All Posts Tagged: cognitive behavorial therapy

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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Adult ADHD

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

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

Signs of ADHD in Adults

The following can be warning signs of adult ADHD:

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

ADHD Symptoms in Adults

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

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

In addition, the following conditions must be met:

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

Adult ADHD Treatment

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

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

Help for Adult ADHD

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

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