Understanding self harm: Why young people self harm and how they can recover.

More and more the world is becoming a difficult place for young people to live in. This is so as youths are confronted with pressure to perform highly on school examinations, deal with complex relationships, experience body changes, bullying and general uncertainties which come with entering adulthood. In some communities there are increases in the number of young person’s engaging in self harm/self injurious behaviors. It is important therefore, that these children be given the opportunity to learn more positive coping mechanisms as they combat feelings of loneliness, low self-esteem and mental health issues.

OCD: Symptoms, Signs & Risk Factors

Written by Ann Pietrangelo

OCD: Symptoms, Signs & Risk Factors

We all double or triple check something on occasion. We forget if we’ve locked the door or wonder if we’ve left the water running, and we want to be certain. Some of us are perfectionists, so we go over our work several times to make sure it’s right. That’s not abnormal behavior. But if you have obsessive-compulsive disorder (OCD), you feel compelled to act out certain rituals repeatedly, even if you don’t want to — and even if it complicates your life unnecessarily.

Obsessions are the worrisome thoughts that cause anxiety. Compulsions are the behaviors you use to relieve that anxiety.

Signs and Symptoms of OCD

Signs of OCD usually become apparent in childhood or early adulthood. It tends to begin slowly and become more intense as you mature. For many people, symptoms come and go, but it’s usually a lifelong problem. In severe cases, it has a profound impact on quality of life. Without treatment, it can become quite disabling.

Some common obsessions associated with OCD include:

  • anxiety about germs and dirt, or fear of contamination
  • need for symmetry and order
  • concern that your thoughts or compulsions will harm others, feeling you can keep other people safe by performing certain rituals
  • worry about discarding things of little or no value
  • disturbing thoughts or images about yourself or others

Some of the behaviors that stem from these obsessive thoughts include:

  • excessive hand washing, repetitive showering, unnecessary household cleaning
  • continually arranging and reordering things to get them just right
  • checking the same things over and over even though you know you’ve already checked them
  • hoarding unnecessary material possessions like old newspapers and used wrapping paper rather than throwing them away
  • counting or repeating a particular word or phrase. Performing a ritual like having to touch something a certain number of times or take a particular number of steps
  • focusing on positive thoughts to combat the bad thoughts

Social Signs: What to Look For

Some people with OCD manage to mask their behaviors so they’re less obvious. For others, social situations trigger compulsions. Some things you might notice in a person with OCD:

  • raw hands from too much hand washing
  • fear of shaking hands or touching things in public
  • avoidance of certain situations that trigger obsessive thoughts
  • intense anxiety when things are not orderly or symmetrical
  • need to check the same things over and over
  • constant need for reassurance
  • inability to break routine
  • counting for no reason or repeating the same word, phrase, or action
  • at least an hour each day is spent on unwanted thoughts or rituals
  • having trouble getting to work on time or keeping to a schedule due to rituals

Since OCD often begins in childhood, teachers may be the first to notice signs in school. A child who is compelled to count, for instance, may not be able to complete the ritual. The stress can cause angry outbursts and other misbehaviors. One who is afraid of germs may be fearful of playing with other children. A child with OCD may fear they are crazy. Obsessions and compulsions can interfere with schoolwork and lead to poor academic performance.

Children with OCD may have trouble expressing themselves. They may be inflexible and upset when plans change. Their discomfort in social situations can make it difficult to make friends and maintain friendships. In an attempt to mask their compulsions, children with OCD may withdraw socially. Isolation increases the risk for depression.

Risk Factors and Complications

The cause of OCD is not known. It seems to run in families, but there may be environmental factors involved. Most of the time, symptoms of OCD occur before age 25.

If you have OCD, you’re also at increased risk of other anxiety disorders, including major depression and social phobias.

Just because you like things a certain way or arrange your spice rack in alphabetical order, it doesn’t mean you have OCD. However, if obsessive thoughts or ritualistic behavior feels out of your control or are interfering with your life, it’s time to seek treatment.

Treatment usually involves psychotherapy, behavioral modification therapy, or psychiatric medications, alone or in combination. According to Harvard Medical School, with treatment, approximately 10 percent of patients fully recover and about half of patients show some improvement.

Original post: http://www.healthline.com/health/ocd/social-signs

Anxiety and Depression Together

By Hara Estroff Marano
The disorders are two sides of the same coin. Over the past couple of years, clinicians and researchers alike have been moving toward a new conclusion: Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.

Are you anxious or are you depressed? In the world of mental health care, where exact diagnosis dictates treatment, anxiety and depression are regarded as two distinct disorders. But in the world of real people, many suffer from both conditions. In fact, most mood disorders present as a combination of anxiety and depression. Surveys show that 60-70% of those with depression also have anxiety. And half of those with chronic anxiety also have clinically significant symptoms of depression.

The coexistence of anxiety and depression-called comorbidity in the psych biz-carries some serious repercussions. It makes the course of disorder more chronic, it impairs functioning at work and in relationships more, and it substantially raises suicide risk.

Over the past couple of years, clinicians and researchers alike have been moving towards a new conclusion: Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.

“They’re probably two sides of the same coin,” says David Barlow, Ph.D., director of the Center for Anxiety and Related Disorders at Boston University. “The genetics seem to be the same. The neurobiology seems to overlap. The psychological and biological nature of the vulnerability are the same. It just seems that some people with the vulnerability react with anxiety to life stressors. And some people, in addition, go beyond that to become depressed.”

They close down. “Depression seems to be a shutdown,” explains Barlow. “Anxiety is a kind of looking to the future, seeing dangerous things that might happen in the next hour, day or weeks. Depression is all that with the addition of ‘I really don’t think I’m going to be able to cope with this, maybe I’ll just give up.’ It’s shutdown marked by mental, cognitive or behavioral slowing.”

At the core of the double disorder is some shared mechanism gone awry. Research points to overreactivity of the stress response system, which sends into overdrive emotional centers of the brain, including the “fear center” in the amygdala. Negative stimuli make a disproportionate impact and hijack response systems.

Mental health professionals often have difficulty distinguishing anxiety from depression, and to some degree they’re off the hook. The treatments that work best for depression also combat anxiety. Cognitive-behavioral therapy (CBT) gets at response patterns central to both conditions. And the drugs most commonly used against depression, the SSRIs, or selective serotonin reuptake inhibitors, have also been proved effective against an array of anxiety disorders, from social phobia to panic and post-traumatic stress disorder (PTSD). Which drug a patient should get is based more on what he or she can tolerate rather than on symptoms.

And therein lies a problem. According to physicians Edward Shorter of Canada and Peter Tyrer of England, the prevailing view of anxiety and depression as two distinct disorders, with multiple flavors of anxiety, is a “wrong classification” that has led the pharmaceutical industry down a “blind alley.” It’s bad enough that the separation of anxiety and depression lacks clinical relevance. But it’s also “one reason for the big slowdown in drug discovery in psychiatric drugs,” the two contend in a recent article published in the British Medical Journal. It’s difficult to create effective drugs for marketing-driven disease “niches.”

Who is at risk for combined anxiety and depression? There’s definitely a family component. “Looking at [what disorders populate] the family history of a person who presents with either primary anxiety or depression provides a clue to whether he or she will end up with both,” says Joseph Himle, Ph.D., associate director of the anxiety disorders unit at University of Michigan.

The nature of the anxiety disorder also has an influence. Obsessive-compulsive disorder, panic disorder and social phobia are particularly associated with depression. Specific phobias are less so.

Age plays a role, too. A person who develops an anxiety disorder for the first time after age 40 is likely also to have depression, observes Himle. “Someone who develops panic attacks for the first time at age 50 often has a history of depression or is experiencing depression at the same time.”

Usually, anxiety precedes depression, typically by several years. Currently, the average age of onset of any anxiety disorder is late childhood/early adolescence. Psychologist Michael Yapko, Ph.D., contends that presents a huge opportunity for the prevention of depression, as the average age of first onset is now mid-20s. “A young person is not likely to outgrow anxiety unless treated and taught cognitive skills,” he says. “But aggressive treatment of the anxiety when it appears can prevent the subsequent development of depression.”

“The shared cornerstone of anxiety and depression is the perceptual process of overestimating the risk in a situation and underestimating personal resources for coping.” Those vulnerable see lots of risk in everyday things-applying for a job, asking for a favor, asking for a date.

Further, anxiety and depression share an avoidant coping style. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable. Often enough a lack of social skills is at the root.

In fact, says Jerilyn Ross, LICSW, president of the Anxiety Disorders Association of America, the link between social phobia and depression is “dramatic. It often affects young people who can’t go out, can’t date, don’t have friends. They’re very isolated, all alone, and feel cut off.”

Sometimes anxiety is dispositional, and sometimes it’s transmitted to children by parental overconcern. “The largest group of depression/anxiety sufferers is Baby Boomers,” says Yapko. “The fastest growing group is their children. They can’t teach kids what they don’t know. Plus their desire to raise perfect children puts tremendous pressures on the kids. They’re creating a bumper crop of anxious/depressed children.”

Treatment seldom hinges on which disorder came first. “In many cases,” says Ross, “the depression exists because the anxiety is so draining. Once you treat the anxiety, the depression lifts.”

In practice, treatment is targeted at depression and anxiety simultaneously. “There’s increasing interest in treating both disorders at the same time,” reports Himle. “Cognitive behavioral therapy is particularly attractive because it has applications to both.”

Studies show that it is effective against both. But sometimes the depression is so incapacitating that it has to be tackled first. Depression, for example, typically interferes with exposure therapy for anxiety, in which people confront in a graduated way situations they avoid because they give rise to overwhelming fear.

“Exposure therapy requires substantial effort,” explains Himle. “That’s effort that depressed people often do not have available to them.” Antidepressants can make a difference. Most SSRIs are approved for use in anxiety disorders and are the first line of drug therapy. But which drug works best for whom can not be predicted in advance. It takes some trial and error.

Ross finds CBT 80-90% successful in getting people functioning well, “provided it’s done correctly.” Not all psychotherapy is CBT, which has a very specific set of procedures, nor is every mental health professional trained in CBT. “Patients have to make sure that is what they are really getting.”

Medication and CBT are equally effective in reducing anxiety/depression. But CBT is better at preventing relapse, and it creates greater patient satisfaction. “It’s more empowering,” says Yapko. “Patients like feeling responsible for their own success.” Further, new data suggests that the active coping CBT encourages creates new brain circuits that circumvent the dysfunctional response pathways.

Treatment averages 12 to 15 weeks, and patients can expect to see significant improvement by six weeks. “CBT doesn’t involve years and years of talk therapy,” says Ross. “There’s homework, practice and development of lifestyle changes. Once patients learn how to identify the trigger thoughts or feelings, or events or people, they need to keep doing that. CBT gives people the tools they need.”

Original post:

https://www.psychologytoday.com/articles/200310/anxiety-and-depression-together

OCD Explained

By:

https://upload.wikimedia.org/wikipedia/commons/thumb/1/1b/OCD_handwash.jpg/737px-OCD_handwash.jpg

Obsessive-compulsive disorder (OCD) is characterized by repetitive thoughts, impulses, or images that are intrusive and inappropriate and cause anxiety or distress, or repetitive behaviors that the person feels driven to perform in response to an obsession or rigid rules that must be applied. Those suffering from this condition recognize that the obsessions are a product of their own mind. The obsessions or compulsions are time consuming or interfere with role functioning.

Click here for the original article: http://scitechconnect.elsevier.com/ocd-explained/

5 Mistakes People Make When Managing Their Depression

 

5 Mistakes People Make When Managing Their DepressionWhen you’re treating any illness, making mistakes is inevitable. After all, making mistakes is how you learn, grow and get better.

Depression is a difficult illness, which colors how you see and feel about yourself. So, if you find yourself making the “mistakes” below, try not to judge yourself. Rather, view these mistakes as stepping stones, as signposts that lead you in a more helpful direction.

Below are five beliefs or behaviors that are ineffective in managing depression, along with insights into what works.

  1. Telling yourself to snap out of it. “When you’re depressed, it’s common to think that there’s no good reason that you’re having trouble getting out of bed, struggling to concentrate, or feeling so low,” said Lee Coleman, Ph.D, a clinical psychologist and author of Depression: A Guide for the Newly Diagnosed.So you might try to motivate yourself by being self-critical or using shame, he said. After all, when you’re depressed, it can feel like you’re swimming in negative, shame-soaked thoughts.While your intentions may be good — you’re trying to motivate yourself to do your best — “the language of criticism, guilt and shame isn’t helpful and usually makes us feel even worse.”

    If these thoughts arise, Coleman stressed the importance of responding to them and reminding yourself of these key facts. “[D]epression is an illness like any other — one that affects not just your mood, but also your sleep, energy, motivation, and even the way you look at yourself.”

    Remind yourself that “nobody ever yelled themselves out of feeling depressed.” Instead, take small steps and stay active, he said. Getting better from any illness takes time.

  2. Not revealing what’s going on. When you have depression it’s also common to feel embarrassed or ashamed. Depression “can feel like a fundamental flaw with who you are,” said Coleman, assistant director and director of training at the California Institute of Technology’s student counseling center.Consequently, you may cover up how you’re feeling, which might lead others to get frustrated with you or simply become confused about what’s going on, he said.“Remember that others, even the ones who love you the most, aren’t psychic and may still be operating on old information.”

    When talking about how you’re feeling, you don’t need to divulge the details or even use the word “depression,” he said. What’s more important is letting them know “what you need while you’re working on feeling better” (some people may automatically ask how they can help). For instance, you might need more time to complete a project, he said.

  3. Underestimating depression. “While many appear to realize that depression has a medical origin, some underestimate exactly how depression impacts their life,” said Deborah Serani, Psy.D, a clinical psychologist and author of the booksLiving with Depression and Depression and Your Child. Some of Serani’s clients don’t realize that depression affects their “personal, social and occupational worlds.” But depression affects all facets of a person’s life.She shared this example: Personally, you might struggle with significant sadness, self-doubt, fatigue, difficulty concentrating and hopelessness. These symptoms might cause you to withdraw from your relationships or become irritable and impatient with others.

    At work or school, fatigue, self-doubt and an inability to concentrate might lead to incomplete assignments, poor performance and difficulty remembering important information.

    When you understand your depression and how it affects your entire life, you’re able to address those symptoms and support yourself with effective techniques.

    As Serani said, “Having knowledge about an illness that touches your life empowers you.”

  4. Getting lax with treatment. When clients start to feel better, they may become “too casual with their treatment plan,” Serani said. This may start with missing medication doses or skipping therapy sessions, she said.Serani often hears clients say: “Why do I have to keep coming for therapy if I feel better? What’s the big deal if I miss a dose of my antidepressant?”However, it is a big deal. Research has shown that if you stick to your treatment plan and view your illness as a priority, you can become symptom-free, Serani said. But if you don’t, it might take you longer to get better, or your symptoms may worsen.

    To convey the seriousness of depression, Serani sometimes substitutes the word “depression” with other illnesses, such as diabetes, heart disease and cancer.

    “Though these are very different illnesses, they all have one thing in common: The need for the patient to respect the seriousness of the illness.”

    She further noted: “If you had cancer, would you skip chemotherapy? If you had heart disease, would you cancel your appointment with your cardiologist? As a diabetic, would you ignore your blood sugar levels?”

    Make a commitment to your depression treatment for at least a year, which research suggests, Serani said. “For those with moderate or severe depression, treatment will be longer.”

  5. Not being self-compassionate. Being compassionate to ourselves is important every day, and it’s especially vital when we’re sick or struggling. However, as Coleman said, “Unfortunately, because depression casts a negative light on our thoughts, it’s easy to see compassion as just feeling sorry for yourself, or as giving permission to lie around all day.”On the contrary, genuine self-compassion involves being honest with yourself and responding to your needs. It means acknowledging that you’re currently struggling, accepting that you’ll need time to feel like yourself, and realizing that it’s absolutely OK to lower your expectations of yourself, he said.“It’s not a judgment about yourself as a person, and it’s not giving yourself a blank check to feel bad forever.”

    If you find it hard to be self-compassionate, think of what you’d say to a loved one who was feeling the same way, Coleman said.

    “Your tone would probably be caring and supportive, not blaming or attacking. That same tone may not come as naturally when you talk to yourself during depression, but it’s absolutely worth remembering and trying to draw from, even if it takes a little effort.”

Again, depression is a serious and difficult illness. But remember that you’re not alone, Serani said. “Depression can often leave a person feeling hopeless and isolated, but there are many out there who know your struggle and can support you along the way.”

She suggested connecting with a “health professional, a mood disorder organization, support group or a compassionate friend who understands you.”

Original post:http://psychcentral.com/blog/archives/2014/06/11/5-mistakes-people-make-when-managing-their-depression/

 

Follow the poodle? Alternatives to prescription sleep medications

Stuart Quan, MD

Posted February 10, 2016, 9:00 am

Stuart Quan, MD, Contributing Editor

A contemporary author once wrote, “The night is the hardest time to be alive and 4 a.m. knows all my secrets.” If you haven’t been sleeping well for a while, this quote might feel like your new reality. You might even find yourself tempted by the happy poodles and free-floating butterflies on TV imploring you to ask your doctor about their new drugs for insomnia. But, before answering their siren call, you pause. You notice the side effects are rattled off rapidly and are difficult to understand. You are worried about being “hooked” on them forever. You ask yourself, is there another way to get better sleep? The answer is an emphatic “Yes!”

CBT: A clear winner for insomnia

Sleep specialists now agree that behavioral (non-drug) techniques should be the first approach to treatment of most cases of chronic insomnia. The best studied of these is cognitive behavioral therapy, or CBT. The goal of CBT is to address harmful behaviors and misbeliefs that are causing and perpetuating insomnia. Components of CBT include restricting time in bed, disrupting the negative association between failure to sleep and the bedroom environment, and correcting any negative or inaccurate beliefs about sleep.

In large-scale studies, CBT has been shown to be equally effective as drug treatment for insomnia. Importantly, improvement in sleep is longer-lasting after CBT than with drug treatment or the combination of drug treatment and CBT. Until recently, the use of CBT, which normally requires several in-person sessions, has been limited because of the lack of qualified therapists. However, studies now have shown that brief interventions (using only 1-2 sessions) as well as therapy administered via online programs can be as effective as conventional CBT.

Relaxation therapy also can be effective for insomnia treatment. However, although improving sleep hygiene (e.g., limiting caffeine, alcohol, tobacco, and exercise close to bedtime) is effective when incorporated into CBT, it’s not effective when used alone, without being part of a larger treatment plan.

What about other complementary therapies?

Non-conventional or complementary and alternative medicine (CAM) approaches are used by approximately 45% of Americans with insomnia. Such remedies include herbal or natural products (e.g., valerian, melatonin), yoga, and acupuncture. But are CAM therapies effective and worth your time and money?

Unfortunately, there have been relatively few studies of CAM therapies for insomnia, and most of them have not been done well. However, acupressure, tai chi, yoga, and other mind-body activities can be effective, but the status of acupuncture and L-tryptophan is unclear. There is no or little evidence that herbal compounds (valerian, chamomile, kava, wuling), aromatherapy, and homeopathy are useful. As for melatonin, it is useful for the treatment of circadian or body rhythm disorders; its role as a therapy for insomnia has not been clearly established.

The bottom line for getting more shut-eye — without any butterflies

Chronic insomnia affects approximately 10% of Americans and results in poorer quality of life. Behavioral or non-drug approaches are effective and should be the initial treatment. A few CAM remedies have been shown to be useful, but most are not. Moreover, you should be aware that most claims about the effectiveness of CAM treatments for insomnia are not supported by good evidence.

Original post: http://www.health.harvard.edu/blog/follow-the-poodle-alternatives-to-prescription-sleep-medications-201602109162

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