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By Traci PedersenAssociate News Editor
A certain marijuana compound known as cannabidiol (CBD) can treat schizophrenia as well as antipsychotic drugs, with far fewer side effects, according to a preliminary clinical trial.

The research team, led by Markus Leweke of the University of Cologne in Germany, studied 39 people with schizophrenia who were hospitalized for a psychotic episode. Nineteen patients were treated with amisulpride, an antipsychotic medication that is not approved in the U.S., but is similar to other approved drugs. The remaining 20 patients were given CBD, a substance found in marijuana that is considered responsible for the mellowing or anxiety-reducing effects. Unlike the main ingredient in marijuana, THC, which can trigger psychotic episodes and worsen schizophrenia, CBD has antipsychotic effects, according to prior research in both animals and humans.

Neither the patients nor the scientists knew who was receiving which drug. At the end of the four-week trial, both groups made significant clinical improvements in their schizophrenic symptoms, and there was no difference between those getting CBD or amisulpride. “The results were amazing,” said Daniel Piomelli, Ph.D., professor of pharmacology at the University of California-Irvine and a co-author of the study. “Not only was [CBD] as effective as standard antipsychotics, but it was also essentially free of the typical side effects seen with antipsychotic drugs.”

Antipsychotic drugs may cause devastating and sometimes permanent movement disorders; they can also lower a patient’s motivation and pleasure. The new generation of these drugs can also lead to weight gain and increase the risk for diabetes. These side effects are well known as a major hindrance during treatment. In the German study, weight gain and movement problems were observed in patients taking amisulpride, but not CBD.

“These exciting findings should stimulate a great deal of research,” said Dr. John Krystal, chair of psychiatry at Yale University School of Medicine, who was not associated with the research. He notes that CBD not only had fewer side effects, but also seemed to work better on schizophrenia’s so-called “negative symptoms,” which are notoriously hard to treat. Negative symptoms of schizophrenia include social withdrawal, a lowered sense of pleasure and a lack of motivation. However, since current antipsychotic medications can actually cause these negative symptoms, it wasn’t clear whether CBD was better than amisulpride at getting rid of these symptoms, or whether CBD simply caused fewer side effects to begin with.

If replicated, the results suggest that CBD may be at least as effective as current medications for the treatment of schizophrenia, without the severe side effects that make patients reluctant to take medication.
“The real problem with CBD is that it’s hard to develop for a variety of silly reasons,” said Piomelli. Since it comes from marijuana, there are obvious political issues surrounding its use. Extracting it from the plant is also expensive.

But the biggest obstacle may be that CBD is a natural compound, and therefore can’t be patented the way new drugs are. So although CBD could outsell the current blockbuster antipsychotic drugs, pharmaceutical companies aren’t likely to develop it. Researchers are working to develop synthetic versions of CBD that would avoid such hurdles. “We have one and are hoping to move forward in the near future,” Piomelli said.
The study is published online in the journal Translational Psychiatry.

Ask Dr. Sam Goldstein Medically reviewed by Ed Zimney, MD
Q: My 14-year-old son has been on Concerta (methylphenidate) for three years. Lately, he has lost weight and been depressed. His grades are also falling. The doctor was concerned about the weight loss and switched him to Strattera (atomoxetine). He said it should help with my son’s depression and appetite. What else can I try for my son? He just seems sad all the time.

A: The first thing you can do for your son is educate yourself. Depression is a whole-body illness; it involves changes not only in mood but also in almost every area of a child or teen’s life. Depression impairs sleep, appetite, energy and general health, and can lead to stomachaches and headaches. It interferes with the ability to concentrate more than ADHD does, and hinders quick thinking.

In depressed children, school performance often declines, and moodiness and emotional outbursts put a strain on family relationships. Friendships tend to suffer as a child with depression becomes increasingly withdrawn, isolated, aggressive or argumentative. If your son fits this description, he may be having a major depressive episode. You should ask your son’s physician to refer you to a psychiatrist who has expertise in the area of children’s psychiatric problems and response to medications.

If your son has been taking Concerta, a slow-release form of methylphenidate, successfully for the past three years and now has sudden weight loss and depressive symptoms, this might be the result of a different psychiatric or medical problem rather than a side effect of his ADHD medicine. Strattera can work as an anti-depressant, but it is marketed as a medication specifically to treat ADHD.

I assume your physician has considered the possibility that the weight loss and mood changes are related to some specific medical condition (for example, mononucleosis).

Jun 7

Damaging Myths About Postpartum Depression


By Margarita Tartakovsky, M.S.

Postpartum depression (PPD) is one of the most common complications of childbirth, according to Samantha Meltzer-Brody, MD, MPH, director of the Perinatal Psychiatry Program at the UNC Center for Women’s Mood Disorders. PPD affects about 10 to 15 percent of moms.

5 Damaging Myths About Postpartum Depression Yet, it’s exceedingly misunderstood — even by medical and mental health professionals.

“You should hear the things I hear from moms across the country — awful things that are said to them by partners, family members, co-workers, nurses and doctors,” said Katherine Stone, an advocate for women with PPD, founder and editor of the award-winning blog Postpartum Progress and a survivor of postpartum OCD.

After reaching out for help, some moms don’t even hear back. Some receive a prescription with no followup or monitoring. Some are informed that they can’t have PPD. And some are told to simply perk up, stop being selfish or get out of the house more, she said.

There’s confusion about everything from PPD’s symptoms to its treatment. Myths also often portray women with PPD in a negative light, which dissuades many from seeking help. Moms worry what others will think, whether they’re even fit for motherhood or, worse, if their kids will be taken away, according to Stone and Meltzer-Brody.

As a result, most moms with PPD don’t get the treatment they need. “Some studies show that only 15 percent of moms with PPD ever get professional help,” Stone said. Untreated PPD can lead to long-term consequences for both mom and child, she said.

The good news is that PPD is treatable and temporary with professional help, Stone said. And education goes a long way! Below Stone and Meltzer-Brody dispel five common myths about PPD.

1. Myth: Women with PPD are sad and cry constantly.

Fact: According to Meltzer-Brody, “Women with PPD usually have low mood, prominent anxiety and worry, disrupted sleep, feelings of being overwhelmed, and can also feel very guilty that they are not enjoying their experience of motherhood.”

But this disorder can look different in every woman. “PPD is not a one-size-fits all illness,” Stone said. She frequently hears from moms who didn’t even realize that their symptoms fit the PPD criteria.

Indeed, some women do feel sad and cry nonstop, she said. Others report feeling numb, while still others mainly feel irritable and angry, she said. Some moms also have fears that they’ll inadvertently harm their kids, which amplifies their anxiety and distress, Meltzer-Brody said. (The myth that moms with PPD harm their kids only heightens these fears and fuels their suffering, she said. More on that below.)

Many moms appear to function just fine but struggle in silence. They still work, take care of the kids and seem calm and polished. That’s because most women experience more moderate symptoms of PPD, Meltzer-Brody said. “They are able to function in their roles but have significant anxiety and mood symptoms that rob them of the joy of being a mother and interfere with their ability to develop good attachment and bonding with their infants.”

2. Myth: PPD occurs within the first few months of childbirth.

Fact: Most women tend to recognize their symptoms after three or four months post-childbirth, Stone said. However, “you can have postpartum depression any time in the first year postpartum.”

Unfortunately, the DSM-IV criteria for PPD leaves this information out. According to Stone, “Since it doesn’t say that in the DSM-IV, I can’t tell you how many moms finally get up the courage to go see the doctor in the second half of their baby’s first year and are told that they ‘can’t have postpartum depression.’ So then the mom goes back home and wonders whether she should have asked for help in the first place and why no one can help her.”

3. Myth: PPD will go away on its own.

Fact: Our society views depression as something to “rise above and overcome,” Meltzer-Brody said. Depression gets dismissed as a minor issue, fixed with a mere attitude adjustment. “I’ve had many patients tell me that they felt so guilty and judged by friends and family for not being able to ‘just snap out of it and focus on the positive,’” she said.

Again, PPD is a serious illness that requires professional help. It’s highly treatable with psychotherapy and medication. The medication part worries some women, and they avoid seeking help. However, treatment is individual, so what works for one woman won’t work for another. Don’t let such misconceptions stop you from seeking the help you need. Both experts underscored the importance of prompt treatment. (See below on how to find help.)

4. Myth: Women with PPD will hurt their kids.

Fact: Almost without fail when the media reports on a mom who hurt or killed her kids, there’s mention of postpartum depression. As Stone reiterated, women with PPD don’t harm or kill their kids, and they’re not bad mothers. The only person a woman with PPD may harm is herself if her illness is so intense that she has suicidal thoughts.

There is a 10 percent risk for infanticide or suicide with a different disorder called postpartum psychosis, Stone said. Moms may harm their kids during psychosis.

Postpartum depression is often confused with postpartum psychosis. But, again, they’re two different illnesses. Postpartum psychosis is rare. “About 1 in 8 new moms gets postpartum depression whereas 1 in 1,000 gets postpartum psychosis,” Stone said.

(Here’s some information about postpartum psychosis symptoms.)

5. Myth: Having PPD is somehow your fault.

Fact: Women often blame themselves for having PPD and experience guilt over their symptoms because they’re not basking in some magical bliss of motherhood. But remember that PPD isn’t something you choose. It’s a serious illness that can’t just be willed away.

According to Meltzer-Brody, hormones play a substantial role in PPD susceptibility. Some women are especially susceptible to rapid fluctuations in estrogen and progesterone, which occur at childbirth, she said. It’s likely that genetics predispose women to mood symptoms during these fluctuations. A history of abuse and trauma also might increase risk in women who are already genetically vulnerable, she said.

As Stone said, “I know it’s hard to believe that it’s not your fault, that you ever should have become a mother, and that you’ll ever get better. I know because I’ve been there. You will get better.”

Again, PPD is a real illness that requires expert help. Dismissing it can negatively affect both mom and baby. Don’t be casual about PPD, and don’t hope for the best, Stone said. Instead, find real hope and recovery with professional treatment.
Getting Help for Postpartum Depression

Below, Stone offered several suggestions for finding a professional for a proper diagnosis and treatment. Many of the links come from Stone’s Postpartum Progress, which is an excellent resource! In fact, just recently it ranked #6 in Babble’s list of top 100 mom blogs.

Start by reading this page on Postpartum Progress, which lists the best PPD treatment programs.

Contact the nonprofit organization Postpartum Support International, which has coordinators in almost every state who can help you find an experienced professional in PPD and related illnesses.
See if your state has its own advocacy organization for moms with perinatal mood and anxiety disorders. Postpartum Progress has a list of advocacy organizations.
If you’re not sure how to talk to a doctor or therapist about your symptoms, print out Postpartum Progress’s list of PPD symptoms to start the conversation.

By David Sack, M.D.

Addicts aren’t the only ones who are haunted by the shame of addiction. Parents are often plagued with worry: “If only I had been a better parent, maybe none of this would’ve happened.”

Addiction is not parents’ fault (about half the risk is genetic), but you can influence the course of your child’s life by helping them develop the skills that protect against addiction.

#1 Coping Skills

One of the most important goals in treating addiction is equipping addicts with effective coping skills. The skills they learned in childhood might have been tempered by difficult life events, or perhaps they never developed appropriate coping mechanisms at all.

In either case, a need to self-medicate anger, disappointment and other difficult emotions is one of the most common reasons people turn to drugs and alcohol.

By learning how to cope with the full range of emotions – both the ones that feel good and the ones that feel miserable – children become resilient. Coping skills can be as basic as proper self-care (diet, sleep and exercise) or healthy distraction (talking to a friend or taking a walk), or they can be as complex as learning to differentiate between the things we can control and those we cannot.

#2 Social Skills

Human beings crave connection with other human beings. Studies show that social skills are essential for children to make friends, do well in school, and cope with life’s ups and downs. Those who aren’t able to lean on others for support are at greater risk of anxiety, depression and substance abuse.

Talking to children about other people’s feelings, beliefs and desires helps build empathy, a fundamental tool for social interaction. This dialogue can begin as early as age two or three by describing the way characters in books or television shows might be feeling in a given situation and how they might deal with those feelings. Skills such as appropriate eye contact, sharing, taking turns, active listening and assertive communication can also be taught directly and through role modeling.

#3 Life Skills

It’s surprising how many people arrive in drug rehab with minimal life skills. They haven’t balanced a checkbook, prepared a basic meal or washed their own laundry, and it shows in their confidence and ability to function each day. While young children wouldn’t be expected to have mastered these skill sets, the groundwork can be put in place early on.

School doesn’t always equip children with the real-world skills they will need to navigate adolescence and adulthood. Parents play a critical role in teaching their children healthy study habits, money management, cleaning their room, staying organized and creating a daily routine.

#4 Emotional Regulation Skills

Poor impulse control and a need for immediate gratification are strongly correlated with addiction. Although these qualities are normal at certain developmental stages, most children begin to use self-regulation skills without outside intervention. Those who have an extreme or persistent lack of self-control are at higher risk of bullying, academic difficulties, substance abuse and other problem behaviors.

Studies show that self-regulation skills in kindergarten predict literacy, vocabulary and early mathematics skills and are important for social development. Taking a time out, labeling and validating a child’s feelings (both pleasant and unpleasant), and offering positive feedback for appropriate behavior are all useful strategies that aid in responding to emotions appropriately.

Harsh discipline, yelling and spanking, on the other hand, do not teach self-regulation. It is also important for parents to consistently set limits and enforce consequences so that children understand the expectations.

#5 Critical Thinking Skills

Critical thinking encourages children to think for themselves rather than giving in to peer pressure. Schools are effective at teaching children what to think but not necessarily how to think. Starting as early as kindergarten, parents can help their children develop these skills by asking open-ended questions and working through a variety of possible solutions. After a decision is made, it can be helpful to reflect on it and ask your child what they might do differently next time.

#6 Distress Tolerance Skills

Many of the most dreaded behaviors that arise in children, including drug use, are the result of mismanaged stress. While distress tolerance skills alone will not prevent addiction, they do empower children to sit with their emotions without trying to escape or numb them.

One of the greatest disservices modern parents do to their children is getting in the way of the child’s innate learning process. “Helicopter parenting” – the increasingly common practice of hovering over children so they don’t get hurt or have to face problems – has contributed to a society that values immediate gratification over resilience. By intervening in arguments between a child and their friends or doing a tough homework assignment for their child, for example, parents deprive their child of valuable lessons and the skills to cope with stress, as well as the confidence boost that goes along with each small success.

Instead, let your kid be a kid. Life is full of moderate stressors that encourage the development of new skills and provide a sense of mastery. You can supplement this process by introducing your child to novel experiences like making a new friend or trying a new game and allowing them to work through problems on their own.

All of these skill sets can be gained through a combination of experiences at school, explicit teaching and, most importantly, parental role modeling. If you accept accountability for your own feelings, provide plenty of praise and support without overprotecting, and avoid using drugs or alcohol yourself, you can put your child in the best possible position to avoid addiction and other serious problems later on.

Jun 7

By Jennifer Oikle, PhD. This article first appeared on

So, you’re really hitting it off with that new guy in your office. You look forward to seeing him, and chatting with him and you’ve even confided a couple things to him over lunch. He’s just a friend, right? No harm in that…

Hold on. Think it through. Sure, it’s good to have friends, but you could be inching down the slippery slope to emotional infidelity without even knowing it. The trouble? Emotional connections often slide into sexual cheating, even if you are happy in your current relationship. So you want to be on the lookout to protect your bond before it’s too late!

But what exactly is emotional infidelity? Emotional infidelity happens when you allow someone of the opposite sex to fulfill emotional needs that should be met by your partner, creating an intimacy that leads to an emotional attachment that then frequently culminates in sex. It can start innocently enough, that’s why you need to be aware of the behaviors that open the door to an inappropriate connection.

Signs You’re Heading into Emotional Infidelity

1. You look forward to seeing him with more excitement than a typical friend, and spend more time with him than you should.

2. You find yourself dressing up and paying more attention to your appearance in a hope that he’ll notice you.

3. You confide in him about your relationship troubles at home.

4. You flirt with him, touching him while talking or making playful comments.

5. You turn to him first, before your partner, when something is troubling you.

6. You fantasize about what it would be like to be together in a relationship or sexually.

7. You either talk way too much about him to your partner & friends, or you never mention him at all, keeping him a secret.

8. You wouldn’t feel completely comfortable telling your partner everything about your relationship with this person because you know some of it is inappropriate.

Basically, when you’re nurturing an emotional bond with an attractive member of the opposite sex that includes a spark of chemistry and secrecy, you know you’re in trouble!

Stopping the Slide into Emotional Infidelity

If you find yourself slipping into the danger zone, it’s time to take precautions to protect your relationship by moving away from the magnetic pull of cheating — even if it’s not so much fun. Now is your opportunity to set some new boundaries to ensure your relationship stays strong. Try these:

1. Step away from the attraction by setting limits on the amount of contact you have.

2. No longer share your troubles, turn to your partner first for support.

3. Only spend time together in groups.

4. Refocus your attention on your partner by stopping all thoughts and fantasies about the new guy.

5. Plan some fun with your partner so you can reconnect and get the spark going again.

It’s important to recognize that everyone is at risk for emotional infidelity, even if you have a solid relationship, because attention and affection from someone new always feels good. So don’t beat yourself up when you notice the pull toward another cutie, just use that as a sign to move closer to the one you already love and spice it up, instead of straying outside the boundaries to get your needs met. As long as you keep the boundaries around your primary relationship strong, you’ll stay safely in love!

What are the lines that you draw? What is appropriate/inappropriate in male-female friendships if in a relationship? We want to hear from you!

Jun 7

Understanding Atypical Depression


By Chris Iliades, MD About 50 years ago, psychiatrists in England described a group of depressed patients as “atypical.” Twenty-five years later, researchers at Columbia University in New York used the term “leaden paralysis” to describe patients who often told doctors that they felt like they had lead weights attached to their legs. Today, this type of depression is called atypical depression, or depression with atypical features.
Need help for depression? Find a mental health professional in your area.

Despite the word “atypical,” atypical depression is not unusual. In fact, atypical depression may be the one of the most common types of depression — and some doctors even believe it is underdiagnosed.

What does atypical depression look like? Studies show that people with atypical depression lose more days from normal activities, have more disability, and use heath care services more than people with other types of depression. If you feel sleepy all the time, are putting on weight, and are overly sensitive to rejection, you could be suffering from atypical depression.

Atypical Depression: Symptoms That Lead to Diagnosis

Atypical depression has different symptoms and responds differently to treatment than other types of depression.

Atypical depression can be overwhelming, both physically and mentally. Unlike other types of depression, people with atypical depression can be briefly cheered up by positive events, but they overreact to negative events. A severe depression can be triggered by any feeling of rejection from a friend, boss, or loved one.

Symptoms of atypical depression include:

Increased appetite. Unlike other types of depression in which people may lose interest in food, if you have atypical depression you may have a craving for comfort foods. Weight gain is a common sign.
Increased sleep. Unlike other types of depression in which people have trouble getting enough sleep, people with atypical depression feel like sleeping all the time.
Leaden paralysis. This term refers to a sense of heaviness in the arms and legs that people with atypical depression experience. They may feel extremely tired, as though their physical movements have slowed down.
Overly sensitive. People with this type of depression tend to have a personality trait of increased sensitivity. They may expect that other people will not like them or not approve of their behavior.

The diagnosis of atypical depression is made when severe depression is seen along with any two of the above symptoms. However, a study published in the Archives of General Psychiatry that compared 304 patients with atypical depression with 836 patients with major depression found that oversleeping and overeating are the two most important symptoms for diagnosing atypical depression.

Atypical Depression: Treatment

One of the earliest clues that atypical depression was a different type of depression was that patients responded better to a type of antidepressant medication called monoamine oxidase inhibitors. Today there are even more options for treating atypical depression:

Monoamine oxidase inhibitors (MAOIs). This older class of antidepressant drugs is still used for atypical depression. However, MAOIs can have dangerous side effects.
Selective serotonin reuptake inhibitors (SSRIs). These newer drugs have fewer side effects than MAOIs. They may be slightly less effective, but their safety makes them a useful drug for atypical depression.
Cognitive therapy. This is a type of talk therapy, or psychotherapy, used to treat many types of depression, including atypical depression. A study published in the Archives of Psychiatry compared cognitive therapy, an MAOI drug, and a placebo in patients with atypical depression. The study found that cognitive therapy was as effective as MAOI, and both were more effective than placebo in treating atypical depression.
Chromium. This is a mineral that plays an important role in blood sugar regulation and may also affect chemical messengers in the brain. A small study published in the Journal of Psychiatric Practice found that taking chromium supplements may relieve symptoms of atypical depression, including the craving for carbohydrates.

If you have any of the symptoms of atypical depression, and especially if you are depressed and find that you are sleeping or eating too much, you need to see your doctor. Atypical depression is a serious illness with higher risks for disability, drug abuse, and suicide than other types of depression.

The good news is that atypical depression is also very treatable. With proper treatment, most people get better and can return to normal activities.

Jun 6

Relationship Skills for Conflicts


By Jenise Harmon, LISW Being in a close, loving relationship is many things. It’s comforting, satisfying, challenging, enlightening, and fun. The one thing that a close relationship is not, however, is simple.

In the beginning of a new relationship, the time I think of as the Golden Days, your partner can do no wrong. Snoring is cute. Picking up the socks that end up all over the house is an act of love. The thought of a serious fight seems impossible — until it happens.

The person you love the most, to whom you are closest, becomes irritating, stupid, or irrational. Suddenly the Golden Days are replaced with reality. You and your partner are shedding your pretenses. Neither you nor your loved one feels the need to impress the other. You are committed to each other. You’re comfortable together.

But the snoring starts to drive you crazy, and you resent the socks you have to pick up. Conflict arrives.

All couples experience conflict, but there are ways to minimize its pain and maximize its growth. Instead of drawing you and your partner apart, conflict can bring your relationship to a new level of intimacy. This happens not by chance, but through learning new ways of relating to your partner and new relationship skills.

1. Decide on a topic and a time.

If there is an issue you want to resolve with your partner, decide together on a time and day to discuss it. Don’t plan it for when you’re tired, or likely to be stressed. If you can, make it for when you’ll have the privacy and time you need. For some, this means talking after the kids are in bed, or when you can hire a babysitter. It may mean planning time on the weekend, when your stress level is lower. Make it an appointment that you have thought about and agreed upon with your partner, and stick to it.

2. Keep on topic.

I can’t stress this one enough. If you’ve set aside time to talk about needed home repairs, don’t start discussing how your partner didn’t take down the Christmas lights until August. It can be very easy to try to get all of your complaints in at once, but resist that temptation. This time is for the agreed-upon topic only. Otherwise you will both become overwhelmed, angry, and frustrated.

3. Learn how to actively listen.

Active listening is more than simply hearing. It is listening with all your attention on what your partner is saying. It means not thinking of what you want to say next, but focusing your entire self on your partner.

As you actively listen, you want to make sure what you’re hearing is what your partner is saying. Saying something like “so, it sounds like you’re really angry that I didn’t go with you to your work party” gives your partner space to clarify — “no, it wasn’t that. It was that you didn’t even ask me how it went when I came home.” Then you try again with a statement such as “you wanted me to show interest in it.”

Ask and clarify until your partner feels like you get it. It might feel strange at first, but once you get a handle on active listening, you will find it is an incredible tool to have for all sorts of conflict in your life, not just in your relationship.

4. Compromise.

A relationship is a partnership that entails give and take. If there is something that you and your partner cannot agree on, then you need to figure out some sort of compromise.You don’t need to be completely enthusiastic about it, but you do have to feel comfortable with it.

5. Be kind.

Some people call this “fighting fair,” but you don’t need to be fighting to use this skill. Don’t call your partner names. This is never helpful, and it only increases tension. Don’t use the word “always” (because it’s often untrue). Try to use “I” statements: “I feel….I think…I need.” Don’t try and read your partner’s mind. “You feel…you think….you need” are phrases to stay away from. Only you partner knows these things — you can only assume or guess.

Learning and using these five skills will improve how you and your partner interact, and your relationship will grow. Couples who have good communication skills are able to work through problems in a healthy way. Conflict will never be fun, but it is expected and normal. Being able to work through problems can lead to growth and deeper levels of intimacy, and in the end makes a relationship stronger.

Jun 6

Was Freud Right About Depression and Guilt?


By Rick Nauert PhD Senior News Editor

New brain imaging research suggests Sigmund Freud was correct that depression can result from exaggerated expressions of guilt and self-blame.

In a study, scientists have shown that the brains of people with depression respond differently to feelings of guilt – even after their symptoms have subsided.

Researchers found that the brain scans of people with a history of depression differed in the regions associated with guilt and knowledge of socially acceptable behavior from individuals who never get depressed.

The University of Manchester study is published in the journal Archives of General Psychiatry.

The hard evidence displayed by functional magnetic imaging (fMRI) is one of the first to show how the brain responds among people with a diagnosis of depression.

Lead researcher Roland Zahn, M.D., from the University’s School of Psychological Sciences, said: “Our research provides the first brain mechanism that could explain the classical observation by Freud that depression is distinguished from normal sadness by proneness to exaggerated feelings of guilt or self-blame.

“For the first time, we chart the regions of the brain that interact to link detailed knowledge about socially appropriate behavior – the anterior temporal lobe – with feelings of guilt – the subgenual region of the brain – in people who are prone to depression.”

Investigators used fMRI to scan the brains of a group of people after remission from major depression for more than a year, and a control group who have never had depression. Both groups were asked to imagine acting badly, for example being “stingy” or “bossy” towards their best friends. They then reported their feelings to the research team.

“The scans revealed that the people with a history of depression did not ‘couple’ the brain regions associated with guilt and knowledge of appropriate behavior together as strongly as the never depressed control group do,” said Zahn, a MRC Clinician Scientist Fellow.

“Interestingly, this ‘decoupling’ only occurs when people prone to depression feel guilty or blame themselves, but not when they feel angry or blame others. This could reflect a lack of access to details about what exactly was inappropriate about their behavior when feeling guilty, thereby extending guilt to things they are not responsible for and feeling guilty for everything.”

Scientists believe the finding is important because it reveals brain mechanisms underlying specific symptoms of depression that may explain why some people react to stress with depression rather than aggression.

Researchers are now investigating whether the results from the study can be used to predict depression risk after remission of a previous episode. Experts say that if this proves successful, then fMRI scans may be a tool to measure risk of future depression.

Jun 5

By Charles Poladian | Sweaty palms and increased heart rate are just two examples of how anxiety can affect a person. In a new study, anxiety also affects how hard the brain works.

That important deadline or a big test may have the worrier inside of us panicking which increases stress, leading to those tell-tale signs of anxiety. For girls, anxiety may cause your brain to work harder, causing it to burn out and you to perform worse in the long run.

Using a simple electrode cap, the study, led by Jason Moser, PhD, from the Department of Psychology at Michigan State University, measured brain activity of 149 students completing a simple task.

The task involved identifying the middle letter of a five-letter sequence. The students, 79 female and 70 male, also filled out questionnaires about how much they worry. While performance was pretty much equal for male and female students, brain activity in girls who were worriers was higher than the other students.

Anxiety made the task more difficult for the girls to complete causing their brain to work harder. As the test increased in difficulty, and individuals were more prone to make mistakes, the females who were identified as anxious performed worse. The anxiety caused the female student’s brain to work overtime because it had to compete with distracting thoughts and worries in addition to completing the task. Over time, this could lead to the brain being overburdened, burning out and more likely to get something wrong.

This burdening of the brain could lead to many problems, including underachievement at school. Anxiety can affect school performance for males and females, not researchers who cite previous studies associating anxiety with difficulty in subjects like math. Using an electrode cap to measure brain activity could also help doctors diagnose anxiety disorders.

The reason for this increased brain activity may be due to a hormonal difference in males and females. Estrogen may play a role in increasing brain activity in females, note researchers. Estrogen has been show to affect dopamine, which could be stimulating parts of the frontal lobe that are involved with learning.

To help reduce anxiety, researchers recommend brain challenges to improve memory and writing out worries to help alleviate stress.

The study was published in the International Journal of Psychophysiology.

Anxiety and mood problems commonly co-occur and make diagnosis and treatment challenging. Individuals with comorbid mood and anxiety issues often have increased symptom severity and more episodes of negative affect that last longer than those that occur in individuals without comorbidity. Extensive research has been conducted exploring this dynamic in clients dealing with mood and anxiety. However, few studies have examined specific types of anxiety. Additionally, most of the studies on comorbid conditions have looked at individuals with depression. Few, if any, have looked at the comorbidity of mood and anxiety problems in individuals with bipolar. Fernando Goes of the Department of Psychiatry and Behavioral Sciences at Johns Hopkins School of Medicine in Maryland recently led a study to address this gap in research. “This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees,” said Goes. His study involved 1,416 participants with BD and 1,726 participants with MDD. Goes and his team looked at how social phobia, panic, obsessive-compulsive disorder (OCD), and specific phobias were influenced by family risk and MDD and BD.

The results revealed that the participants with the highest levels of comorbidity were those with the earliest onset ages and the most frequent number of depressive episodes. Additionally, those most at risk for comorbidity were more likely to have attempted suicide than those without comorbidity. Family history and genetic risk was a contributing factor for comorbid OCD and panic in all the participants. Although specific phobia was also linked to family history, the relationship was less significant. Family history did not influence vulnerability for comorbid social phobia. In sum, the findings clearly demonstrate that individuals with a family history of MDD or BD are at increased risk for co-occurring anxiety issues that could predict the eventual development of BD and MDD. These results could help clinicians identify individuals at risk before they experience their first episode of depression.

Jun 5

Why Good Women Stay In Bad Relationships


When people think about an “abused woman,” they probably don’t picture a strong, smart, intelligent, and sassy kind of person. I’d guess they’d picture a housewife wearing Mom jeans crying into her apron over her latest black eye.

Couldn’t be farther from the truth. ANY woman can get caught up in a bad relationship – be it the executive down the hall or the janitor who sweeps up after you in the ladies room.

So let’s break down those stereotypes and figure out why women – all KINDS of women – stay in bad relationships.

1) Fear of being alone. I know in this day and age, we women are supposed to be tough and fearless, but it’s not always the case. We can behave as though we’re tough and fearless, while inside, we long to be wanted by our partner.

2) The devil you know versus the devil you don’t. There’s something comforting in staying with your partner – bad relationship and all – because at least you know what’s next.

3) Fear that this is the best there is out there. A lot of people – women who have been in bad relationships, especially – have their self-esteem eroded slowly by their partner (and life) so much that they honestly believe their current partner IS the best they’ll ever get.

4) “It’s not that bad.” I don’t know how many times I’ve run across those words on my non-profit site, where we get a great number of domestic abuse stories sent in to us. Women believe erroneously that because their story isn’t as graphic or as horrible as someone else’s, it’s not really worth it to talk about their partners who really only get upset when they “do something wrong.”

5) You’re a perfectionist. Everything you do is the BEST out there. Therefore, your relationship must not be broken, it’s just facing “challenges.” The idea of failure is so tremendous that leaving never even crosses your mind.

6) He has some sort of leverage. Often men who are truly abusive threaten a woman, saying he will hurt her children, her pets, or her family if she leaves him.

7) You love him – plain and simple.

8) You believe he will change. He says he will. He’s TRYING to change. You just make him SO MAD. If only you STOPPED making him SO MAD!

9) He makes you feel special beyond compare. Even if you’re not quite good enough (his words), he’ll manipulate you into feeling grateful that someone like him could be with someone like YOU.

10) You can’t see how truly bad it is. Whether it’s because you’ve been isolated from friends or family or you don’t want to see how bad things are, you don’t have any idea things have gotten this dire.

How do I know all this? I’ve been there, too.

By Lisa EspositoTHURSDAY, Feb. 2, 2012 (HealthDay News) — Children who have more than one surgery with general anesthesia by their second birthday might be at higher risk for attention-deficit/hyperactivity disorder (ADHD), a new study suggests.

Mayo Clinic researchers looked through medical records of 341 children diagnosed with ADHD before age 19, to find who had undergone a surgical procedure with anesthesia before they were 2. Nearly 18 percent of children exposed twice or more eventually developed ADHD. Children with only one exposure had an ADHD rate of nearly 11 percent, while never-exposed children had a rate of slightly more than 7 percent.

The researchers also looked at anesthesia given to mothers during childbirth. “With Cesarean section with a general anesthetic, only a single anesthetic, we didn’t find any effect,” said study author Dr. Juraj Sprung, a professor of anesthesiology at the Mayo Clinic. The study appears in the Feb. 2 issue of the journal Mayo Clinic Proceedings.

An earlier study conducted by the same team and published in Pediatrics last November found a connection between early multiple anesthesia exposures and a higher rate of learning disabilities in reading, language and math. Data for both studies came from the Rochester Epidemiology Project, which analyzed education records of children born between 1976 and 1982 in Minnesota. Nearly one in 10 children is estimated to have ADHD, which hampers attention and focus, and includes restless and impulsive behavior. Studies suggest that both genetic and environmental factors play a part in causing the neurodevelopmental disorder.

For human studies, it’s difficult to separate the effects of anesthesia from those of surgery. “Essentially, we did an observational study and we examined whether there is association with exposure to anesthesia, but not only to anesthesia,” Sprung said. In earlier animal studies, rats given anesthesia developed nerve damage in the cortical areas of the brain and became hyperactive. Newborn monkeys exposed to the anesthetic ketamine for 24 hours had changes in their ability to perform tasks involving executive function.

While she was struck by the animal data, Dr. Tanya Froehlich, a specialist in developmental and behavioral pediatrics at Cincinnati Children’s Hospital Medical Center, said the new study does not prove a cause-and-effect connection between surgical anesthesia and ADHD. Any link “could be confounded by a lot of things,” she said. “For instance, kids with ADHD are more prone to injury. They’re more prone to breaking their bones, possibly having some kind of head trauma that might require surgery. A child who’s under 2 is prone to being more active, getting into things, so they might have a propensity to have more accidents.”

With ADHD’s familial component, she said, it might also be that caregivers are more likely to have the condition themselves and “may be less adept at keeping track of what the kids are doing and putting those safety precautions in place.” Or, a child’s surgery could be for a congenital malformation that itself may have affected the brain and increased the ADHD risk. “And it doesn’t necessarily have to be the surgery or anesthesia per se,” Froehlich said. “When I read the study, I thought of a lot of reasons that anesthesia and ADHD may be associated but not necessarily causative. In the study they’re only proving an association,” she said.

The findings may not apply to children of all racial or ethnic groups, Sprung added. “The population in 1976 and 1982 was mostly white/Caucasian here in Minnesota.” However, Froehlich said, “the dataset that the Minnesota people have is a huge strength. Notably, they did account for birth weight, gestational age and maternal education in their analyses, so that all speaks very well for the study and strengths of the study.” Both experts stressed that parents should not avoid needed surgery for their young children.

“At the present time, we shouldn’t make any recommendations based on the study, to do or don’t do the surgery. If you need the surgery, if you need the procedure, you certainly should go for it,” Sprung said. “What I would personally say: If it’s the type of surgery, the type of procedure that can wait, maybe it’s better to wait.”
And Froehlich said, “Even though we can think of all these confounders we can’t just dismiss the study. It’s something that we as doctors should be aware of and should think about.”

By Athena Staik, Ph.D. True, the mystery and complexity of the mind and brain may remain an ever present reality. Thanks in large part to advanced methods of studying the brain, however, recent findings in neuroscience have come a long way to unravel numerous puzzles.

Safe to say, many operations of the brain and body are governed by scientific laws as real as the Law of Gravity. Unquestionably, there is less mystery.

One of the laws discovered by recent findings is the ability of the brain to restructure and heal itself throughout life. This discovery alone tossed out centuries of scientific creeds, which previously held that we cannot do much about the damage caused by trauma and certain set patterns such as those labeled mental or behavioral “disorders.”

Known as neuroplasticity, findings show you have an innate ability to restructure the gray matter of your brain, literally speaking, with your mind and conscious action. When you change what you think, say or do in response to an event or situation, you change inner emotional states. As emotions are molecules that transmit the “what” to fire and wire” messages, whenever your felt experience of an event changes, accordingly, this physically restructures the gray matter of your brain.

More and more, psychological treatment is less guesswork and mystery, and more application of proven science.

Even deeply entrenched behavior problems, such as addictions, post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD) have been shown to respond to treatment that follows proven methods of rewiring the brain by altering current thought-response patterns. For OCD, for example, neuroscientist Dr. Jeffrey Schwartz has developed four steps in a ‘response prevention” cognitive-biobehavioral approach.

It makes sense. Most emotional issues have to do with rigid patterns of thinking associated with the body’s fear response.

What follows are four steps to rewire your brain to think and feel a different way, which can be applied to enhance your behavior or thought patterns overall. With more serious issues, seek the support of a professional.

1. See your automatic response patterns as learned brain-strategies.

The first step is to realize that toxic behaviors and patterns do not mean you are weak, inferior or defective as a human being. As a culture, it is unfortunate that most major institutions, i.e., family, school, church, even our medical and mental health industries, are overly problem-focused, judging those with problems as bad, weak, defective, and the like. Problems are not the problem, your brain is designed to solve them. You were born with a brain that not only loves to resolve challenges, it simply cannot be healthy and vibrant without them!

See problem behaviors instead for what they are: learned strategies that your brain adapted because they ‘worked’ to protect you. You may not remember because this involves subconscious processes. You’ve been practicing many of these patterns from the time you were a child, thus, they can seem like they are ‘you’ – when in truth they are learned patterns that can be un-learned.

It’s a mistake to think that you are your thoughts, your emotions or your actions. You always have the option, once you realize this, to choose the thoughts, emotions, actions you want to express. Truth be told, all automatic thought-, emotion- or action-patterns that cause toxicity in your relationships and problems in your life are based on misguided understandings, mostly subconscious, between your mind and body. It is these toxic or limiting neural patterns that jam up the communication network of your mind and brain with unnecessary levels of fear.

If you have low tolerance for discomfort, or get bored easily, it’s time to take back what you lost somewhere along the way, that is, your innate passion to learn, to grow, to stretch, to discover, to be curious, to create, all of which you had naturally as a child! You need a new worldview that allows you to recapture your zest for life and healthy adventure, and to stretch out of old comfort zones. In this way, when thoughts surface that hold you back, such as “I can’t do that, that’s just not me,” you can bring yourself to speak truth, to say, “I am capable of stretching and doing whatever I put my mind and heart into realizing!!”

2. Re-frame a behavior as a problem located outside of who you are as a person.

The second step is to reframe a certain thought or behavior pattern so you can clearly see what is true and what is not true. This allows you to step back and separate yourself (or another), as a human being, from the behavior. When you do, you have a clearer picture of what is in your hands to change, and what is not.

Use a descriptive word that resonates with you, and grabs your attention. For example, call an unwanted thought, such as “I’m inadequate” or “there’s no point, nothing works,” a ‘big lie,’ a ‘misguided belief’ or a ‘false illusion.’ Refer to a shopping addiction as “a selfish money-grabbing thief’ or an addictive food “a high-cost cheap-thrill.’ Instead of telling yourself “I have to have a drink” you train yourself to say, “I’m having a compulsive urge to drink, and it’s trying to trick me into thinking ‘just one drink can’t hurt’ when I know that’s lie.”

This may sound too easy to be true. Rest assured, it’s anything but easy.

To consciously shift your focus on something opposite from what your brain has been automatically trained to do to ensure your survival will require you to come at this with determined force, to understand and accept that this will be quite a challenge, incredibly so. It’s about taking the reins as captain of your mind and emotional states, to develop your innate capacity by consciously navigating your responses to life.

3. Set clear life vision to refocus your energies on what you consciously prioritize and most value.

To the extent you have a clear vision of your life and what you most value, your body and mind subconscious galvanizes, and sharply focuses, your emotional energy to create thoughts, ideas, and actions that alight with your highest yearning.

If you are like many, you mostly have vague ideas of what you want in the long and short term, what you believe deep inside about yourself and life, and what is most important to you, what you value. The reason you may not have what you want, however, may be that you do not have a clear idea, a sharp vision, and specific and clearly stated goals. An articulated vision is a key trait of those who succeed in any endeavor. It is critical information to consciously feed your subconscious mind.

It’s not an option. It’s how your brain is designed to work. You need a clear vision of what you really want, who you want to be, what you’re willing to do and not do, clear enough so you can see it, preferably involving most or all of your senses, that is, you picture it, taste it, smell it, hear it, and feel it-as if it were already a present reality.

When your vision is a passion, the part of your mind that is in control of forming and breaking habits, the subconscious, is more quickly persuaded to let go of and replace the patterns that have been causing problems. Most protective survival-strategies, for example, are associated with a “low-energy” (fear-based) strivings, such as seeking “to prove your worth to others” or “to make sure no one gets upset or angry at you,” which you must necessarily replace. Fear-based patterns keep the subconscious mind on alert for certain cues, which it has learned to misinterpret as threats to your survival. To influence change, you must gain the cooperation of your subconscious mind. You need a vision to energize your mind and body and focus the direction of change. You can achieve what you want, more easily and effortlessly, when your conscious and subconscious mind work together toward common goals.

4. Take action to express your commitment to this new priority or value.

The fourth step is where the toughest work is, because it’s the actual changing of behavior. You have to perform another behavior instead of the old one. Once you recognize the problem for what it is and why it’s re-occurring, you now have to replace the old behavior by giving your brain new things to do. This is where the change in brain chemistry occurs, where you are creating new neural patterns, with your new mindset. By refusing to be misled by the old messages, by understanding they aren’t what they tell you they are, your subconscious is more willing to adapt change, and allow conscious you to be in charge of your brain (when you get triggered).

Action seals the deal. It says that the first three steps really matter to you. Your subconscious mind follows your lead the more you persuade it that you can handle those scary feelings of inadequacy or rejection, loss of control or abandonment, and thus stops treating you like a baby that has to be rescued with old strategies recorded in your early survival love map.

When you consistently take action, going opposite the emotional response you used to respond with to a triggering situation, you are consciously self-directing changes in your brain. These changes will make it increasingly easier for you to train yourself to respond, for example, with relative calm and confidence to a situation that is normally triggering for you. The more you practice a behavior, the more likely your subconscious mind will integrate it as a learned pattern that becomes more and more automatic.

Eventually, old thought patterns and intense emotional responses fade in intensity, and your brain is not highjacked by the body’s ‘fight, flee or freeze’ response, thus, your brain’s higher reflective thinking operates to allow you to make conscious choices. You’ve developed the capacity to accordingly maintain an optimal emotional state of mind and body. Your subconscious mind can perform its regular amazing functions, instead of acting like a dictator that usurps all the energies of your body thinking it needs to prepare for ‘enemy’ attack.

Ready to take the helm as captain?

Extensive studies say that, when you determinately decide to change your mind, you cause physical changes to your brain. Providing the change is in a positive direction, this is fantastic news.

This can involve a change in behavior to eliminate a compulsive pattern, take your life back from an addiction, or heal your relationship with money or food, a person you love or a difficult boss or colleague. Change and healing are about reshaping your mindset in a particular area of your life. You can make this a conscious process, where shifts in your thoughts, attitude and beliefs rewire current problematic emotional circuits.

It has been scientifically shown that the brain is structurally altered by changes in your behavior patterns. You can conquer toxic thinking patterns and old limiting beliefs by shifting your view, having a new vision, reframing problems. Safe to say, you get to choose what you will create or change.

By Janice Wood The molecular structure of a protein involved in Alzheimer’s disease — and the surprising discovery that it binds cholesterol — could lead to new therapies for the disease, according to new research.

Charles Sanders, Ph.D., professor of biochemistry, and colleagues at Vanderbilt University recently determined the structure of part of the amyloid precursor protein (APP) — the source of amyloid-beta, which characterizes Alzheimer’s disease.

Amyloid-beta clumps together into oligomers that kill neurons, causing dementia and memory loss. The amyloid-beta oligomers eventually form plaques in the brain, one of the hallmarks of Alzheimer’s, the researchers note.

“Anything that lowers amyloid-beta production should help prevent, or possibly treat, Alzheimer’s disease,” Sanders said.

Amyloid-beta production requires two “cuts” of the APP protein, he said. The first cut, by the enzyme beta-secretase, generates the C99 protein, which is then cut by gamma-secretase to release amyloid-beta. The Vanderbilt researchers used nuclear magnetic resonance and electron paragmagnetic resonance spectroscopy to determine the structure of C99.

The researchers said they were surprised to discover what appeared to be a “binding” domain in the protein.

Based on previously reported evidence that cholesterol promotes Alzheimer’s disease, they suspected that cholesterol might be the binding partner.

The researchers used a model membrane system called “bicelles” that Sanders developed as a postdoctoral fellow to demonstrate that C99 binds cholesterol.

“It has long been thought that cholesterol somehow promotes Alzheimer’s disease, but the mechanisms haven’t been clear,” Sanders said. “Cholesterol binding to APP and its C99 fragment is probably one of the ways it makes the disease more likely.”

Sanders and his team propose that cholesterol binding moves APP to special regions of the cell membrane called “lipid rafts,” which contain “cliques of molecules that like to hang out together,” he said.

“We think that when APP doesn’t have cholesterol around, it doesn’t care what part of the membrane it’s in,” Sanders said. “But when it binds (to) cholesterol, that drives it to lipid rafts, where these ‘bad’ secretases are waiting to clip it and produce amyloid-beta.”

The findings suggest a new strategy to reduce amyloid-beta production, he said.

“If you could develop a drug that blocks cholesterol from binding to APP, then you would keep the protein from going to lipid rafts,” he said. “Instead it would be cleaved by alpha-secretase — a ‘good’ secretase that isn’t in rafts and doesn’t generate amyloid-beta.”

Drugs that inhibit beta- or gamma-secretase to limit amyloid-beta production have been developed and tested, but they have toxic side effects, the researchers note.

A drug that blocks cholesterol binding to APP may be more effective in reducing amyloid-beta levels and in preventing, or treating, Alzheimer’s disease, the researchers conclude.

Jun 2

By Madeline Vann, MPH If you’re depressed, antidepressants can help you minimize those feelings of sadness and hopelessness — but will the drugs also undermine your ability to feel joy?

Emotional blunting — an overall unfeeling or numbness — is a common complaint of depression patients prescribed to certain antidepressants. This diminished capacity to have feel-good emotions during positive moments can be a significant side effect for some people taking selective serotonin reuptake inhibitors, or SSRIs.

And when research supporting the idea was first discussed at a national conference in 2002, mental health professionals nodded in agreement over the existence of this unwanted side effect, recalls psychiatrist Heidi Combs, MD, an assistant professor of psychiatry at the University of Washington in Seattle.

However, emotional blunting is largely based on what doctors hear from their patients, as opposed to results from clinical research. So what can be done about it?

Who Experiences Emotional Blunting?

SSRIs are a class of antidepressants that affect the way the brain uses the neurotransmitter serotonin. Their effect is intended to relieve the symptoms of depression — and they’re often successful in doing so. Unfortunately, explains Dr. Combs, the drugs also act on the reward pathways in the brain — the pathways that bring us pleasure. For some people, this means that they experience emotional blunting, or the sensation that all their emotional responses are dulled.

“If something positive is going on, these patients might not have the full response,” Combs says. Though there are many case studies, the lack of large clinical studies makes it difficult to predict which people will experience this side effect — and which ones won’t.

Part of the problem is the very nature of depression. People struggling with depression often complain that they have lost some of their ability to respond emotionally to events and people around them. So for a long time, emotional blunting caused by antidepressants was written off a as symptom of hard-to-treat depression.

However, says Combs, it’s fairly easy now for physicians to tease apart the symptoms of depression itself and this antidepressant side effect. If the depression symptoms have improved, but emotional blunting persists, it’s likely due to the antidepressant. If, on the other hand, the emotional blunting continues alongside unrelieved sadness, weepiness, and other depression symptoms, then it’s more apt to be part of the original disorder, she explains.

Get Your Glee Back: What to Do About Emotional Blunting

To regain your pleasure response, Combs recommends these solutions:

Switch antidepressants. It may be a good idea to move to another class of antidepressants entirely because someone who responds to one SSRI drug with emotional blunting may respond the same way to another one. Add a second medication. If switching to another class of drugs just leaves you with more troublesome symptoms (which can happen if you’re dealing with anxiety), ask your doctor about adding just a small amount of another antidepressant to free the reward pathways. Talk it out. If you’re feeling an overall loss of emotional response, working through the problems that are causing stress and depression in the first place (including solving practical problems like those related to housing or income) may help.If you find that your depression medication is edging out all your emotions, talk to your doctor. This is a real effect, emphasizes Combs, but the good news is that it has real solutions.

Jun 2

By Sandrine Belier Ph.D., Most people are aware of how high sugar intake can affect your body. But what about your brain? A recent study published in the Journal of Physiology has shown the negative effect of a long-term high-fructose diet has on the brain. The study was conducted on rats and indicated that drinking soft drinks or eating sweets on a regular basis affects our learning and memory skills. Indeed, the study dealt with high-fructose corn syrup, not with naturally occurring fructose, as found in fruit. This artificially produced syrup is frequently added to manufactured food such as soft drinks or sweets but can also be found in baby food. However not everything is lost: One group of rats which, as well as the fructose solution, was also given omega-3 fatty acids showed better results, which indicates that these fatty acids may be able to fight against the harmful effects of fructose.


Jun 2

Passive-Aggressive: What Does It Really Mean?


By Diana Rodriguez The term passive-aggressive is defined as the “unassertive” expression of negative sentiments, feelings of anger, and resentfulness. So instead of verbally or physically expressing frustration or anger — or even simply saying “no” when asked to complete a task — someone described as passive-aggressive might simply act agreeable but then not follow through with completing the task.

Passive-aggressive personality can sometimes seem pretty easy to recognize. In fact, these behaviors were once known as a personality disorder of the same name — passive-aggressive personality disorder.

Today, passive-aggressive personality disorder is no longer considered a mental health condition and the diagnosis is not recognized. But that doesn’t mean that these personality traits no longer exist.

Passive-aggressive behaviors can be truly troubling and may still require medical treatment and help to cope with them. People with passive-aggressive personality traits also tend to, over time, develop feelings of anger.

Symptoms of Passive-Aggressive Behavior

It’s not understood why some people behave in a passive-aggressive manner or have chronic passive-aggressive personality characteristics. But it’s thought that genetics could play a role, in addition to environment.

Some identifiable signs and symptoms of passive-aggressive behaviors include:

Putting off responsibilities
Carrying out responsibilities late, not at all, or inefficiently
“Forgetting” to do things or using forgetfulness as an excuse not to do things
Being reluctant to accept others’ suggestions
Being afraid of those in positions of authority
Having pent-up feelings of anger
Resenting and blaming other people
People with passive-aggressive personality typically don’t disagree or voice their resentment; it’s their behaviors that indicate that they’re passively ignoring a request or responsibility, or doing it only with resentment.

Diagnosing and Treating Passive Aggression

A mental health professional, such as a psychologist or psychiatrist, may perform a psychological evaluation to diagnose passive-aggressive behaviors. He will also do some careful questioning and review a history of symptoms in order to recommend the appropriate course of treatment.

Passive-aggressive personality disorder was considered a chronic condition, meaning that it had no chance of improving. But people with passive-aggressive behaviors can learn to deal with those behaviors and learn ways to cope with their symptoms.

Therapy and counseling can help people with passive-aggressive behaviors learn to understand their behaviors and react more appropriately. They can learn to better express their feelings before they develop hostility or resentfulness. Treatment can be effective, and the prognosis for overcoming passive aggression is generally considered good.

It’s also important to avoid dependency on drugs or alcohol, and any substance abuse problems or dependencies should be brought under control as part of managing passive aggression.

So perhaps that friend who conveniently “forgets” her promise to help you clean out your closets didn’t really want to do it in the first place. Or maybe you realize that you yourself miss deadlines when you dislike the project you were assigned at work. If you exhibit these behaviors and symptoms repeatedly over time, it may be a good idea to seek guidance from a mental health professional to determine if you might have a passive-aggressive personality — and learn how to better handle situations that cause frustration.

Jun 2

Depression a Hazard With Long Work Days


By Nancy Walsh, THURSDAY, Jan. 26, 2012 (MedPage Today) — Employees who put in excessively long hours on the job may be dedicated and hard-working, but they also are at risk for major depression, European researchers found.

After adjustment for socioeconomic factors, the risk of depression more than doubled for individuals who worked 11 or more hours a day compared with those working seven to eight hours, according to Marianna Virtanen, PhD, of the Finnish Institute of Occupational Health in Helsinki, and colleagues.

Even after adjustment for factors such as job strain and social support on the job, the increased risk persisted, the researchers reported online in PLoS One.

Some studies have linked psychological distress, sleep disturbances, and cognitive dysfunction with routine overtime work, but whether the association extends to major depression has not been determined.

To examine this possibility, Virtanen and colleagues analyzed data from 2,123 employees enrolled in the prospective Whitehall II study of London civil servants ages 35 to 55.

At baseline, participants reported demographic factors, health behaviors, and overall physical health. Those with psychiatric disorders were excluded from this analysis.

Participants also reported their occupational grade, daily hours, and degree of job strain.

Employees who worked the longest hours were typically men, married, and had a high occupational grade.

They also were less likely to have low-strain or passive jobs.

During 5.8 years of follow-up, there were 66 cases of major depression among the cohort, for an annual rate of 3.1 percent.

This rate was lower than is typically seen in the general population, which is about 5 percent, possibly because the Whitehall cohort consists of largely healthy white-collar workers, according to the researchers.

Factors associated with depression were younger age, female sex, low occupational grade, chronic physical illness, and moderate alcohol use.

Associations with depression were not seen for marital status, job strain, or smoking.

No significant risks for major depression were seen for individuals working nine to 10 hours per day, even after adjustment for occupational grade, job strain, chronic physical illness, and alcohol use.

And even for those working 11 or more hours, the association was not statistically significant until the model was adjusted for socioeconomic status.

This reflected the fact that while individuals with higher socioeconomic status often have long work days, they also are at lower risk for developing depression, according to the researchers.

A sensitivity analysis that included individuals who were no longer employed at the time of follow-up also found an increased risk of major depression with working 11 or more hours per day at the time of study enrollment.

Strengths of the study were its prospective design, large population, and use of standardized depression screening tools.

Limitations included its reliance on observational data, so there may have been unmeasured confounding factors, and the relatively few cases of major depression. In addition, the researchers were unable to take into account possible interactions such as greater rewards or difficult working conditions.

It also is unclear if these findings apply to workers employed in other types of occupations such as manual labor.

“Long working hours may in part affect mental health through factors not measured in our study, such as work-family conflicts, difficulties in unwinding after work, or prolonged increased cortisol levels,” the researchers observed.

They called for further studies to explore this concern in the wider population and to determine if reductions in work time could help lessen workers’ risk of depression.

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