All Posts Tagged: mood disorder

The Connection Between Diet And Mental Health

The Connection Between Diet And Mental Health

Hungry? Beware – reaching for the chips or soda could be at the root of your mental health. After all, we really are what we eat. As it turns out, recent studies have shown that diet and mental health are more closely linked than we realize.

“A very large body of evidence now exists that suggests diet is as important to mental health as it is to physical health,” says Felice Jacka, president of the International Society for Nutritional Psychiatry Research. “A healthy diet is protective and an unhealthy diet is a risk factor for depression and anxiety.”

Nutrition Psychiatry

Mental health conditions are more common than you think in the United States. In fact, the Centers for Disease Control and Prevention (CDC) estimates that about 50 percent of Americans will be diagnosed with a mental health condition at some point during their lives. As of 2018, “mental illnesses, such as depression, are the third most common cause of hospitalization in the United States for those aged 18-44 years old.”

These alarming statistics, coupled with the fact that the Western diet is often filled with junk food, made scientists wonder if the two were linked. Does nutrition affect the brain as much as it does the body? To find out, about ten years ago, researchers began to look into the relationship between diet and mental health.

The last decade of study has shown that, “the risk of depression increases about 80% when you compare teens with the lowest-quality diet, or what we call the Western diet, to those who eat a higher-quality, whole-foods diet”, reports Drew Ramsey, MD, an assistant clinical professor at Columbia University. He goes on to note that, “the risk of attention-deficit disorder (ADD) doubles.”

Now researchers are even thinking that food allergies may play a role in bipolar disorder and schizophrenia.

Food and Mental Health

Most of the recent studies have revolved around the connection between a healthy diet and mood disorders like anxiety and depression. Although direct evidence connecting diet and mental health hasn’t been found yet, currently there are trials in progress to obtain it.

Meanwhile, we do know that a healthy diet affects brain health by:

  • Boosting brain development.
  • Changing brain proteins and enzymes to increase neural transmitters, which are the connections between brain cells.
  • Increasing good gut bacteria. This promotes a healthy gut biome, which decreases inflammation. Inflammation is known to affect both cognition and mood.
  • Raising serotonin levels through various food enzymes, which improves mood.

We know that a nutrient-rich diet produces changes in brain proteins that improve the connections between brain cells. But diets that are high in saturated fats and refined sugars have been shown to have a “very potent negative impact on brain proteins,” Jacka says.

Additionally, a high sugar, high fat diet decreases the healthy bacteria in the gut. Some study results have shown that a diet that is high in sugar may worsen the symptoms of schizophrenia. And, a 2017 study of the sugar intake of 23,000 people by Knuppel, et al., “confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.”

Foods For Brain Health

It sounds logical that the foods that are best for the body would also be the ones that promote brain health. This is supported by the results from a large European study that showed that nutrient-dense foods like the ones found on the Mediterranean diet may actually help prevent depression.

The nutrients that may help brain health include:

  • Zinc – low levels of zinc can cause depression.
  • Omega 3s – may improve mood and do help improve memory and thinking.
  • B12 – A report by Ramsey and Muskin that was published in Current Psychiatry in 2013y, noted that “low B12 levels and elevated homocysteine increase the risk of cognitive decline and Alzheimer’s disease and are linked to a 5-fold increase in the rate of brain atrophy.”
  • Vitamin C – The report by Ramsey and Muskin also noted that, “Vitamin C intake is significantly lower in older adults (age ≥60) with depression.”
  • Iron – iron-deficiency anemia plays a part in depression.

Eating nutrient-dense foods like whole grains, leafy greens, colorful vegetables, beans and legumes, seafood, and fruits will boost the body’s overall health – including brain health. Both the Mediterranean diet and the DASH diet, which eliminates sugar, were found to significantly improve symptoms in the patients who took part in one study on diet and mental health.

Adding fermented foods like sauerkraut, miso, kimchi, pickles, or kombucha, to your diet can improve gut health and increase serotonin levels. Serotonin is a neurotransmitter that helps to regulate sleep and stabilize mood. About 95% of serotonin is produced in the gut, so it is understandable that eating these foods can make you feel more emotionally healthy.

The next time you reach for the chips and soda, ask yourself if they are benefiting your brain. Then, grab some cultured yogurt or an apple instead. Remember – every bite counts!

Note: Dietary changes shouldn’t substitute for treatment. If you are on medications for a mental health disorder, don’t replace or reduce them with food on your own. Speak with your doctor about what you should eat, as well as what you shouldn’t. Medications will work better in a healthy body than an unhealthy one.

Questions? We Can Help

For more information about the relationship between your diet and mental health, talk to the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida help. Contact us or call us today at 561-496-1094.

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Is Suicide Contagion Behind The Recent Parkland Deaths?

We are only one month past the first anniversary of the shootings at Marjorie Stoneman Douglas High School and this past week we have all been saddened to learn of the suicides of two students who survived the attack. Additionally, the father of a child who was killed in the 2012 Sandy Hook school shootings also died this week – apparently due to suicide. Is it possible that these deaths are the result of suicide contagion?

What Is Suicide Contagion?

When the media reports that someone notable has died by suicide, it often seems that other suicides quickly follow – as if taking one’s life somehow becomes “contagious.” As an example, we saw this phenomenon last summer when Anthony Bourdain took his own life within days of Kate Spade’s death. Now there are concerns that this most recent suicide cluster involving the Parkland students and the Sandy Hook father may have happened partly because of suicide contagion.

Suicide contagion is also known as the Werther Effect – a phrase coined by suicide researcher, David Phillips, in the 1970s. Werther was a character in a 1774 novel by Johann Wolfgang von Goethe. In the book, Werther kills himself after the woman he loves marries another man.

The book was blamed for numerous copycat suicides across Europe after its release. In this early example of suicide contagion, many of the victims died in a similar manner to the Werther character’s death in the novel. Some were even found with copies of the book on or near their bodies.

There is strong evidence to suggest that suicides can occur in groups. Moreover, Phillips’ research into clusters of suicides led him to conclude that copycat suicides rise when there is excessive media coverage of the suicide of notable figures.

The Media’s Connection To Suicide Clusters

Besides Phillips’ research, several other studies agree that suicide rates go up when there is an increase in media coverage about a suicide. And the rates fall when the media coverage stops. Dr. Madelyn Gould, a suicide researcher from Columbia University has said, “The way suicide is reported is a significant factor in media-related suicide contagion, with more dramatic headlines and more prominently placed (i.e., front page) stories associated with greater increases in subsequent suicide rates.”

And, as with Goethe’s book, suicide clusters also tend to happen when a fictional television or movie character dies by their own hand. Dr. Gould says, “Research into the impact of media stories about suicide has demonstrated an increase in suicide rates after both nonfictional and fictional stories about suicide.”

Experts have long debated why suicide contagion occurs. Does the news coverage of a suicide cause other people to take their own lives or do they do so because they were already in a vulnerable state?

Either way, media guidelines for reporting these deaths have been in place in many parts of the world since the end of the twentieth century. The Centers for Disease Controls and Prevention (CDC) and the World Health Organization (WHO) have both issued policies for how news reports should cover notable and celebrity suicides.

Nowadays, however, we have a new concern. In the twenty-first century, we rely less on standard media reporting (like radio, newspapers, or television reports) and depend more on online sources to find out what is happening around us.

In particular, young people get their news from the internet and social media, which can spread a topic far faster than news broadcasts and – unfortunately – can do so with no filtering.

Suicide Risk Factors

In the case of the Parkland tragedy, we know that the first student to take her life was struggling with post-traumatic stress disorder (PTSD). She also suffered with survivor’s guilt, as do many of the teens who were there that day. It can be devastating to know that you’re still alive, but your friends will not reach the milestones that you will. Instead of being happy occasions, events like graduation or the first day of college are often very distressing for a survivor.

For young people between the ages of 10 and 24, suicide is already the second leading cause of death and this is without factoring in the trauma of a massacre like the one in Parkland. Clearly, we need to talk more openly about suicide prevention.

Adults and peers can help prevent a death by watching for youth suicide signs and risk factors and asking direct questions.

Although a risk factor can’t predict if someone will take their own life, having one or more of them makes it more likely the person will consider or attempt suicide. These risk factors are:

  • Mood or mental disorders (particularly anxiety disorders, schizophrenia, and some personality disorders)
  • A personal history of trauma or abuse
  • Feeling hopeless
  • A family history of suicide
  • A previous suicide attempt
  • Isolating themselves or having a lack of social support
  • Stigma against asking for or needing help
  • Alcohol abuse or abuse of other substances
  • Absence of mental health and substance abuse treatment
  • Knowledge of recent suicides of peers or learning about others who have taken their lives via news stories, the internet, or social media
  • Suicide ideation

The chances of suicide can also increase in someone who has recently had a financial loss, been diagnosed with a major physical illness, lost their job, or lost a close relationship.

Preventing Suicide

The first step in suicide prevention is awareness that someone is considering suicide. The next step is determining whether intervention is needed immediately.

If you know someone is at risk, you can help them by using the Columbia Protocol suicide risk assessment. The Columbia Protocol was developed jointly by researchers from Columbia University, the University of Pittsburgh, and the University of Pennsylvania, in conjunction with the National Institute of Mental Health (NIMH). In 2011, it was adopted by the CDC and today it is used worldwide to assess at-risk individuals.

The Columbia Protocol is a series of three to six simple, direct questions that you ask the person you are concerned about. The answers they give will provide enough information to know whether they need help and whether urgent action is needed (download the free Columbia Protocol toolkit now).

If your child or someone else you know tells you they are considering suicide, don’t judge them. Instead, show compassion for their feelings. Next, get help from a mental health professional or a suicide crisis hotline. The crisis hotline is especially critical if the person is in immediate danger of attempting suicide.

Never leave someone alone if they are threatening suicide. If you believe they are in immediate danger, call 911 or the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) in the United States. The line is open 24/7.

Let Us Help

If you are worried about yourself or a loved one who may be at risk for suicide, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Contact us or call us today at 561-496-1094.

References

Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine; National Research Council. Contagion of Violence: Workshop Summary. Washington (DC): National Academies Press (US); 2013 Feb 6. II.4, THE CONTAGION OF SUICIDAL BEHAVIOR. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207262/

 

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Abusive Relationships – Are You Involved With A Narcissist?

Abusive Relationships – Are You Involved With A Narcissist?

A narcissist is usually described as someone who believes they are better than others. It’s all about them. They think they know more about everything, are better looking, and have a better personality than those around them. They don’t have much regard for others.

Narcissists feel they deserve special treatment because they are so special. Everything they do stems from their need for approval. Life is good as long as they get their “fix.” But, those in a relationship with a narcissist often find that they unknowingly say or do the wrong thing, which sets off the narcissist’s hostility – even in minor situations.

What Makes A Person A Narcissist?

When you are in a relationship with a narcissist, the beginning stages can be overwhelmingly romantic. Narcissists are often popular people who are charming and engaging. They’ll “sweep you off your feet,” causing you to overlook any red flags.

In a new relationships, narcissists will go out of the way to make you feel special by sending flowers and surprising you with thoughtful gifts. They’ll flatter you and tell you how wonderful you are. They usually want quick intimacy and a commitment from you.

But, they are prone to grand ideas and exaggeration. They often have more than one intimate partner (even if they are in a long-term relationship) because they need more attention and admiration than one person can give them.

When something goes wrong, they lash out and their loved ones are generally their primary target. Narcissists have trouble holding positive feelings toward someone while they are angry at them. Thus, they become cold, withhold their love and attention, and sometimes become violent.

Their bullying and belittling is a way to cover up an underlying fear that they don’t measure up. A narcissist must maintain superiority at all costs, even if it means putting down or insulting their loved one in public or striking them in anger.

Narcissistic Personality Disorder (NPD)

In a 2009 study, Levy et al., noted that, “Narcissistic personality disorder (NPD) is characterized by a pervasive pattern of grandiosity, a sense of privilege or entitlement, an expectation of preferential treatment, an exaggerated sense of self-importance, and arrogant, haughty behaviors or attitudes.”

A 2008 study by Stinson, et al., revealed that 6.2% of the U.S. adult population has NPD. The disorder is most common in males. It is thought to be caused by both genetics and biology, combined with the person’s early home life and life experiences.

Psychology Today reports that narcissistic personality disorder is indicated by five or more of the following symptoms:

  • Exaggerates own importance
  • Is preoccupied with fantasies of success, power, beauty, intelligence or ideal romance
  • Believes he or she is special and can only be understood by other special people or institutions
  • Requires constant attention and admiration from others
  • Has unreasonable expectations of favorable treatment
  • Takes advantage of others to reach his or her own goals
  • Disregards the feelings of others, lacks empathy
  • Is often envious of others or believes other people are envious of him or her
  • Shows arrogant behaviors and attitudes

How Do You Get Away From A Narcissist?

Don’t think that a narcissist will change if only you care about them enough – especially if the person has NPD.

No matter what you do, it will never be enough, last long enough, or be loving enough for them, unless the person can become more self-aware. But, it is a rare narcissist who digs deeply enough into their own shortcomings to change that much.

In their minds, everything that goes wrong is someone else’s fault. In a relationship, they fault their significant other, although their loved one has no idea what they did wrong.

Tiptoeing around their outbursts isn’t going to change them. Letting them rant won’t pacify them. In order for them to change, they have to want to change – and a narcissist won’t even be willing to try unless they can really understand and empathize with your pain.

If you want to leave a narcissist:

  • Block them from your social media, block their phone number, and block the friends you have in common. A narcissist can’t stand to lose, so they’ll have no problem using any of these methods to win you back.
  • Don’t go back, despite their pleas that they made a mistake or that this time will be different. For narcissists, it’s all about winning. They’ll say or do whatever it takes to get you back. But, if you go back, ultimately nothing will change and you’ll go through the cycle of upset, pain, and leaving them again.
  • Concentrate on the future. You deserve to be in a healthy relationship. Don’t worry about the narcissist or try to contact them. Once a narcissist realizes the relationship is truly over, they can move on with very little thought to the pain you are going through.
  • Don’t beat yourself up over the relationship. Narcissists are great manipulators and deceivers. There is even a term – narcissistic trauma bonding – that explains why it can be so difficult to leave a relationship with a narcissist.
  • Learn from the relationship so you don’t repeat the pattern with someone else.

Can Narcissism Be Cured?

Current treatment for NPD is talk therapy and group therapy. These modalities sometimes can help a narcissist learn to relate to others more compassionately. Additionally, mentalization-based therapy may help the person learn to analyze someone’s behavior before misinterpreting it and reacting inappropriately.

The success of any therapy for narcissism relies on the person being able to acknowledge that they have a problem. Given a narcissist’s inflated view of themselves and their general defensiveness, this can be challenging. In fact, to date there have been no randomized clinical trials examining the efficacy of any treatment for the disorder (Levy, et al).

For many people, the best thing they can do for themselves is to break away from the narcissist. If that isn’t possible, seek therapy and get support to rebuild the self-esteem and confidence you have lost because of your abuse.

Seek out a mental health professional who has been specially trained in trauma recovery to aid in healing from narcissistic abuse. A therapist can help you learn to communicate effectively and set boundaries so the narcissist can no longer take advantage of you.

Important: if you are experiencing physical abuse, understand that it will continue or will get worse. Get help immediately by calling the National Domestic Violence Hotline at 1-800-799-7233.

Let Us Help

If you are involved with a narcissist, get help from our specially-trained trauma recovery mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

References

Levy KN, Chauhan P, Clarkin JF, et al.: Narcissistic pathology: empirical approaches. Psychiatr Ann 2009; 39:203–213

Frederick Stinson, Deborah Dawson, Rise Goldstein, S. Patricia Chou, Boji Huang, Sharon Smith, W. June Ruan, Attila Pulay, Tulshi Saha, Roger Pickering and Bridget Grant, “Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions,” Journal of Clinical Psychiatry 69, no. 7 (July 2008):1033–45, 1036.

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Grieving The Death Of A Celebrity

When the nation mourned the passing of former President George H. W. Bush recently, the media covered every detail. We relived important moments in the President’s life via televised tributes. Images of Sully, the President’s faithful service dog, coursed across our screens as he lay at the base of the casket. Mr. Bush’s funeral was streamed live in its entirety, making us all feel as if we were grieving together at the service as the world bid farewell.

Even though you likely never met Mr. Bush, you probably feel as if you knew him. The lives of celebrities and important figures are covered so extensively by today’s media that we often feel a kinship with these people. Because of this, sometimes it can feel intensely personal when they pass away, triggering our own grief or bringing up latent emotions surrounding the deaths of our own loved ones.

Why Do We Mourn Celebrity Deaths?

It’s normal to feel emotional after the death of someone famous. Even if you don’t know them, you might go through a period of sadness and grief, or feel shock or anger at their loss.

Parasocial interaction is a term psychologists use to describe the one-sided feeling that comes from becoming emotionally attached to celebrities. Patrick Wanis, a human behavior and relationship expert and therapist describes parasocial interaction by stating, “Another way to look at it, is to say, the fan in his/her own mind projects and shares feelings, thoughts and fantasies with the celebrity, but the celebrity never reciprocates.”

Because of today’s prevalent social media platforms, we know the most intimate details of the person’s life. We can view pictures of them whenever we want to and can read their own thoughts in their online posts. This 24/7 accessibility makes us feel like we have a personal relationship with them. In other words, we identify with them, so we feel a bond and we grieve when they pass away.

Symptoms of Grieving

The loss of a celebrity and the ensuing grief of their admirers is both natural and common. The depth of the sadness and loss a fan feels is influenced by the closeness of their perceived connection to the celebrity. In a sense, a fan might almost feel like they’ve lost a family member. The resulting deluge of social media tributes to the person only deepens their sense of loss.

As with mourning people close to us, some common symptoms of grieving a celebrity can include:

  • Shock or feeling numb, having difficulty believing the person has passed away.
  • Fatigue or trouble sleeping.
  • Difficulty eating or appetite changes that result in losing or gaining weight.
  • Anger or resentment.
  • Feeling sad, lonely, empty, or despair over their loss.
  • Physical symptoms such as stomach upset, irritability, headaches or migraines.

How To Stop Grieving Over A Celebrity Death

It is natural to feel sad or even angry as you process the passing of a famous person with whom you felt a connection. Following these guidelines can help you stop grieving over a celebrity death:

  • Stop watching news coverage of the person’s passing. Celebrities are larger than life, so they seem invincible. Watching endless recaps of their life on the news or reading about it on the internet can increase your distress. Instead, try to focus on something positive, which raises your optimism and makes you feel less discouraged.
  • Remember that the person’s impact on your life is still with you even if they are gone. You can revisit those good memories by reading their books, listening to their music, or watching a show the celebrity was in. Collect and hold on to a few items of memorabilia that represent your connection to them, so that their impact on your life will remain.
  • Devote some time to mourn. Everyone processes grief in different ways. Give yourself time (and permission) to mourn the person. Connect with other fans of the celebrity, so you can share your feelings and feel supported.
  • Be aware that sometimes your reaction to a celebrity death may tie into your mourning for someone close to you. It isn’t uncommon for a celebrity death to trigger emotions relating to the passing of someone we knew and loved. Society tends to frown on emotional displays, so you may not have been able to let go and publicly grieve for your loved one. The mourning of a celebrity is expected, however, which can free you to grieve the person you actually lost.
  • Maintain your regular routine. Patterns provide a sense of security and comfort when you are upset and grieving.
  • Seek help if it becomes too much. While it is natural to feel emotional about the loss of a celebrity, be aware of how long you take to move past your grief. If you are struggling, you may benefit from talking with a licensed mental health professional who specializes in grief counseling. It is especially important to do this if you find that you can’t carry out the daily tasks of living, such as sleeping, eating, and other functions.

Let Us Help

Watching the national coverage of the passing of a famous person can trigger grief and feelings of loss. If you are having a hard time moving past the death of former President George H. W. Bush or another celebrity, the grief and loss treatment programs at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, can help. To get more information, contact us or call us today at 561-496-1094.

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What is Self Harm?

Self harm or self-injury is the intentional wounding of one’s own body. Most commonly, a person who self harms will cut themselves with a sharp object.

Self harm can also include:

  • burning or branding (using cigarettes, lit matches or lighters, or other hot objects)
  • severely scratching
  • hair pulling (trichotillomania)
  • biting themselves
  • excessively picking at their skin (dermatillomania) or wounds
  • punching or hitting themselves
  • head banging
  • carving words or patterns into their skin
  • excessive skin-piercing or tattooing, which may also be indicators of self harm

Generally, a person who self-harms does so in private. They often follow a ritual. For example, they may use a favorite object to cut themselves or play certain music while they self injure.

Any area of the body may be targeted, however the arms, legs, or front of the torso are the most commonly selected. These areas are easy to reach and easy to cover up so the person can hide their wounds away from judgmental eyes.

In addition, self harming can also include actions that don’t seem so obvious. Behaviors like binge drinking or excessive substance abuse, having unsafe sex, or driving recklessly can be signs of self harm.

Self Harm Causes

There isn’t a simple answer for what causes people to self-injure. Although this extreme behavior may seem like a suicide attempt on the surface, it’s really an unhealthy coping mechanism.

People cut or hurt themselves to release intolerable mental distress or to distract themselves from painful emotions. Often, the self-mutilator may have difficulty expressing or understanding their emotions. People who self harm report feelings of loneliness or isolation, worthlessness and rejection, self-hatred, guilt, and anger.

When they attack themselves, they are looking for:

  • a sense of control over their feelings, their body, or their lives
  • a physical diversion from emotional pain or emotional “numbness”
  • relief from anxiety and distress
  • punishment of supposed faults

People who self harm often describe an intense yearning to injure themselves. Completing the act of mutilation and feeling the resulting pain releases their distress and anxiety. This is only temporary, however, until their guilt, shame, and emotional pain triggers them to injure themselves again.

Who is At Risk for Self Injury?

Self harm occurs in all walks of life. It is not restricted to a certain age group, nor to a particular race, educational, or socioeconomic background.

It does occur more often in:

  • people with a background of childhood trauma, such as verbal, physical, or sexual abuse
  • those without a strong social support network or, conversely, in those who have friends who self harm
  • those who have difficulty expressing their emotions
  • people who also have eating disorders, post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), borderline personality disorder, or those who engage in substance abuse

Although anyone may self harm, the behavior happens most frequently in teens and young adults. Females tend to engage in cutting and other forms of self-mutilation at an earlier age than males, but adolescent boys have the highest incidence of non-suicidal self injury.

Self-Harming Symptoms

Physical signs of self harm may include:

  • unexplained scars, often on wrists, arms, chest, or thighs
  • fresh bruises, scratches or cuts
  • covering up arms or legs with long pants or long-sleeved shirts, even in very hot weather
  • telling others they are clumsy and have frequent “accidents” as a way to explain their injuries
  • keeping sharp objects (knives, razors, needles) either on their person or nearby
  • blood stains on tissues, towels, or bed sheets

Emotional signs of self harm may include:

  • isolation and withdrawal
  • making statements of feeling hopeless, worthless, or helpless
  • impulsivity
  • emotional unpredictability
  • problems with personal relationships

Help for Self Harm

The first step in getting help for self harm is to tell someone that you are injuring yourself. Make sure the person is someone you trust, like a parent, your significant other, or a close friend. If you feel uncomfortable telling someone close to you, seek out a teacher, counselor, religious or spiritual advisor, or a mental health professional.

 Professional treatment for self injury depends on your specific case and whether or not there are any related mental health concerns. For example, if you are self harming but also have depression, the underlying mood disorder will need to be addressed as well.

Most commonly, self harm is treated with a psychotherapy modality, such as:

  • Cognitive behavioral therapy (CBT), which helps you identify negative beliefs and inaccurate thoughts, so you can challenge them and learn to react more positively.
  • Psychodynamic psychotherapy, which helps identify the issues that trigger your self-harming impulses. This therapy will help you develop skills to better manage stress and regulate your emotions.
  • Dialectical behavior therapy (DBT), which helps you learn better ways to tolerate distress. You’ll learn coping skills so you can control your urges to self harm.
  • Mindfulness-based therapies, which can help you develop skills to effectively cope with the myriad of issues that cause distress on a regular basis.

Treatment for self injury may include group therapy or family therapy in addition to individual therapy.

 Self care for self-harming includes:

  • Asking for help from someone whom you can call immediately if you feel the need to self injure.
  • Following your treatment plan by keeping your therapy appointments.
  • Taking any prescribed medicines as directed, for underlying mental health conditions.
  • Identifying the feelings or situations that trigger your need to self harm. When you feel an urge, document what happened before it started. What were you doing? Who was with you? What was said? How did you feel? After a while, you’ll see a pattern, which will help you avoid the trigger. This also allows you to make a plan for ways to soothe or distract yourself when it comes up.
  • Being kind to yourself – eat healthy foods, learn relaxation techniques, and become more physically active.
  • Avoiding websites that idealize self harm.

 If your loved one self-injures:

  • Offer support and don’t criticize or judge. Yelling and arguments may increase the risk that they will self harm.
  • Praise their efforts as they work toward healthier emotional expression.
  • Learn more about self-injuring so you can understand the behavior and be compassionate towards your loved one.
  • Know the plan that the person and their therapist made for preventing relapse, then help them follow these coping strategies if they encounter a trigger.
  • Find support for yourself by joining a local or online support group for those affected by self-injuring behaviors.
  • Let the person know they’re not alone and that you care.

Need More Information?

Are you engaging in self harm or is your loved one self injuring? Don’t wait to seek help – speak to one of our caring, compassionate mental health professionals today. Contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida for more information or call us at 561-496-1094.

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Does Breast Cancer Awareness Month Increase Health Anxiety?

It’s October and pink ribbons are popping up everywhere. While this time of year is good for reminding women to do their breast self-exams or get an annual mammogram, it also can be a month of great concern for women who suffer from health anxiety.

The Anxiety and Depression Association of America defines health anxiety as “the misinterpretation of normal bodily sensations as dangerous.” It is the excessive fear of physical illness and women who have the disorder often find it difficult to cope with Breast Cancer Awareness Month. For these women, every new twinge or tiny pain in their breasts likely signals cancer.

People with health anxiety may be so overwhelmed by their fears that they find it hard to live a normal life. They can spend hours online researching a symptom, convinced that a minor symptom is a sign of a serious illness. When October rolls around, the stories of breast cancer survivors may drive a woman with health anxiety to compulsively examine her breasts, positive that every small bump is a tumor just waiting to kill her. Or, she might feel something as innocent as an itch in her breast and suffer severe anxiety because she’s surrounded by breast cancer images on the news and on social media. And, like too many people with health anxiety, she may beg her doctor for unnecessary tests and spend an exorbitant amount of time and money visiting doctors in the quest for a diagnosis that will never come.

What are the Symptoms of Health Anxiety?

Health Anxiety Disorder is also known as hypochondria. Roughly 1-5% of the population suffers from health anxiety. It’s estimated that those with hypochondria use about 10-13 times the health resources that the average person does.

People who suffer from health anxiety:

  • Frequently check their bodies for new pains, blemishes, lumps, or lesions
  • Live in terror that any new physical symptom is a sign of a serious or life-threatening disease
  • Research health problems obsessively
  • Compulsively check their vital signs, take their temperature, or monitor their blood pressure and pulse rate
  • Switch doctors frequently because their current physician can’t find anything wrong with them
  • Either avoid doctors altogether or go to numerous medical consultations
  • May have strained relationships with friends or family
  • Are reluctant to consider that anxiety and other psychosocial factors may be causing their symptoms

Who is at Risk of Developing Health Anxiety?

While there are no easy answers, the people who are most at risk of becoming hypochondriacs tend to be worriers. They may strongly believe that being in good health means you have no physical symptoms or sensations. Frequently, they know someone with a serious disease or they went through a serious illness themselves during their childhood. Additionally, health anxiety can be triggered by the death of a loved one.

Overcoming Health Anxiety

Often, patients with hypochondria are so resistant to the idea of having an anxiety disorder that it may take intervention from their loved ones to help them understand they need treatment.

Cognitive behavioral therapy (CBT) is very effective for the treatment of health anxiety disorders. This type of therapy focuses on recognizing and understanding the false beliefs, thoughts, and actions that bring on the anxiety. Because people with hypochondria assign meanings to certain symptoms or sensations (“My breast is tender and that definitely means I have breast cancer”), CBT helps patients realize that it isn’t the symptom that causes the anxiety, it’s their reaction to the symptom that does.

By changing their mindset, a person with health anxiety learns to see a worrisome situation in a different way. Cognitive behavioral therapy teaches them how to stop the negative behaviors that reinforce the disorder.

It’s Important to Get Help for Health Anxiety

If you or someone you care about is overly worried about health concerns, it could be caused by health anxiety. Delaying treatment for hypochondria can cause complications such as depression and substance abuse, not to mention financial difficulties due to excessive medical costs or health risks from undergoing unnecessary procedures. Our compassionate mental health professionals are here to help. Contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida for more information or call us today at 561-496-1094.

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Can Virtual Reality Therapy Treat Eating Disorders?

Can Virtual Reality Therapy Treat Eating Disorders?

Eating disorders affect a person’s physical and psychological functioning differently than any other mental health disorder. Once thought to be a problem of the wealthy, eating disorders are now known to impact various cultures, socioeconomic statuses, ages, and genders, and can be found worldwide.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes people with eating disorders as having “pathological eating habits and a tendency to overestimate their weight and body shape.” Eating disorders are not to be taken lightly: patients with an eating disorder faces a high risk of medical and psychological effects, along with the possibility of death if their condition becomes severe enough.

Eating disorders are also more common than you might think. In fact, a 2007 survey by Hudson, et al., noted that about 1.5% of American women (0.5% of men) experience bulimia nervosa, about 0.9% of women (0.3% of men) have been diagnosed with anorexia nervosa, and roughly 3.5% of women (2% of men) struggle with binge eating disorder.

Until recently, eating disorders have been treated mainly through cognitive behavioral therapy (CBT). New advances in the emerging field of virtual reality therapy (VRT), however, are being combined with traditional therapy and show promise for more effective treatment.

How Does VRT Work?

Virtual reality therapy is a high tech approach to helping people learn effective ways to cope with the fearful situations they dread. During VRT, you wear a virtual reality headset that looks similar to the type you’d use when playing video games. The therapist plays a simulation program that displays avatars in a variety of anxiety-provoking settings, such as in a restaurant or a store dressing room for those with an eating disorder. These settings are low stress to begin with, then stress levels are increased as you become more desensitized to the worrisome scenario.

You use a virtual “body” during VRT. Although this avatar isn’t really “you”, studies show that people feel a close enough association to the avatar that they emotionally respond as if they were in the actual setting. In this way, they can address their eating disorder and work through their body-image issues in a safe, controlled environment. The psychologist listens in during the session to coach, help with relaxation techniques and provide coping skills. They also can control the environment and either stop the program or lower the stress level if you become too upset.

How Effective is VRT for Eating Disorders?

Virtual reality exposure therapy gives people an experience that is just real enough to trigger an emotional response to their eating disorder, but is it effective?

In 2017, DeCarvalho, et. al., did a systematic review of several studies that used virtual reality therapy for binge eating and bulimia nervosa (BN) treatment. One of the studies they analyzed was done by Perpina, et. al., and focused on treatment with a combination of VRT and cognitive behavioral therapy (CBT) versus treatment with CBT alone. The study found that the “VR treatment group showed more BI [body image] improvement than CBT and greater improvement in the behavior clinical measures. At post-treatment, the VR group improved on body attitudes, frequency of negative automatic thoughts on BI, body satisfaction, discomfort caused by body-related situations and BN symptoms (measured by Bulimic Investigatory Test; BITE). These results were maintained or continued to improve (body attitudes, frequency of negative automatic thoughts on BI) at one-year follow-up.” All participants improved in the eating disorders measures and it was also maintained at follow-up.

In a different study, a body-swapping illusion was used in conjunction with virtual reality. Women with body image anxiety were asked to estimate their own body size before participating in two different body-swapping scenarios. In both illusions, the women were shown a virtual image of themselves with skinny stomachs.

The theory was that it may be possible to modify a person’s allocentric memory (a type of spatial memory in which the person mentally manipulates objects from a stationary point of view) for the positive. Indeed, after going through the virtual scenarios, the women in the study reported a decreased estimated body measurement and assessed their body size more accurately than before participating in the illusion.

Get Help for Eating Disorders

Eating disorders impact a person’s biological and psychological functioning in ways unlike other mental health disorders. If you are struggling, we can help through both traditional and virtual reality therapies. Talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida today. For more information, contact us or call us today at 561-496-1094.

Reference:

Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007 Feb 01;61(3):348–58. doi: 10.1016/j.biopsych.2006.03.040. http://europepmc.org/abstract/MED/16815322. [PMC free article] [PubMed] [Cross Ref]

De Carvalho, M. R., Dias, T. R. de S., Duchesne, M., Nardi, A. E., & Appolinario, J. C. (2017). Virtual Reality as a Promising Strategy in the Assessment and Treatment of Bulimia Nervosa and Binge Eating Disorder: A Systematic Review. Behavioral Sciences, 7(3), 43. http://doi.org/10.3390/bs7030043

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Midlife Anxiety

Patient in need of In Vivo Exposure Therapy.A 2014 study by the British government found that while most people of all age levels are generally content with their lives, those in the middle age years – between the ages of 45 and 59 – are the least happy. These respondents reported low ratings of overall happiness and life satisfaction and a sharp increase in midlife anxiety. Interestingly, even adults aged 90 and older reported being happier and more satisfied than the middle aged group.

What Causes Anxiety in Middle Age?

The U. K. study, done by the Office of National Statistics, analyzed data from more than 300,000 respondents during a three-year period from 2012 to 2015. It generated average scores for specific areas including happiness, life satisfaction, anxiety, and the feelings of being worthwhile. The scores showed that anxiety levels were highest for people between the ages of 40 and 60. The peak anxiety levels were noted in those in the 50 – 54 age group.

Many things can cause midlife anxiety, ranging from underlying health problems to financial concerns. In women, even the fluctuating hormones of menopause and perimenopause can change the chemistry in their brain and bring on anxiety and panic attacks.

For men, while many are aware that anxiety disorders exist, very few realize how often anxiety affects them. Men often refuse to admit to themselves or others that they might have a mental health issue and may seek out unhealthy ways to cope (example: alcohol use) rather than admit to the concern.

There is no one specific trigger that causes midlife anxiety. Instead, people who experience anxiety in middle age are often burdened with simultaneous stressors that other generations aren’t facing: the raising of children, while at the same time trying to hold down jobs and care for elderly parents. Top this off with the financial pressures of putting children through college, empty nest syndrome, and facing worries of possibly not having saved enough for a retirement that is drawing ever closer, and stress rises even higher.

Midlife Anxiety Treatment

Self-help:

One of the best ways to manage anxiety is to reduce your stress. There are several things you can do to accomplish this and a side benefit is that they are also good for your overall health:

  • Get daily exercise. The newest research recommends that we all do some type of aerobic exercise at least 30 minutes a day, a total of 5 days per week. Regular physical exercise causes the brain to release serotonin, the “feel-good” neurotransmitter. Serotonin helps to reduce stress, improve your mood, and gives you more energy. Low-impact exercise, such as swimming, yoga or walking are great examples of workouts that will help raise your serotonin levels.
  • Make time for relaxation. When your days are filled with rush, rush, rush – getting the kids to school, getting yourself to work, finishing projects, taking the kids to after-school activities – relaxation time can be hard to come by. Yet, relaxing is crucial to reducing anxiety and stress levels. Try to set aside time every day, just for yourself. Relaxation can come from simple activities that you look forward to, such as soaking in a warm bath at the end of your day or taking a few minutes to read, meditate or listen to some soothing music.
  • Silence your phone and put away your laptop or tablet (or at least turn off all but the most important alerts). Limit your use of social media and reduce the amount of time you spend reading the news. We’re so used to having our electronics with us at all times, but getting constant notifications and reading endless news reports about crime, wars, and world problems can keep you from truly relaxing. Give yourself an electronic break every day.
  • Visualize yourself in a peaceful setting. Your brain can’t distinguish between a real setting and one you visualize, so reduce your stress by imagining yourself on a tranquil beach or in a beautiful forest. Smell the salt air at the beach or the pine trees in the woods, imagine the sound of the waves on the sand or the birds singing in the forest. Being as specific as you can and really trying to imagine all the aspects of the setting can take you away from your stressors and help you unwind.

Professional help:

When you have anxiety, it’s easy to become overwhelmed by your emotions. When that happens, people tend to react to certain aspects of their lives in a more negative way. It is common to begin to avoid the situations or experience that make you anxious, but that avoidance can actually increase anxiety.

If self-help to reduce your midlife anxiety isn’t working any longer, consider seeing a mental health professional, particularly if your anxiety is causing you extreme distress or disrupting your daily life. Anxiety is treatable and the majority of people who seek help are able to improve, reduce or eliminate their anxiety symptoms after working with a psychologist to address their own, specific concerns.

Cognitive behavioral therapy (CBT) is a form of psychotherapy that is very effective for treating anxiety in middle age. CBT helps you understand how your own negative thoughts contribute to your anxiety symptoms. By learning to recognize these negative thought patterns, you can change them, which allows you to manage your symptoms. Additionally, cognitive behavioral therapy teaches you skills and techniques for coping with your midlife anxiety.

CBT is often used in conjunction with exposure therapy. Exposure therapy allows you to gradually confront your fears in a safe environment and in a way that gives you control. When you face your fears without harm, you reduce your anxiety by learning that the outcome you feared is unlikely to happen.

Get Help for Midlife Anxiety

If you’re feeling overwhelmed and facing midlife anxiety, we can help. Talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida today. For more information, contact us or call us today at 561-496-1094.

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Signs You May be a Hypochondriac

A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.

Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with health anxiety (also known as illness anxiety disorder) each year.

Hypochondriac Symptoms

Hypochondria is a mental health disorder. It usually starts in early adulthood and may show up after the person or someone they know has gone through an illness or after they’ve lost someone to a serious medical condition. About two-thirds of hypochondriacs have a co-existing psychiatric disorder, such as panic disorder, obsessive compulsive disorder (OCD), or major depression. Hypochondria symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.

Hypochondriac symptoms may include:

·         Regularly checking themselves for any sign of illness

·         Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness

·         Making frequent visits to their doctor

·         Conversely, avoiding the doctor due to fear that the doctor will find they have a dreaded disease or serious illness

·         Talking excessively about their health

·         Spending a lot of time online, researching their symptoms

·         May focus on just one thing: a certain disease (example: cancer) or a certain body part (example: the lungs if they cough). Or, they may fear any disease or might become focused on a trending disease (example: during flu season, they may be convinced that a sniffle means they’re coming down with the flu)

·         Are unconvinced that their negative medical tests are correct, then worry that they have something undiagnosed and that no one will be able to find it and cure them

·         Avoiding people or places they fear may cause them to get sick

Health anxiety can actually have its own symptoms because it’s possible for the person to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the person can become debilitated.

You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The person with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. They may be going through major life stress or have had a serious illness during childhood. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.

Hypochondriac Treatment

Often, when a person repeatedly runs to their doctor at the first sign of a minor symptom, their doctor doesn’t take them seriously and may consider them to be a “difficult patient,” rather than a person who is honestly concerned about their health. Worse, some doctors will take advantage of the person’s fears and may run unnecessary tests just to appease the patient. In fact, it’s been estimated that more than $20 billion is spent annually on unnecessary procedures and examinations.

Self-help for hypochondria can include:

  • Learning stress management and relaxation techniques
  • Avoiding online searches for the possible meanings behind your symptoms
  • Focusing on outside activities such as a hobby you enjoy or volunteer work you feel passionate about
  • Avoiding alcohol and recreational drugs, which can increase anxiety
  • Working to recognize that the physical signs you experience are not a symptom of something ominous, but are actually normal bodily sensations
  • Setting up a schedule for regular appointments with your primary care doctor to discuss your health concerns. Work with them to set a realistic limit on medical tests and specialist referrals.

Professional treatments for hypochondria include:

  • Cognitive Behavioral Therapy (CBT), which is very helpful for reducing patient fears. In this type of therapy, the person learns to recognize and understand the false beliefs that set off their anxiety. Research has shown that CBT successfully teaches hypochondriacs to identify what triggers their behavior and gives them coping skills to help them manage it.
  • Behavioral stress management or exposure therapy may be helpful
  • Psychotropic medications, such as anti-depressants, are sometimes used to treat health anxiety disorder

It is worth noting that many sufferers are unwilling to acknowledge the role anxiety plays in their symptoms. This makes them less likely to seek help from a mental health professional. Often, hypochondriacs are so resistant to the idea that they have anxiety that it takes intervention from loved ones to help them understand that they need assistance.

Get Help for Health Anxiety Disorder

Being a hypochondriac and experiencing health anxiety can be debilitating. It can severely affect the lives of the people who suffer from it.  The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at 561-496-1094.

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13 Ways to Overcome Travel Anxiety

The summer travel season is just kicking off. Scores of tourists are excitedly packing their luggage and consulting websites or glossy brochures as they anticipate their upcoming vacations. While the idea of seeing new places or relaxing in cozy, familiar locations is appealing to most people, there are those who find the whole idea of travel frightening. It’s hard to get excited about new adventures when the mere thought of taking a trip brings up travel anxiety.

Here’s How to Help Your Travel Anxiety

For some, just being out of their home and familiar surroundings can be enough to bring on travel anxiety, especially if you suffer from panic attacks. Meeting new people or experiencing new foods can also make people feel insecure, plus worrying about how you’ll react emotionally may trigger anxiety.

If you have travel anxiety these tips should help you feel more in control:

  • Plan for your anxiety. Brush up on your coping skills and bring along items you know will help you stay calm. For example, you might check to be sure your favorite music is downloaded to your phone or you might tuck your favorite pillow into your suitcase so you’ll be sure to get some restful sleep.
  • Practice relaxation techniques before your trip, so you can use them the minute you start to feel anxious.
    • Focus on a calming image in your mind or on an object you can physically see to take your mind off your fears. Concentrating on a book or watching a movie is distracting and can keep you from stressing over the unfamiliar.
    • Use affirmations, such as “I am safe,” to calm your thoughts.
    • Long, slow breaths have been proven to reduce anxiety and it’s worth it to learn deep breathing techniques. Breathing in slowly through your nose, then exhaling gradually through your mouth helps keep you from taking the short, hurried breaths that can trigger a panic attack.
    • Learn to meditate, which has been proven to reduce stress and boost overall health. Meditation can be done in so many ways – did you know that getting lost in music or even daydreaming are forms of meditation? Regular meditation practice can build long-term resilience.
  • Remind yourself of why you’re traveling. Picture your life a year from now – will you regret not having gone to your destination?
  • Because anxiety often stems from a feeling that you’re not in control, plan the first few days of your trip in detail. Look for photos of the airport and its terminals, explore the city’s subway system or figure out local transportation, look for your hotel on a maps website, and check out nearby restaurant and read their reviews. Having the details handy helps to keep your from worrying about the unexpected.
  • Join a community. There are many online forums or local support groups for anxiety sufferers where you can talk about your travel fears and find support.

If you’re scared of flying (also called aerophobia), these tips can help make your next flight the best you’ve ever taken:

  • Travel with a companion who is an experienced flyer. Having someone there to explain what the various sounds of flying mean or to walk you through the procedures associated with flying (security checks, boarding passes, terminals, etc), can go a long way toward calming nervousness. If they can sit next to you, they can help distract you with conversation, play games to keep your mind off of flying, or give your encouragement.
  • Be sure to talk with your travel companion before you board so they are aware of your fears and they know what you need. For example, if you don’t like to be touched, they should be told they shouldn’t try to hold your hand during a tense moment, which could increase your anxiety.
  • Avoid alcohol, which can alter the way your brain reacts and may increase your travel anxiety.
  • Practice relaxation techniques before your flight, then keep using them from the minute you reach the airport.
    • Focus on an object you can see or on a calming image in your mind.
    • Take in slow, long breaths through your nose and exhale slowly through your mouth.
    • Try tensing each part of your body for ten seconds, then slowly relax it and move on to another body part (example: tense your right hand for ten seconds, then relax and tense your right arm for ten more seconds. Repeat on your left side, then move to your legs, etc.).
  • Listen to your favorite, calming music on your phone or other device or watch a movie or television show.
  • Try the SOAR app for Android or iOS. Part of the SOAR fear of flying program, developed by Capt. Tom Bunn, a former U. S. Air Force pilot and commercial jet pilot, the app has reassuring features like a built-in G-force meter that reads your plane’s current turbulence so you’ll know the jet can sustain it. It also links to weather and turbulence forecasts and allows you to download videos of Capt. Bunn walking you through each step of the flight process so you know what’s happening in the cockpit and on the plane.
  • Exercise before you fly. The endorphins from exercise are calming and will help dissipate your nervous energy. If you can’t exercise before your trip, try walking around the terminal to distract yourself and to keep your muscles loose, which helps reduce travel anxiety.
  • Consider booking a seat towards the front of the plane and along the aisle, so you don’t feel hemmed in or like you’re in a tunnel. Seats toward the front may cost more, but the additional expense can be worth it for more leg room, making it easier to relax.

If you’ve tried some of these tips on previous trips and they haven’t worked for you, consider seeking help from a mental health professional. They may prescribe medications to help ease your travel anxiety and often have programs that teach coping techniques you can use when you’re scared of flying. Some even offer virtual reality sessions that simulate the flying experience in manageable doses in a safe office setting, so you can conquer your fears before even setting foot on a plane.

Get Help for Travel Anxiety

If you’re still facing travel anxiety after trying our tips to reduce your stress over an upcoming trip, 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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