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  • **DEPRESSION - SUICIDE/CRISIS INTERVENTION**
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  • DEPRESSION & ANXIETY MEDICATIONS - LOOKING FOR ANSWERS
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  1. Anyone tell is lock down one of the reason for increase the depression rate . If yes so how to decrease it. Please share your valuable thoughts..
  2. PTSD - Post-Traumatic Stress Disorder: It’s Not Just Veterans Sources: National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm Anxiety & Depression Association of America: http://www.adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd National Institute of Mental Health What is Post-traumatic Stress Disorder (PTSD)? When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger. PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes. Signs & Symptoms PTSD can cause many symptoms. These symptoms can be grouped into three categories: 1. Re-experiencing symptoms Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweatingBad dreamsFrightening thoughts. Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing. 2. Avoidance symptoms Staying away from places, events, or objects that are reminders of the experienceFeeling emotionally numbFeeling strong guilt, depression, or worryLosing interest in activities that were enjoyable in the pastHaving trouble remembering the dangerous event. Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car. 3. Hyperarousal symptoms Being easily startledFeeling tense or “on edge”Having difficulty sleeping, and/or having angry outbursts. Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating. It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. Who Is At Risk? PTSD can occur at any age, including childhood. Women are more likely to develop PTSD than men, and there is some evidence that susceptibility to the disorder may run in families. Anyone can get PTSD at any age. This includes war veterans and survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events. Not everyone with PTSD has been through a dangerous event. Some people get PTSD after a friend or family member experiences danger or is harmed. The sudden, unexpected death of a loved one can also cause PTSD. Why do some people get PTSD and other people do not? It is important to remember that not everyone who lives through a dangerous event gets PTSD. In fact, most will not get the disorder. Many factors play a part in whether a person will get PTSD. Some of these are risk factors that make a person more likely to get PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder. Some of these risk and resilience factors are present before the trauma and others become important during and after a traumatic event. Risk factors for PTSD include: Living through dangerous events and traumasHaving a history of mental illnessGetting hurtSeeing people hurt or killedFeeling horror, helplessness, or extreme fearHaving little or no social support after the eventDealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.Resilience factors that may reduce the risk of PTSD include: Seeking out support from other people, such as friends and familyFinding a support group after a traumatic eventFeeling good about one’s own actions in the face of dangerHaving a coping strategy, or a way of getting through the bad event and learning from itBeing able to act and respond effectively despite feeling fear. Researchers are studying the importance of various risk and resilience factors. With more study, it may be possible someday to predict who is likely to get PTSD and prevent it. HelpGuide Getting help for post-traumatic stress disorder (PTSD) Recovering from PTSD involves helping your nervous system return to its pre-trauma state of balance. As discussed above, the best way to regulate your nervous system is through social engagement—interacting with another human being—be it a loved one, a friend, or a professional therapist. However, as someone with PTSD, you need to first become “unstuck” and move out of the immobilization stress response. While this process is easier with the guidance and support of an experienced therapist or doctor, you don’t need to wait for a medical appointment to start feeling better. There are plenty of things you can do now to help yourself cope with symptoms, reduce anxiety and fear, and take back control of your life. PTSD Self-Help Tips (See the website for more details) 1) Get moving. (spending time in nature) 2) Connect with others. 3) Challenge your sense of helplessness. 4) Take care of yourself. Helping someone with post-traumatic stress disorder (PTSD) If a loved one has post-traumatic stress disorder, it can take a heavy toll on your relationship and family life. It can be hard to understand why your loved one won’t open up to you—why he or she is less affectionate and more volatile. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems. Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to take care of your loved one, you first need to take care of yourself. It’s also helpful to learn all you can about PTSD. The more you know about the symptoms and treatment options, the better equipped you'll be to help your loved one and keep things in perspective. Tips for helping a loved one with PTSD Be patient and understanding. Getting better takes time so be patient with the pace of recovery and offer a sympathetic ear. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Try to anticipate and prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you’ll be in a better position to offer your support and help your loved one calm down. Don’t take the symptoms of PTSD personally. Common symptoms of post-traumatic stress disorder include emotional numbness, anger, and withdrawal. If your loved one seems distant, irritable, or closed off, remember that this may not have anything to do with you or your relationship. Don’t pressure your loved one into talking. It is often very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Never try to force your loved one to open up. Let the person know, however, that you’re there when and if he or she wants to talk.
  3. Non-Soldiers Suffer Post-Traumatic Stress August 15, 2005 GLENVILLE, N.Y. (AP) -- For hundreds of thousands of Americans, mental illness is just a drive down the road. Ask Beth Puglisi. The 45-year-old mother was out to fill her gas tank on a bitter-cold January day last year. She turned the wheel of her pickup, felt a wrenching jolt, and watched the roadway fly into a spin. "No!" she heard herself screech. The rubbery aroma of spilled antifreeze filled her nostrils. In the days after her crash with a car, she took to the couch, weeping -- but not over her fractured vertebra and dislocated shoulder. Her mind was staggering. "It felt like a death," she says. Her body was quickly tended, but it took months before doctors even put a name to her other injury: post-traumatic stress disorder. Once associated mainly with the horror of combat, PTSD has stretched to take in more frequent swerves along life's road -- car crashes, house fires, a sudden death or severe family illness, witnessing a disaster, or even learning of one. PTSD has broadened the model of mental illness to cover disturbances set off solely by external events, outside of the mind. Almost anyone can be vulnerable. Research suggests the disorder is now present in 5 percent of Americans, or more than 13 million, according to the PTSD Alliance, which unites professionals and advocates. It is expected to touch 8 percent of adults during their lives. By contrast, just over 3 percent of Americans have cancer. Puglisi had been in accidents before, but she never felt this way. She couldn't stop picking over this crash in her mind. It wasn't her fault; it just wasn't. So why did it have to happen? Why? Her family encouraged her to talk: "Each time I would tell someone about it, I could feel it and smell it -- the whole thing." In a kind of flashback typical of PTSD, she could still smell the antifreeze. As PTSD's debilitating anxiety took hold, Puglisi started to feel nervous, flushed, even lightheaded when she was driven to a doctor or physical therapist. She would tremble, and her chest would tighten: "Just thinking about it was making me crazy." When she tried driving again, she'd have to circle around to avoid making the same kind of turn as in the crash. She'd bypass where it happened. Ashamed, she asked her husband to drive the children to their activities. While television droned war news from Iraq, she felt trapped in her own combat zone: "When you're in the war, you have no idea if you're going to be alive or dead in 10 minutes. That's exactly the way I felt." Warring soldiers have carried home psychological scars for centuries. The ancient Greeks noticed it. In American wars, it has been called shell shock, combat fatigue and post-Vietnam syndrome. Though skeptics discounted some cases as shams meant to win compensation, other extreme cases were taken for schizophrenia. Medical authorities first accepted PTSD as a distinct psychiatric condition in 1980 at the urging of Vietnam veterans and their medical caretakers. In PTSD, stress hormones like adrenaline scorch a painful event deep into long-term memory, scientists believe. Lab studies show such hormones normally improve memory in animals. They seem to overshoot the mark in PTSD. People get very edgy and fearful, prone to nightmares or flashbacks. They desperately want to avoid reminders of their shock, even to the point of feeling numb. PTSD happens more often in women, in cases of multiple traumas (Puglisi had another road accident just a couple weeks earlier), and in people with depression. Once defined, the disease was soon embraced, and insurance coverage expanded. Here was a psychiatric condition touched off by concrete events, not something hidden in the mind's dim recesses. It could theoretically happen to anyone, even the hardiest and soundest of mind. It wasn't your fault. The federal government established the National Center for Post-Traumatic Stress Disorder. It began researching PTSD and treating hundreds of thousands of veterans. Survivors from rape and car crashes began to seek therapy in greater numbers too. In 1994, the sudden death of a relative, or even learning that one was hurt, joined the expanding list of PTSD traumas in the chief diagnostic manual for psychiatry. By the late 1990s, when Dr. Greenbrier Almond was working as a psychiatrist at a West Virginia veterans hospital, PTSD was already its leading diagnosis, above heart disease and diabetes, he says. Over the past five years, the number of cases among veterans -- mostly from combat -- has exploded nationally by almost 80 percent to 215,871 last year, according to the Department of Veterans Affairs. It is the agency's fastest-growing disability. No similar statistics are collected for civilians, but the numbers are clearly substantial. Dr. Almond, who has left the veterans hospital, now treats PTSD in abused children at a community health clinic. Research at Henry Ford Health System, Harvard and Georgia State has identified the two leading causes of PTSD as unexpected deaths of relatives and car crashes. Combat ranks far down on the list. Some bad diagnosticians and purveyors of pop culture have come to consider just about any of life's shocks -- divorcing, losing a job, even failing a test -- as triggers for PTSD. Though veterans officials say rising awareness has driven most of their growth, they are also reviewing whether some cases have been diagnosed too readily. "Anything that happens to you that's remotely icky now qualifies," says psychologist J. Gayle Beck, at the University at Buffalo-State University of New York. "It's been culturally overdiagnosed." This psychiatric illness has carried cultural baggage since its birth in the social turmoil over the Vietnam War. The new disorder tied to external events meshed with a Kafkaesque view of society inherited from the 1960s: Outside forces constantly threaten peace of mind. Since 2001, PTSD has tapped into another source of anxiety: terrorists who can inflict mass death in an instant. A survey found highly elevated rates of PTSD in the New York metropolitan area, where the smoking towers of the World Trade Center could be seen for miles. Afterward, some companies sent reassuring notices to workers listing PTSD symptoms and saying they were common responses. One compared them to a minor flu. "It speaks to dangerous times and threats, and that certainly defines our era," says Dr. Robert Jay Lifton, a Harvard University psychiatrist who helped define PTSD as a condition. "There is bound to be widespread PTSD and an awareness of it." Even so, many people with PTSD still do not come forward for help, caregivers say. And even experts may miss the signs. "My father dropped dead in front of my mother. She developed PTSD for two years, and I was completely unaware of it. I knew something was wrong, but I didn't know it was PTSD," says psychologist Terence Keane. Yet he is director of behavioral science at the federal PTSD center. The good news is this: Even untreated, PTSD goes away in about half of the cases within six months, research indicates. The bad news: When it doesn't, it can last for decades. Puglisi had never needed therapy before and didn't think of treating her embarrassing automotive anxiety. "I would say I'm all right," she recalls. But she wasn't. Her doctor told her she'd soon get over it, but her physical therapists knew better. After several months, they persuaded her to look for help. She found Edward Hickling, a former veterans psychologist who now specializes in road-accident PTSD. "I came to private practice, and I saw motor-vehicle accident victims that looked a lot like ... the post-traumatic stress responses I saw in the veterans hospital," says the therapist based in nearby Albany. Like many PTSD therapists, he relies on cognitive behavioral therapy. A common psychological treatment, it teaches how to replace negative mental monologues ("I could die on the way to work") with positive, rational ones ("I'll probably get there just fine, as usual"). It can be carried out one-on-one or in groups. Like many PTSD therapists, Hickling re-exposes participants to memories of the terrifying situation, while desensitizing them over a few months or longer. They start by telling what happened and graduate to driving back to the crash site. One woman was able to drive back and gaze at the place where her car plunged down a hill, trapping her for more than two hours. Later, she felt as though she had "removed a cloud from her brain," according to Hickling. The therapy can work in up to 75 percent of road-accident survivors with chronic PTSD, research suggests. Some patients, though, can't tolerate thoughts of their ordeal. "It's just too painful," says psychologist Charles Figley, at Florida State University. Lesser symptoms persist in many people. Psychiatrists often treat PTSD with drugs. The federal government has approved two depression medicines, Zoloft and Paxil, for PTSD. Research suggests they help at least a quarter of PTSD patients. Other researchers are experimenting with potential PTSD drugs like anti-adrenaline agents and the antibiotic D-cycloserine. In theory, they might disrupt the consolidation of long-term PTSD memories or help the brain forget them later. Psychological therapy alone conquered Puglisi's symptoms, though it took a year. She still hasn't gone back to work but doesn't feel so alone. Now she knows of many others like her: "The mind does this sometimes." What happened to her, she has learned, is normal. Copyright 2005 The Associated Press. All rights reserved.
  4. Living with a Mental Health Condition If you have a mental health condition, you're not alone. One in 5 American adults experiences some form of mental illness in any given year. And across the population, 1 in every 25 adults is living with a serious mental health condition such as schizophrenia, bipolar disorder or long-term recurring major depression. As with other serious illnesses, mental illness is not your fault or that of the people around you, but widespread misunderstandings about mental illness remain. Many people don't seek treatment or remain unaware that their symptoms could be connected to a mental health condition. People may expect a person with serious mental illness to look visibly different from others, and they may tell someone who doesn't "look ill" to "get over it" through willpower. These misperceptions add to the challenges of living with a mental health condition. Every year people overcome the challenges of mental illness to do the things they enjoy. Through developing and following a treatment plan, you can dramatically reduce many of your symptoms. People with mental health conditions can and do pursue higher education, succeed in their careers, make friends and have relationships. Mental illness can slow us down, but we don't need to let it stop us. - See more at: https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition#sthash.BLfmLjJY.dpuf To determine a diagnosis and check for related complications, you may have: A physical exam. Your doctor will try to rule out physical problems that could cause your symptoms. Lab tests. These may include, for example, a check of your thyroid function or a screening for alcohol and drugs. A psychological evaluation. A doctor or mental health provider talks to you about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions. Determining which mental illness you have Sometimes it's difficult to find out which mental illness may be causing your symptoms. But taking the time and effort to get an accurate diagnosis will help determine the appropriate treatment. The defining symptoms for each mental illness are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. Classes of mental illness The main classes of mental illness are: Neurodevelopmental disorders. This class covers a wide range of problems that usually begin in infancy or childhood, often before the child begins grade school. Examples include autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) and learning disorders. Schizophrenia spectrum and other psychotic disorders. Psychotic disorders cause detachment from reality — such as delusions, hallucinations, and disorganized thinking and speech. The most notable example is schizophrenia, although other classes of disorders can be associated with detachment from reality at times. Bipolar and related disorders. This class includes disorders with alternating episodes of mania — periods of excessive activity, energy and excitement — and depression. Depressive disorders. These include disorders that affect how you feel emotionally, such as the level of sadness and happiness, and they can disrupt your ability to function. Examples include major depressive disorder and premenstrual dysphoric disorder. Anxiety disorders. Anxiety is an emotion characterized by the anticipation of future danger or misfortune, along with excessive worrying. It can include behavior aimed at avoiding situations that cause anxiety. This class includes generalized anxiety disorder, panic disorder and phobias. Obsessive-compulsive and related disorders. These disorders involve preoccupations or obsessions and repetitive thoughts and actions. Examples include obsessive-compulsive disorder, hoarding disorder and hair-pulling disorder (trichotillomania). Trauma- and stressor-related disorders. These are adjustment disorders in which a person has trouble coping during or after a stressful life event. Examples include post-traumatic stress disorder (PTSD) and acute stress disorder. Dissociative disorders. These are disorders in which your sense of self is disrupted, such as with dissociative identity disorder and dissociative amnesia. Somatic symptom and related disorders. A person with one of these disorders may have physical symptoms with no clear medical cause, but the disorders are associated with significant distress and impairment. The disorders include somatic symptom disorder (previously known as hypochondriasis) and factitious disorder. Feeding and eating disorders. These disorders include disturbances related to eating, such as anorexia nervosa and binge-eating disorder. Elimination disorders. These disorders relate to the inappropriate elimination of urine or stool by accident or on purpose. Bedwetting (enuresis) is an example. Sleep-wake disorders. These are disorders of sleep severe enough to require clinical attention, such as insomnia, sleep apnea and restless legs syndrome. Sexual dysfunctions. These include disorders of sexual response, such as premature ejaculation and female orgasmic disorder. Gender dysphoria. This refers to the distress that accompanies a person's stated desire to be another gender. Disruptive, impulse-control and conduct disorders. These disorders include problems with emotional and behavioral self-control, such as kleptomania or intermittent explosive disorder. Substance-related and addictive disorders. These include problems associated with the excessive use of alcohol, caffeine, tobacco and drugs. This class also includes gambling disorder. Neurocognitive disorders. Neurocognitive disorders affect your ability to think and reason. These acquired (rather than developmental) cognitive problems include delirium, as well as neurocognitive disorders due to conditions or diseases such as traumatic brain injury or Alzheimer's disease. Personality disorders. A personality disorder involves a lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships. Examples include borderline, antisocial and narcissistic personality disorders. Paraphilic disorders. These disorders include sexual interest that causes personal distress or impairment or causes potential or actual harm to another person. Examples are sexual sadism disorder, voyeuristic disorder and pedophilic disorder. Other mental disorders. This class includes mental disorders that are due to other medical conditions or that don't meet the full criteria for one of the above disorders. http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/tests-diagnosis/con-20033813
  5. until
    National Mental Health Month raises awareness about mental illness and related issues in the United States. In recent times, attitudes towards mental health issues appear to be changing. Negative attitudes and stigma associated with mental health have reduced and there has been growing acceptance towards mental health issues and support for people with them. Despite this shift in attitude, the idea of a mental health awareness campaign is not a recent one. In the late 1940's, the first National Mental Health Awareness Week was launched in the United States. During the 1960's, this annual, weekly campaign was upgraded to a monthly one with May the designated month. During this month, National Health America, the main organization which sponsors this event, run a number of activities which are often based on a theme. In 2010, the theme was 'Live Your Life Well'. 'Live Your Life Well' encouraged people to take responsibility for the prevention of mental health issues during times of personal challenge and stress. Many mental health problems can be avoided by taking positive lifestyle choices in how we act and think before they can manifest. To coincide with Mental Health Awareness month, Other mental health campaigns & activities also run during this month. National Children's Mental Health Awareness Day is one such campaign. This event is sponsored by the American Psychological Association (APA). Other activities have included 'Blogging for Mental Health' and 'Help For People Seeking Psychological Services'.
  6. Sometimes, I feel like no one really knows me. Including me. So much of the time I feel... disconnected. From myself. From my environment. From my family. I suppose if I didn't feel disconnected, I wouldn't be able to function. Most of the time, when I do feel, it is searing-hot flashes of passion or moments of incandescent rage, or aching hours of blinding terror and drowning inadequacy. These feelings sear my mind to carbonized crumbled ash. There doesn't seem to be any nice normal for me. At least, I haven't been able to recognize it. Yet. And I've been looking for a long time now. And what is normal, anyway? Normal is just the setting on a dryer, honey. Yeah, right. I work with Desperately Normal and Judgmentally Average. Gossip is the language of the natives, honey. And Heaven won't help you if you stand out. You know how the saying goes - 'The nail that sticks out gets hammered down.' And then judiciously torn apart piece by juicy, gossipy piece. I feel like I live and work for aliens, family excepted. I don't understand a single thing about them. I mean, I must understand them on some level, because I think I mostly get along, right? Even though everyone sees me as arrogant and aloof, hard to know and opinionated. I'd rather them see that than what's really there: a terrified and inadequate, bewildered and starving interloper trying to find her way home. Trying to find her people. Sometimes I see a glimmer here. Sometimes I catch a glimpse, a teaser, a faint glow in the distance here, like maybe.... just maybe.... there might be another interloper out there straggling their way home like me. -20YaC 'Bluff' found on bromartdotcom via Pinterest [Pinterest] [the page this came from doesn't exist anymore; Pinterest]
  7. This class of drugs, which includes Xanax and Valium, helps control anxiety and panic attacks. A recent study found 1 in 20 adults received a prescription for benzodiazepines in 2008. By Kirstin Fawcett Feb. 19, 2015 | 10:28 a.m. EST+ More The mere thought of climbing into a car sends Jenn Waterman spiraling into a state of agitation and fear. Waterman, a 30-year-old freelance book editor who lives in Arapaho, North Carolina, survived two near-fatal car accidents as a teenager. Since then, she’s battled post-traumatic stress disorder and panic attacks. Waterman has visited a therapist, and she regularly takes Zoloft, a medication that treats depression, anxiety and other conditions. But the only thing that truly quells her nerves before sliding into a vehicle’s passenger seat, she says, is Valium. “I notice that once I go ahead and take it, I feel so much better – like I can finally relax,” she says. “Sometimes that makes all the difference in the world.” Valium is a medication that’s part of a larger class of drugs called benzodiazepines. Benzodiazepines are commonly prescribed for anxiety and agitation. They can also be used for insomnia, seizures and alcohol withdrawal. Some types of benzodiazepines are instantly recognizable; Ativan and Xanax, for example, have infiltrated popular culture and are now colloquially considered “quick fixes” for everything from poor sleep to panic disorders. But other forms include – but aren’t limited to – the drugs Klonopin and Valium. Benzodiazepines are some of the most common medications in the world; a recent study sponsored by the National Institutes of Health found that about 1 in 20 adults received a prescription for them in 2008. They’re extremely effective for patients like Waterman, who have crippling anxiety. Unlike medications like selective-serotonin reuptake inhibitors, which take several weeks to reach full efficacy, benzodiazepines work almost immediately. They can also be good for treating chronic anxiety in patients who have adverse reactions to SSRIs and similar medicines. The drawbacks? Benzodiazepines can be habit-forming. And they carry a host of dangerous side effects – including impaired cognition and mobility in older individuals, and potentially life-threatening withdrawal symptoms in people with severe addictions. A study sponsored by the National Institute of Mental Health recently linked long-term use of benzodiazepines to a heightened risk for Alzheimer’s disease. And data from the Centers for Disease Control and Prevention showed that benzodiazepines, along with opioid pain relievers, are the prescription drugs most often responsible for emergency department visits and drug-related deaths. So are benzodiazepines helpful or dangerous? Like most pharmaceutical drugs, experts say, they’re a mixed bag. Despite studies suggesting that physicians over-prescribe them, even those in the medical community tend to disagree on whether the benefits of benzodiazepines outweigh the risks. For every doctor who writes a prescription for Xanax, there’s another who refuses to do so, says Jerrold Rosenbaum, chief of psychiatry at Massachusetts General Hospital. “It’s amazing how polarizing the conversation gets,” Rosenbaum says. "There is a constituency that views [benzodiazepines] as evil and harmful; they tend to come out of the substance use disorder community. They’re not perfect drugs, but they do work for conditions for which nothing else [is as effective].” Benzodiazepines can be safe for short-term use. “Benzodiazapines are very effective, particularly in the short term, for the treatment of acute anxiety and insomnia,” says Larissa Mooney, an assistant professor of psychiatry and director of the Addiction Medicine Clinic at the University of California-Los Angeles. “They calm people down, and they help people fall asleep and stay asleep.” Most doctors say benzodiazepines should not be prescribed for more than a few weeks. The body slowly builds up a dependency to the pills, which can be averted by not taking them for an extended duration. Patients should also make sure to follow their doctor's dosage instructions, and to slowly taper off the medication instead of stopping cold turkey. In some cases, though, long-term use of benzodiazepines can be acceptable, Mooney says. “There are a subset of people who seem to respond very well to long-term benzodiazepines,” she says. “They may be maintained on a low dose and never need anything higher – meaning they don’t develop a tolerance. They may be intolerant to other classes of medications. And it seems to augment their treatment for anxiety.” All of the above are true for Waterman, who has sporadically taken Valium over the years. She sticks to a low dosage, goes periods of time without taking the medicine and says she’s never felt any physical side effects. She’s also had bad reactions to other antianxiety drugs; Valium is the only medicine she’s taken that hasn't produced physical side effects. And while Zoloft helps her anxiety, Valium is more effective at halting her nightmares and panic attacks. Benzodiazepines are not a cure-all. Many people with panic disorder or acute anxiety use benzodiazepines as a first-line method of treatment until they’re able to find another coping mechanism. But they might also have underlying issues that contribute to their anxiety, Rosenbaum says. These problems might be best addressed by tackling life stressors, taking an antidepressant that helps with anxiety or trying cognitive-behavioral therapy. Certain people should not take benzodiazepines – or they should take extra precautions. People with a history of alcoholism or drug addiction are advised against taking benzodiazepines. Similarly, elderly people face an increased risk of falls, cognitive disturbance, sleep apnea and a potentially heightened chance of dementia, says Charles Reynolds, a professor of geriatric psychiatry at the University of Pittsburgh School of Medicine. However, he says, certain factors that often appear with aging – for instance, bereavement, insomnia and low-grade depression complicated by anxiety – mean benzodiazepines “do have a place in the management of emotional distress in older adults.” In these cases, he says their best bet is a short-acting benzodiazepine prescribed for a limited duration. And it goes without saying, he adds, that anyone taking benzodiazepines should avoid depressants such as alcohol or opioids. Doctors should carefully monitor patients’ use of benzodiazepines. “In most cases of benzodiazepine dependence, addiction begins with a legitimate prescription,” says Tiffany Jones-Rouse, a licensed social worker and substance abuse counselor based in the Baltimore-District of Columbia metro area. “Folks seek intervention for a variety of conditions, from muscle spasms to chronic anxiety disorders, and they're often issued a prescription for Xanax, Valium, Klonazepam, Ativan or another tranquilizer.” These drugs, she says, can be beneficial for people who have never demonstrated drug or alcohol dependence. In this case, their dosage should always be time-limited and closely monitored by a physician who addresses the potential for addiction. The problem, Jones-Rouse says, is that while many physicians impose prescription time limits and address the risks and side effects, others might not. Over time, a patient will sometimes develop a tolerance toward the benzodiazepines. Their negative symptoms will return, and they will either request a larger dosage from their doctors, buy the medicine illegally or turn to another substance, like alcohol. In certain cases, Jones-Rouse adds, people don't recognize that they're dependent until they make the decision to stop taking the medication. They’ll quickly find that they experience uncomfortable withdrawal symptoms such as mood swings, agitation and irritability, and changes in appetite and sleep patterns, among others. In worst-case scenarios, unmonitored benzodiazepine withdrawal can lead to stroke, seizures and heart attacks. And benzodiazepines, when combined with other drugs, can result in overdose and death. It's possible to safely withdraw from benzodiazepines, even after extended use or abuse. According to Jones-Rouse, hospitals and treatment programs provide medical monitoring for the detoxification phase. Therapists, social workers and psychologists trained in dealing with substance abuse can provide longer-term psychological care. And public support programs such as the 12-step programs Narcotics Anonymous and Chemically Dependents Anonymous provide a social support network that aids in recovery. SOURCE: Lloyd Sederer is medical director of the New York State Office of Mental Health, adjunct professor at Columbia University’s Mailman School of Public Health and medical editor for Mental Health for the Huffington Post. Follow him @askdrlloyd and visit his website www.askdrlloyd.com. The opinions expressed here are his own However, experts say most physicians agree on the following guidelines – independent of whether or not they themselves prescribe benzodiazepines.
  8. Hi guys, I'm (obviously) new here, but I've been looking for somewhere I can pour out my anxieties without feeling too judged, or judged at all if I can avoid it. I'm female, 29 living in the UK and have suffered depression since a young age. I think I was first aware I was suffering low moods when I was fifteen, but never thought too much about them. As I look back now, I have always had major avoidance issues with people, out of fear of being judged and reprimanded and I just don't work well with strangers. Over the years I've been to university twice and gained two seperate high qualifications, but each has been a dark struggle with wanting to lie in bed, cry and sleep all day. Over the next few years I've yo-yo'd with what I call 'highest highs and lowest lows'. I don't think I'm bi-polar, but let me explain a bit more. On a 'high' day, I consider myself active, functional, chirpy and happy. I don't often have days like these so I find it increasingly neccessary to fake it to those who love me and know me well. I know it's never a good thing, I recently found out. On a low day, I stay in bed, stare at the paint and I find my mind blank and numb. I interact with people but I feel so dead inside, nothing they say has absolutely any impact on me whatsoever. I had a big episode last year, in the middle of march. This was set off by me catching pnuemonia. I worked in customer service at an open window (I think we can all guess where this was...) and the extreme cold in the UK coupled with me constantly going in and out of hot to cold, made my chest and illness worse despite me telling management I was too wheezy to work at the window day after day. The outcome was predictable, I began coughing up blood and spent a considerable time at home, feeling like crud and wishing against hope I could drag myself out of the despair. This year, after limping onward with a mood I could feel getting lower and lower, I began to suffer stomach pains. My boss then fired me without cause and it felt like something in me finally snapped. I don't remember too much, which is probably for the best. I know I made out my will and settled my funeral arrangements. Despite being caught writing the note and frantic calls from my mother to the doctors, I attempted to take my own life. I was seen by an emergency assessor who diagnosed me with 'major depressive disorder' with 'extreme social anxiety'. It's taken them a long time to arrange counselling, almost two months, and in that time I've tried three further times. Each time I've been stopped by someone else. I feel at the end of a long dark road. I haven't showered or brushed my teeth since mid january. I dont think I've even washed my clothes or changed my bedding. I either sleep all day or come down to my desk like a ghost and fill my head with video games and documentaries about people who suffer. I seem to find it soothing watching those. My mother has attempted to lighten my day with aromatherapy and I know it's hard on her, hearing me cry and knowing I get 'out of my mind' sometimes. When I have days of insomnia, I stay awake doing nothing at all. My anxiety is probably even worse; I've never been good with strangers and lately this has become almost crushing. I don't leave the house, I haven't in almost three weeks. I know I have to soon because there is my counselling coming up. The last time I left the house, I tried to brave the outside and hit Asda. The bus journey was deafening in silence, and I was sure everyone was looking at me. I can't help but imagine their eyes boring into my skin and the things they;re thinking about me, the words they're whispering about me. In Asda, with so many people in a tighter space, I could feel the panic starting to rise and I avoided looking at faces, trying not to notice their eyes or their lips and pressing myself against shelves to avoid touch. I was bumped into and I had a full blown panic attack. It felt like my windpipe was closing and no air could get in. My hands were shaking and the blood was pounding in my ears, and I went to my knees and then I blacked out. I haven't been out since. One of my qualifications is as an illustrator, digital. I can't even bring myself to put a pencil onto paper. Art was my greatest passion, now I can't even face it. On a lighter note; I hope one day that I can manage this properly. My aim is to be able to go into a cinema filled with people and sit there alone with them and watch a film. It's nothing grand or fancy, but if I can manage that step one day (hopefully soon) - then I can finally see some light on my road. (ps sorry if this depressed anyone, I'm having such a hard time right now and I'm struggling like mad to cope, thanks xx)
  9. What if you could get what a psychologist offers without actually having to see one? James Cartreine, PhD Posted November 04, 2015, 12:10 pm , Updated November 04, 2015, 9:50 am James Cartreine, PhD, Contributing Editor Many people enjoy the warm, caring relationship provided by a mental health clinician, but others simply want to get better. Many people would rather not open up to another person about their problems — at least, not in person. Plus, seeing a mental health clinician can be inconvenient and expensive — and there might not even be any nearby. One of the new frontiers in psychotherapy is using the Internet to deliver cognitive behavioral therapy (CBT) for depression, anxiety, and other behavioral health problems in a way that reduces — or sometimes eliminates — the amount of time spent with clinicians in person. This novel delivery method allows treatments that have traditionally been provided one-on-one to be scaled up so they can reach far more people. After all, it doesn’t matter if a good treatment exists if people don’t have access to it. What are these online therapies? The field is new, so the data about these online programs are sparse — but a team of British researchers recently conducted a review of the available literature. For the review, they scoured medical journals looking for “John Henry” studies — that is, comparisons of live cognitive behavioral therapy against websites or computer programs that deliver treatments for anxiety or depression. What did the researchers find? They used a high bar of scientific rigor and found only five online mental health interventions that had been directly compared with live clinicians providing the same treatment, for working-age adults. Two of the interventions were Australian and three were Swedish, and all of them were for social anxiety or panic disorder. Most online interventions studied by the researchers were divided into sessions, mirroring the way in-person CBT is delivered on a weekly basis. All of the online therapies delivered treatment via written content, also known as “bibliotherapy.” This was combined with communication with a mental health clinician, usually a psychologist, over email or private messaging systems. In one study, psychologists were limited to spending only 10 minutes per week on each participant. Some programs added text messaging and discussion forums, and most included homework — things that participants did between sessions — just as in-person CBT involves between-session practice. All treatment groups, for both in-person and online CBT, significantly improved in symptoms. One study found better outcomes for the online treatment, and the others found equal results between the two types. The online treatments required much less clinician time, making them more cost-effective. The downside? All of the online treatment participants needed to do a lot of reading, which can be a limiting factor for some people. Also, written interaction with a psychologist or other clinician was part of every online intervention in this review. This means that to some extent, the effectiveness of the intervention still depends on the clinician who’s on the other end. Plus, requiring clinicians to be involved at all creates a hurdle to scaling up treatments to reach massive numbers of people. The newest innovations in a very new field New online programs and mobile apps are emerging that minimize the amount of reading, use video and audio to deliver treatments, and require no clinician involvement at all. These simulate live CBT but can be delivered to huge numbers of people. Head-to-head comparisons of these newer programs against traditional therapy (the kind of comparison that would meet the criteria of the British team) have not yet been published. So stay tuned for developments in this next generation of treatment delivery. Related Information: Understanding Depression health.harvard.edu
  10. In the video link below, Bradley Cooper, star of Silver Linings Playbook, an Oscar-nominated film about a man living with bipolar disorder, joins former Rhode Island Rep. Patrick Kennedy for a press conference at the Center for American Progress to discuss how this recent film is making progress toward removing the stigma of mental illness. Cooper and Kennedy are joined by Dr. Barbara Van Dahlen, president and founder of Give an Hour, a nonprofit organization providing free mental health services to U.S. military and their families affected by Iraq and Afghanistan, and Topher Spiro, Director of Health Policy at the Center for American Progress. _______ http://www.huffingtonpost.com/bradley-cooper/silver-linings-playbook-mental-health_b_2595390.html This is a matter of the Stigma that surrounds our illnesses. Please feel free to discuss...
  11. P. T. S. D. – Veterans Sources: HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/ptsd-in-veterans.htm http://www.helpguide.org/articles/stress/stress-relief-in-the-moment.htm Veterans’ Administration: http://www.ptsd.va.gov/public/family/ptsd-and-relationships.asp HelpGuide PTSD in Military Veterans Symptoms, Treatment, and the Road to Recovery for Post-Traumatic Stress Disorder Are you having a hard time readjusting to life outside the military? Are you always on edge, always on the verge of panicking or exploding, or, on the flip side, do you feel emotionally numb and disconnected from your loved ones? Do you believe that you’ll never feel normal again? For all too many veterans, these are common experiences—lingering symptoms of post-traumatic stress disorder (PTSD). It’s hard living with untreated PTSD and, with long V.A. wait times, it’s easy to get discouraged. But you can feel better, and you can start today, even while you’re waiting for professional treatment. There are things you can do to help yourself overcome PTSD and come out the other side even stronger than before. What is PTSD? Post-traumatic stress disorder (PTSD), sometimes known as shell shock or combat stress, occurs after experiencing severe trauma or a life-threatening event. It’s normal for the mind and body to be in shock after such an event, but this normal response becomes PTSD when your nervous system gets “stuck.” The latest research into the brain shows that there are three ways of regulating the nervous system and responding to stressful events: Social engagement is the most evolved strategy for keeping yourself feeling calm and safe. Socially interacting with another person—making eye contact, listening in an attentive way, talking—can quickly calm you down and put the brakes on defensive responses like “fight-or-flight.”Mobilization, otherwise known as the fight-or-flight response, occurs when social engagement isn’t an appropriate response—such as in a combat situation—and you need to either defend yourself or escape the danger at hand. Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your strength and stamina, speed your reaction time, and enhance your focus. Once the danger has passed, your nervous system then calms the body, slowing heart rate, lowering blood pressure, and winding back down to its normal balance.Immobilization. Immobilization occurs when you’ve experienced a traumatic amount of stress—in combat, for example. The physical danger of war has passed but you find yourself “stuck,” your nervous system unable to return to its pre-stress state of balance. This is PTSD.Who is affected by PTSD? Many military veterans develop symptoms of PTSD. In fact, military service is the most common cause of PTSD in men. Close to 30 percent of Afghanistan and Iraq War veterans treated at V.A. hospitals and clinics have been diagnosed with PTSD. For veterans who saw combat, the numbers are even higher, up to 49%. The more tours you made and the more combat you experienced, the more likely it is that you’ll develop PTSD. But however isolated or emotionally cut off from others you feel, it’s important to know that you’re not alone and there are things you can do to help yourself. What are the symptoms of PTSD in veterans? Symptoms sometimes don’t surface for months or even years after returning from deployment. While PTSD develops differently from veteran to veteran, there are four symptom clusters: Recurrent, intrusive reminders of the traumatic event, including distressing thoughts, nightmares, and flashbacks where you feel like it’s happening again. Experiencing extreme emotional and physical reactions to reminders of the trauma (panic attacks, uncontrollable shaking, heart palpitations, etc.).Extreme avoidance of things that remind you of the traumatic event, including people, places, people, thoughts, or situations you associate with the bad memories. Withdrawing from friends and family and losing interest in everyday activities.Negative changes in thoughts and mood, such as exaggerated negative beliefs about yourself or the world and persistent feelings of fear, guilt, or shame. Diminished ability to experience positive emotions and feeling detached from others.Being on guard all the time, jumpy, and emotionally reactive, as indicated by irritability, angry outbursts, reckless behavior, difficulty sleeping, trouble concentrating, hypervigilance, and an exaggerated start response.Suicide prevention in veterans with PTSD Suicidal thoughts and feelings are common symptoms of PTSD among military veterans. Feeling suicidal is not a character defect, and it doesn't mean that you are crazy, weak, or flawed. If you are thinking about taking your own life, seek help immediately. Please read Suicide Help, talk to someone you trust, or call a suicide helpline: In the U.S., call 1-800-273-TALK (8255).In the UK, call 08457 90 90 90.In Australia, call 13 11 14. Or visit IASP to find a helpline in your country. Self-help for PTSD in veterans While it’s common for veterans with PTSD to have to endure long waits for treatment at the V.A., there are plenty of things you can do for yourself to start feeling better. The job of recovery is to transition out of the mental and emotional war zone you’re still living in and help your nervous system return to its pre-war state of balance. As discussed above, the best way to regulate your nervous system is through social engagement—interacting with another human being, be it a loved one, a family member or a professional therapist. However, as a veteran with PTSD, you need to first become “unstuck” and move out of the immobilization stress response. With these recovery steps, you’ll learn how to deal with your combat stress and also learn skills that can benefit the rest of your post-war life. You’ll learn how to feel calm again, reconnect with others, deal with nightmares and flashbacks, cope with feelings of depression, anxiety, or guilt, and restore your sense of control. And when you do get to see a doctor or therapist at the V.A., you’ll be in a better position to benefit from professional treatment as well. The Road to PTSD Recovery for Veterans, 7 Steps: 1) The road to PTSD recovery step 1: Get moving Getting regular exercise has always been important for veterans with PTSD. As well as helping to burn off adrenaline, exercise can release endorphins and make you feel better, both mentally and physically. However, new research suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and move out of the immobilization stress response. Any exercise that engages both your arms and legs—such as running, swimming, basketball, or even dancing—will work well if, instead of continuing to focus on your thoughts as you exercise, you focus on how your body feels instead. Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. Many veterans find rock climbing, boxing, or martial arts especially effective as these activities make it easier to focus on your body movements—after all, if you don’t, you could get seriously hurt. 2) The road to PTSD recovery step 2: Connect with others Social interaction with someone who cares about you is an effective way to calm your nervous system. For any veteran with PTSD, it’s important to find someone you can connect with face to face—someone you can talk to for an uninterrupted period of time, someone who will listen to you without judging, criticizing, or continually being distracted by the phone or other people. That person may be your significant other, a family member, one of your buddies from the service, or a civilian friend. You may feel like the civilians in your life can’t understand you since they don't know what it's like to be in the military or to have seen the things you have. But people don't have to have gone through the exact same experiences to understand and relate to painful emotions and be able to offer support. What matters is that the person you're turning to cares about you, is a good listener, and is able to be there for you as a source of strength and comfort. If you're not ready to open up about the details of what happened, that's perfectly okay. You can talk about how you feel without going into a blow-by-blow account of events. You can also tell the other person what you need or what they can do to help, whether it's just sitting with you, listening, or doing something practical. Comfort comes from someone else understanding your emotional experience. You’ll also find that people who care about you welcome the opportunity to help. Listening is not a burden for them but an opportunity. How PTSD can get in the way of connecting with others Many veterans find that PTSD can leave them feeling disconnected, withdrawn and, while their nervous system is still stuck, make it tough to connect with other people. No matter how close they are to the person, or how helpful that person tries to be, they just don’t feel any better after talking with them. If that describes you, there are some things you can do to help the process along. Before you’re due to sit down with a friend over a alcohol or coffee, for example, take some time to exercise, as described in step 1 above. As well as calming you when you’re feeling anxious, irritable or on edge, physical movement can also open your nervous system’s pathway to social engagement. Think of it as shaking loose all the blockages to connecting with people. If working out isn’t practical, find a quiet place and take a few minutes before you meet your friend to move around, jump up and down, swing your arms and legs—in other words, flail around like you did as a three year old. A few minutes of that and you’ll be breathing heavily, your head will feel clearer, and you’ll be in a better place to connect. It may sound weird, but vocal toning is also a great way to open up your nervous system to social engagement—even if you can’t sing or consider yourself “tone-deaf.” Again, find a quiet place before hooking up with a buddy and, with your lips together and teeth slightly apart, simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face. Practice for a few minutes and notice if the vibration spreads to your heart and stomach as well. Other ways to connect with others Many veterans find it helpful to join a PTSD support group or to connect with other veterans or trauma survivors. Listening to others' stories and struggles may help you feel less isolated. You can also volunteer in the community, which can help you feel more connected and useful, especially if you’re not currently working. 3) The road to PTSD recovery step 3: More ways to calm your nervous system Just as loud noises, certain smells, or the feel of sand in your clothes can instantly transport you back to the trauma of a combat zone, so too can sights, sounds, smells, and other sensory input quickly calm you down. The key is to find the sensory input that works for you. Think back to your time on deployment: what brought you comfort at the end of the day? Perhaps it was looking at photos of your family? Or maybe it was the taste of candy in a care package from home, or listening to a favorite song, or smelling a certain brand of soap or cologne? Or maybe petting an animal works quickly to make you feel calm and centered? Everyone responds to sensory input a little differently, so experiment to find what works best for you. 4) The road to PTSD recovery step 4: Take care of your body The symptoms of PTSD can be hard on your body so it’s important to put a priority on sleep, exercise, healthy food, and relaxing activities. You may find it very difficult to relax at first. It’s common for veterans to be drawn to behaviors that pump up adrenaline. After being in a combat zone, that’s what feels normal. Without the rush, you feel strange or even dead inside. Things you may turn to for that familiar adrenaline rush include energy drinks, coffee, drugs, cigarettes, violent video games, and daredevil sports. If you recognize these urges for what they are, you can make better choices that will calm and care for your body and mind. Healthy habits for veterans with PTSD Here are some active steps you can take to improve your PTSD symptoms: Take time to rest and restore your body’s balance. Relaxation techniques such as massage, meditation, yoga, and tai chi are powerful defensive weapons against the symptoms of PTSD.Avoid alcohol and drugs (including nicotine). It can be tempting to turn to drugs and alcohol to numb painful feelings and memories and get to sleep. But substance abuse can make the symptoms of PTSD worse and compound your problems. The same goes for cigarettes.Find safe ways to blow off steam. Pound on a punching bag, pummel a pillow, go for a hard run, sing along to loud music, head to the gym for a vigorous workout, go somewhere private where you can scream at the top of your lungs, or vent in your journal or to someone you trust.Support your body with a healthy diet. Eat plenty of complex carbohydrates, such as potatoes and whole grains, to support mental clarity and physical stamina. Limit processed sugars, which can exacerbate mood swings and energy fluctuations.Get plenty of sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as soothing as possible. Use curtains to block outside light and if noise is a problem, try using a sound machine. 5) The road to PTSD recovery step 5: Deal with flashbacks, nightmares, and intrusive thoughts Flashbacks usually involve visual and auditory memories of combat or other trauma you experienced. It feels as if it’s happening all over again so it’s vital for you to accept and reassure yourself that your traumatic experience is not occurring in the present. One effective technique is to state to yourself (either out loud or in your head) the reality that while you feel as if the trauma is currently happening, you can look around and recognize that you’re safe. Here’s a simple script you can use when you awaken from a nightmare or start to experience a flashback or intrusive thought: “I am feeling [panicked, overwhelmed, etc.] because I am remembering [traumatic event], but as I look around I can see that the event isn’t happening right now and I’m not actually in danger.” Other techniques that can be helpful in bringing you back to the present include tapping your arms or describing what you see when look around (name the place where you are, the current date, and three things you see when you look around). Tips for grounding yourself during a flashback If you’re starting to disassociate or experience a flashback, try using your senses to bring you back to the present and "ground" yourself. Experiment to find what works best for you. Movement: Move around vigorously (run in place, jump up and down, etc.); rub your hands together; shake your head Touch : Splash cold water on your face; grip a piece of ice; touch or grab on to a safe object; pinch yourself; play with worry beads or a stress ball Sight: Blink rapidly and firmly; look around and take inventory of what you see Sound : Turn on loud music; clap your hands or stomp your feet; talk to yourself (tell yourself you’re safe, that you’ll be okay) Smell: Smell something that links you to the present (coffee, mouthwash, your wife’s perfume) or a scent that has good memories Taste : Suck on a strong mint or chew a piece of gum; bite into something tart or spicy; drink a glass of cold water or juice 6) The road to PTSD recovery step 6: Work through survivor's guilt Feelings of guilt are very common among veterans with PTSD. You may have seen people injured or killed, often your friends and comrades. You may ask yourself questions such as: Why didn’t I get hurt?Why did I survive when others didn’t?Could I have done something differently to save them? You may end up blaming yourself for what happened and believing that your actions (or inability to act) led to someone else’s death. You may feel like others deserved to live more than you—that you’re the one who should have died. This is survivor’s guilt. Healing from survivor's guilt Healing doesn’t mean that you’ll forget what happened or those who died. And it doesn’t mean you’ll have no regrets. What it does mean is that you’ll look at your role more realistically. Remember, you are only human. The following questions can help you “reality test” your guilty feelings: Is the amount of responsibility you’re assuming reasonable?Could you really have prevented or stopped what happened? Could you really have reacted differently?Are you judging your decisions based on full information about the event, or just your emotions?Did you do your best at the time, under challenging circumstances?Do you truly believe that if you had died, someone else would have survived? Honestly assessing your responsibility and role can free you to move on and grieve your losses. Instead of punishing yourself, you can redirect your energy into honoring those you lost and finding ways to keep their memory alive. And in those cases where you truly believe you did something wrong, you can make amends. Even when you can’t make amends directly, there is always something you can do (such as volunteering for a cause that’s connected in some way to one of the friends you lost). The goal is to put your guilt to positive use, and thus transform tragedy, even in a small way, into something good. 7) The road to PTSD recovery step 7: Seek professional treatment Under the guidance of an experienced therapist or doctor, there are several different types of professional treatment for PTSD available. Cognitive-behavioral therapy or “counselling” involves carefully and gradually “exposing” yourself to thoughts and feelings that remind you of the event. Therapy also involves identifying distorted and irrational thoughts about the event—and replacing them with more balanced picture.Medication, such as antidepressants, is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These work by helping the nervous system become “unstuck.” Veterans’ Administration Relationships and PTSD How does trauma affect relationships? Trauma survivors with PTSD may have trouble with their close family relationships or friendships. The symptoms of PTSD can cause problems with trust, closeness, communication, and problem solving. These problems may affect the way the survivor acts with others. In turn, the way a loved one responds to him or her affects the trauma survivor. A circular pattern can develop that may sometimes harm relationships. How might trauma survivors react? In the first weeks and months following a trauma, survivors may feel angry, detached, tense or worried in their relationships. In time, most are able to resume their prior level of closeness in relationships. Yet the 5% to 10% of survivors who develop PTSD may have lasting relationship problems. Survivors with PTSD may feel distant from others and feel numb. They may have less interest in social or sexual activities. Because survivors feel irritable, on guard, jumpy, worried, or nervous, they may not be able to relax or be intimate. They may also feel an increased need to protect their loved ones. They may come across as tense or demanding. The trauma survivor may often have trauma memories or flashbacks. He or she might go to great lengths to avoid such memories. Survivors may avoid any activity that could trigger a memory. If the survivor has trouble sleeping or has nightmares, both the survivor and partner may not be able to get enough rest. This may make sleeping together harder. Survivors often struggle with intense anger and impulses. In order to suppress angry feelings and actions, they may avoid closeness. They may push away or find fault with loved ones and friends. Also, drinking and drug problems, which can be an attempt to cope with PTSD, can destroy intimacy and friendships. Verbal or physical violence can occur. In other cases, survivors may depend too much on their partners, family members, and friends. This could also include support persons such as health care providers or therapists. Dealing with these symptoms can take up a lot of the survivor's attention. He or she may not be able to focus on the partner. It may be hard to listen carefully and make decisions together with someone else. Partners may come to feel that talking together and working as a team are not possible. How might loved ones react? Partners, friends, or family members may feel hurt, cut off, or down because the survivor has not been able to get over the trauma. Loved ones may become angry or distant toward the survivor. They may feel pressured, tense, and controlled. The survivor's symptoms can make a loved one feel like he or she is living in a war zone or in constant threat of danger. Living with someone who has PTSD can sometimes lead the partner to have some of the same feelings of having been through trauma. In sum, a person who goes through a trauma may have certain common reactions. These reactions affect the people around the survivor. Family, friends, and others then react to how the survivor is behaving. This in turn comes back to affect the person who went through the trauma. Trauma types and relationships Certain types of "man-made" traumas can have a more severe effect on relationships. These traumas include: Childhood sexual and physical abuseRapeDomestic violenceCombatTerrorismGenocideTortureKidnappingPrisoner of war Survivors of man-made traumas often feel a lasting sense of terror, horror, endangerment, and betrayal. These feelings affect how they relate to others. They may feel like they are letting down their guard if they get close to someone else and trust them. This is not to say a survivor never feels a strong bond of love or friendship. However, a close relationship can also feel scary or dangerous to a trauma survivor. Do all trauma survivors have relationship problems? Many trauma survivors do not develop PTSD. Also, many people with PTSD do not have relationship problems. People with PTSD can create and maintain good relationships by: Building a personal support network to help cope with PTSD while working on family and friend relationshipsSharing feelings honestly and openly, with respect and compassionBuilding skills at problem solving and connecting with othersIncluding ways to play, be creative, relax, and enjoy others What can be done to help someone who has PTSD? Relations with others are very important for trauma survivors. Social support is one of the best things to protect against getting PTSD. Relationships can offset feelings of being alone. Relationships may also help the survivor's self-esteem. This may help reduce depression and guilt. A relationship can also give the survivor a way to help someone else. Helping others can reduce feelings of failure or feeling cut off from others. Lastly, relationships are a source of support when coping with stress. If you need to seek professional help, try to find a therapist who has skills in treating PTSD as well as working with couples or families. For resources, please see our Where to Get Help for PTSD page. Many treatment approaches may be helpful for dealing with relationship issues. Options include: One-to-one and group therapyAnger and stress managementAssertiveness trainingCouples counselingFamily education classesFamily therapy
  12. P. T. S. D. – Helping Your Child Cope With Traumatic Events Sources: Anxiety & Depression Association of America: http://www.adaa.org/living-with-anxiety/children-and-teens/tips-parents-and-caregivers/help-your-child-manage-traumatic- http://www.adaa.org/living-with-anxiety/children National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml HelpGuide: http://www.helpguide.org/articles/ptsd-trauma/post-traumatic-stress-disorder.htm KidsHealth: http://kidshealth.org/parent/emotions/feelings/ptsd.html Veterans’ Administration: http://www.ptsd.va.gov/public/family/ptsd-children-adolescents.asp http://www.ptsd.va.gov/public/family/very_young_trauma_survivors.asp Anxiety & Depression Association of America Help Your Child Manage Traumatic Events Since the terrorist attacks of 9/11, most adults have accepted that we live in a new era of trying times. Tornadoes, hurricanes, and other natural disasters, as well as explosions, and other traumatic events threaten our sense of safety and security, and they occur around the world on any given day. Adults often struggle with the effects of trauma, even though they understand them. But children react differently based on their personality, age, and circumstances. Children rely on the support of parents and teachers to help them deal with their emotions during and after traumatic events. Parents should decide how much information their children can handle. ADAA member Aureen Wagner, PhD, Director of The Anxiety Wellness Center in Cary, North Carolina, offers this recommendation for parents: “Remain as calm as possible; watch and listen to your child to understand how upset he or she is. Explain a traumatic event as accurately as possible, but don’t give graphic details. It’s best not to give more information than your child asks for. Let your child know that it is normal to feel upset, scared or angry. If older children or teenagers want to watch television or read news online about a traumatic event, be available to them, especially to discuss what they are seeing and reading.” These tips are important for children and adolescents of all ages: Reassure them that you’ll do everything you can to keep them and their loved ones safe.Encourage them to talk and ask questionsLet them know that they can be open about their feelings.Answer questions honestly.Protect them from what they don’t need to know.Avoid discussing worst-case scenarios.Limit excessive watching and listening to graphic replays of the traumatic eventStick to your daily routine as much as possible. Most children and teenagers will recover from their fear. But you can watch for these signs of ongoing distress: Difficulty sleepingChange in eating habitsClinginessRe-experiencing the event through nightmares, recollections, or playAvoidance anything reminiscent of the eventEmotional numbing or lack of feeling about the eventJumpinessPersistent fears about another disaster If after a month or so your child is still showing signs of distress, professional help may be indicated. Children who have trouble getting beyond their fears may be suffering from PTSD, or posttraumatic stress disorder. And that’s when it’s time to seek the assistance of a mental health professional. Many effective treatments are available for children and teens. Anxiety & Depression Association of America (Anxiety & Depression In) Children & Teens Anxiety and depression are treatable, but 80% of kids with a diagnosable anxiety disorder and 60% of kids with diagnosable depression are not getting treatment, according to the 2015 Child Mind Institute Children’s Mental Health Report. Anxiety is a normal part of childhood, and every child goes through phases. A phase is temporary and usually harmless. But children who suffer from an anxiety disorder experience fear, nervousness, and shyness, and they start to avoid places and activities. A child who sees a scary movie and then has trouble falling asleep or has a similar temporary fear can be reassured and comforted. But that is not enough to help a child with an anxiety disorder get past his or her fear and anxiety. Anxiety disorders affect one in eight children. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. Anxiety disorders often co-occur with depression as well as eating disorders, attention-deficit/hyperactivity disorder (ADHD), and others. With treatment and support, your child can learn how to successfully manage the symptoms of an anxiety disorder and depression and live a normal childhood. National Institute of Mental Health Do Children React Differently (To PTSD) Than Adults? Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children, these symptoms can include: Bedwetting, when they’d learned how to use the toilet beforeForgetting how or being unable to talkActing out the scary event during playtimeBeing unusually clingy with a parent or other adult. Older children and teens usually show symptoms more like those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge. For more information, see the NIMH booklets on helping children cope with violence and disasters. HelpGuide Symptoms of PTSD In Children & Adolescents In children—especially those who are very young—the symptoms of PTSD can be different than those in adults. Symptoms in children include: Fear of being separated from parentLosing previously-acquired skills (such as toilet training)Sleep problems and nightmares without recognizable contentSomber, compulsive play in which themes or aspects of the trauma are repeatedNew phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)Acting out the trauma through play, stories, or drawingsAches and pains with no apparent causeIrritability and aggression Veterans’ Administration Very Young Trauma Survivors: The Role of Attachment Years ago, little was known about PTSD in infants and young children. Today, we know that trauma and abuse can have grave impact on the very young. We also know how much the attachment or bond between a child and parent matters as a young child grows. This can make a difference in how a child responds to trauma. Below we discuss rates of trauma-related problems in infants and young children, as well as treatment options. How many infants and young children are abused? In the United States, Child Protective Services receives reports on the abuse or neglect of about 5.5 million children in a year. Infants and young children have more risk of abuse than older children. Over one-third of proven reports to child protection services are for children under the age of five years. Further, children are most often hurt or killed from abuse when they are in the first year of life. Over three-quarters of children killed due to abuse are under the age of three years. How do trauma and neglect affect infants and young children? As with adults, following trauma, most children will have some symptoms. Young children may show a fear of strangers or be scared to leave their parent. They might also have sleep problems or bad dreams. Young children may also repeat themes of the trauma in their play. For example, a child who was sexually abused in her bed might play out "dark" bedroom scenes with dolls. They might also be more fussy, irritable, aggressive, or reckless. Young children may lose skills they once had, such as toilet training. They might go back to earlier habits, like sucking their thumb. Very young children may not show the same PTSD symptoms we see in adults. This may be because many of the symptoms of PTSD require that the child be able to talk about what happened. Early trauma affects the child's nervous system. The nervous system is shaped by the child's experiences. Stress over a period of time can lead to changes in the parts of the brain that control and manage feelings. That is to say, stress and trauma early in life can change the brain. This can have long-term effects on physical, mental, and emotional growth. What's more, the impact of early abuse often extends into later childhood, teen, and even adult years. Diagnosing PTSD in infants and young children Although most children have symptoms following trauma, only a few will go on to get PTSD. Diagnosing PTSD in children can be difficult. The definition of trauma that is used to diagnose PTSD is specific. It says that a person must feel fear, helplessness, or horror for an event to be a "trauma." It is hard to say if this happens for a very small child. Young children are often not able to describe in words the event or how they felt about it. For this reason, other ways of diagnosing PTSD have been created for use with children ages zero to three years. What is attachment? Attachment is the connection found in the main relationship in a child's life. Usually it is with his or her caregiver. Children and parents are meant to form attachments with each other. For example, your baby is born knowing how to cuddle and cry, and it causes you to respond. Also, infants like their caregiver's face and voice more than other sights and sounds. The type of attachment between a child and caregiver can affect how a child will relate to the people she or he comes across in life. Why is attachment important when dealing with trauma? A child's main attachment helps him learn to control his emotions and thoughts. When a caregiver's responses are in tune with a child's needs, the child feels secure. The child then uses this relationship pattern as practice to build coping skills. On the other hand, a child who gets confusing or inconsistent responses from the caregiver might be fussy, have a hard time calming down, withdraw from others, or have tantrums. Children also use their caregivers to guide how they should respond to events. Have you noticed how a child sometimes looks at his or her parent to know how to respond? When you stop your child from doing something unsafe, he in time learns to stop himself. So a parent's reaction to trauma affects the child. Through a relationship with their caregiver, children learn how to be in charge of feelings and behaviors, and how to act with other people. Here are some examples: If a caregiver often helps a child manage her feelings, the child can build coping skills. This could lead to better healing for children who go through trauma.A traumatic event might hurt the attachment between a caregiver and child due to strong feelings that get in the way of a good relationship. Sometimes a child can be angry toward her parent for not keeping her safe. Even very young children can have these feelings. Or, a parent might feel guilty about the event and this might affect the relationship.If the caregiver has her own trauma history, her symptoms (trying not to feel, always worried about danger) might get in the way of caring for her child. What kind of help is out there? Child health care settings, doctors, and other health care providers can give support, education, safety planning, and information about treatment.Child and family social services can help caregivers with many issues.In-home nurses and other providers can help new parents provide good care for their young children. They might help with feeding, sleep, safety, or illness.Therapy is needed if relationship problems or PTSD symptoms do not get better. Treatment that involves the caregiver and child together is best for cases with poor attachment and trauma. One such treatment is called child-parent psychotherapy (CPP). CPP helps caregivers understand their children, keep them safe, and give emotional help.For some children, treatment does not take place for many years. No matter the age, when trauma and PTSD are involved, evidence-based, effective treatment exists. Veterans’ Administration PTSD In Children & Teens What events cause PTSD in children? Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live. Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur: 65% neglect18% physical abuse10% sexual abuse7% psychological (mental) abuse Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.) How many children get PTSD? Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors. What are the risk factors for PTSD? Three factors have been shown to raise the chances that children will get PTSD. These factors are: How severe the trauma isHow the parents react to the traumaHow close or far away the child is from the trauma Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress. Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas. Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages. What does PTSD look like in children? School-aged children (ages 5-12) These children may not have flashbacks or problems remembering parts of the trauma, the way adults with PTSD often do. Children, though, might put the events of the trauma in the wrong order. They might also think there were signs that the trauma was going to happen. As a result, they think that they will see these signs again before another trauma happens. They think that if they pay attention, they can avoid future traumas. Children of this age might also show signs of PTSD in their play. They might keep repeating a part of the trauma. These games do not make their worry and distress go away. For example, a child might always want to play shooting games after he sees a school shooting. Children may also fit parts of the trauma into their daily lives. For example, a child might carry a gun to school after seeing a school shooting. Teens (ages 12-18) Teens are in between children and adults. Some PTSD symptoms in teens begin to look like those of adults. One difference is that teens are more likely than younger children or adults to show impulsive and aggressive behaviors. What are the other effects of trauma on children? Besides PTSD, children and teens that have gone through trauma often have other types of problems. Much of what we know about the effects of trauma on children comes from the research on child sexual abuse. This research shows that sexually abused children often have problems with Fear, worry, sadness, anger, feeling alone and apart from others, feeling as if people are looking down on them, low self-worth, and not being able to trust othersBehaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcoholHow is PTSD treated in children and teens? For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years if they do not get treatment. There are many treatment options, described below: Cognitive-Behavioral Therapy (CBT) CBT is the most effective approach for treating children. One type of CBT is called Trauma-Focused CBT (TF-CBT). In TF-CBT, the child may talk about his or her memory of the trauma. TF-CBT also includes techniques to help lower worry and stress. The child may learn how to assert himself or herself. The therapy may involve learning to change thoughts or beliefs about the trauma that are not correct or true. For example, after a trauma, a child may start thinking, "the world is totally unsafe." Some may question whether children should be asked to think about and remember events that scared them. However, this type of treatment approach is useful when children are distressed by memories of the trauma. The child can be taught at his or her own pace to relax while they are thinking about the trauma. That way, they learn that they do not have to be afraid of their memories. Research shows that TF-CBT is safe and effective for children with PTSD. CBT often uses training for parents and caregivers as well. It is important for caregivers to understand the effects of PTSD. Parents need to learn coping skills that will help them help their children. Psychological first aid/crisis management Psychological First Aid (PFA) has been used with school-aged children and teens that have been through violence where they live. PFA can be used in schools and traditional settings. It involves providing comfort and support, and letting children know their reactions are normal. PFA teaches calming and problem solving skills. PFA also helps caregivers deal with changes in the child's feelings and behavior. Children with more severe symptoms may be referred for added treatment. Eye movement desensitization and reprocessing (EMDR) EMDR combines cognitive therapy with directed eye movements. EMDR is effective in treating both children and adults with PTSD, yet studies indicate that the eye movements are not needed to make it work. Play therapy Play therapy can be used to treat young children with PTSD who are not able to deal with the trauma more directly. The therapist uses games, drawings, and other methods to help children process their traumatic memories. Other treatments Special treatments may be needed for children who show out-of-place sexual behaviors, extreme behavior problems, or problems with drugs or alcohol. What can you do to help? Reading this fact sheet is a first step toward helping your child. Learn about PTSD and pay attention to how your child is doing. Watch for signs such as sleep problems, anger, and avoidance of certain people or places. Also watch for changes in school performance and problems with friends. You may need to get professional help for your child. Find a mental health provider who has treated PTSD in children. Ask how the therapist treats PTSD, and choose someone who makes you and your child feel at ease. You, as a parent, might also get help from talking to a therapist on your own.
  13. Now is the time for teens and parents to think about how to handle disorders without the family nearby Brown University junior Eliza Lanzillo had a relapse of anorexia and anxiety during her freshman year. She advises arriving students with mental health issues to find a therapist near campus even if they think they won’t need one. Photo: Brittany Comunale ByAndrea Petersen April 13, 2015 1:01 p.m. ET When Eliza Lanzillo went off to college, she was excited to leave behind her old school, her old routines—and her old mental health challenges. “I thought of it as a clean slate. Nobody knows my history. I could be a new person,” says the now 21-year-old junior at Brown University. “I didn’t want people to see me as the girl with anorexia.” Ms. Lanzillo started struggling with the eating disorder and anxiety in high school. She had been doing so well the summer before college that she stopped therapy when she arrived for college in Providence, R.I. But a few months into her first semester, she relapsed. With high-school seniors deciding where they’ll be attending college in the fall, now is the time, psychologists and psychiatrists say, for teens and their parents to focus on how to maintain good mental health away from home. This is particularly vital for the growing number of teenagers who have already struggled with mental illness in high school. A Different Kind of College PrepTeens should be able to handle several basic tasks on their own before college. Feeling comfortable with these tasks is particularly important for students with pre-existing mental health issues: Make doctor/dentist appointments.Get enough sleep—without parental prodding.Make travel reservations and get to the airport or train station.Advocate for themselves with teachers and other authority figures.Manage a budget.Manage emotional upheavals.Source: Anne Marie Albano, Columbia University Clinic for Anxiety and Related Disorders About 14.3% of college students were diagnosed with or treated for anxiety problems during the past year, and 12% were diagnosed with or treated for depression, according to a spring 2014 survey of 79,266 college students by the American College Health Association. That is up from 10.4% for anxiety and 10.2% for depression in the fall 2008 survey. Anxiety and depression are the most common disorders, according to the survey. Why mental illness seems to be rising among college students is unclear. Better medications and therapies are likely making it possible for more young adults with even serious mental disorders to attend college. The growing number of outreach programs by colleges is likely bringing more young adults into treatment. Advocacy groups like Active Minds Inc., a nonprofit with chapters on 428 campuses, are trying to reduce the stigma around having a mental illness. But many students arrive unprepared, experts say. “What happens is everyone is under the impression that at the end of high school, magically college will be different,” says Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders in New York. “That once she or he gets away from the same old routine and the same old peers that never connected with him, and the teachers who were mean, it is going to be different. And it isn’t.” Indeed, in a study published in JAMA Psychiatry in 2014 that followed 288 adolescents and young adults with anxiety disorders, nearly half relapsed within six years of treatment. Late adolescence is also when more serious illnesses such as schizophrenia and bipolar disorder often kick in. Living away from home for the first time, making new friends and handling the rigors of college coursework can all make the transition to college difficult—especially when those are added on top of an existing mental illness. Dr. Anne Marie Albano, director of the Columbia University Clinic for Anxiety and Related Disorders, has created a college-readiness program for high school seniors with anxiety disorders and depression. Photo: Brandon Schulman Photography for The Wall Street Journal “Even good change is stressful,” says Micky M. Sharma, a clinical psychologist and the director of the Office of Student Life Counseling and Consultation Service at Ohio State University. He says traffic in the counseling center surges in mid-October, around the time of the first midterm exams. Psychologists and psychiatrists say it is critical for students to become as independent as possible during the months before school starts. Parents are on the hook, too. Now is the time for them to learn to let go. They should move from doing things for teens to taking on the role of adviser or coach, experts say. That includes formulating strategies and weighing solutions to problems with children and—after they make attempts at independence—reviewing how things went. This often means parents must confront their own anxieties about their children failing. Ideally, parents should be practicing letting go all along and not waiting until just before college starts. Concerned adults should try to avoid becoming what Dr. Sharma calls snowplow parents: those who remain too involved at college. “They will just come in and knock me out of the way to make sure their son or daughter gets what they need. Just because you can text your son and daughter 10 times a day doesn’t mean that should be happening.” Dr. Albano at Columbia runs a six-to-eight-week college readiness program for high-school seniors with anxiety disorders and depression. During “exposure” group sessions, teenagers role-play to practice talking to professors and meeting new people—and learn to deal with negative or anxious thoughts that arise. Dr. Albano has Columbia colleagues act the part of skeptical professors. The teens practice asking for help or extensions on assignments. Students are also sent to cafeterias at local universities to practice getting food and approaching groups of peers. A young woman attends a group meeting of Dr. Albano’s Launching Emerging Adults Program at Columbia. Photo: Brian Harkin for The Wall Street Journal Then, in periodic transition sessions, parents and teens meet together. The goal is to help parents ease up on any overprotection. Often, parents of children who have struggled with mental illness have responded by doing more and more things for them. Then the children “start falling behind their peers in developmental tasks,” Dr. Albano says. Dr. Albano has compiled a list of young-adult milestones that include managing money responsibly and establishing emotional independence from parents as part of the overall program dubbed LEAP (for Launching Emerging Adults Program). Parents and teens fill out what she calls scaffolding forms that detail which life tasks the teens can do independently, which they can’t and which are in the gray zone—ones they sometimes do on their own, sometimes not. The families work on moving tasks from the dependent zone to the independent one. Dr. Albano says college-bound students should go to yearly physicals by themselves. They should also take at least one out-of-town trip alone, including making travel reservations and getting to the train or plane by themselves. “If you end up on a train going to Boston instead of Baltimore, all the better,” Dr. Albano says. “They learn it is not a catastrophe to make mistakes.” Students arriving on campus also need to make sure they can handle taking their medication and getting refills on their own. Louis Kraus, chief of child psychiatry at Rush University Medical Center in Chicago, suggests students get a seven-day pill pack and set a daily alarm on their smartphones to help remember medication. Dr. Kraus has frank discussions about drinking with students on stimulants and benzodiazepines, drugs that can be deadly when combined with alcohol. If teens are stable, they may be able to continue working with their home psychologist or psychiatrist via phone or Skype sessions, Dr. Kraus says. But establishing a relationship with a doctor near campus is critical if there’s a risk of a relapse or medication changes. While college counseling centers often offer emergency sessions, waits to initiate regular therapy appointments can be several weeks long. Many centers have caps on the number of sessions students can have. About ¼ of colleges have no access to psychiatrists except as a private referral, according to a 2013 survey by the Association for University and College Counseling Center Directors. Still, these logistical problems are solvable. Ms. Lanzillo, the Brown student, found her equilibrium after finding treatment near campus. The transition also proved tricky for Josh Ratner, a 21-year-old junior at the University of Maryland in College Park. He says not having some basic life skills made his move to college much more stressful. “A lot of parents don’t realize they’re babying their kids. When you have mental health issues, the really simple things become intimidating.” Mr. Ratner, who struggles with ADHD and anxiety but says he is now doing well, recalls a time when his car broke down at school. “I didn’t know what tire I needed, what service station to go to,” he says. “I spent a whole day missing classes on the phone with my Dad.” Write to Andrea Petersen at andrea.petersen@wsj.com Source: http://www.wsj.com/articles/good-mental-health-away-from-home-starts-before-college-1428944477
  14. So as probably everybody hear knows soon I'm goona start my 'CBT therapy'. I'm quite concern and obsess about it. I fear I may loose my job before actually start the therapy. Even despite the antidepressants I have huge setbacks. So my question is to all that have done this. I've read that the wellbeing practitioner is not a therapist and is guided by other professionals. Do you think he will be able to diagnose me properly (if I have another problem with the depression) and is this person going to be able to guide me trough the appropriate therapy? Because from what I understand they threat ONLY depression and anxiety ONLY with CBT! So what happens if this doesn't work for me or I really have another problem? I know everybody say I should wait but yes, I'm waiting and obsessing everyday. I need someone to put my mind at rest. Are they gonna be able to help me? EDIT: Please I really need someone that has been true this or is familiar with the way the system works to tell me, even if the answer is what you think I don't want to hear. I promise I will post feedback for how the things are going with it for other people to know.
  15. Hi guys, I have had depression most of my life, I've identified it, and am dealing with it - most people know now (friends and family) and the meds keep me up. Still going through NHS hoops to get the right help - but that's another story. My partner of 10 yrs is struggling to know what to do. He gives me advice - but It's from his head and how he feels. I think he needs some coping mechanisms himself and learn what not to say, how to encourage and how to deal with things when I'm bad. He's in it for the long run. I want to try and point him in the right direction to get some help on how to deal with me when I'm bad or just generally without making me feel worse. At the moment, only people who have had depression and anxiety seem to understand what I'm going through and I think he needs some help, resources, things he can read. I'm building him an online notebook of links or places he can go to understand as an outsider of my illness - he's not depressed but he says I'm making him depressed! Any advice? Sticky's on this forum? Websites for help? How does your other half cope? I've told him to look at my 'Mind over Mood' book and DF but not sure if that's the best advice for him. Thanks xx
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