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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.

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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Mindfulness Therapy Can Help With Anxiety Disorders

Mindfulness – The Secret To Being Happier Throughout Your Day

Most people go through their lives in reaction-mode. They respond to something that happens in their environment – a conversation, a changing traffic light, the boss calling a meeting – but they often aren’t truly aware of the world around them. They can be so focused on the distractions of life that they aren’t actually experiencing life.

You’ve probably heard the phrase “be more mindful” or “be present in your day,” but do you know what that really means? Is it simply paying attention to your surroundings or is there some deeper concept to be explored? Are there benefits to being mindful?

What Does It Mean To Be More Mindful?

Strictly speaking, mindfulness is defined by the Merriam-Webster dictionary as, “the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis.”

In practice, being mindful does encompass an awareness of your surroundings, but being present also means to stay focused on the here and now. For example, worrying about a work trip that will happen next week distracts from the joy you might take in playing catch with your son right this minute. Because you are absorbed by something other than playing with your child, you are denying yourself the full experience of being with him.

To be mindful, you might focus on the sound of the ball hitting your glove when you catch a ball he has thrown. You may enjoy the warmth of the sun on your skin or hearing your son exclaim, “yes!” when he catches a difficult toss of the ball. Or, you might listen to a bird chirping in the tree or smell your neighbor’s freshly mown lawn.

When you choose to be mindful, you experience your life more richly instead of just cruising through it.

Benefits Of Staying Present

In today’s high-paced, digital world, slowing down and just taking in the world around you can be challenging. Not many of us are able to fully relax: we’re always thinking of the next task we have to do, checking texts and emails, or planning the next activity. This stressful way of living can lead to health concerns, as well as to emotional and psychological issues.

Mindfulness, however, can:

  • Make you happier and feel more peaceful – According to a study by Keng, et al, “mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation.”
  • Help you stay healthier – In a study of HIV-positive patients, an 8-week study on the effects of mindfulness meditation training showed that mindfulness “can buffer CD4+ T lymphocyte declines in HIV-1 infected adults.” Further, a study by Hughes, et al, on the effects of mindfulness in pre-hypertension patients showed a reduction in both diastolic and systolic blood pressure readings as compared with those who only did progressive muscle relaxation exercises.
  • Minimize the negative impact of illness – A study by Davidson, et al, showed that an 8-week mindfulness meditation program caused “significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group.”
  • Teach you how to regulate emotions through experiencing thoughts as they happen. This allows us to label and categorize these thoughts and emotions instead of letting them become overpowering.
  • Improve relationships – A 2016 meta-analysis by McGill, et al, (published in the Journal of Human Sciences and Extension) found that “the association between mindfulness and relationship satisfaction is statistically significant, indicating when an individual is more mindful they are more satisfied in their romantic relationship.”
  • Enhance the quality of your sleep – “Sleep disturbances pose a significant medical and public health concern for our nation’s aging population. An estimated 50% of persons 55 years and older have some form of sleep problem, including initiating and maintaining sleep,” according to a 2015 study by Black, et al. This study showed that mindfulness meditation promoted better sleep quality and reduced daytime impairment in older adults who had sleep disturbances.
  • Help you eat healthier – Instead of rushing through a fast food lunch at your desk, being mindful of how your food contributes to your health will allow you to reach for more nutritious foods. In fact, choosing to take small bites, chewing your food thoroughly, and savoring the flavors not only reduces stress, a study from the American Journal of Clinical Nutrition says it can also help you lose weight without counting calories.

What Are Some Ways To Be Mindful?

Mindfulness is done by keeping your attention on the present – on what you are experiencing in that particular moment. It doesn’t matter where you are or what you are doing, you simply tune in to the experience of the here and now.

An article from HelpGuide.org says, “You can choose any task or moment to practice informal mindfulness, whether you are eating, showering, walking, touching a partner, or playing with a child or grandchild. Attending to these points will help:

  • Start by bringing your attention to the sensations in your body
  • Breathe in through your nose, allowing the air downward into your lower belly. Let your abdomen expand fully.
  • Now breathe out through your mouth
  • Notice the sensations of each inhalation and exhalation
  • Proceed with the task at hand slowly and with full deliberation
  • Engage your senses fully. Notice each sight, touch, and sound so that you savor every sensation.
  • When you notice that your mind has wandered from the task at hand, gently bring your attention back to the sensations of the moment.”

Mindfulness can also be done as part of practices such as yoga, aikido, and tai chi training, as well as being a form of meditation in its own right.

How To Practice Mindfulness For Anxiety

Anxiety is connected to our thoughts and triggered by our reaction to them.

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

  • Start with focusing on your breathing.
  • Zero in on the sensations you feel. Notice the sensation of your breath flowing through your nose and lungs as you inhale and exhale. Feel your chest expand and contract with each breath.
  • Notice the room’s temperature, the sounds around you, any smells or fragrances, and your physical reactions (sweating, pulse rate, etc).
  • If you have an anxious thought, label it, but don’t get caught up in it or reject it. Instead, think “that is a fearful thought” or “that is a sad thought,” then take 3 deep breaths.
  • After taking these breaths, try to gain perspective about the anxious thought. Ask yourself if the worry or fear was valid? Or, was it actually something you might be making bigger than it deserves? Or, could it be that you are jumping to conclusions? 
  • Experiencing those few seconds of calm as you gain perspective allows you to release the anxious thought, so let it go and focus on your next breath.
  • Don’t judge yourself for having anxious thoughts. Once you notice them, simply return your attention to your breathing and repeat these mindfulness steps.

“Practice makes perfect,” as the saying goes. You probably won’t experience a total release of anxiety the first time you try mindfulness, but you should get some relief from your concerns.

If you keep practicing, you will improve over time. Each time you focus on the present, your mind gets a chance to relax so you can see things from a new perspective.

Learn More About Mindfulness Here

If you or a loved one are struggling with anxiety, we can 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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breast cancer awareness ribbon

PTSD In Breast Cancer Survivors

October is Breast Cancer Awareness month and pink ribbons abound. Everywhere you look, people are wearing pink and various organizations are engaging in fundraising for cancer research. For survivors of the disease, this outpouring of hope is welcome, but at the same time, these visual reminders of their fight can bring up symptoms of post traumatic stress disorder (PTSD).

Even though it is best known for affecting war veterans or people who have been through violent events like mass shootings, PTSD is also found in cancer survivors. “It’s common for cancer patients, even if they don’t have full-blown PTSD, to have some of the symptoms of it,” says Fremonta Meyer, MD, of Dana-Farber’s department of Psychosocial Oncology and Palliative Care.

The color pink isn’t the only thing that can trigger PTSD in breast cancer survivors. Simple actions such as driving past their treatment centers or seeing cancer care commercials on the television can do it, as can hearing about someone else’s diagnosis (or breast cancer scare).

Cancer And PTSD Symptoms

A contract employee of ours went through treatment for stage 1 breast cancer last year. She recently told me how her niece’s routine exam triggered her own PTSD earlier this month.

During an annual exam, the doctor found a lump in her niece’s breast, which led to a mammogram and ultrasound. The results were negative, but our employee found herself crying for no reason, depressed, and sleepless for about two weeks following her niece’s “all clear,” despite the fact that she was obviously very happy that her niece was fine. When she mentioned her symptoms to me, it was clear that she was experiencing some post traumatic stress.

Symptoms of PTSD can include any of the following:

  • Insomnia
  • Startling easily
  • Inability to think clearly or concentrate
  • Re-experiencing the traumatic event – this can happen through nightmares, flashbacks, or memories.
  • Avoidance of situations or places that remind the person of the event
  • Feeling defensive, fearful, or angry
  • Negative self-perceptions

These symptoms could be triggered when the person encounters certain sights, smells, or sounds that remind them of their diagnosis, going through chemotherapy, or other cancer treatments. Additionally, post treatment screening, testing, and waiting for test results can bring the original trauma back to the forefront.

In general, PTSD symptoms begin soon after the initial traumatic event, but sometimes they do not appear for months or even years after the trauma occurred. This happens because, for cancer survivors, the traumatic event continues from the time of diagnosis to the end of treatment, which can take a year or longer. Thereafter, survivors often spend years worrying about recurrence, which may keep their PTSD active.

It also should be noted that the parents of children who go through cancer treatment can also suffer from PTSD, with similar triggers and symptoms.

Factors Contributing To The Development Of PTSD After A Cancer Diagnosis

The National Cancer Institute (NCI) at cancer.gov reports that “certain physical and mental factors that are linked to PTS [post traumatic stress] or PTSD have been reported in some studies:

Physical factors

  • Cancer that recurs (comes back) was shown to increase stress symptoms in patients.
  • Breast cancer survivors who had more advanced cancer or lengthy surgeries, or a history of trauma or anxiety disorders were more likely to be diagnosed with PTSD.
  • In survivors of childhood cancers, symptoms of post-traumatic stress occurred more often when there was a longer treatment time.

Psychological, mental and social factors

  • Previous trauma.
  • High level of general stress.
  • Genetic factors and biological factors (such as a hormone disorder) that affect memory and learning.
  • The amount of social support available.
  • Threat to life and body.
  • Having PTSD or other psychological problems before being diagnosed with cancer.
  • The use of avoidance to cope with stress.

Cancer patients may have a lower risk of post-traumatic stress if they have the following:

  • Good social support.
  • Clear information about the stage of their cancer.
  • An open relationship with their healthcare providers.”

Treatment for Cancer PTSD

Therapy for cancer-related PTSD is similar to treatment for other forms of the disorder and usually involves a combination of therapies:

  • Relaxation techniques, such as deep breathing, mindfulness training, and meditation can help survivors release muscle tension, lower blood pressure, and reduce anger and anxiety levels.
  • Cognitive Behavioral Therapy (CBT) helps survivors challenge and change the negative thoughts and thinking patterns that are causing them stress. CBT helps people cope with their situation in a healthy way.
  • Support groups for survivors in which coping skills and emotional support can come from others who have gone through similar experiences.
  • Sometimes medications are used in the short term to help survivors who have severe trauma symptoms or flashbacks.

Above all, therapy helps the person understand that a disorder like this one develops because of extraordinary stress, not because of weakness.

The key is to get treatment early. Symptoms and mental distress are often long-lasting and can affect your relationships, your job, and your overall health. Please seek help before these symptoms have a chance to further disturb your life.

We Can Help

If you or someone you love have gone through cancer treatment and find that you have some PTSD after your treatment, 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.

Resources

PDQ® Supportive and Palliative Care Editorial Board. PDQ Cancer-Related Post-traumatic Stress. Bethesda, MD: National Cancer Institute. Available at: https://www.cancer.gov/about-cancer/coping/survivorship/new-normal/ptsd-pdq. Accessed 10/12/2019. [PMID: 26389374]

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HOCD and Intrusive Thoughts

HOCD (homosexual obsessive compulsive disorder) is a subgroup of Obsessive Compulsive Disorder (OCD). It causes relentless questioning of one’s sexual orientation via the intrusive thoughts that are characteristic of OCD. HOCD is also known as Gay OCD or Sexual Orientation OCD (SO-OCD).

The term HOCD is not a recognized scientific or diagnostic name. Instead, it is more of a reference name or “title” that is used within the OCD community. This term defines the mental anguish that comes from experiencing intrusive, unwanted thoughts that you might be gay. If you have HOCD, these thoughts can come so often that, over time, it can become unbearable.

Part of the frustration with HOCD is that, once the intrusive thoughts are triggered, the person’s mind refuses to accept the reality that they have never been attracted to the opposite sex before. They can try to convince themselves that they are content with their straight orientation, but their OCD won’t allow them to do so. Eventually, these thoughts can become intrusive enough to make a person quit a job or leave a relationship because they are so convinced that they have been lying to themselves their entire life.

If you have HOCD, you might:

  • Fear that you have been living in denial of your true orientation.
  • Worry that just the fact that you are questioning your sexual identity means you are gay, because “I wouldn’t wonder about my orientation if I was straight.”
  • Fear losing your “self” and your previous identity.
  • Be concerned that homosexuality is “catching” in the same way that a cold or the flu can be caught.
  • Worry that being around a gay person will trigger your own latent tendencies and cause you to act out.
  • Fear that being unable to perform sexually means you are gay.
  • Think that other people will see you as gay because of a certain mannerism or because of how you dress or act.

HOCD Is All About Intrusive Thoughts

The truth is, HOCD is not about the person’s sexual orientation – it is really about their intrusive thoughts and how they react to those thoughts.

People without OCD will have a random thought and then dismiss it because it has no meaning. Those who have OCD and HOCD, however, attach deep meaning to these random thoughts and often spend countless hours searching for one hundred percent assurance that the thought is or is not true.

These intrusive thoughts don’t go away, either. For someone with OCD, once an intrusive comes into their mind, they cannot dismiss the thought because it sets up a cycle of doubt and questioning that repeats over and over again.

As far as OCD goes, no proven cause has been found for the disorder. And, since there isn’t just one concrete cause for OCD, there also is no exact reason for why someone with OCD will go on to develop HOCD or another subgroup. What we do know is that OCD and its subgroups revolve around whatever it is that the person fears. For example, while some may worry that they are actually gay (HOCD), another may worry that they will hurt themselves or others (Harm OCD).

Help for HOCD

Because there are only a few studies out there on HOCD, many mental health professionals don’t realize this subcategory exists. Therefore, they don’t understand how to properly diagnose and treat it. In many cases, clinicians either miss the diagnosis or they call it “sexual identity confusion” instead of HOCD. But, remember – HOCD is not about sexual identity, it is about the person’s OCD (whether it has been diagnosed or not).

There is a big problem with labeling and treating HOCD as “sexual identity confusion.” It can cause the individual to believe that their misinterpretation of their sexual orientation is actually meaningful and true. For this reason, when seeking help for HOCD, it is extremely important to find a therapist who specializes in treating either OCD or the HOCD subgroup.  

A therapist who is familiar with the condition will also understand that HOCD is not something that can be cured through reasoning and talk therapy because there is no underlying homosexuality to uncover. Instead, treatment for HOCD should involve the same therapies clinicians use when treating classic OCD. These include cognitive behavioral therapy (CBT), exposure and response therapy (ERP), exposure and ritual prevention therapy (EX/RP), and sometimes the short term use of medication to help with depression and anxiety.

We Are Experts In The Treatment of HOCD

Learn more about HOCD in Dr. Rosen’s newest book, HOCD: Everything You Didn’t Know – A primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder. Find it online here.

In addition to this book, our clinic has therapists who are specially trained to treat OCD, HOCD, and other subgroups of the disorder. For more information or to schedule an appointment, 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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HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

If HOCD has left you struggling with relentless questions about your sexual identity, a new book by Dr. Rosen, Founder and Clinical Director of The Center for Treatment of Anxiety and Mood Disorders will be an indispensable and compassionate guide that will demystify the disorder and offer hope.

HOCD (Homosexual Obsessive Compulsive Disorder) is a debilitating condition that attacks without warning in those who already struggle with classic OCD. It leaves its victims reeling with uncontrollable doubt about their sexual orientation (despite never having questioned it before), while igniting a vain pursuit of certainty over the question of whether they are truly straight.

In this HOCD primer, Andrew Rosen, Ph.D. draws on more than forty years of clinical practice to give readers insight into the disorder, as well as offering practical help to those who are fighting against a sexuality they know deep down really doesn’t exist for them.

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