All Posts Tagged: the center for treatment of anxiety and mood disorders

woman wearing mask

Are You Struggling With Covid Stress Syndrome Or Covid PTSD?

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

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

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

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

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

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

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

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

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

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

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

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

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

Covid Stress Syndrome

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

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

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

This stress may also be causing:

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

Covid PTSD Symptoms

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

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

The symptoms of Covid PTSD can include:

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

Covid PTSD Self-Assessment Quiz

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

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

Are you troubled by the following?

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

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

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

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

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

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

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

Are you troubled by at least two of the following?

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

Post Covid Anxiety Treatment

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

Self-Care

Self-care includes:

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

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

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

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

Professional Treatment For Covid PTSD And Anxiety

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

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

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

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

We Are Here For You – Through The Pandemic And Beyond

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

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

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virtual therapy

Will Teletherapy Continue After Covid?

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

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

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

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

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

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

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

How Effective Is Teletherapy?

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

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

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

Risks And Benefits Of Teletherapy

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

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

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

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

Will Teletherapy Continue After Covid?

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

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

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

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

Our Teletherapy Services Are Here For You

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

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

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

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

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

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HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

HOCD: Everything You Didn’t Know – A Primer for Understanding & Overcoming Homosexual Obsessive Compulsive Disorder

HOCD (Homosexual Obsessive Compulsive Disorder) is a debilitating condition that attacks without warning in those who already struggle with classic OCD. It leaves its victims reeling with uncontrollable doubt about their sexual orientation (despite never having questioned it before), while igniting a vain pursuit of certainty over the question of whether they are truly straight.

In this HOCD primer, Andrew Rosen, Ph.D. draws on more than forty years of clinical practice to give readers insight into the disorder, as well as offering practical help to those who are fighting against a sexuality they know deep down really doesn’t exist for them.

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What Is Harm OCD?

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

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

Defining Harm OCD

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

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

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

Harm OCD Symptoms

Those who suffer from Harm OCD may:

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

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

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

Treatment for Harm OCD

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

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

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

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

Have Further Questions?

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

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Counseling Adults with Autism

Our very own Dr. Ali Cunningham recently released a book, Counseling Adults with Autism. The cover art for the book was produced by a local man with autism, Michael Vidal (pictured here with Dr. Cunningham).

Counseling Adults with Autism is a practical guide for counselors, psychologists, and other mental health professionals looking to improve their confidence and competence in counseling adults diagnosed with mild to moderate autism spectrum disorder (ASD). Organized into 11 chapters based on key areas for guiding assessment and treatment planning for this population, this book highlights evidence-based practices and therapeutic interventions through case examples to demonstrate how assessment and treatment can be applied. Replete with insights from a variety of disciplinary approaches, this is a comprehensive and accessible resource for practitioners looking to support and empower clients struggling with social and behavioral challenges. Buy the book here.

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toddler with social anxiety

Social Anxiety in Toddlers

Toddlerhood is defined as the age range from 12 to 36 months. During this period, a child’s emotional and cognitive development grows by leaps and bounds, as do their social skills. This also coincides with the time when children are likely to go into a daycare environment or head off to preschool. As they engage more often with other children and adults, it may also be the stage when a toddler’s social anxiety begin to emerge.

Just as with adults, some children are comfortable with social interactions while others may not be. Each group of kids will have the social butterfly as well as the “shy” child who quietly observes and doesn’t interact as much. It is one thing to be shy, however, and another to be intensely fearful and anxious in a social setting. Because we know it can show up early in life, a toddler who shows such strong reactions in a social environment is often regarded as having social anxiety.

What causes social anxiety in toddlers?

We aren’t really sure what causes social anxiety in toddlers. Genetics likely plays a role, since it contributes to a child’s temperament and personality. We also know that some genetic traits can influence certain mental health conditions.

A toddler’s environment could also predispose them to social anxiety. For a young child who already has a higher genetic risk, living with trauma or a severe parenting style may be enough to initiate social anxiety. Social anxiety may also be learned from a parent, according to a 2006 study by de Rosnay, et al. Their research focused on indirect expressions of a mother’s social anxiety on their infant. The results showed that, “compared to their responses following their mothers interacting normally with a stranger, following a socially anxious mother-stranger interaction, infants were significantly more fearful and avoidant with the stranger. Infant-stranger avoidance was further modified by infant temperament; high fear infants were more avoidant in the socially anxious condition than low-fear infants.”

Is social anxiety a form of autism?

Studies have shown that social anxiety is not a form of autism, although the two have overlapping indicators, such as separation anxiety and avoiding eye contact. In fact, not only are they two distinct disorders, but the symptoms and diagnostic criteria for each are vastly different.

As the name implies, social anxiety is driven by anxiety. A child who has social anxiety will function within the parameters of their level of unease. For instance, they may simply keep to themselves, avoid other children, or might talk too quietly. Some kids may not talk at all.

On the other hand, a child with autism spectrum disorder doesn’t behave based on their anxiety level. Instead, this child has trouble understanding social cues and the nuances of communication. They might speak too loudly, may push their way into a group of children, or might misinterpret facial expressions or gestures.

Does my kid have social anxiety?

Children who have social anxiety may be branded as difficult kids because their anxiety can show up in forms other than just in social interactions.

Toddlers with social anxiety often show certain signs, such as:

  • Being a picky eater
  • Easily startled by noises
  • Not adapting well to new situations
  • May have a higher sensitivity to tactile sensations
  • Acting shy around new people and fearing strangers
  • Disliking being separated from their parents (separation anxiety) and distraction doesn’t calm them
  • Having strong emotional reactions and difficulty self-soothing
  • Might have sleep issues
  • Seems afraid to interact with peers, both individually or in a group setting
  • Often has other phobias or fears

How to help a child with social anxiety

At home, parents can demonstrate healthy social interactions when their child is with them, so the toddler learns not to be so fearful.

They can also rehearse a new situation with their child before it comes up. For example, a toddler who will be going to daycare for the first time might role-play some of the things they’ll do while they are there. Practicing certain aspects of the day or even dropping by the daycare a couple of times before officially attending can ease fears because the daycare will already be familiar. It would also be helpful to let the teachers or caregivers know about your child’s fears, so they can help build confidence.

Other supportive methods include:

  • Encouraging your toddler, but not forcing them in social interactions
  • Using praise when the child successfully navigates a scary situation
  • Not criticizing them for their fears
  • Being calm and showing the toddler that you are confident
  • Not being overprotective, which only reinforces the idea that the toddler has something to be afraid of
  • Reading books or watching videos that show confident children

Have Further Questions?

If your toddler is experiencing social anxiety, 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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Asperger’s And Diagnosing Autism In Adults

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

Autism In Adults

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

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

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

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

Adult Autism Checklist

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

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

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

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

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

Interventions For Adults With Autism

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

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

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

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

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

Have Further Questions?

If you or someone you love have questions or would like further information about the assessment and diagnosis for adults with spectrum disorder, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, can help. For more information, contact us or call us today at 561-496-1094.

Resources

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

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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

In Getting to Know Anxiety Drs. Rosen and Gross offer readers an overview of today’s challenging mental health issues and the most current treatment methods available, as well as practical strategies for mental and emotional self-care.

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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