All Posts Tagged: mood disorder

Postpartum Depression

Welcoming a new family member into your household is an exciting and joyous event. There is so much anticipation about the new baby and women often go through their pregnancy daydreaming about happy things: who will the baby will look like, what will their first words be? Understandably, the knowledge that you’re going to have a baby can also give rise to a certain level of concern and anxiety – there will be sleepless nights, adjustments in your daily life, and possible financial concerns to face.

It’s perfectly normal to feel both anxious and excited after the birth of a new baby and it’s also quite common for new mothers to experience the “baby blues” as they adjust to the arrival of their child. In fact, research shows the symptoms of the baby blues (mood swings, difficulty sleeping, crying, and anxiety) can affect up to 80% of new moms. These symptoms usually begin somewhere in the first few days after giving birth and generally last for about two weeks.

For some new mothers, however, the birth of their baby can trigger a long-lasting and more severe episode of depression, called postpartum depression or postnatal depression. Additionally, and rarely, a new mother can go also through postpartum psychosis – an extreme and dangerous mood disorder.

What is Postpartum Depression?

First, whether you are experiencing “just” the baby blues or an actual incidence of postpartum depression, understand that it is not a sign of weakness on your part and it doesn’t mean you are “a bad mom”! There is plenty of evidence showing that this mood disorder can actually be a complication of the birth process for some women.

After giving birth, many physical and emotional changes take place: hormone levels drop dramatically, you’re sleep-deprived, you may feel overwhelmed, and you may feel like you’re losing control of your life. Researchers think these changes may contribute to the development of postpartum depression. Furthermore, studies have shown that women who have a past history of depression and anxiety or those with a thyroid imbalance may be at higher risk for postnatal depression.

At first, postpartum depression can be mistaken for the baby blues, but the symptoms of postnatal depression last longer than the typical week or two in the case of the baby blues and are more profound. And, while the symptoms of post partum depression generally begin within the first few weeks after having a baby, they can even start anywhere from six months to a year after giving birth. Left untreated, postnatal depression can last a long time, ranging from several months to several years.

Postpartum Depression Symptoms

The Mayo Clinic  lists postpartum depression symptoms that may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Postpartum Psychosis

As mentioned above, postpartum psychosis is rare, occurring in about .1% of births or about 1 to 2 out of every 1,000 deliveries. Postpartum psychosis is severe and usually comes on suddenly – most often within the first two weeks after giving birth. The women most at risk have had a prior psychotic episode or are those with a personal or family history of bipolar disorder.

Postpartum psychosis can include:

  • Hallucinations
  • Paranoia
  • Delusions
  • Bizarre beliefs
  • Irrational judgements

Research shows that, in women undergoing postpartum psychosis, there is a suicide rate of about 5% and a rate of infanticide of approximately 4%. Because of the woman’s psychotic state, her delusions and beliefs feel very real, make total sense to her, and may cause her to act on them.

It is imperative that a woman going through postpartum psychosis get immediate help. This condition is treatable, but it is an emergency condition. Call your doctor or an emergency helpline to get the assistance you need as soon as possible!

Getting Help for Postpartum Depression

If you suspect you may have postpartum depression, the sooner you seek help, the better for both your baby and yourself. Call your doctor or a mental health professional right away if the signs and symptoms of your depression:

  • Don’t lessen or go away after two weeks
  • Seem to be getting worse
  • Are making it hard for you to care for yourself and/or your baby
  • Are making it difficult to carry out everyday tasks
  • Include thoughts of harming yourself or your baby

Treatment for postpartum depression may include counseling and talk therapy via Cognitive Behavioral Therapy, as well as the use of antidepressant medications.

Learn More

Without treatment, postpartum depression can last for months or years. If you think you or a loved one may be suffering from postnatal depression, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.

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Physician Burnout

There is no denying the fact that physician burnout is a growing problem in the United States. The statistics that support this trend are appalling:

  • Approximately 1 in 3 doctors experience physician burnout at any given time
  • Doctors are 15 times more likely to experience burnout than other types of professionals
  • 45% of primary care physicians report that, if finances allowed, they would quit their jobs
  • There are approximately 300 to 400 physician-suicide deaths every year

These numbers make a strong case that physician burnout is a major issue that needs to be addressed and addressed quickly.

Physician Burnout Symptoms

The symptoms of physician burnout bear a strong resemblance to those typically seen in other stress disorders, but there are also distinct differences. Dr. Dike Drummond, author of the blog, “The Happy MD“, hits the nail on the head by identifying that physician burnout occurs when stress is present and a doctor is unable to recover from it in their free time. He pinpoints three distinct burnout symptoms:

1. Physical and emotional exhaustion that leaves you worn out and unable to recover during down time.
2. The development of a cynical and negative attitude with regard to your work and your patients.
3. A reduced sense of purpose and a feeling that your work is meaningless and without value.

The Factors

A variety of factors in a doctor’s work life combine to explain why burnout has become so prevalent. The most common factors that lead to this syndrome include:

  • The inherent stress that comes with the job. Any profession that includes high responsibility and a small amount of control over outcomes is bound to be stressful. Adding to this stress are the kinds of outcomes that can occur as a result of physician decisions. It’s no wonder that stress levels are high.
  • The extreme lack of work-life balance. Doctors are expected to be available 24/7. This expectation, combined with long hours and shifting schedules, can have a negative impact on physicians in numerous ways, including:
    • Poor sleep patterns
    • Interference with family relationships (doctors tend to have a divorce rate that is 10 – 20 percent higher than the general population)
    • Physical and emotional exhaustion
  • Overwhelming administrative hassles. Being a physician in today’s medical world is rarely as simple as just being able to treat illness. Navigating the mazes of insurance paperwork and the new burdens of healthcare reform has added extra administrative work to a doctor’s duties. They must keep up with it if they want to get paid for their services and remain compliant with government regulations.

An Even Greater Challenge

It’s easy to see how the everyday challenges of being a doctor can continuously build up until the physician hits the burnout stage. The real difficulty lies in understanding how we can improve those statistics. The unfortunate reality is that many doctors will not seek assistance for physician burnout even when they realize there is a problem. There are several reasons for this:

  • Fear: licenses have the potential of being denied if a doctor is under treatment for substance abuse or depression and many physicians are afraid to take that risk.
  • Pride: in comparison to other professions, the world of physicians is pretty small. This means that a doctor seeking treatment would most likely be getting help from a colleague. Since doctor’s careers are built on reputation, it can be difficult for a physician to let a colleague see their perceived weaknesses, even in light of patient privacy laws.
  • Poor self-care: the combination of all the stressors mentioned above often lead to a doctor not taking care of themselves simply because they don’t have the time or energy to do so.

Where to Go from Here

If you or someone you know is showing signs of physician burnout, it’s important to seek help. Don’t let yourself become part of the growing statistics related to this trend. Recognizing and acknowledging this is a concern can be the biggest stepping stone toward finding a resolution.

For more information about easing the effects of physician burnout, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders at 561-496-1094.  Also, you can email The Center at their Delray Beach, Florida location.

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EMDR Therapy Helps Trauma Recovery

EMDR Therapy Helps Trauma Recovery

Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder (PTSD). PTSD is a disorder that often develops after exposure to a terrifying event or ordeal – one in which intense physical harm occurred or was threatened. PTSD can also result after someone has witnessed an event that is disturbing, distressing, or dangerous. Sufferers of this disorder have persistent, frightening thoughts and memories of their ordeal.

PTSD can be triggered by events such as:

  • Military combat
  • Violent personal assaults
  • Natural or human-caused disasters
  • Car accidents, plane crashes

To understand EMDR therapy, it’s important to first understand how PTSD can impact people. People who have developed this type of disorder often have ‘re-experiencing symptoms’ or exhibit avoidance symptoms, which can include:

  • Flashbacks of the event
  • Nightmares and bad dreams
  • Uncontrollable and frightening thoughts about the event
  • Avoidance of people, activities, or places that remind them of the traumatic experience
  • Severe emotional distress or physical reactions to something that makes them think of the event
  • Irritability, aggressive behavior, angry outbursts
  • Feeling guilt, shame, or worry about the event

What is EMDR?

A great way to understand EMDR is to think through the body’s normal healing process. When you cut yourself, your body works on its own to heal the injury. If the wound is irritated by a foreign object, the abrasion festers and the body is unable to close the wound until the object is removed.

There is evidence to support the theory that the mind works in much the same way. With post traumatic stress disorder, healing cannot happen because the survivor keeps reliving the trauma through their flashbacks and dreams. Those memories are the “foreign objects” that fight the healing process.

Effective EMDR therapy includes some important elements:

  • Processing of the traumatic memory and disturbing feelings
  • Transformation of the painful events on an emotional level
  • Empowerment of the person dealing with PTSD

EMDR therapy also involves using bilateral (both sides of the body) stimulation, such as:

  • Eye movements
  • Physical hand tapping or toe tapping
  • Musical tones

These bilateral stimuli and the guidance of the therapist allow the survivor to tap into the biological mechanisms that come into play during Rapid Eye Movement (REM) sleep. It is believed that this allows the individual to naturally process their memories – effectively removing those “foreign objects” so their mind can heal.

What Does EMDR Therapy Include?

Eye movement desensitization and reprocessing therapy consists of eight therapy phases that are focused around three specific time periods:

  • The past – the event(s) that created or intensified the trauma is identified
  • The present – attention is given to the current situations that are causing distress
  • The future – action is taken to develop the skills and attitudes needed for positive progress

Phase 1: The therapist works with the individual to uncover the incident or trigger event from the survivor’s past that might be relevant for the therapy. This may include not only the traumatic event, but also other incidents from the person’s past. The treatment plan is developed during this stage.

Phase 2: The therapist teaches the individual a variety of stress reduction and imagery techniques that can be used during and between sessions to help them handle their emotional distress.

Phases 3-6: A target memory is chosen and processed using EMDR therapy techniques. In order to start this procedure, the individual must identify the following:

  1. Emotions and physical sensations related to the memory
  2. Visual imagery related to the memory
  3. A negative belief about themselves that is related to their distress
  4. A positive belief they’d like to have

The therapist asks the individual to rate the strength of the negative and positive beliefs they choose. Then, the person is instructed to focus on the imagery, negative thoughts, and body sensations they relate to the target memory while the therapist directs them in performing the bilateral stimulation that is the hallmark of EMDR therapy. These steps are done repetitively in ‘sets’, with the survivor rating the strength of the negative beliefs after each set. Once the person no longer reports distress related to the memory, the therapist will repeat the process while focusing on the positive belief previously identified.

Phase 7: This is the closure phase, where the trauma survivor keeps a log of any lingering negative thoughts or emotions that come up throughout the week. By reviewing the person’s journal of their negative emotions or thoughts, the therapist gains information to help the individual continue to work through their pain while reminding them of self-calming techniques learned during therapy.

Phase 8: In this final phase, the therapist and patient examine the progress made during previous sessions.

How to Get Help

One of the benefits of EMDR is that it has been shown to help trauma survivors with post traumatic stress disorder heal faster than through traditional therapy. Look at these amazing results:

  • One study revealed 84%-90% of single-trauma victims no longer had PTSD after only three 90-minute sessions
  • Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after six 50-minute sessions
  • A third study showed that 77% of combat veterans were free of PTSD in 12 sessions

This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time. If you or someone you know is suffering from PTSD, seeking professional help can be the most direct path to reclaiming your life.

Learn More

For more information about EMDR and how EMDR therapy can help you or a loved one overcome trauma and PTSD, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us at 561-496-1094.

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Children and the Benefits of Mindfulness Training

 

These days, children often have stressors that come at them from all directions. Schools are sending more homework and projects home with children, kids are busy after school with extra-curricular sports and activities, and there are video games, social media, and cell phones all competing for their attention. In addition, they may have to deal with being picked on at school or may be coping with the pressures of divorcing parents or the arrival of a new sibling in the home. With all that kids have to contend with, it’s no wonder that children who engage in mindfulness exercises tend to be happier kids who are more able to self-regulate and calm themselves during periods of stress.

What is Mindfulness?

What is mindfulness, anyway? According to experts in the field, mindfulness is defined as “paying attention to something, in a particular way, on purpose, in the present moment, non-judgmentally” (Kabat-Zinn, 2003).

Mindfulness helps with emotional regulation and cognitive focus. It allows children to choose a calmer, practiced response to stressors instead of throwing a tantrum or losing control. It teaches them to be conscious of how their emotions “show up” in their bodies (in the form of headaches, stomachaches, nightmares etc), and helps them understand that their thoughts are “just thoughts.” Children who undergo mindfulness training become adept at recognizing when their attention has wandered and learn to implement tools for impulse control.

How Can Mindfulness Training Help Your Child?

There is a growing body of research that indicates mindfulness training can help children improve their ability to calm down when they are stressed or upset, learn to pay attention and become more focused, increase their ability to concentrate, and learn to make better decisions.

Mindfulness activities for children can also help with:

  • Anxiety and depression
  • Sleep difficulties
  • Anger issues and separation anxiety
  • Coping with increased life stressors
  • Anxiety at school (for example: test taking or athletic performance)
  • Chronic medical conditions
  • Learning compassion and acceptance for themselves and others
  • Breaking the cycle of worry before it turns into full-blown anxiety or panic attacks

Mindfulness Activities for Children

If you would like to help your children learn to become more mindful, there are a few things to take into account when teaching them. First, remember to take the age of the child into consideration and keep the mindfulness sessions short until they get used to practicing it. Also, make the practice times age appropriate – limit them to about five minutes or less, particularly for younger children. Praise your child for the effort they put into their mindfulness exercises and reward them with hugs and cuddles or by doing something they want to do together afterward.

Try these exercises to help your child practice being more mindful:

  • Belly breathing – Have your child put one hand on their tummy and one hand on their heart. Have them take a deep breath in for a slow count of 3 and then breathe out again to another slow count of 3. They should repeat this deep breathing exercise at least three to five times to feel calmer in times of stress. For younger children, it can be helpful to have them lie down and place a small stuffed animal on their stomach while breathing in and out during the exercise. As they focus on watching the stuffed animal rise and fall with their breathing, they learn how to breathe from their belly.
  • “Cool Your Food” breathing – Have your child breathe in through their nose and blow their breath out of their mouth as if they were trying to cool down hot food. Repeat this 5-10 times, very slowly.
  • Listen to the sounds around you – An easy way for children to practice mindfulness is to focus on paying attention to what they can hear. Take a walk and listen to the birds chirping, lawn mowers mowing, or the wind blowing. You can also download phone apps that have calming waterfalls or nature sounds and have your child listen to see what they can hear (for example: are there frogs croaking or birds chirping in the background?)
  • Mindful Playtime – Finger paints or coloring books offer great ways for children to be mindful. As they color, ask your child how the crayons smell or how the finger paint feels against their hands. What do the colors they are using mean to them? Can they hear the crayon or pencil scratching against the paper or the paint swishing as they swirl it across the paper?
  • Ring a bell – or chimes or perhaps strike a note on a piano (or use a phone app that has these sounds on it) and have your child listen carefully to the sound of the tone until it gradually fades away and stops.
  • Practice gratitude – Have your child tell you one or two things they were grateful for today. You can have them do this at dinner time or just before they go to bed. Tell them what you are grateful for, as well!

Learn More

We have mindfulness programs for both adults and children at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To find out more about these programs, call us at 561-496-1094 or email The Center today.

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Mood Disorders: Bipolar Disorder

Bipolar Disorder

We’ve all had “those days” at work or at home – days when we feel exhausted, irritable, or out of sorts and when nothing seems to go our way. Conversely, we’ve all also experienced days when we are chock full of energy, when we feel like we can take on the world, when ideas seems to flow effortlessly, and we feel joyful and optimistic. For most of us, those feelings of the “blues” or of being happy will ebb and flow from one day to another and they don’t really change our daily lives. But, for people with bipolar disorder (also known as manic depression), the swings between emotional highs and lows are chronic and can fluctuate broadly from extreme euphoria, overconfidence, and boundless energy, to the other end of the spectrum and despair, anger, and deep depression. People can also experience a mixture of the two extremes.

Bipolar Definition

About 1% of people (or 1 in 100) will develop bipolar disorder. The National Institute of Mental Health’s bipolar definition states that, “Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.”

Bipolar Disorder Symptoms

One of the worrisome things about the disorder is that it is often hard for people to pin down and identify. In fact, family and friends of the individual may recognize the need for evaluation long before the person does. This is because bipolar disorder symptoms can sometimes be subtle and are often dismissed by the person who has the condition. After all, if you have troubles at work or have been moody, why would that indicate that anything else might be wrong?

The main bipolar disorder symptom is mania. While a mania episode can be extreme enough that some people can lose sight of reality, hypomania (a milder form of mania) is subclinical and produces a state of more energy and activity, but lasts for less than the bipolar threshold of four days. Because this shortened state doesn’t really impact a person’s life, they can easily deny it as being a symptom of anything.

Other bipolar disorder mania symptoms may include:

  • Feeling euphoric, overly happy, extremely optimistic
  • Inability to sleep, sleeping fitfully, racing thoughts
  • Easy to anger, irritability, aggressive behavior
  • Poor judgment, reckless behavior, high risk behavior
  • Inability to concentrate, easily distracted
  • Rapid speech (the person may just “talk right over you” in a conversation)

On the other end of the spectrum, the depressive state of bipolar disorder symptoms can be where some people spend an overly long period of time. These symptoms may include:

  • Losing interest in activities you once enjoyed
  • Having trouble making decisions, being easily distracted, having problems remembering or concentrating
  • Loss of energy, loss of appetite
  • Feeling guilty, worthless, or helpless
  • Feeling very tired, sleeping more than usual
  • Chronic pain that can’t be accounted for through injury or illness
  • Thoughts of suicide or death

To make this disorder even more confusing, some people can be in a depressive state, yet have a lot of energy or they may feel hopeless and agitated at the same time.

Diagnosis and Treatment

If you are worried whether you or someone you know may have bipolar disorder, the red flag is when the person does things that are out of character for them. Are they normally careful with their money, but suddenly go on a reckless spending spree or take up gambling? Are they engaging in uncharacteristic behaviors (drinking too much, engaging in substance abuse, having one-night-stands or frequent sexual encounters)? Maybe they aren’t interested in their hobbies or are sleeping all the time. If you spot atypical behaviors, encourage the person to see their health provider to rule out possible medical conditions. If everything checks out and the symptoms aren’t caused by injury or illness, they can provide a referral to a mental health professional.

A mental health professional will discuss family history to see if there may be a genetic component to the disorder. In some cases, medications may be prescribed to help with severe symptoms. Cognitive Behavioral Therapy is also used in treating bipolar disorder to change harmful behavior patterns and reduce negative thought patterns. Additionally, family focused therapy can provide coping strategies to help family members learn to recognize an impending episode and to improve communication between the person and their family members.

Learn More

Bipolar disorder can worsen if left undiagnosed and untreated. If you know someone who may be suffering from bipolar disorder, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to help – online or in the office.  To find our more, contact them at 561-496-1094 or email The Center today.

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