Showing posts with label diagnosis. Show all posts
Showing posts with label diagnosis. Show all posts

Wednesday, 1 April 2015

Mental health myths: Intelligence

Sometimes, I take the opportunity to discuss mental health myths and the truths behind them. There is so much misinformation out there and we all need to do our part to help others see the truth about mental illness. This time, I’m talking about intelligence.

Myth: People with mental illnesses are less intelligent.

Fact: Mental illnesses, learning disorders and intellectual disabilities are not the same thing.

   
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While psychologists diagnose mental illnesses, learning disabilities and intellectual disabilities, they are not the same thing. What we commonly refer to as “mental illness” generally means the emotional disorders, with symptoms such as depression, anxiety, psychosis and so on. These are what I talk about most of the time on this blog. They don’t, however, have anything to do with how intelligent you are.

Learning disorders are when you have a problem with your cognition that leaves you on unequal footing with your peers when it comes to your capacity to learn. These include, for instance, dyslexia, math disability and, depending on who you ask, ADHD. These are caused by the way your brain processes information. But they still aren’t a measure of how intelligent you are, just the way you learn and what you struggle with.


Intellectual disabilities are about intelligence. While the actual diagnostic criteria are a little more complicated, they are generally considered to be associated with an IQ of 70 or lower. Since the average IQ is 100 (more or less), this puts someone with an intellectual disability at a serious disadvantage. For comparison, above average intelligence is generally considered 110 and higher. That means that the difference between average and gifted is smaller than that of average and intellectually disabled. An intellectual disability therefore means that you have very real struggles in your day-to-day functioning. 

So how do they all relate? 

• Mental illness is not correlated with IQ.
• You can have a learning disorder without having an intellectual disability.
• Intellectual disabilities and learning disorders can influence each other, but one is not a measure of the other.

Think of the whole “crazy genius” archetype, if nothing else. There have been enough people with extraordinary intelligence and a mental illness for that idea to even exist. Anecdotally, some of the smartest people I’ve met have struggled with some form of mental illness or even a learning disorder. People considered intelligent are just as likely to have a mental illness as those who are less intelligent. 

Intelligence is also not measured perfectly by IQ testing. Artistic aptitude, for instance, is not measured on standardized tests. Neither are your ability to build something with your hands or your social intelligence. The truth is, intelligence comes in many forms. And here another archetype comes into place: the idiot savant. There are people who struggle with overall intelligence, but are geniuses in a specific area. These individuals can have just as much to offer as anyone else, just in a very specific way.

Whether someone has a mental illness, a learning disorder, an intellectual disability or none of these at all, everyone deserves respect. Don’t treat others as if you assume they are “stupid.” Differences in intelligence are a part of human existence, just like race, sexuality, religion, physical illnesses and so on. And remember that emotional disorders have nothing to do with intelligence. They happen to the best of us.



What has your experience been with mental illness and intelligence? Share your stories in the comments.

Tuesday, 24 March 2015

100 ways to improve your mental health

We’ve reached a milestone today – this is my 100th post! To celebrate, I decided to make a list of 100 things. The most helpful idea that came to mind was ways to improve mental health, so here it is. I have broken the list down into categories so that you can find the ones that are the most relevant for what you are working on. (Another milestone: Happy birthday, A. You’re my favorite.)

  
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Emotionally
1. Honor your emotions for what they are and accept them fully.
5. Ask for help when you feel overwhelmed.
6. Know when to back out of a situation.
7. Stop your thinking and ask yourself what you are actually feeling and why.
8. Use a feelings chart to identify what you are experiencing.
9. Surround yourself with little things that make you happy – flowers, art, scented candles, etc.



Keerati/FreeDigitalPhotos.net
Mentally
11. Stay in the present.
13. Eliminate bad habits. 
16. Reward yourself for doing difficult things.
17. Take a break when you need it.
18. Find new ways to do things.
19. Stop and consider other perspectives on what you’re experiencing.
20. Use good common sense.


                                                                                              Physically
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21. Exercise regularly.
22. Take time to relax.
23. Eat three meals a day.
25. Stay at a healthy weight. 
26. Get enough sleep.
28. Choose healthy food.

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Socially
33. Be a helpful friend.
34. Respect the needs of others and expect that they do the same.
35. Engage in volunteer work.
36. Eliminate negative influences in your life.
37. Set and keep healthy boundaries.
38. Make time for yourself.
40. Be considerate.


Sira Anamwong/FreeDigitalPhotos.net
Intellectually
43. Study things you genuinely find interesting.
44. Study something you know absolutely nothing about.
45. Do mind exercises like sudoku, crossword puzzles and word games.
46. Talk to other people about what they do.
47. Take an evening or community course.
48. Think up funny jokes and witty responses.
49. Take notes when you are learning about something. Refer to them later.
50. Do calculations in your head instead of using your phone.



Spiritually
tiverylucky/FreeDigitalPhotos.net
51. Practice mindfulness
52. Meditate and/or pray.
53. Eliminate unhealthy beliefs.
54. Rely on a higher power.
55. Learn about the beliefs of others.
56. Journal about your spiritual experiences.
57. Share your spiritual experiences with open-minded loved ones.
58. Forgive.
59. Find or decide on your life’s purpose and live it.
60. Stay true to what you believe.


                                                             Environmentally
                                                             61. Surround yourself with beautiful things.
marcolm/FreeDigitalPhotos.net
62. Hang up motivational posters.
64. Keep your home clean.
66. Support any environmental causes you believe in.
67. Use your resources well.
69. Repair broken things so they don’t continue to frustrate you.
70. Stay organized.


Occupationally
71. Do things you love.
Ambro/FreeDigitalPhotos.net
72. Know your limits when it comes to work.
73. Develop schedules and routines.
74. Simplify your work.
75. Get support from colleagues when necessary.
76. Keep good boundaries between your personal and professional lives.
77. Compliment coworkers on a job well done.
78. If you are unhappy in your job, look for a new one.
79. Multitask less.
80. Take a day off when you need to.

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Self-care
82. Go for a walk.
83. Make your favorite meal.
87. Keep a gratitude journal.
89. Respect yourself.



Other
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91. Stand up for yourself.
93. Keep a beginner’s mindset.
94. Learn from every experience.
95. Keep some money in savings.


Do you have any tips to add? Please do so in the comments!

Friday, 6 February 2015

5 tips for dating someone with a mental illness

  
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It’s February, so romance is on everyone’s minds. Love is such an important emotion. It can change lives in a way that nothing else can. We all need love, and that includes those of us with mental health issues. Here are some suggestions to help you if you are dating someone with a mental illness.

1. Ask appropriate questions.
You need to be reasonably respectful of your partner’s privacy, but don’t be afraid to ask questions. Preface them with, “You don’t have to answer this, but I’d like to know…” so that he doesn’t feel like he is being pressured. Focus on what pertains to you. “What do you want me to know about your condition and how it makes you feel?” “How can I be helpful?” “What are signs that your symptoms are worsening and what do you need when that happens?” It matters a lot when someone takes the time to find out how she can be supportive.

2. Give him space – or don’t.
At a time when your partner is doing reasonably well, talk about how much space she needs and when she needs it. Also talk about when he should not be alone. For instance, someone with PTSD might not want to be touched while experiencing flashbacks. Discuss those boundaries. Alternately, depressed people tend to shy away from others, but it isn’t always healthy. Asking in advance, is it okay to take initiative when these times come? If serious suicidal thoughts are an issue, make sure that your partner has someone to be around at all times. Support and space are equally important and it’s helpful to know when each is needed.

3. Focus on her strengths.
Mental illness can make you feel vulnerable, inferior – even useless. Some people feel like they aren’t contributing enough to the relationship or that they are being a burden. This is why it’s very important to make note of when he does something positive. Notice specific actions and comment on them. Things as simple as “Thank you for making me dinner,” “You look nice today,” and “I appreciate that you spent time with me today,” can boost self-confidence and foster positive emotions. A lot of people with mental illness need reassurance, so knowing they did something right can bring peace of mind.

4. Be accommodating and flexible.
Part of the challenge of mental illness is that it’s unpredictable. Sometimes there’s a reason that symptoms flare up, such as stress or failure, but other times random little things can set off an episode. Work with what you have at any given time. If you had a dinner and movie date planned, but your partner is too anxious to leave the house, order takeout and watch something on Netflix. If physical intimacy is difficult, go slowly and let him take the lead. If she has a hard time being around strangers, don’t drag her to big social events. 

5. Set your own boundaries.
Having a partner with a mental illness can be stressful. At times, you might find yourself in a caretaker role and it can be draining. This is why it’s important that you set boundaries. For instance, make sure you have enough time to take care of yourself. You might need to state that when he starts yelling at you, you will leave until he has calmed down. It might be helpful to make clear that there are some things she can’t blame on her illness (and what they are). It’s important to be understanding, but if you are struggling, you need to have the space to take a break and gather your strength. You can’t be as helpful if you aren’t doing well yourself.

Mental illness is hard on both partners, but it isn’t an impossible barrier to a happy relationship. While your partner might have some challenges, he also has gifts to offer. Living with a mental illness can make you empathetic, brave, considerate, grateful, persistent, thoughtful, strong and any other number of positive qualities. It encourages deep feelings and that includes love. In the end, both of you are just people. You have frustrating qualities as well. But love is beautiful in that it can make everything else disappear, if only for a moment at a time. Love is worth whatever it takes.

Check back on Tuesday to hear about dating from the other side.



What have you found helpful in dating someone with a mental illness? Tell us in the comments.

Wednesday, 29 October 2014

10 commonly used psychological assessments



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Sometimes, meeting with a client in therapy isn’t enough for a therapist to know what is going on. You are seeing someone out of her regular context, moved into a intrusive (though supportive) environment. You aren’t the same self in therapy as you are the rest of the time, so it can be good to get a closer look at traits and symptoms. If your therapist needs more insight into your situation, he might request that you take one or a series of assessments. Following are some of the most widely used ones.

1. Clinical interviews
Clinical interviews are a series of set questions that focus on any symptoms you may have, helping the clinician better assess if you have a diagnosable disorder. During the interview, you will be asked open-ended questions. The interviews generally last between 30 minutes and two hours. Sometimes, the clinician that is administering the test will assess 
attitudes, appearances and behaviors in order to 
supplement the verbal answers given.

2. Screening inventories 
A screening inventory is an assessment that is looking at client symptoms and distress. They can be used both to diagnose mental illnesses and to look at therapy progress and outcomes, depending on the test and context you are taking it in. For instance, the Outcome Questionnaire-45 (OQ-45) can be used before each session to check in on where the client is at. The Beck Depression Inventory (BDI) might be used to get a better handle on a client’s depression symptoms. The Symptom Checklist-90-R (SCL-90-R) might be used to look at a number of symptom clusters while conducting a psychological study. There are a wide variety of tests to suit many purposes.

3. Rorschach test
The Rorschach test (also known as the inkblot test) is perhaps the most famous psychological test of all time. It is a projective assessment wherein the subject is shown a series of symmetrical images created by ink on paper. The subject says what she sees in the images and the test administrator will write down everything, no matter how trivial it may seem. These statements are later interpreted in regards to personality, emotional functioning and to detect thought disorders. 

4. Thematic Apperception Test (TAT)
The TAT is another projective assessment. In this one, the subject is shown ambiguous images of people. The client will tell the proctor stories about the individuals the pictures, which can be interpreted in a multitude of ways. This test is considered a glimpse into the subconscious and the way people see the world. It has been used to study a variety of items, such as motives, concerns, personality and emotional stability. 

5. Rotter Incomplete Sentence Blank (RISB)
A third commonly used projective test is the RISB. In this assessment, the subject is given a list of 40 sentence stems, or incomplete sentences. These are deliberately vague and encompass such phrases as, “I need…,” “Other people…” and “My greatest fear…”. The subject simply completes the sentences however he wants. There is not much in terms of standardized scoring, but themes will emerge, such as a preoccupation with ones appearance or social anxiety. These can help the therapist better tailor treatment to areas of concern. 

                                                                                                                   6. Wechsler Adult Intelligence Scale (WAIS)
   
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The WAIS, currently in its fourth edition, is an intelligence test. It measures raw intelligence and gives you an IQ score. The average IQ is 100. It focuses on a variety of areas, including working memory, processing speed, arithmetic and vocabulary. It has questions ranging from picture completion to finding similarities between words. This test measures your aptitude, not how well you are actually doing in the areas tested.

7. Woodcock-Johnson Tests of Cognitive Abilities
The Woodcock-Johnson, in contrast to the WAIS, is made to measure cognitive performance. It shows how well you actually do in the areas of math, reading and writing. You may score higher or lower than your actual IQ would indicate; for this reason, it can be useful in identifying learning disorders. 

8. Minnesota Multiphasic Personality Inventory (MMPI)
The MMPI is the most commonly used psychological test. It is used to assess personality and psychopathology. Depending on the version of the test you take, you answer either 338 or 567 true or false questions about yourself. This is used to gauge your level of pathology in areas such as depression, hysteria and paranoia. Based on the areas you have the highest scores in, a portrait of your personality and psychological issues can be made. There is also an adolescent version of this assessment, the MMPI-A, which is 478 items long.

9. Millon Clinical Multiaxial Inventory (MCMI)
Used strictly to assess psychopathology, the MCMI does not tell you about personality in the same way the MMPI does. It has a clear focus on psychological symptoms, as it identifies personality disorders and clinical syndromes. It is, however, much shorter than the MMPI, only having 175 true or false questions that can generally be answered in 25-30 minutes. The adolescent version of this assessment is called the Millon Adolescent Clinical Inventory (MACI) and is 160 items long.

10. Child Behavior Checklist (CBCL)
This test is designed to be used with minors, starting as young as 18 months of age. A parent or caregiver takes the test and reports social, behavioral and emotional observations of the subject. There are also versions of the test that can be filled out by teachers or the youth themselves. The assessment asks how true certain statements are, such as “talks or walks in sleep” or “acts too young for his/her age.” Because parents and teachers have higher access to the youth than the therapist does, it can be helpful to get input from someone used to seeing the child in other settings. 



Have you taken any psychological assessments? Did you learn anything interesting about yourself? Talk about it in the comments. 

Sunday, 12 October 2014

Diagnosis spotlight: anorexia nervosa

   
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When most people hear the word “anorexia,” they think of really skinny people. There is, however, a lot more to this disorder than ones weight. Anorexia nervosa is a disorder of both the body and the mind. It can have adverse effects in many areas of one’s life and should always be taken seriously.

First of all, it’s important to acknowledge that anorexia can happen to anyone, regardless of gender, age or race. A college boy could develop anorexia in response to athletic pressures, or transitioning out of independent living could instigate it for a senior citizen. The stressors that can lead to eating disorders are in all our lives and while young females are more at risk, it is important to acknowledge that that isn’t the whole population.

A hallmark trait of anorexia is the restriction of food intake. Someone with anorexia might create unhealthy diet plans, not giving the body the calories and nutrients it needs. Certain foods are avoided completely, leading to a very restricted diet of what has been called “safe foods.” 

For anorexia to be diagnosed, as opposed to another eating disorder, this restriction should lead to a low body weight. The DSM-V diagnostic criteria used by mental health professionals defines this as “less than minimally normal” for adults and “less than that minimally expected” for children and adolescents. 

Another criteria for anorexia is an intense fear of gaining weight or interfering with weight gain despite being at a low weight. This is often related to the final criteria. One of the following needs to be present: disturbance in how you perceive your body (thinking you’re fat when you’re not, for instance), your self-esteem being excessively influenced by the way you see your body or a failure to acknowledge the seriousness of the low body weight. 

Furthermore, there are two types of anorexia: binge-eating/purging type and restricting type. The former involves episodes of binge eating and/or purging behavior. Purging refers to expelling food from your body, like self-induced vomiting or misuse of laxatives or diuretics. The restricting type does not binge and/or purge, but loses weight through dieting, fasting and/or excessive exercise.

Anorexia also often accompanies other psychiatric illnesses. Depression, bipolar disorder, obsessive-compulsive disorder, personality disorders and self-injury are some of the more common comorbid conditions. This can make the anorexia even worse, as there is more internal turmoil. Getting treatment for other mental health – and physical – disorders can help in the recovery from anorexia.

If you or someone you love is experiencing these symptoms, it’s imperative that you seek out help from a qualified professional. Anorexia nervosa is the most deadly mental health disorder. It will wreak havoc on your body until it literally eats itself. You cannot survive without nutrition. But it’s not just your body. Suicide causes one in five anorexia deaths. It is so important to get help.

Find someone who specializes in eating disorders. They have their own specific challenges and your best shot at recovery is with someone experienced. There might also be local support groups you could join in addition to therapy. If the anorexia is severe or treatment-resistant, consider finding a treatment center. If serious physical symptoms develop, call 911 or get to an emergency room. Look out for fainting, seizures, irregular pulse and other symptoms that could be considered serious. Recovery from anorexia is essential, so don’t hesitate to get whatever help you need.


To learn more about supporting loved ones with eating disorders, read this.


What has been your experience with anorexia? What helped you or a loved one get better? Share your thoughts in the comments.

Monday, 14 July 2014

Diagnosis spotlight: depersonalization/derealization disorder

We all experience dissociation in some way or another. It can be as simple as highway hypnosis, where you suddenly realize you’ve driven for miles without noticing, and as complicated as dissociative identity disorder, formerly known as multiple personality disorder. Somewhere in-between, there is depersonalization/derealization disorder.

First of all, what are depersonalization and derealization?

Depersonalization refers to a distortion in self-awareness. You are, in a sense, unfamiliar with yourself. One typically experiences detachment from the body or the sense that it is unreal. It can even mean watching yourself from outside your body. The self just doesn’t feel real and things might seem like a part of a dream. It can also be watching yourself go about your day and making decisions, but not really feeling in control. Time might also be distorted and there can be physical and/or emotional numbing. 



Derealization is when everything else doesn’t feel real. Your surroundings might feel foggy, distorted, unreal or, again, like a dream. People, places and things that may be familiar seem strange or surreal. It’s hard to fully perceive the world around yourself and it might seem like you are watching everything through a filter of sorts. It can be like living in a bubble. What is around you is very separate from you and it can be hard to fully engage in life. 

Depersonalization/derealization disorder means having episodes of one or both of these. It can be accompanied with a feeling that you’re “going crazy.” There might also be vague physical symptoms, like tingling or lightheadedness. It is often associated with anxiety and/or depression. 

Approximately one-half of adults have had an episode of depersonalization or derealization. It happens. But when it is recurring or even constant, it can become pathological. Onset is almost always before age 25, so it’s something that can be experienced from a very young age. Childhood trauma is considered one of the causes of depersonalization and derealization, but it can happen without it. Symptoms can also be caused by physical conditions or substance use, so those need to be ruled out. Episodes are often preceded by high levels of stress, anxiety, depression, traumatic events (or reminders of them) and/or drug use.

Both therapy and medication are used to treat depersonalization/derealization disorder. In particular, cognitive behavioral therapy allows people to reinterpret the symptoms and psychodynamic therapy can look at unresolved and suppressed internal conflicts. Medication-wise, nothing has been approved specifically for the treatment of this disorder, but anxiety medication and anti-depressants have shown some success. There is also research supporting the use of lamotrigine, an anti-convulsant typically used to treat epilepsy. Using grounding techniques can also be very helpful.

Having the experiences of depersonalization and derealization can be very frightening. But it is a recognized mental health condition and a notable amount of people experience it. If you feel like the symptoms described apply to you, please talk to a doctor or therapist. It is possible to gain control over it enough to where it is not interfering with your life, if it doesn’t go away altogether. 


Have you experienced depersonalization or derealization? What was it like for you? Share your experience in the comments.

Thursday, 26 June 2014

The isolation of mental illness

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Mental illness can be a very lonely experience. It can feel like what applies to the rest of the world gets turned on its head when it comes to you. When others ask questions like, “Why didn’t you come to the party?” or “Why haven’t you finished your assignment?” it can be hard to come up with answers that are both understandable and that protect your dignity. It’s hard to find words to describe what permeates your life and makes you feel separate from everyone else.

I wish I could say that people are generally understanding and that if you just say it how it is, you’ll get an empathetic response and an offer of help. The truth is, people are generally uncomfortable talking about mental illness. This societal silence perpetuates the feelings of isolation that mental illness can create.

Still, mental illness affects everyone, whether through experience or indirectly through others in their lives. With one in four Americans struggling with mental illness in any given year, everyone knows someone. It is, however, for the most part an “invisible illness” and people learn to hide their symptoms so no one knows anything is wrong. But it’s still there. 

The next time you sit in a meeting, classroom or other group situation, start counting off one in four people. Now take that group and expand. Remember, the one in four figure is for any given year. Some people have recovered from a past mental illness and others will experience it in the future. Seeing how common it is in this way can be an eye-opener. It’s a lot more prevalent than it seems when you’re lying in bed at 3:00 p.m. and wondering what’s wrong with you since “everyone else” can move on with their days. 

   
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But knowing you are not alone and feeling isolated are not mutually exclusive. While you might theoretically know that others are struggling, too, it’s not like people show up to work saying, “I didn’t come in yesterday because I had a really bad panic attack,” like they say, “I didn’t show up because I had the flu.” Mental illness is surrounded by so much stigma and perceived shame that it’s hard to talk about.

If you want to change the conversation and help others understand how mental illness impacts everyone, that’s great. Just take care of yourself while you do so. As a starting point, here is an article on how to tell others you have a mental illness. If you’d rather avoid the topic, that’s okay, too. It’s your right to decide how much you want to talk about your condition, if you want to talk about it at all.


One thing that can help you feel less alone is through entertainment. Finding stories of others we can relate to can be cathartic and empowering. There are lots of mental health memoirs that focus on specific conditions, so you can surely find one for yours. For instance, there’s Prozac Nation for depression and Girl, Interrupted about borderline personality disorder. There are so many more if you just search for them. There are also fictional stories of mental illness, as well as more technical books. (I’ve compiled a list of books that help you learn more about your condition.) Movies that address mental health topics abound, too, like these Oscar-winning best picture films.

There are also online communities that can offer support. For instance, HealthyPlace has a variety of forums addressing different conditions. Another cool site is PatientsLikeMe, where in addition to having access to forums, you can track your symptoms. Everyone’s data is used to come up with helpful information. It covers a lot of medical conditions, but there’s a section for mental health concerns. Be aware, though, that these groups are for support only. They are not a replacement for a doctor or a therapist. Simple symptom management tips and sympathetic stories are great, but you should not use forums to resolve more serious issues.

Remember that mental health issues are just as much a part of the human experience as anything else. It can feel isolating, but you are by no means alone. You can choose to seek out others who share your experience, or you can just comfort yourself with the knowledge that what you are experiencing is, in its own way, normal. How you approach your condition is entirely up to you, but always know that you aren’t broken, you aren’t weird, you aren’t crazy and you aren’t alone.


What do you do when your mental illness makes you feel alone? Share feedback in the comments.

Wednesday, 4 June 2014

Mental health myths: causes of depression

I occasionally post about mental health myths. I try to debunk incorrect beliefs about mental illness. This time I am talking about the causes of depression.

Myth: Depression is caused by sad or upsetting events.

Fact: Depression can strike at any time.

Some people believe that depression is caused by something unfortunate happening. This might be a death, a breakup, illness, loss of employment or other difficult life events. While these situations can certainly trigger a depressive episode, they are not the sole cause of depression.

No one knows exactly how mental illness works, and that includes depression. It is generally believed to be a mix of several different factors. Some of the possible contributors are listed below.

• Genetics. You might have inherited more from your parents than your looks or your mannerisms. Having family members with depression increases your risk of developing it. It’s not a straightforward genetic trait, so it’s unpredictable to know who will get it. But if your parents, siblings, grandparents or other blood relatives have struggled with depression, keep an eye out for symptoms in yourself.

• Brain chemistry. The brain chemistry of depressed individuals is different than that those without it. This brings up the whole chicken or the egg argument about whether it’s the chemistry that causes depression or the depression that changes the chemistry. Either way, it is a factor that might contribute to developing a depressive
                                                                                                                               disorder.

• Hormones. Hormonal imbalances are another potential cause of depression. This might be due to thyroid problems, pregnancy, menopause or other changes in ones hormones. Your doctor can look for other symptoms of a hormonal condition and order tests to confirm any suspicions. There are treatments for hormonal imbalances that will by extension alleviate the depression.

• Substance abuse. Depression often goes hand in hand with substance abuse. One estimate is that 30% of people struggling with substance abuse also experience clinical depression. This might partially be because alcohol and drugs can be used to self-medicate, but the effects of these substances on the body can increase chances of depression as well. 

Taking medication. Some drugs increase the risk of depression. It can be a side effect. If you are feeling depressed and have recently started taking or changed your dose of a medication, talk to your doctor. There might be other medications that treat the same things and won’t cause you to experience depression.

• Stressful events. We’ve already established that negative events can contribute to depression, but positive ones can as well. If it is causing significant stress, it can cause depression. Some events might include getting married, buying a new home, graduating or starting a new job. 

• Social problems. How you interact – or don’t interact – with others can influence depression. If you feel socially isolated or are struggling with interpersonal difficulties, you might become more depressed. Rejection from a social group can be especially triggering.

It is apparent that a variety of factors contribute to depression. It can be affected by genetics, biology, behaviors, events, relationships and more. It can be complicated to pin down what, exactly, is causing a depressive episode, so it is important to be open with your doctor and your therapist. They can help figure out the causes of your depression and recommend appropriate treatment specific to your causes.

To read all the mental health myth segments, click here.



What has triggered depressive episodes for you? Share your stories in the comments.

Monday, 26 May 2014

7 ways to support someone with an eating disorder

Eating disorders have the highest mortality rate of any mental illnesses. Because of this, it is extremely important to work towards recovery. It is easier to get better when friends and family are supportive. But eating disorders are complex both physically and psychologically, so it can be hard to know what to do and say – or what to not do and say. Here are some suggestions on how to be supportive of someone with an eating disorder.

1. Remember that eating disorders don’t discriminate. A person of any age, gender, race or size can have an eating disorder. They’re not all bone-thin, white teenage girls. There are several different kinds of eating disorders and it’s impossible to tell by a glance whether or not someone is struggling with one.

  
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2. Understand that it’s not just about being skinny. Eating disorders are complex. While societal pressure to be thin can be a factor, it’s not the only one. There are usually intricate emotional reasons behind the disorder. Risk factors that can influence the development of an eating disorder include having another mental illness, substance abuse, perfectionism, sexual abuse and being involved in activities focused on weight (sports, dance, modeling, etc.).

3. Focus on positive non-physical traits. Eating disorders are often accompanied by a lot of insecurity. It’s therefore important to help build self-esteem in areas not related to the body. Compliment your loved one for his kindness, intelligence, skills, etc. Encourage participation in hobbies and activities that she excels in.

4. Be a good listener. If you are consistently paying attention and responding appropriately to your loved one, he will find it easier to talk to you about difficult subjects. Don’t push the topic of eating disorders, but if it comes up, be supportive and gently encourage recovery. If she has brought up the topic, you can carefully try to follow up, but follow her lead.

5. Do things together that don’t involve food. Eating disorders can be very isolating. It’s important to still have a social life, but a lot of social activities are centered around food. This can be very difficult. Invite him to do things where food is not the focus. Instead of going out for ice cream, go to the arcade or a concert. She’ll feel a lot more comfortable.

6. Don’t make demands about recovery. You can’t force someone to change. Recovery can only happen at the pace that someone is able to work at, so you need to respect that. Not doing so can damage your relationship and make your loved one feel uncomfortable around you. Trust his treatment team to keep tabs on how he’s doing.

7. Get emergency help if needed. Forcing treatment on someone can be ineffective and potentially counterproductive, but sometimes intervention is necessary. If symptoms get severe enough, call 911 or take her to the emergency room. Fainting, seizures, an irregular pulse and other severe symptoms call for medical intervention.



How do you maintain relationships with someone who has an eating disorder? If you have one, what do you find helpful? Share your thoughts in the comments.

Tuesday, 20 May 2014

Diagnosis spotlight: narcissistic personality disorder

Everyone knows someone who might be described as arrogant, self-absorbed or vain. When these traits are taken to an extreme, they can become pathological. In narcissistic personality disorder (NPD), self-centeredness overtakes a person and can hurt ones functioning, success and relationships with others. 

 
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In someone with NPD, there is a certain grandiosity and a need for admiration. This is further complicated by a lack of empathy. With NPD, it is expected that one is treated as special and valuable while other people might not even be on the radar. This can manifest in several ways.

According to the DSM-5 (the manual used to diagnose mental illness), people with NPD have an exaggerated sense of self-importance. This might manifest through overstating accomplishments or expecting recognition of superiority without the achievements to match. There can also be fantasies of unlimited success, power, brilliance, beauty, or ideal love. He might see himself as special or unique and therefore only able to be understood by or willing to associate with other people deemed special. There can also be an excessive need for admiration.

NPD might lead someone to take advantage of others. This can be done due to an unwillingness to recognize the feelings or needs of others. Someone with NPD might also be very envious or believe that others are envious of her. There is commonly displays of arrogant behaviors or attitudes.

No one knows exactly how NPD develops. It might be a combination of biology, temperament and early social interactions. It is believed that it can develop as a result of parenting that focuses too much on the child’s specialness. This might be done to increase the parents' own self-esteem. On the other hand, it is possible for it to develop as a response to a childhood of neglect and abuse.

When properly managed, people with NPD actually have some highly adaptive traits. They might have high self-confidence, allowing them to try new things. Their self-esteem can encourage positive risk-taking. NPD can make someone very charming, which can be socially advantageous when used responsibly. There is a lot of leadership potential that can be tapped into in a healthy way.

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Left unregulated, however, NPD can take over lives and lead to a lot of social problems. Friends and family might get worn down by the self-centeredness and lack of empathy, making it difficult to build and retain meaningful relationships. Professional relationships can also be disrupted due to shows of entitlement and an unwillingness to collaborate. At its most destructive end, people with NPD can become abusive. They are able to make their victims feel like they are at fault. 

People with NPD rarely seek treatment. They fail to see how they are being destructive to themselves and those around them. It is not uncommon for NPD to go untreated while those in his life end up seeking help for themselves. When treatment is sought, it is usually only at the insistence of loved ones.

NPD can be hard to treat. Treatment generally means psychotherapy, as there is no medication for NPD. The course of therapy might focus on changing beliefs and behaviors that are destructive. They might be taught to be more empathetic and learn how to use their talents and resources to help others. This might not change feelings such as entitlement, but in practical terms, it leads to a more functional life.

Specific symptoms, such as anger and impulsivity, can be worked on as well. In general, one might look for the areas in which NPD is causing the most problems and focus on those. For instance, if a business owner cannot retain employees because of the way he treats them, therapy might focus on respect and valuing the contributions of others. Group and couples therapy can also be beneficial, as it allows those with NPD to explore relationships and how they relate to others. 

Treatment can be difficult for those with NPD. It challenges their world views and asks for a lot in terms of change. It is usually a long-term process. This might be especially bothersome if the person with NPD does not believe she has a problem. Loved ones can be helpful by responding positively to the person with NPD seeking treatment and can offer praise and support as changes are gradually made. It can be a rough path, but the improvements in relationships are worth the effort.

Tuesday, 13 May 2014

7 rights you have in therapy

  
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Because therapy can become so intimate, you might occasionally lose sight of the fact that it is also a business transaction. As the client, you have a set of rights. These also apply with psychiatrists and other doctors.

1. Right to know your therapist’s qualifications
You have the right to know that your therapist has been properly trained and is professionally competent. You can ask about his education, membership in professional organizations and standing with regards to his license. Any therapist who is hesitant to give you this information is worth investigating or dropping altogether. 

2. Right to know the limits of confidentiality
For the most part, you can tell your therapist anything. But by law and ethics, there are a few things she might have to disclose. At the beginning of therapy, you should be informed of these. It might be in your initial paperwork. If you are unsure about something, ask. You can also read the post about the limits of confidentiality.

3. Right to know diagnostic information
If you want to know any diagnostic impressions your therapist has, you can ask for that information. You are also entitled to an explanation of what your condition is and how it is treated. Don’t expect him to have this information at the end of the first session. An accurate diagnosis takes time. But as you move forward, you can check in on it.

4. Right to know your treatment plan
When treating a client, a therapist should think ahead and see where treatment is going. This is information you can ask for as well. There won’t always be a written plan, but your therapist should be able to tell you where she is going and what strategies she will be using to get there. Don’t expect a play-by-play, but you have a right to know the basics.

5. Right to have questions answered
While your therapist will probably be the one asking the most questions, you can ask for information, too. This can range from explanations of terms used to his reaction to something you said or did. When it comes to personal information, therapists have varying levels of comfort in disclosing. Respect that. But if your question is relevant to your treatment, ask away.

6. Right to be treated with respect
As intimate as therapy can get, you are also in a professional situation. You are paying for a service and that entitles you to a certain level of respect. Your therapist should not be rude, mock you, blow you off, be offensive or otherwise make you have an uncomfortable experience. While minor offenses should be worked out in sessions (read how here), a pattern of disrespect is grounds for termination. 

7. Right to have boundaries observed
Another part of therapy being a professional situation is that there are certain boundaries. Your therapist is not your friend. She should not be a business partner. And he should certainly never, ever be your lover. Your relationship should be confined to the therapy room and never be physical. Your therapist might be okay with occasional contact between sessions (email or phone calls), but that should only be about treatment.


What has been your experience in regards to client rights? Tell us your stories in the comments.

Saturday, 10 May 2014

Living with physical and mental illness

Health is a complex concept. A holistic view of health allows for multiple aspects to be examined, including physical, mental, social and spiritual health. These different facets interconnect and feed into each other, creating an intricate person as a whole. 

   
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Physical and mental health are highly related. According to the Canadian Mental Health Association, people with a mental illness are at a higher risk for a chronic physical illness. It works the other way, too: If you have a chronic physical condition, your mental health is at risk. Some disorders concern both the body and the mind, including hypochondria, eating disorders and insomnia. 

A combination of mental and physical symptoms can be more debilitating than either on its own. It creates a double struggle. If you are having mental health issues, it might be difficult to attend to physical symptoms. Physical conditions can also increase psychological symptoms such as depression and anxiety.

If you are in this situation, it is possible that you have an extended medical treatment team. You might, for instance, have a primary care physician, a psychiatrist and a specialist for your physical condition. In order to receive the best possible treatment, it becomes extremely important to be open and honest with all of them. If one doctor puts you on a medication that is contraindicated with one you are on from another, you can have very bad reactions. Your primary care physician, especially, should get documentation from everyone you visit. It can be hard to talk about mental illness with someone who doesn’t specialize in it, but do it anyway. She can always consult with colleagues if she is stumped. 

Self-care can help mediate the barrage of symptoms. Taking time to let go of everything else and do something that feels good for you is important. Try to think of things that make you feel better mentally and physically. Listening to and focusing on music can be cathartic emotionally while distracting you from your pain. Exercise is very effective in improving depression and can be part of healing some physical illnesses as well (talk to your doctor about what is safe if you have a physical condition). Getting a massage gives you a nice, relaxing break while relieving muscle tension.

Don’t be afraid to ask for help. It can reduce stress, which negatively impacts both physical and mental health. If you can’t do heavy lifting, call your brother. If you are struggling in school because of a condition, talk to your school’s accessibility services. If a work task becomes difficult, ask a colleague to help or talk to your boss about possibly changing your responsibilities. If you can’t get out of bed, ask a friend to drop off dinner and maybe have a chat. If you would be willing to do it for someone else, there is probably someone willing to do it for you, too.

Having limitations due to illness can be discouraging. It might mean giving up your favorite hobby. It could exclude you from having certain careers. It means you may have to be more dependent on your loved ones. But there are still ways you can contribute. Just find the things you can do, no matter how small. It adds up and you never know how much something will matter to someone else. We are all interdependent and your contributions, while maybe not as obvious or notable as those of others, are part of what makes your relationships work. 

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As someone living with multiple physical and mental health conditions, I have found that attitude is essential in this situation. When I give in to feeling discouraged, I become more dysfunctional. I lay in bed all day thinking negatively about how I am laying in bed, then I keep doing that. When I focus on how I made my brother happy by spending time with him, had all of my studying pay off at the end of the semester or wrote four blog posts in one day (it happened once), it’s a lot easier to be healthier. When I concentrate on enjoying the things I am doing, it gives me more motivation to keep doing those and other things. 

It’s a special kind of burden to struggle with illnesses of both the mind and the body. Don’t do it alone. Let those around you help you, whether it’s your medical team or your neighbor. When everyone does what they can, things tend to fall into place eventually.



Do you struggle with both physical and mental health? Tell us what you find helpful in the comments.

Sunday, 4 May 2014

How do I tell someone I have a mental illness?

It is hard to come to terms with having a mental illness. It can be even harder, at times, to help others understand where you’re at because they are not living it. But the path to recovery is best walked with support, so at some point, you might want to tell someone about your mental health condition. Since May is Mental Health Awareness Month, let’s look at talking about mental illness.

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Remember that you get to decide who does and doesn’t know about what you’re struggling with and how much you want to share. Telling someone one thing does not entitle her to know everything. It’s also important to feel safe with the person you are confiding in. When you have carefully considered telling someone and feel comfortable with it, here are some tips on how to have that initial conversation.

Be aware of your own feelings in advance

Don’t go into the conversation unprepared. You are opening up a whole new box of information and feelings, so know what’s in it. Plan for how you are going to deal with any emotions that come up while you’re explaining yourself. Remember that it’s okay to take breaks or to finish the conversation another time. 

Also attend to how you are feeling before you have “the talk.” Are you anxious? Scared? Relieved? Practice some self-care that is appropriate to how you are feeling. Plan for what could help you during the conversation when you are having strong emotions. Maybe playing with a stress ball would help. Perhaps your anxiety is reduced if you have a bottle of water so you can take a drink to buy time when you’re uncertain about an answer. Find whatever works for you.

Understand your condition

If you want him to be understanding of you, some education might be needed. In order to provide that, you need to learn about your diagnosis and/or symptoms. There will probably be questions and it’s best to have the answers. You can read the post on learning about your diagnosis. The chance of misunderstandings and confusion are decreased if you can use factual information instead of conjecture. 

But it’s okay not to know everything. If you are unsure of the answer to a question asked, say something like, “I don’t actually know the answer to that. I’m still learning, too. Let me see what I can find out and we can talk more about it later.” You don’t have to be an expert on your condition; you just need to be appropriately informed about your mental health concerns.

Set appropriate boundaries

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I once told someone about some of my problems who went on to share them with other people. That was difficult, but I realized that I never set the boundary of who I was comfortable with knowing. I now spell out who I want to know if I am going to say something to an individual who is a part of a group I'm in (family, a circle of friends, support group, etc.). 

If the person you are confiding in can’t promise to respect your privacy, reconsider telling her unless you are ready for everyone to know what you are about to share. If you need to set boundaries about what you are willing to discuss, make sure to do that, too. Think ahead so you can express any limitations and boundaries that you need him to respect in the future as well.

Explain the support you need

People will leave the conversation feeling much more positively about it if they have some answers about how this applies to them. If these people are trusted enough for you to talk with, they are likely the kinds people who will want to help. Think about this in advance and be specific. Ask if it’s okay to call her if you have the urge to self-injure. Request to have lunch with him after your therapy appointments to de-stress. Tell her that you need someone to just ask how you’re doing from time to time.

Also let him know what you want him not to do. Again, be specific. If you have triggers, it might help to give her a list of them. If you feel it would be helpful, you can also refer him to the post about helping loved ones with mental illnesses

Be prepared for a variety of responses

As much as I wish there wasn’t, there is a lot of stigma surrounding mental illness. This means that people already have ideas of what mental illness is and those beliefs are going to influence their response to you. Not everyone is going to be completely supportive from the get-go. Instead of blurting out everything at once, pace the conversation. See how she reacts to minor information before revealing major points. If there seems to be a negative response, find a way to end the conversation. 

On the other hand, some people can become overly invested in your situation. If he tries to take control over your treatment or starts coddling you excessively, have a conversation about how this affects you. Tell her that your treatment team is plenty competent to help you make decisions about the hows of recovery. No matter the response, plan on engaging in some self-care after the conversation. It’s stressful and you need to take care of yourself.



Have you told someone about your mental illness? How did it go? Post your own tips and observations in the comments. 

Monday, 14 April 2014

Books about mental illness and recovery

Books are an invaluable source of information. When it comes to mental health, they can be a great resource in helping you understand what you are going through. Following is a list of some of the top-selling books on various mental illnesses. I have not read all of them and I do not endorse any of them. I am simply going by what the most popular titles in the field are. I recommend reading reviews before purchasing a book, as that will give you a better idea of the content. The list is not comprehensive in any way. I hope you find something useful!

Anxiety
The Anxiety and Phobia Workbook by Edmund J. Bourne, Ph.D.
The 10 Best-Ever Anxiety Management Techniques by Margaret Wehrenberg, Psy.D.
The Mindful Way through Anxiety by Susan M. Orsillo, Ph.D. and Lizabeth Roemer, Ph.D.

Attention deficit hyperactivity disorder (ADHD)
Parenting Children with ADHD by Vincent J. Monastra, Ph.D.
Your Life Can Be Better by Douglas A. Puryear, M.D.
Driven to Distraction by Edward M. Hallowell, M.D. and John J. Ratey, M.D.

Autism spectrum disorders
Autism by Dr. Robert Melillo
The Complete Guide to Asperger’s Syndrome by Tony Attwood, M.A., Ph.D.

Bipolar disorder
The Bipolar Disorder Survival Guide by David J. Miklowitz, Ph.D.
The Bipolar Workbook by Monica Ramirez Basco, Ph.D.
Living with Someone Who’s Living with Bipolar Disorder by Chelsea Lowe and Bruce M. Cohen, M.D., Ph.D.

Depression
The Depression Cure by Stephen S. Ilardi, Ph.D. 
The Mindful Way through Depression by Mark Williams, Ph.D., John Teasdale, Ph.D., Zinder Segal, Ph.D. and Jon Kabat-Zinn, Ph.D.
Feeling Good by David D. Burns, M.D.

Dissociative disorders
Coping with Trauma-Related Dissociation by Suzette Boon, Ph.D., Kathy Steele, M.N., C.S. and Onno van der Hart, Ph.D.
The Dissociative Identity Disorder Sourcebook by Deborah Bray Haddock, M.Ed., M.A., L.P. 
Rebuilding Shattered Lives by James A. Chu, M.D.

Eating disorders
8 Keys to Recovery from an Eating Disorder by Carolyn Costin, M.A., M.Ed., MFT and Gwen Schubert Grabb, MFT
Life Without Ed by Jenni Schaefer
Healing Your Hungry Heart by Joanna Poppink, MFT

Insomnia
Say Good Night to Insomnia by Gregg D. Jacobs, Ph.D.
The Effortless Sleep Method by Sasha Stephens
The Insomnia Workbook by Stephanie A. Silberman, Ph.D., DABSM

Obsessive-compulsive disorder 
The OCD Workbook by Bruce M. Hyman, Ph.D. and Cherry Pedrick, RN
The Mindfulness Workbook for OCD by Jon Hershfield, MFT and Tom Corboy, MFT
Obsessive-Compulsive Disorders by Fred Penzel, Ph.D.

Panic disorders
When Panic Attacks by David D. Burns, M.D.
Panic Attacks Workbook by David Carbonell, Ph.D.
From Panic to Power by Lucinda Bassett

Personality disorders
Understanding Personality Disorders by Duane L. Dobbert, Ph.D.
Difficult Personalities by Helen McGrath, Ph.D. and Hazel Edwards, M.Ed.

Posttraumatic stress disorder
The PTSD Workbook by Mary Beth Williams, Ph.D., LCSW, CTS and Soili Poijula, Ph.D.
When Someone You Love Suffers from Posttraumatic Stress by Claudia Zayfert, Ph.D. and Jason C. DeViva, Ph.D.

Schizophrenia
Surviving Schizophrenia by E. Fuller Torrey, M.D.
The Complete Family Guide to Schizophrenia  by Kim T. Mueser, Ph.D. and Susan Gingerich, MSW

Substance abuse
The Mindfulness Workbook for Addiction by Rebecca E. Williams, Ph.D. and Julie S. Kraft, M.A.
Clean by David Sheff
Beyond Addiction by Jeffrey Foote, Ph.D., Carrie Wilkens, Ph.D. and Nicole Kosanke, Ph.D. with Stephanie Higgs

For loved ones
The Family Guide To Mental Health Care by Lloyd I. Sederer, M.D.
When Someone You Love Has a Mental Illness by Rebecca Woolis, M.F.C.C.
You Need Help! by Mark S. Komrad, M.D.

Memoirs



Share your favorite books on mental illness and recovery in the comments.