All Posts Tagged: ptsd

How Coronavirus News Coverage Can Activate PTSD

As the world struggles with the global coronavirus pandemic, we are learning how to deal with the “new normal.” Health care workers are going without breaks or days off. Families are coping with layoffs and have been thrown into homeschooling their children. The majority of us are under stay-at-home orders. The outcome of such undue psychological stress creates anxiety and can trigger symptoms of post traumatic stress disorder (PTSD). Watching the constant news coverage of the outbreak doesn’t help.

The therapists at the Center for Treatment of Anxiety and Mood Disorders have long been concerned about the repetitive exposure to traumatic life events that people get through the internet and television newscasts. Not only are we captive audiences to the trauma, we are often mesmerized by it and can have trouble disconnecting ourselves from the TV set or internet.

Trauma Symptoms In The Wake Of COVID19

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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).

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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?

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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).

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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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PTSD After The Sudden Death Of A Loved One

PTSD After The Sudden Death Of A Loved One

People form countless relationships throughout their lives – with family members, friends, coworkers, and neighbors. We have the deepest connections with the people we love – these relationships help make us who we are. They contribute to our sense of identity and have the power to transform us, for good or bad. Because of this, the death of a loved one can create numerous psychological issues, including PTSD, particularly if the loss was tragic and unexpected.

Posttraumatic Stress Disorder (PTSD) Symptoms

We know that survivors often experience depression or anxiety after the death of someone close. We don’t usually think about them having posttraumatic stress disorder (PTSD), but it can also happen, especially after a catastrophic death.

By definition, PTSD can occur when someone has “experienced, witnessed, or been confronted with a terrible event.” News of an unexpected death already brings up especially strong emotions because it catches us off guard. A tragic death magnifies those feelings.

In fact, a 2014 study¹ by Keyes, et al, noted that, “unexpected death was associated consistently with elevated odds of new onsets of PTSD, panic disorder, and depressive episodes at all stages of the life course.”

The symptoms of PTSD include:

  • Being frequently angry, tense, or jumpy.
  • Physical symptoms like heart palpitations, sweating, or hyperventilating.
  • Flashbacks of the trauma or dwelling on what the person might have gone through in their final moments.
  • Persistent avoidance of things or events that remind us of the person or place where the tragedy occurred.
  • Avoiding the emotions surrounding the death or event.
  • Problems sleeping or nightmares.
  • Changing their personal routine to avoid reminders of the event.
  • Distorted feelings of guilt; blaming themselves for the event.
  • Negative thoughts

Most of the time, people will slowly begin to recover from the initial shock and grief of a death. For those with PTSD, though, the symptoms dramatically affect their day-to-day life and they experience them for at least a month.

Treating PTSD After A Sudden Death

There are several effective treatment therapies for PTSD after the sudden or traumatic death of a loved one, including Cognitive Behavior Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Sometimes medications are used in conjunction with these modalities.

Cognitive Behavioral Therapy (CBT)

A tragedy and the resulting trauma can alter your thinking as you try to process what happened. For example, you might feel overwhelming guilt as if you were somehow responsible for the event. Or you may feel detached from the world or from those you love.

These negative thoughts can cause you to avoid the things you normally enjoy or make you worry obsessively that you’ll lose someone else in a similar manner.

Cognitive behavioral therapy (CBT) teaches you to become aware of your beliefs and thoughts about the situation. Once you identify them, it gives you the skills to see whether there are facts to support those thoughts and how to let them go if there aren’t. In short, CBT helps you manage your destructive beliefs so you can replace them with accurate views.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR helps people process trauma on an emotional level. It has been shown to help PTSD sufferers heal faster than through traditional therapy. In fact, a study funded by the Kaiser Permanente HMO found that 100% of single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after just six 50-minute sessions.

In PTSD, traumatic thoughts and memories work against the brain’s healing process. Flashbacks, nightmares, and disturbing emotions cycle through the brain, keeping the ordeal in the forefront of the person’s mind. Eye Movement Desensitization and Reprocessing therapy can break that cycle.

EMDR uses bilateral (both sides of the body) stimuli to tap into the biological mechanisms the brain uses during Rapid Eye Movement (REM) sleep. The theory is that using REM while recalling the disturbing thoughts or memories of the trauma helps the brain process it naturally, allowing the mind to heal.

The bilateral stimulation a therapist might use can include:

  • Hand tapping or toe tapping
  • Eye movements (following a pattern of lights)
  • Musical tones

Let Us Help

If you or someone you love has been suffering from PTSD following the traumatic death of someone close to you, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida help. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

References

  1. Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. The American journal of psychiatry171(8), 864-71.
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How Stress Affects Child Development

How Stress Affects Child Development

Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.

Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in, raising blood pressure and heart rate, and sometimes causing you to lose sleep or feel like you can’t breathe. While this response usually subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under constant stress. It’s called toxic stress, and children can be affected by it just the same as adults.

What are the Effects of Stress on Kids?

The incidence of obesity, diabetes and heart problems, cancer and other diseases goes up when a child lives with toxic stress. Additionally, their chances of depression, substance abuse and dependence, smoking, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence greatly increase. So does their tendency to be more violent or to become a victim of violence.

Studies done by the Centers for Disease Control and Prevention (CDC) have shown that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse, and they lack adequate support from adults, their brain architecture is actually altered and their organ systems become weakened. As a result, these kids risk lifelong health and social problems.

Of the 17,000 people who took part in the CDC study, two thirds had an Adverse Childhood Experiences (ACE) score of 1 or higher. 87% of those people had more than one ACE. By measuring and scoring ten types of trauma ranging from childhood sexual abuse to neglect or bullying and even divorce, researchers were able to assess the chronic disease risk for the study’s mostly white, middle class participants. Their results show that the problem of toxic stress isn’t limited to children who face poverty or to those who come from certain ethnic groups – children from all walks of life can have high ACE scores.

If you are interested in finding out your ACE score and what it might mean for you, go here.

Signs of stress

Children who are exposed to toxic stress exhibit:

  • Poorly developed executive functioning skills
  • Lack of self-regulation and self-reflection
  • Reduced impulse control
  • Maladaptive coping skills
  • Poor stress management

Research on children who face continued toxic stress shows they have:

  • More trouble learning in school
  • More difficulty trusting adults and forming healthy relationships and an increased chance of divorce as an adult
  • Higher incidence of unhealthy behaviors such as substance abuse, sexual experimentation and unsafe sexual practices, engaging in high-risk sports, smoking and alcohol abuse
  • Higher incidence of depressive disorder, post-traumatic stress disorders (PTSD), behavioral disorders, and even psychosis
  • Poor health outcomes such as obesity, heart disease, diabetes, cancer, and a higher suicide risk

Help for Toxic Stress

Awareness is key to preventing and reducing toxic stress in kids. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities have set up task forces and others are working with schools, pediatricians, daycare centers and the justice system to set up screening programs that can turn lives around.

Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that decrease stressors and strengthen the individual’s response to stress.

As more programs are enacted, researchers are finding that children benefit even when the solutions are solely focused on their caregiver and not on the child. This is likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, telephone support and peer support are beneficial, as are cognitive behavioral therapy and relaxation methods like yoga and mindfulness. Additionally, community-based programs like Head Start have been shown to be effective.

Do you have Questions?

For more information about toxic stress and its effects on child development, 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.

 

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Post-Traumatic Growth

Post-Traumatic Growth

Emotional trauma or psychological trauma is a reaction to an experience or event that is deeply distressing or disturbing to the individual. Trauma can be the result of things such as going through a natural disaster, being involved in a car accident, living through a major event, such as war or abuse, or having been the victim of a crime. A trauma response will be similar no matter what caused it.

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

Even though these emotional responses are part of a normal reaction, trauma changes patterns in your brain, causing you to carry the burden of distress long after the events have passed. However, by working with a mental health professional who specializes in trauma, you can experience trauma recovery and learn to feel safe again.

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What is Trauma?

What is Trauma

In general, trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. When loosely applied, this trauma definition can refer to something upsetting, such as being involved in an accident, having an illness or injury, losing a loved one, or going through a divorce. However, it can also encompass the far extreme and include experiences that are severely damaging, such as rape or torture.

Because events are viewed subjectively, this broad trauma definition is more of a guideline. Everyone processes a traumatic event differently because we all face them through the lens of prior experiences in our lives. For example: one person might be upset and fearful after going through a hurricane, but someone else might have lost family and barely escaped from a flooded home during Hurricane Katrina. In this case, a minor Category One hurricane may bring up traumatic flashbacks of their terrifying experience.

Because trauma reactions fall across a wide spectrum, psychologists have developed categories as a way to differentiate between types of trauma. Among them are complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder.

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Complex Trauma Disorder

Trauma can come in many forms. The soldier returning from active duty in a war zone, the child who lives with physical, sexual, or emotional abuse or neglect, the first responder who must deal with human suffering on a daily basis, and the adult who endures domestic abuse all are experiencing trauma. Complex trauma occurs repeatedly and often involves direct harm to the victim. Its effects are cumulative and generally transpire in a specific setting and, frequently, within a particular time frame or within a specific relationship.

Going through trauma can make an individual experience intense feelings of guilt, as if they are somehow responsible for the event(s) that are so terrifying to them. This altered sense of shame and painful self-perception is crippling. It can make the person feel isolated and hopeless, and as if they are no longer in charge of themselves.

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