Category Archives: Science

A Pill for Phobias?

Antibacterial eases phobia: TB drug plus virtual reality relieves fear of heights.

A common antibacterial drug has helped phobics to overcome their fear of heights. Combined with standard behavioural therapy, D-cycloserine (DCS) speeded recovery fourfold compared with therapy alone.

Apparently it works by aiding in the transmission of a protein to a brain receptor. Studies in rats show that this helps them to unlearn fear more quickly. Seems, according to this preliminary study, that it might work the same way in humans.

Holiday Shopping Tips

There is an article on Yahoo news that I found pretty interesting, in terms of practical advice for holiday shopping. The expert consulted said:

“Our bodies have the capacity to do a little more than we normally do,” says Dr. Scott Bautch, past president of the ACA’s Council on Occupational Health. “But our bodies do not adapt very well to doing a lot more than we normally do. Since the added demands of this season can stress the capacity of our bodies, we need to do everything we can to help ourselves. Eat right, drink plenty of water, stretch, exercise and take a few minutes to slow down and reflect on what the season is all about.”

The rest of the article provides suggestions for “treating holiday shopping as an athletic event,” scheduling breaks, whether to shop with children, and wrapping presents. To wit:
Continue reading →

Geno-What?!

When I’m beginning to work with clients, as individuals and especially as couples, I often encourage them to create a genogram. The genogram is useful in identifying the medical history of one’s family. In the context of counseling, a genogram provides a means to create a family map. It helps us to identify patterns of interaction, gender rules, secrets kept, themes (the family’s idea of who they are), losses experienced, possible mental illness, substance abuse, and what is generally functional or dysfunctional in the family. Of course, you may not have all the information at hand, and this is instructive about the family culture as well.

A genogram ideally contains three generations. It’s simple to create, or computer programs can be purchased.

People are shaped by their families as well as society as they grow into adulthood. Therefore, it is beneficial to look to one’s childhood and the entire family tree to gain insight into how one came to believe in certain things, some of which may not be helpful in the pursuit of life goals. For instance, a family culture might be that girls grow up to get married and that money is wasted if they attend college. A woman may come to therapy depressed about her life, because she is unhappy with the assigned role; the family theme shaped her understanding of what is possible for her. Recognizing that this is just one way of looking at what’s possible for women opens her mind to explore other perspectives.

If you prefer to learn from books, Genograms: Assessment and Intervention comes highly recommended. For the non-student just beginning to explore family themes, Genograms by Emily Marlin is a compact, highly readable book.

Ego Pain is Real

According to findings reported by the Associated Press, emotional pain such as a broken heart actually has a physical basis. Experiments designed to generate social distress indicated that the anterior cingulate cortex, a part of the brain which responds to physical pain, was activated. It is suggested that our need for social connection is deeply rooted, because it was a mechanism to ensure survival long ago. This may also be why if infants and children don’t experience sufficient loving attachment with their caregivers, they don’t develop the needed social skills for healthy relationships, leading to dysfunctional thinking and behavior.

The Rise of Obesity

From a New York Times article, Fight Against Fat Moves to the Workplace:

Programs that nudge people to move more or eat better are responding to a growing public health crisis: the federal Department of Health and Human Services puts the cost of overweight and obese Americans at $117 billion in 2000, and said that being overweight results in 300,000 deaths a year.

“There are times when we as a nation feel that personal responsibility is not getting the job done, and so we have to take action,” said Kelly D. Brownell, director of the Yale University Center for Eating and Weight Disorders. “We could count on parents to get their children immunized, but they don’t, therefore we require it. We could count on people being responsible and not smoking cigarettes, but we have a huge health crisis brought on by people smoking cigarettes.”

It’s time our work culture provided incentive to be more active, although I would not want to see it being made a condition of employment, nor a law permitting this. Is there no other way to get Americans moving than to force them?

Texas Isn’t Alone

Idaho, another state of vast rural expanses, also has difficulty providing mental health services. In some cases, such as Grangeville, the nearest mental health provider is 71 miles away.

In rural areas, mental health patients simply cannot access services –community doctors do their best to patch up their physical problems and send them back home, knowing they’ll be back.

And even in Boise, a patient can’t get an outpatient follow-up visit with one of the 28 psychiatrists in town for two to three months after an emergency situation.

Throughout the state, police officers and sheriff’s deputies have become the gatekeepers for mental health services — and they aren´t trained to know what to do.

“We have to deal with the fact that by default our legal system has become our health system,” Saint Alphonsus Regional Medical Center ER director Dr. Mike Mercy said.

Too many mental health issues are first diagnosed in the emergency room, he said, and by the time patients get to the ER, they need extensive therapy, but they’re now in one of the most expensive places to get it.

Some tout the internet as a resource — online counseling. Unfortunately, online therapy services are not the answer. For one, financial obstacles prevent some people from affording a computer. Also, not all rural areas have reliable access to Internet connection. Most importantly, serious mental issues need to be handled in person; isolation is an exacerbating factor. The best answer is for the community to provide support via publicly funded government programs. Having worked at a for-profit mental health company, I have observed that the focus on profit often takes precedence over services. Mental health is best served by non-profit entities. At the moment, most services are provided thusly — except the government has decided mental health is expendable and has slashed funding for services.

It’s a quagmire.

The Idaho Statesman

Women, Health, & Marital Satisfaction

A recently published 13-year longitudinal study assessing the effect of marriage on women shows that a good marriage supports women’s health.

How might being in a good marriage influence health? Previous research indicates several direct and indirect factors may be a work, according to the authors. Marriage itself may offer a health advantage by providing social support and protecting against the risks associated with social isolation. Also, spousal influence and involvement may encourage health-promoting behaviors and deter unhealthy behaviors. Married people, especially women, may also be at a health advantage relative to their unmarried counterparts through the increased availability of socioeconomic resources.

However, research shows poor marital quality may erase these health advantages, say the authors. Marital stress is associated with lifestyle risk factors and nonadherence to medical regimens. Poor marital quality is also linked with more depression, hostility and anger, all risk factors for coronary heart disease. Thus, marital status and quality could influence metabolic risk factors and acute stress responses, which in turn predict cardio-vascular morbidity and mortality, according to the study.

APA Press Releases

On the Other Hand

More positive news regarding antidepressants are described in Nursing Kids on Prozac via U.S. News:

Babies with depressed moms tend to weigh less after six months than babies with happy moms; less weight often means more illness. But the same study that uncovered this disturbing fact has also turned up hope: Breast-fed babies grow better if depressed moms take drugs that alleviate depression. This challenges a popular belief that the traces of Prozac, Paxil, and similar drugs that seep into breast milk can harm a nursing infant.

“Time and again, doctors are telling nursing women that if they’re depressed, they can’t take medicine,” says Victoria Hendrick, a psychiatrist at the University of California-Los Angeles and an author of the study. That may be true during pregnancy. Other research found that pregnant women who took Paxil during their third trimester were more likely to have infants with medical complications than were mothers who took other kinds of drugs. Yet few studies have looked at how Paxil-like antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), affect life after the womb.

So Hendrick followed a group of nursing babies and their mothers for six months. Infants with depressed moms who improved on SSRIs grew just as well as did infants with mentally healthy moms. Both groups grew bigger than babies whose moms remained depressed, even if they took medicine. “We were struck by the results,” Hendrick says. “It didn’t seem like exposure to antidepressants had any bad effect on the baby’s weight.” Hendrick’s study, published earlier this year in the Journal of Clinical Psychiatry, also found that babies whose mothers had major depressive episodes that lasted at least two months weighed less than babies whose moms were depressed only mildly or for shorter periods.

The Future of Antidpressants

A psychiatrist, Giovanni Fava, performed a meta-analysis of clinical literature and neurobiological findings over several decades, concluding that the long-term outlook for depression treated with antidepressants is less than favorable. Medication effects seem to decrease over time; his finding suggests that depression may be a more progressive disease than previously thought, and also that patients develop tolerance to drugs, so that their effects fade. He also explores the impact of changing one part of the chemical interaction in the brain, and how it can effect architectural and chemical changes in other parts. For example, if a drug prevents the reception of serotonin, the brain may compensate by creating more receptors, which continues the imbalance. There is also the suggestion that impaired neurogenesis — the production of brain cells — is a factor in the cause of depression. Medications that reduce serotonin may be inhibiting neurogenesis, since serotonin affects the process.

Journal of Clinical Psychiatry (v. 64, no. 123: 123–33). Mindfulness: Journal of Personality and Social Psychology (v. 84, no. 4: 822–48).

(Article summarized from an item featured in Psychotherapy Networker)

Defining Mental Illness

Another well-put concept, written by David Markham himself.

As therapists know, psychiatry is not an exact science. In fact, it is mostly descriptive. The DSM IV, (Diagnostic and Statistical Manual, 4th edition) published by the American Psychiatric Association, describes various “mental illnesses” which are defined as a certain set of symptoms. Making a psychiatric diagnosis is kind of like astronomy, one gazes at the various symptoms as if at stars, and as various constellations emerge in some pattern, we give it a name.

He continues by describing the trend of state legislatures attempting to define mental illness, and links to an article in the Psychiatric Services Journal that provides in-depth consideration.

October 5-11: Mental Health Awareness Week

In addition to being domestic violence awareness month, October is also mental health awareness month — October 5-11, to be specific. Some interesting resources pertaining to Texas mental health issues can be found at The Mental Health Association in Texas. Here is some information from a link on their website:

Untreated mental health problems put young people on a trajectory toward jail rather than college. Approximately HALF of youth in the Juvenile Justice System have at least one mental disorder.

–(Juvenile Probation Commission, 2003; and Criminal Justice Policy Council, 2003)

Access to Mental Health Care is already extremely limited. While 9 counties on Texas served more than 90 percent of children in the county who are ‘At Risk’ and eligible for MHMR services in 2002, 33 counties in Texas served fewer than 10 percent of children needing mental health services in the county.

Lack of access to services and proper medications can lead to tragic consequences including hospitalization, incarceration, and suicide.

  • There are 1 ½ times more suicides than homicides with an average of 6 deaths each day by suicide in Texas.
  • Of the suicides carried out, 90% are related to untreated or under-treated mental illness with the most common factor associated with suicide being depression.
  • Nearly 20% of the people diagnosed with bipolar disorder and 15% diagnosed with schizophrenia die by suicide.
  • 121 more people committed suicide in 2001 than in 2000 — a 6% increase in just one year.
  • 33 children below the age of 14 committed suicide in Texas in 2000. Suicide is increasing among children 10-14 yrs.
  • 167 people over age 75 in Texas committed suicide in 2000.
  • 2,093 people committed suicide in Texas in 2000.
  • The highest rates for suicide in Texas are among the 45-54 age group (15.2 per 100,000) and the 75 and over age group (18 per 100,000 people).

How ironic and disturbing that in times of economic stress, money for mental health is slashed from budgets when, in fact, more people need services. The CDC maintains a list of mental health agencies in the U.S. Contact your local agencies to learn about services in your area.

Ritalin and Depression

Recently I heard of a person being prescribed and antidepressant and Ritalin for depression. The problem is, Ritalin is a stimulant, and depression that manifests in irritation or rageful outbursts is exacerbated by it. A quick search on Ritalin and depression led me to the article, Attention Deficit Disorder and Medication: The Basics, which states:

Sometimes medication failure is due to lack of communication between patient and doctor (and sometimes school). The doctor, patient and family should be clear about exactly which symptoms they expect the medication to treat. Patients should ask questions. They should inform the doctor if there are side effects or if the medication does not seem to be working.

If medication is still not working as expected, it may be time to re-evaluate the diagnosis. Individuals with ADHD may also have other disorders at the same time. Anxiety and depression may superficially resemble ADHD. Occasionally a medical illness may masquerade as a psychiatric condition.

Medication can only take the individual part of the way to recovery. Therapy, community support, coaching and the individuals own determination are important parts of treatment.

Further searching brought me to the transcript of a t.v. interview caled Senior Depression: Healthy For Life from the Eyewitness News Newsroom. The doctor, Helen Lavretsky, M.D., (a geriatric psychiatrist at UCLA), stated:

Normally, an individual who is with geriatric depression, late life depression, responds or shows some signs of improvement in depression after weeks to months of active treatment.

In order to provide faster effect, she prescribes low doses of ritaling to “kick start the effects of anti-depressants in her patients.” She “treated 21 elderly patients with ritalin, along with their traditional anti-depressants. Many felt better in as little as 72 hours.”

However, she noted that the energizing effect of ritalin is brief. By prescribing this with antidepressants, the goal is that the efficacy of the antidepressants will have taken root when the ritalin effect wanes.

In any medical situation, it is in your best interest to be curious, ask questions, and do your research. Learn what your medicine is for and the various effects it has (including side-effects). Check with your doctor to learn what foods and medicines (over the counter or prescription) are contraindicated — that is, could cause a toxic reaction if the medicine is combined with that other substance.

Hair Today, Gone Tomorrow

I’ve been trying to keep weekends free of writing in this blog, as an attempt to shape my time and create boundaries around my work life.

However, since it’s my blog, I get to break my own rules.

There is a blog I read called What’s Brewing, written by a very intelligent and creative woman who has recently begun to do battle with breast cancer. She is now enduring chemotherapy, and this has raised issue of losing hair. In the post I’m linking to, she explains her position on why she doesn’t want to get a wig, and then tactfully points out that anyone trying to dissuade her “for her sake” might really need to take a look within. It’s such a well-written piece that I couldn’t not link to it! My hope is that anyone who is coping with cancer — either as the patient or a supporter of the patient — will find some strength in the energy that Jennifer exudes.

Ten Steps to Positive Body Image

This is a reprint for educational purposes.

Ten Steps To Positive Body Image
Compiled by Margo Maine, Ph. D.

One list can not automatically tell you how to turn negative body thoughts into positive body image, but it can help you think about new ways of looking more healthfully and happily at yourself and your body. The more you do that, the more likely you are to feel good about who you are and the body you naturally have.

  1. Appreciate all that your body can do. Every day your body carries you closer to your dreams. Celebrate all of the amazing things your body does for you — running, dancing, breathing, laughing, dreaming, etc.
  2. Keep a top-10 list of things you like about yourself — things that aren’t related to how much you weigh or what you look like. Read your list often. Add to it as you become aware of more things to like about you.
  3. Remind yourself that “true beauty” is not simply skin-deep. When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance, and openness that makes you beautiful regardless of whether you physically look like a supermodel. Beauty is a state of mind, not a state of your body.
  4. Look at yourself as a whole person. When you see yourself in a mirror or in your mind, choose not to focus on specific body parts. See yourself as you want others to see you — as a whole person.
  5. Surround yourself with positive people. It is easier to feel good about yourself and your body when you are around others who are supportive and who recognize the importance of liking yourself just as you naturally are.
  6. Shut down those voices in your head that tell you your body is not “right” or that you are a “bad” person. You can overpower those negative thoughts with positive ones. The next time you start to tear yourself down, build yourself back up with a few quick affirmations that work for you.
  7. Wear clothes that are comfortable and that make you feel good about your body. Work with your body, not against it.
  8. Become a critical viewer of social and media messages. Pay attention to images, slogans, or attitudes that make you feel bad about yourself or your body. Protest these messages: write a letter to the advertiser or talk back to the image or message.
  9. Do something nice for yourself — something that lets your body know you appreciate it. Take a bubble bath, make time for a nap, find a peaceful place outside to relax.
  10. Use the time and energy that you might have spent worrying about food, calories, and your weight to do something to help others. Sometimes reaching out to other people can help you feel better about yourself and can make a positive change in our world.

From the National Eating Disorders Association

A New Resource for Teens

SchoolBlues.com was recently launched by founder Bill Keefe to provide mental health information tailored to high school students. This arose from the overwhelming success of CampusBlues.com, which provides mental/physical health education and outreach to college students at more than more than 300 colleges and universities in the U.S. and Canada.

SchoolBlues is a free program. In November, students from registered high schools can go to the website, select their schools, and click on a link to find the name of a local counselor. They will be able to find community-based resources as well. The website currently offers articles on issues such as depression, gambling, stress, addiction, anxiety, anger, violence, eating disorders, acne, and listening skills. It also provides information and guidance for parents who want better understanding of and communication with their teenager.