All Posts Tagged: mood disorder

woman wearing mask

Are You Struggling With Covid Stress Syndrome Or Covid PTSD?

Those with mental health concerns often feel like they can’t control the world around them. Sometimes they may feel like they, themselves, are spiraling out of control. Now that we’ve gone through the last year and the challenges brought by the coronavirus pandemic, I think most of us can relate to those feelings in some way.

For many people, going through this pandemic means that trauma and post traumatic stress disorder (PTSD) has now become a part of their life. This can be for a variety of reasons.

Maybe you’re a front line worker who is burned out and mentally exhausted. You may have had the personal experience of having had Covid-19. Or, perhaps you’ve had to face the illness and/or passing of someone close to you, due to the disease. Even going through lock downs, losing jobs, and being separated from friends and family for long periods can wreak havoc on our mental health.

No matter the reason, anyone who witnesses or goes through the events surrounding a traumatic, life-threatening illness like Covid-19 may find they have anxiety, depression, or post traumatic stress afterwards.

What Are The Effects Of The Covid-19 Pandemic On Mental Health?

Prior to Covid-19’s appearance, the World Health Organization (WHO) estimated that about one in four people, worldwide, would suffer from mental health concerns at some point in their lives.

Now that we’ve all been so touched by the pandemic, the CDC estimates that around forty percent of us are struggling with mental health, suicide ideation or substance abuse concerns. Ken Duckworth, the CEO of the National Alliance on Mental Illness (NAMI) backed this up when he reported that, “data showed that about one in five Americans suffered from some sort of mental illness before the pandemic, and that number is now two in five.” 

In reality, these numbers are probably low, as the instances of anxiety, depression, trauma and stress-related disorders have been steadily rising as the pandemic drags on. Clearly, we will continue to see the mental health repercussions of this worldwide health crisis, even long after the world returns to normal.

What Are The Possible Mental Symptoms After Recovering From Covid-19?

When people experience trauma, it usually shakes them to their core, especially if they felt they had little to no control over the event. They feel helpless, they may experience flashbacks, or they may experience a persistent fear that something bad will happen to them again.

If you are someone who has had Covid-19, you may have recovered from the illness, but you might now have some lingering side effects. These can affect you physically or mentally, or both.

Possible mental health symptoms related to having Covid-19 can include:

  • Brain fog
  • Short term memory loss
  • Confusion
  • Not feeling “like myself”
  • Problems concentrating

Covid Stress Syndrome

If you lost a loved one to the illness, you are no doubt coping with grief, along with fear for yourself and others with whom you are close.

Even if you never lost your job, didn’t get sick or didn’t lose anyone to Covid-19, however, you still have been affected by the pandemic. The separation from those we care about, combined with shut downs, social distancing, mask wearing, working from home, changes to a child’s schooling, virtually non-existent travel, and other interruptions to our normal lives has affected everyone in some way.

Furthermore, these continued disruptions – without a known end date – have resulted in and ongoing Covid stress syndrome for many of us. As a result, some people are avoiding medical or dental services and healthcare workers altogether. They may be gathering (and possibly hoarding) PPE like masks and gloves, or be terrified to go into stores or anywhere that others might potentially expose them to the virus.

This stress may also be causing:

  • Problems sleeping
  • Difficulties with concentration
  • Angry outbursts
  • Changes to your eating patterns, such as not eating or over-indulging
  • New or increased substance abuse (tobacco, alcohol, or recreational drug use)
  • Chronic health problems may be getting worse
  • Pre-pandemic mental health conditions may be worsening

Covid PTSD Symptoms

Signs of Covid PTSD are similar to the signs of trauma that people experience after going through disturbing and life-threatening events, such as natural disasters, wars, or other serious medical diagnoses.

Even though emotional responses are part of a normal reaction to a stressful situation, trauma actually changes patterns in your brain. It causes you to carry the emotional distress long after the events have passed.

The symptoms of Covid PTSD can include:

  • Flashbacks to the event
  • Sudden, overwhelming fear for no apparent reason
  • Anger or irritability
  • Physical symptoms, such as a rapid heartbeat, sweating, or difficulty breathing
  • Negative thoughts
  • Feeling guilt or blaming yourself for what happened
  • Worry that something bad will happen again, to you or a loved one
  • Beginning or increased substance abuse
  • Suicide consideration

Covid PTSD Self-Assessment Quiz

Sometimes, taking a self-assessment quiz can be helpful. While taking a test such as this isn’t a substitute for the opinion of a qualified expert, it can quickly help you determine if you should seek help before your symptoms become overwhelming.

The following quiz has been adapted from the Anxiety & Depression Association of America. If you suspect that you might suffer from PTSD, answer the questions below, please share these results with your health care professional.

Are you troubled by the following?

Yes No You have experienced Covid-19 or witnessed a loved one’s life-threatening Covid-19 event that caused intense fear, helplessness, or horror.

Do you have intrusions about the event in at least one of the following ways?

Yes  No Repeated, distressing memories, or dreams
Yes  No Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)
Yes  No Intense physical and/or emotional distress when you are exposed to things that remind you of the event

Do you avoid things that remind you of the event in at least one of the following ways?

Yes   NoAvoiding thoughts, feelings, or conversations about it
Yes   NoAvoiding activities and places or people who remind you of it

Since the event, do you have negative thoughts and mood associated with the event in at least 2 of the following ways?

Yes   NoBlanking on important parts of it
Yes   NoNegative beliefs about oneself, others and the world and about the cause or consequences of the event
Yes   NoFeeling detached from other people
Yes   NoInability to feel positive emotions
Yes   NoPersistent negative emotional state

Are you troubled by at least two of the following?

Yes   NoProblems sleeping
Yes   NoIrritability or outbursts of anger
Yes   NoReckless or self-destructive behavior
Yes   NoProblems concentrating
Yes   NoFeeling “on guard”
Yes   NoAn exaggerated startle response

Post Covid Anxiety Treatment

The goal of anxiety treatment is to get you back to a more “normal” world as soon as possible. Sometimes you can achieve this through self-care, however if your symptoms are affecting how you go through your daily activities or your emotional upheaval lasts longer than two weeks, it’s time to seek help through a professional.

Self-Care

Self-care includes:

  • Being kind to yourself – don’t criticize yourself for how you feel. It’s normal to have strong emotions when facing a life-altering event.
  • Eating nutritious meals
  • Getting plenty or restful sleep
  • Keeping to a schedule for eating, sleeping, showering, cleaning the home, etc.
  • Exercising – even as little as walking 15 minutes a day can help distract you, allowing a reset of your emotions
  • Limiting your news and social media consumption. News organizations make money when you click on their stories, so they are certain to post worst-case scenarios to lure you in. This keeps your emotions running high, which is why setting viewing limits can help.

Meditation or mindfulness is also very helpful for retraining the brain to be calmer and less anxious. In fact, studies show they actually help to increase your positivity and reduce negative thinking.

If you don’t know how to work with these modalities, you can find YouTube videos or books to instruct you. Also, there are a variety of phone apps that can help, including:

  • Calm (free for those with Kaiser insurance)
  • Headspace
  • Personal Zen
  • Mindfulness Coach

Professional Treatment For Covid PTSD And Anxiety

By working with a mental health professional who specializes in trauma, you can recover and learn to feel safe again.

Covid PTSD can be treated through two very effective therapies: Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitizing And Reprocessing (EMDR).

Cognitive behavioral therapy (CBT) helps you identify and manage your distorted thoughts and beliefs about the event so you can replace them with accurate views.

Eye Movement Desensitizing And Reprocessing (EMDR) helps you process your trauma on an emotional level. This therapy is simple, yet studies have shown that it can help PTSD sufferers heal faster than through traditional therapy.

We Are Here For You – Through The Pandemic And Beyond

If you are experiencing emotional and mental health challenges during the pandemic or afterwards, our licensed, professional therapists are available to help – in person, online or through a video session. Our virtual platforms are highly secure, allowing us to maintain absolute confidentiality with strict non disclosure policies.

Whatever the difficulties you are facing, we are here to listen and offer effective solutions. For more information, contact us or call us today at 561-496-1094.

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virtual therapy

Will Teletherapy Continue After Covid?

Before the Covid 19 pandemic, the potential of telehealth and virtual therapy was just starting to be recognized as an option for the treatment of mental health disorders. Then, the world shut down and remote care exploded into universal acceptance.

In the months since, people (and insurance companies) have learned to navigate the ins and outs of virtual therapy. Once we are free to resume our normal lives, however, will this option go away?

What Is A Telepysch Appointment For Mental Health Care During The Covid-19 Pandemic?

In a nutshell, a telepsych appointment for mental health care is pretty similar to an in-person session – with a few convenient differences.

With telemedicine, the client talks to their licensed mental health professional from the comfort of their own couch, instead of going in to the office.

Clients can choose to see their therapist via an online platform like Skype or Zoom or they can take part in an online chat session via their phone or computer. They don’t have to worry about traffic or commuting to the office in bad weather – and don’t even have to change out of their pajamas!

Because there was often no other option during the pandemic shut downs, individuals who had been in therapy before covid-19 quickly adapted to virtual and online teletherapy. This allowed them to safely continue treatment at a time when stress levels were through the roof.

How Effective Is Teletherapy?

We already knew that teletherapy was effective before the pandemic. In fact, studies by the Veteran’s Administration showed that vets who suffered from PTSD and received counseling via videoconferencing did equally well, in general, as those who went to in-person appointments.

Other reviews have shown that children and adolescents who received teletherapy for substance abuse and eating disorders did as well with virtual sessions as they did in traditional settings.

Moreover, in a review of 24 studies on teletherapy, researchers concluded that, “Telephone-delivered and VTC-delivered psychological interventions provide a mode of treatment delivery that can potentially overcome barriers and increase access to psychological interventions.”

Risks And Benefits Of Teletherapy

Along with being able to receive therapy from the comfort of your home, there are other benefits to virtual and online therapy:

  • It saves time and money on commuting costs.
  • Allows the client to keep their session in the event of car trouble or transit delays and keeps them safe from possible covid exposure from commuting to a session via public transportation.
  • The client can talk to any therapist they wish. This gives them flexibility if they live in a remote area and allows them to keep the same therapist if they move to another city.
  • Removes the stigma of mental health therapy and provides anonymity (there’s no chance of bumping into a friend or neighbor as you are walking into a therapy session)
  • This type of therapy is accessible for those who have a disability or physical limitations.

As with anything, there are certain negatives to teletherapy, as well. They include:

  • Technology problems could be frustrating and result in rescheduling a much-needed appointment.
  • Distractions can reduce the effectiveness of the therapy session.
  • Insurance coverage may not be available for virtual mental health treatment, although many insurance companies have begun covering it since the pandemic.
  • Possible state licensing limitations if you wish to see an out-of-state provider. Some states will only allow an out-of-state psychologist or mental health therapist to provide services in that state for a short period of time (generally for less than a month).
  • Can reduce the facial and physical cues a therapist would pick up on if they were seeing the client in person. This may mean they may not get a clear idea of the client’s mood or thoughts, or the client may have a harder time expressing their emotions and concerns.
  • Lack of privacy for the client if others (for example, roommates or family members) are around when they are speaking with their therapist.
  • Providers may unknowingly be using a platform that is not HIPAA compliant.

Will Teletherapy Continue After Covid?

It is highly likely that telepsychology will continue after the pandemic is over. While clinicians and clients were slow to embrace the technology, once they were forced to do so out of safety concerns, most quickly adapted.

Now, both therapists and clients are seeing the benefits. Jeanine Turner, PhD., a professor of Communication, Culture & Technology at Georgetown University, says, “Last year, within weeks, the system had to absorb all the challenges of wide-scale adoption. Now, it’s taken off—and there will be no going back.”

One hurdle to get over may be that of health insurance coverage. While the major insurance carriers are covering telepsychology, some are starting to balk at covering it, despite the ongoing pandemic.

Also, many people have self-insured plans, covered by the Employee Retirement Income Security Act of 1974 (ERISA), which is not required to cover teletherapy. To combat this, the American Psychological Association (APA) is advocating to ensure coverage.

Our Teletherapy Services Are Here For You

If you need expert help during the pandemic or afterwards, you can talk with our licensed, professional therapists online or through a video session. Our virtual platforms provide the highest possible security to your personal information and allow us to maintain absolute confidentiality with strict non disclosure policies.

Whatever the difficulty that you are facing in your life, we are here to listen and offer effective solutions. For more information, contact us or call us today at 561-496-1094.

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book cover for Hope for OCD: One Man’s Story of Living and Thriving With Obsessive Compulsive Disorder

Hope for OCD: One Man’s Story of Living and Thriving With Obsessive Compulsive Disorder

Millions of Americans go through each day tormented by the uncontrollable thoughts (obsessions) and compulsive rituals and behaviors that characterize OCD. Difficult to understand and even harder to experience, Hope for OCD – One Person’s Story of Living and Thriving with Obsessive Compulsive Disorder is a profoundly courageous inside look at navigating life with the challenges of this anxiety disorder.

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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

If HOCD has left you struggling with relentless questions about your sexual identity, HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder, a 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.

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

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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What Is Harm OCD?

Studies show that the vast majority of us occasionally have unwanted violent thoughts about injuring ourselves or others. For example, we might briefly fantasize about harm befalling the guy who just cut us off in traffic and then scared us even more when he immediately slammed on his brakes to avoid other cars. Although we don’t like to acknowledge them, about 85 percent of people do experience some type of random harmful thoughts, but they are fleeting and don’t disturb our normal lives.

For people who have obsessive compulsive disorder (OCD), however, having unwanted thoughts about hurting someone may not be able to be dismissed so easily. In fact, these thoughts can become frequent enough to become intrusive, taking over the person’s life. When this happens, the individual is dealing with Harm OCD.

Defining Harm OCD

Harm OCD is a subset of classic obsessive compulsive disorder (OCD). The condition is characterized by having aggressive, intrusive thoughts of doing violence to someone, as well as the responses the person uses to cope with these thoughts.

OCD makes the individual feel that they can’t trust their own mind. Wherein someone without OCD could have a violent thought and recognize that it is simply a thought, a person with OCD who has the Harm OCD subset worries that just having the thought is somehow meaningful. As a result, they want full assurance that they won’t act on the thought.

Having these intrusive thoughts leads to engaging in compulsions and rituals to decrease the anxiety the person feels about the thought. Once they complete the ritual, they feel less anxious, but then the intrusive thought comes again, setting up endless cycles of doubt and fear.

Harm OCD Symptoms

Those who suffer from Harm OCD may:

  • Have aggressive thoughts or see images in their minds of violence and worry that this means they will carry them out.
  • Fixate on the idea that they could inadvertently be responsible for causing harm and not realize it (for example, they may worry about running someone over by accident, and then leaving the scene because they were unaware of what they had done).
  • Be terrified that they will hurt someone (or themselves) on impulse – whether intentionally or not.
  • Worry they are hiding their true nature from themselves and others and that they are really a vicious, aggressive person who will act out someday because they will lose control.

In response to their intrusive thoughts, people who experience Harm OCD engage in compulsions and rituals to help relieve their anxiety. These may include such actions as:

  • Hiding dangerous objects (kitchen knives, poisonous chemicals, medications, ropes, razor blades, and the like) so they aren’t tempted to use them to hurt someone.
  • Reviewing their every action to see if they could have, or did, cause harm
  • Avoiding watching the news or such things as violent movies, television shows or videos, so as to keep from triggering violent ideas.
  • Spending excessive amounts of time online, researching violent crimes and ideology in an effort to know whether they have things in common with the offenders.
  • Compulsive praying or carrying and using spiritual items so that they won’t lose control.
  • Asking others if they think the person with Harm OCD could hurt others.
  • They may also endlessly question themselves in an effort to answer, once and for all, if they are capable of injuring anyone (including themselves).

Treatment for Harm OCD

As with classic OCD, Exposure and Ritual Prevention (ERP) is the treatment for any OCD subset, like Harm OCD.

The first part of the therapy – exposure – happens when the individual allows themselves (with the help of their therapist) to encounter the triggering object, image, or environment that begins their cycle of intrusive thoughts. The idea is to confront what they fear, but to refrain from using their compensating compulsions (ritual prevention).

By resisting the urge to complete a ritual after the exposure and then finding that they do not act on the violent thought, the person builds self-confidence and begins to retrain their brain. This leads to learning to trust that their thoughts are simply thoughts. Over time, consistently avoiding the use of compulsions while remaining nonviolent helps break the cycle of doubt.

For the best chance of overcoming Harm OCD, find a therapist who specializes in treating classic OCD. Trying to get past intrusive thoughts on your own can keep you stuck because it can be difficult to stop “testing” yourself to see how you are reacting – which is a ritual that could reinforce your false beliefs.

Have Further Questions?

If you are concerned about your violent thoughts or worried that you may harm yourself or someone else, seek help from the OCD-trained therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, contact us or call us today at 561-496-1094.

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Asperger’s And Diagnosing Autism In Adults

We usually think of autism as being a childhood disorder because it is typically talked about in kids. Nowadays, children are screened for the signs of autism by their pediatricians during their 18- and 24-month well checks. This means that most cases of autism will have been identified by the time a child is two years of age. But, this screening procedure is fairly recent, so what if you are an adult who was told you had a learning disorder years ago or were called a “difficult” child before this protocol? Is it possible that you may have undiagnosed autism spectrum disorder (ASD), even if your symptoms are mild?

Autism In Adults

Back in the day, autism spectrum disorder was often misdiagnosed or mistaken for other conditions, like obsessive compulsive disorder (OCD) or attention deficit hyperactive disorder (ADHD). Many adults who were labeled with behavioral concerns as kids might wonder now if they actually have ASD instead. Currently, it can be problematic to get an answer, however. There is no set protocol for screening adults for the disorder and it isn’t a common practice for doctors to watch for signs of autism in adults.

But, that will change as we learn more about ASD. According to a 2016 study by Murphy, et al, “Autism spectrum disorder is a lifelong neurodevelopmental disorder that has a potentially detrimental impact on adult functioning.” Today it is widely thought to be a disorder that comes from a combination of inherited genetic causes and environmental factors

Initially, autism was considered rare. Back in the 1960s, it was believed that only about 4 in 10,000 people had it. We now know, however, that ASD affects around one percent of adults and children.

This upsurge in cases is not due to an increase in the condition. Rather, it is because we have increased our awareness of it. We also have better diagnostic tools and classification systems in place now. For instance, in 2013, Asperger’s syndrome was reclassified as part of ASD after it was decided there wasn’t enough evidence to show it was a separate condition from autism.

Adult Autism Checklist

At present, adult autism spectrum disorder is diagnosed through behavioral observations. There is no test or checklist to identify it, although one is in the process of being developed.

Still, there are symptoms that can indicate possible ASD. These behavioral signs of autism in adults include:

  • Wanting to stick to a strict routine, schedule, or firm guidelines.
  • Problems adjusting to change or emotional outbursts when something doesn’t happen according to plan.
  • Increased chance of having an accompanying mood disorder, anxiety, or having obsessive compulsive disorder (OCD).
  • Difficulty with social interactions. It can be hard to make friends and a struggle to keep them.
  • Issues with making inferences from verbal cues, making predictions, sequencing tasks, or problem solving.
  • Problems interpreting other people’s points of view.
  • Difficulty with communication skills, especially in group settings. Not good at making small talk.
  • Rituals or repetitive behaviors.
  • Specific and extreme interest in a particular topic or hobby (bordering on obsession). It may be difficult for the person to relate socially until a favored topic is introduced, then they can easily converse on it at length.

The problem with diagnosing adults with spectrum disorder comes from the fact that someone who has had it for a long time has gotten good at hiding their symptoms. Since there hasn’t been as much research into autism in adults, usually a doctor will rely on observation and either your childhood memories or those of a close family member to help with carrying out an in-depth assessment.

Despite these issues, it can be good to get a diagnosis. In this way, you might begin to understand your youthful difficulties a little better and you can learn coping skills to help you in the future.

Interventions For Adults With Autism

Clinicians treat autism differently in adults than they do in children. In part this is because other mental health conditions like anxiety or OCD may also be playing a role in the person’s life, and must be addressed. Also there can be other concerns to treat at the same time, such as job or relationship difficulties.

A formal diagnosis opens the doors to resources and autism-related services, like vocational training and job placement. These programs vary by state and may not be available everywhere in the country, however.

The 2016 study authors noted that, “service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD.“

Although this is discouraging, today’s children with ASD are aging, so things will change to accommodate them and we’ll see more adult services in the coming years. Meanwhile, in addition to the programs that are currently in place, adults have access to professional treatment and things like books, online forums, and in-person support groups.

While ASD can’t be cured, it can be successfully managed. Behavioral interventions and learning targeted skills can reduce the challenges that those with autism may face throughout their lives.

Have Further Questions?

If you or someone you love have questions or would like further information about the assessment and diagnosis for adults with spectrum disorder, 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

Murphy CM, Wilson CE, Robertson DM, et al. Autism spectrum disorder in adults: diagnosis, management, and health services development. Neuropsychiatr Dis Treat. 2016;12:1669–1686. Published 2016 Jul 7. doi:10.2147/NDT.S65455

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