and to return to that focus when negative thinking, emotions, and physical sensations intrude — which happens a lot when you feel stressed and anxious.”

He added that, “When you meditate, you are better able to ignore the negative sensations of stress and anxiety, which explains, in part, why stress levels fall when you meditate.”

As with anxiety, you won’t get total relief from depression after just one meditation session. “But with practice, meditation can help many people control how they react to the stress and anxiety that often leads to depression,” Dr. Denninger noted.

In Getting to Know Anxiety Drs. Rosen and Gross offer readers an overview of today’s challenging mental health issues and the most current treatment methods available, as well as practical strategies for mental and emotional self-care.

When Meditation Isn’t Enough

Although meditation can be helpful for keeping stress, anxiety, and depression at bay, if you find that your anxiety or depression are impacting your life on a daily basis it’s time to seek help. For more information, 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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What Is Overcontrol And Is It Contributing To Your Social Anxiety?

What Is Overcontrol And Is It Contributing To Your Social Anxiety?

One of the most quickly growing areas of clinical research and treatment implementation is for people who are considered to be overcontrolled. What does being overcontrolled mean, and what does it have to do with feeling socially anxious? The concept of self-control refers to the ability to inhibit problematic behaviors. This is generally accepted by our society as a positive thing to have! It is true that to an extent, being overcontrolled can be very adaptive and helpful. Overcontrol is associated with the ability to delay gratification, follow rules, and valuing accuracy and fairness. However, when these traits are very pronounced and overemphasized, they can become problematic and affect our mental health. It’s like having too much of a good thing.

Social and Emotional Impact of Overcontrol

There are common difficulties with people who have maladaptive levels of overcontrol. The first is low receptivity and openness. This can result in avoidance (a hallmark of anxiety disorders) and an aversion to having new or novel experiences. Also, there tends to be a strong need for order, structure, and rules. There is a focus on right and wrong, which we know is not conducive for more flexible thinking (which is important for decreasing anxiety symptoms). The third feature is reduced emotional expression and emotional awareness. This means that people who are maladaptively overcontrolled may not display emotions that one would expect (having a flat face when someone tells a joke), making it difficult for others to feel connected to them. The final trait that tends to cause difficulties for people is feeling a lack of closeness to others, and/or feeling different from other people. Loneliness and isolation are often experiences of those who are overcontrolled.

Given these features, it is not uncommon for people with chronic social anxiety to also be overcontrolled. The reliance on emotional and situational avoidance makes it difficult for people to learn new things (challenging their social anxiety) and feel connected to others. Their difficulty in successfully social signaling to others often results in them being disliked or rejected (a self fulfilling prophecy). People who are more overcontrolled also tend to engage frequently in social comparisons, which is also frequently observed in the socially anxious population.

Learning to Open Up and Connect

The most effective treatment for disorders of overcontrol (which include chronic depression, treatment resistant anxiety, obsessive compulsive personality disorder, and anorexia nervosa) is called Radically Open Dialectical Behavior Therapy. It is a skills-based protocol to help people struggling with overcontrol to be more open to experiences, and more emotionally expressive in order to connect with others in a more meaningful way. We are a social species, and when we feel disconnected from others, this impacts our mental health. RO-DBT is conducted both individually and in thirty-week classes. For more information, check out www.radicallyopen.net.

How to Get Help for Social Anxiety

For more information, 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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woman typing on a laptop

How Much Is Too Much? Technology, Screen Time, And Your Mental Health

It’s no secret that people are somewhat “addicted” to their screen time. Just look around you at any restaurant and you’ll see families and friends interacting more with their phones than with each other. The same hold true for almost anywhere you go: some people can’t even take their eyes off their screens when driving or walking, which has resulted in numerous accidents and deaths.

In a 2018 study done by the Pew Research Center, 54 percent of teens aged 13 – 17 said they were concerned about the amount of time they were spending online and on their phones. In fact, they were so alarmed about it that “Some 52% of U.S. teens report taking steps to cut back on their mobile phone use, and similar shares have tried to limit their use of social media (57%) or video games (58%),” according to the researchers.

Parents don’t do much better. The study reported that, “36% say they themselves spend too much time on their cellphone.”

Because of all the time spent watching screens, research is being done to find out the physical and emotional effects it might be causing for us.

What Does Too Much Screen Time Do To Your Brain?

Since phones and computers have only been easily accessible and affordable for people in the last thirty years or so, we don’t yet know the long term effects of screen time on the brains of kids or adults. But, we do know that, because children’s brains are still in the process of developing and growing, it seems likely that they would be affected by this technology.

The Adolescent Brain Cognitive Development (ABCD) study by the National Institutes of Health agrees. It has been following more than 11,000 kids, ages 9 and 10 years old, at 21 different areas throughout the United States. According to an article on Healthline, the initial results of the research show that:

  • MRI scans found significant differences in the brains of some children who reported using smartphones, tablets, and video games more than seven hours a day.
  • Children who reported more than two hours a day of screen time got lower scores on thinking and language tests.

The scary thing is that it will take many more years to discover whether these effects are the result of too much screen time or whether the differences were from something else.

So, does that mean adults are safe from the adverse effects of too much screen time? Actually, no.

Today’s adults have been estimated to spend more than 10 hours a day in front of screens (Harvard T. H. Chan School Of Public Health). Because the activity is sedentary, this exposure has been linked, in part, to higher obesity rates (which can lead to diabetes) and sleep problems.

Additionally, when asked, 15 percent of adults reported that they were more likely to lose focus at work due to checking their cellphone, which is double the number of teens who have trouble focusing in class for that same reason.

And, the Pew Research study indicates that more than half of teens (51 percent) say their parents are “often or sometimes” distracted by their own phones while in conversation with their child, leading to feelings of unimportance in the child.

What Are The Emotional Effects Of Too Much Screen Time?

For kids, anxiety, depression, and loneliness are often the result of too much screen time. A 2018 population-based study by Twenge and Campbell showed that after an hour of screen time per day, “…increasing screen time was generally linked to progressively lower psychological well-being.” The researchers also noted that, “High users of screens were also significantly more likely to have been diagnosed with anxiety or depression.”

But maybe screen time isn’t bad if kids are texting or gaming together? After all, they are interacting with each other and developing social relationships, right?

Again, the answer is ‘no’. According to a Psychology Today article by Victoria L. Dunckley M.D., “…many parents mistakenly believe that interactive screen-time—Internet or social media use, texting, emailing, and gaming—isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because it’s more likely to cause hyperarousal and compulsive use.”  

In addition to the physical and psychological effects, too much social media time can lead to problems with social skills and their application, as well as a decrease in self-esteem – in both children and adults. Furthermore, kids can be bullied online while sitting right next to their parents and they can’t get away from it.

How To Limit Screen Time

For parents who are wondering how to limit their child’s screen time, the American Academy of Pediatrics set out updated media guidelines based on the latest research. They suggest:

  • For children under 18 months old, no screen time.
  • For children 18 to 24 months old, parents should choose only high-quality media and watch it with their child.
  • For children 2 to 5 years old, less than one hour per day of high-quality programming is recommended, with parents watching along.
  • Don’t use screen time as a way to calm your child down or as a babysitter.
  • No screens 1 hour before bedtime, and remove devices from bedrooms before bed.
  • Keep bedrooms, mealtimes, and parent–child play times screen free for children and parents. Parents can set a “do not disturb” option on their phones during these times.

For adults who are trying to limit their own screen time:

  • As with the suggestions for kids: Keep bedrooms, mealtimes, and parent–child play times screen free
  • Use phone apps to remind you when it’s time to stop using the phone
  • Turn off the majority of your notifications
  • Delete your social media apps
  • Stop using your phone as an alarm clock because it’s too easy to get caught up in checking for updates from friends, scanning texts, and reading emails if you pick up the phone to turn off the alarm

We Can Help Break The Screen Time Cycle

If you are concerned about your teen or ‘tween’s screen time amount – or your own – we can help you take steps to “disconnect.” For more information, 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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marijuana plant

Mental Health Risks Of Marijuana

As more states legalize the possession and use of marijuana, we are beginning to get a clearer picture of the effects it can have on mental health. While advocates feel that the drug can do no harm, critics of legalization feel that there is nothing beneficial in marijuana – and the truth probably lies somewhere in between. However we do know that there has been an upswing in suicides and mental health disorders in states that have legalized the drug. So, what are the mental health risks of marijuana use?

Long Term Side Effects Of Marijuana Use

The short term effects of marijuana use have been known for years. They include altered judgement, weakened motor skills, and impairment of short term memory, along with an associated difficulty in learning and retaining information.

However, with long term use or heavy use of cannabinoids – particularly if the drug was initially used early in adolescence – people are developing more serious mental side effects. A 2016 study by Volkow, et al, found:

  • Addiction (in about 9% of users overall, 17% of those who begin use in adolescence, and 25 to 50% of those who are daily users)
  • Altered brain development
  • Cognitive impairment, with lower IQ among those who were frequent users during adolescence
  • Diminished life satisfaction
  • Symptoms of chronic bronchitis (*we are now seeing this in the current vaping crisis, which has been linked to the use of THC pods)
  • Increased risk of chronic psychosis disorders (including schizophrenia) in persons with a predisposition to such disorders

This is especially concerning because the Volkow study also reported that, “Currently, marijuana is the most commonly used “illicit” drug in the United States, with about 12% of people 12 years of age or older reporting use in the past year and particularly high rates of use among young people.”

Marijuana And Psychosis: Are They Linked?

Today’s marijuana is not the same strength as what people were familiar with in the past – cannabis is now much stronger. A review of the negative health effects of pot in the Western Journal of Emergency Medicine reported that, “Current commercialized cannabis is near 20% tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis, while in the 1980s concentration was <2%. This 10-fold increase in potency does not include other formulations such as oils, waxes, and dabs, which can reach 80–90% THC.” And, as the potency of marijuana increases, so do the rates of mental health disorders and psychosis.

Age at first use of the drug also makes a big difference. A 5-year study by Di Forti, et al, that was published in The Lancet in 2019 compiled data from across 11 sites in Europe and in Brazil to reveal that the occurrence of first-episode psychosis increased exponentially in those who used marijuana daily or in high potency form. Although the study authors reported that “Use of high-potency cannabis (THC ≥10%) modestly increased the odds of a psychotic disorder compared with never use… those who had started using high-potency cannabis by age 15 years showed a doubling of risk.” And, they said that, “daily use of high-potency cannabis carried more than a four-times increase in the risk of psychotic disorder.”

Cannabinoid Induced Psychosis

USAToday recently ran an article about the debate over cannabinoid induced psychosis. In it, they detailed the downward spiral of a young man who had once been a star high school athlete. After months of vaping a highly potent form of THC, he showed up at work disoriented and speaking incoherently. Upon hospitalization, doctors diagnosed him with “cannabis use disorder” and “psychotic disorder, unspecified.”

If the young man stays off pot for a year and has no further psychotic symptoms or episodes during that time, he will join the growing number of pot smokers who have been identified as suffering from cannabinoid induced psychosis (the diagnosis takes a year in order to be sure the psychotic episode did not stem from another reason).

This person is not alone. For their story, USAToday also “interviewed a dozen parents whose children suffered psychotic episodes – some of which led to schizophrenia – related to their marijuana use. Several of the children died by suicide. “

The USAToday article went on to say that, “In May, more than 40 Massachusetts doctors, psychiatrists, pediatricians and other public health professionals urged the state to add psychiatric risk warnings to marijuana packaging and to prohibit most advertising.”

Be Cautious Before Using Marijuana

In addition to concerns about marijuana use and the associated mental health risks are the recent vaping illnesses and deaths that have been reported. THC-containing vaping products and e-cigarettes have been implicated in almost all the cases. The Centers for Disease Control and Prevention (CDC) has recommended that people “should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online sellers.”

At this point, it is obvious that more research and time are needed to understand how marijuana affects the brain. Clearly the drug isn’t as innocent as some people believe. Until the results are in, think through the risks before deciding to use pot or vape THC.

Find Help Here

For more information about how we can help if you or a loved one are struggling with marijuana use and mental health concerns, 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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Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation: High Tech Help For Treatment Resistant Mood Disorders

Despite therapy and the use of medications, we occasionally find that the effects of a mental health disorder persist in some people. For these individuals, brain stimulation therapies like transcranial magnetic stimulation (TMS) may provide relief from their symptoms. TMS may also be an alternative for those who cannot tolerate mood stabilizing medications.

The National Institute of Mental Health (NIMH) reports that TMS and other brain stimulation therapies “involve activating or inhibiting the brain directly with electricity.” TMS is the most noninvasive of these treatments and is given via energy pulses that are generated by an electromagnetic coil held near or against the person’s head.

Because these magnetic pulses are given over and over in a repetitive rhythm, the most technically correct term for TMS is repetitive transcranial magnetic stimulation (rTMS).

What Is Transcranial Magnetic Stimulation Used For?

In 2008, the Food and Drug Administration (FDA) approved repetitive transcranial magnetic stimulation to treat major depressive disorders and their associated cases of severe depression and anxiety. It has also been studied as a therapy for psychosis and researchers are looking into how it may help conditions like post traumatic stress disorder (PTSD). Additionally, another form of rTMS, called deep transcranial magnetic stimulation (dTMS), has been FDA-approved for the treatment of obsessive compulsive disorder (OCD).

In 2010, the NIMH funded a clinical trial on the effectiveness of transcranial magnetic stimulation. Initial results showed that the effectiveness of rTMS was around 14 percent compared with a placebo-type procedure, which was only 5 percent effective. However, when participants were put into a second-phase trial, the remission rate of rTMS increased to 30 percent.

How Does A TMS Work?

When you go through a session of rTMS, you will be fully awake. Each session lasts between 40 and 60 minutes and no anesthesia is required. It is an outpatient procedure so you can drive yourself to the appointment and back home again. Typically, a person is treated four to five times per week for between four and six weeks.

During the rTMS session, an electromagnetic coil, which is about the size of your hand, will be passed over your forehead and scalp along the region of the brain thought to regulate mood. This coil produces short electromagnetic pulses similar in strength to the ones generated by a magnetic resonance imaging (MRI) machine. According to the Anxiety and Depression Association of America (ADAA), “The magnetic pulses cause small electrical currents that stimulate nerve cells in the targeted region of the brain.”

As scientists gain more knowledge about how rTMS can help people, they are developing new treatment methods. In fact, the FDA has sanctioned the use of theta burst stimulation, which is a variation of rTMS. In the theta burst procedure, the person only receives transcranial stimulation for about 10 minutes per session, however they still need to have daily sessions for several weeks.

In addition, another form of rTBS, called iTBS or intermittent theta burst stimulation, is now being given in 3 minute treatments. iTBS (also FDA-approved) gives intensive bursts of high frequency stimulation and has shown results comparable to the customary rTMS therapy.

Does TMS Therapy Hurt?

While rTMS therapy doesn’t hurt, the person may feel some mild sensations as the electromagnetic pulses are administered. These sensations might include:

  • A light knocking or a mild tapping feeling on their skull.
  • The muscles in their face, jaw, or scalp tingling when the magnet is applied.
  • These same muscles contracting while the magnet is in use.

Is Transcranial Magnetic Stimulation Safe?

Although most people do very well with it, rTMS does have some temporary, mild side effects for a small number of people. They can include:

  • Mild headaches
  • Lightheadedness
  • Scalp discomfort

Rare, but possible, is the chance of a seizure, however no seizures were reported during the two large studies that have been done on the safety of rTMS, according to the NIMH.

Additionally, Johns Hopkins reports that people who have non-removable metal objects in their head (for example: stents or aneurysm clips) should not receive rTMS. This is because the magnets can cause these objects to move or heat up, which could produce a serious injury or even death.

It’s worth noting that because transcranial magnetic stimulation is relatively new, we haven’t been able to study its long term effects. That said, treatment data has been compiled and studied since the mid-1990s and there have been no long term complications from its use, to date.

We Can Help

If you are struggling with anxiety, depression, or other mental health concerns, consider speaking with the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information on how we can help, contact us or call us today at 561-496-1094.

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What Problems Do Adopted Adults Have?

When we think about adopted children, most of us picture a happy family of cooing parents bonding with an adorable infant. For the adult who was adopted as a child, however, this blissful image is often tarnished by issues that carry over from childhood.

What problems do adopted adults have? Among other things, they often suffer from:

  • Feelings of loss and grief
  • Problems with developing an identity
  • Reduced self-esteem and self-confidence
  • Increased risk of substance abuse
  • Higher rates of mental health disorders, such as depression and PTSD.

In fact, Childwelfare.gov reports that, “…most of the literature points to adopted adolescents and adults being more likely to receive counseling than their nonadopted peers (Borders et al., 2000; Miller et al., 2000).”

What Are The Psychological Effects Of Adoption?

Way back in 1982, Silverstein and Kaplan did a study that identified seven core issues in adoption that still hold true today. They are:

  • Loss
  • Rejection
  • Guilt/Shame
  • Grief
  • Identity
  • Intimacy
  • and Mastery/Control

The study reports that, “Many of the issues inherent in the adoption experience converge when the adoptee reaches adolescence. At this time three factors intersect: an acute awareness of the significance of being adopted; a drive toward emancipation; and a biopsychosocial striving toward the development of an integrated identity.”

Loss first comes into the adoptee’s life when they are given up by their birth parents. Although the child is taken into a new family, there is still a sense of loss, even if the child is an infant. We know that it is very beneficial for newborns to bond with their mother – imagine how it can affect a baby who does not make this crucial connection.

Later, as the child matures and finds out they were adopted, that sense of loss becomes a theme running through the person’s subconscious. As such, adopted children typically feel succeeding losses much more deeply than their non-adopted counterparts.

Rejection is part of the initial loss the adoptee experiences. In order to be adopted, they had to be rejected by their birth parents. Later in life, if a birth parent blocks the adoptee’s search for them, the person experiences yet another rejection.

Guilt/shame comes from the adoptee’s feelings of rejection. As we know, children tend to blame themselves when something bad happens, therefore an adopted child naturally questions what they must have done wrong (or what was wrong or “bad” about them) that made their birth parent give them away. Even if the adoptee knows the reason they were placed for adoption, they often still secretly harbor the idea that they were somehow “broken” or could have been a “better” baby, which is why their birth parents rejected them.

Grief is part of adoption because the child lost their birth parents. We see adoption as a joyous occasion for the parents who are adopting the child, therefore the thought is that adopted kids should feel thankful to have a new family. Grieving for what they lost doesn’t usually have a place in the child’s life – it is considered a rejection of the adoptive parents if the child grieves.

Additionally, children sometimes don’t feel the effects of their deep-seated loss until they reach adolescence or adulthood and have developed a high enough cognitive level to understand what the loss means to their life. In many cases, this leads to substance abuse, depression, or aggression.

Identity is another loss the adopted adult must face. While they have been given a new name and identity by their adoptive parents, is it who they truly are? Or are they really the person they were before the adoption?

Even if they fully embrace their new family, the adoptee still suffers a loss of identity because they often know nothing about their birth family. What medical concerns do they need to watch out for (i.e.” does heart disease run in their birth family)? Who are their ancestors? What do they know about inherited genetic ties or family backgrounds?

Intimacy is frequently difficult for the adopted adult because they have such deeply rooted feelings of rejection, guilt or shame, and don’t truly have an identity. Often people who have gone through these negative emotions subconsciously push others away to avoid experiencing another loss.

The Silverstein and Kaplan study notes that, “Many adoptees as teen[s] state that they truly have never felt close to anyone. Some youngsters declare a lifetime emptiness related to a longing for the birth mother they may have never seen.”

Lastly, adoptees often feel little sense of mastery/control over their lives because they had no say in the matter of their adoption. Whether placed with their adoptive family at birth or as an older child, they were not given an option. As they mature, this can result in power struggles with authority figures and a reduced sense of responsibility.

How To Cope With Being Adopted

The first step to coping with being adopted is to recognize that the experience itself leaves residual problems. When the adoptee learns about and acknowledges the core issues inherent to adoption, they can begin to talk about them with someone, such as their adoptive parents, support groups, or a professional.

Accepting and exploring these core issues helps the adoptee work through them. The open adoptions that are the norm nowadays may reduce their sense of loss and guilt, while interacting with other adopted adults can allow the person to feel less alone.

It should be said that, while finding the birth parents can give the adoptee answers and closure, this is a deeply emotional process. Before contacting their birth family, the individual should prepare themselves to experience possible further rejection if a reunion is not what they dreamed it would be (or if the birth parents refuse to meet them once they have been found).

In addition, if an adoptee seeks out a therapist, they should make sure they talk to a professional who has special training in adoption issues.  

We Can Help

If you are an adopted adult and are struggling with your feelings, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, can help. For more information, contact us or call us today at 561-496-1094.

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