By Janice Wood

A new computerized game could help people control their snacking and lose weight, according to new research.

A new study from psychologists at the University of Exeter and Cardiff University shows that participants lost an average of 0.7 kg (about 1.5 pounds) and consumed around 220 fewer calories a day while undergoing a week of training on the online computer game.

With obesity reaching epidemic proportions, the research opens up possibilities that brain training techniques targeting problematic behaviors — such as overeating and drinking alcohol — might help people take control, the researchers noted.

Led by Dr. Natalia Lawrence, the researchers developed an online computer game that trains people to resist unhealthy snack foods. The game requires people to repeatedly avoid pressing on pictures of certain images — for example, biscuits — while responding to other images, such as fruit or clothes. This trains people to associate calorie-dense foods with “stopping,” according to the researchers.

In a previous study, the researchers showed that this training reduces how much food people eat in laboratory tests.

The new study, published in the journal Appetite, found that 41 adults who completed four 10-minute sessions of the online training lost a small but significant amount of weight and ate fewer calories, according to estimates derived from food diaries.

The training also reduced how much the calorie-dense “stop” foods were liked, according to the researchers.

The reduction in weight and unhealthy snacking was maintained six months after the study, according to participants’ self-reporting.

The effects were observed relative to a control group of 42 adults who completed the same “stop versus go” training, but involving pictures of non-food objects, the researchers added.

“These findings are among the first to suggest that a brief, simple computerized tool can change people’s everyday eating behavior,” said Lawrence.

She noted that while it is “exciting to see the effects of our lab studies translate to the real world,” the research is still in its infancy.

“Larger, registered trials with longer-term measures need to be conducted,” she noted. “However, our findings suggest that this cognitive training approach is worth pursuing: It is free, easy to do and 88 percent of our participants said they would be happy to keep doing it and would recommend it to a friend. This opens up exciting possibilities for new behavior change interventions based on underlying psychological processes.”

By Traci Pedersen

People who suffer from major depressive disorder (MDD) may experience relief through synchronized transcranial magnetic stimulation (sTMS) therapy, according to a new study that tested the safety and efficacy of low-field magnetic stimulation using the new NEST® device on adult patients with MDD.

The findings are published in the Elsevier journal Brain Stimulation.

For the study, more than 200 participants were evaluated from 17 leading academic and private psychiatric institutions in the United States; enrollment included both treatment naïve and treatment-resistant patients as previous exposure to antidepressant medication was not a requirement for inclusion into the trial.

“The study found sTMS therapy to be significantly more effective than sham when administered as intended, supporting the hypothesis that low-field magnetic stimulation improves depressive symptoms,” said principal investigator Andrew Leuchter, M.D., professor of Psychiatry in the Semel Institute at University of California, Los Angeles.

“Additional analyses found subjects who failed to benefit from or tolerate prior antidepressant treatment in the current episode were most likely to demonstrate significant benefit from sTMS therapy compared to sham.”

When delivered accurately and consistently, sTMS therapy was successful in relieving depression symptoms in 34.2 percent of participants who had not responded to drug treatment, compared to 8.3 percent of those treated with an inactive device.

In addition, NEST® appeared safe and tolerable, with no significant differences seen between active and sham treatment in the rate or severity of negative events. There were no device-related serious adverse events in this study.

“These promising results indicate that sTMS is a promising novel technology for the treatment of depression,” said co-author Mark S. George, M.D., Distinguished Professor of Psychiatry, Radiology and Neurology at the Medical University of South Carolina, and the Editor-in-Chief of Brain Stimulation.

“This technology is revolutionary in two ways over the current FDA-approved forms of TMS. First, this device tunes the stimulation to the patient’s own brain rhythms. By stimulating at each patient’s individual resonant frequency, sTMS may be able to achieve therapeutic success using lower energy. Second, this device is safe, easy to use, and portable, which would allow use in a wide variety of treatment settings.

“sTMS may expand the options we have for treating serious depression.”

“We are very pleased with the outcome of this trial and what it could mean for those with MDD, particularly those who have failed to achieve adequate improvement from prior antidepressant treatment,” said Kate Rumrill, president and CEO of NeoSync.

By GRETCHEN REYNOLDS
Instead of telling children with hyperactivity and attention problems to sit still, perhaps we should encourage them to wriggle at will, according to a new study of children with attention deficit hyperactivity disorder, or A.D.H.D. The study, in Child Neuropsychology, found that children with A.D.H.D. concentrate much better when they fidget than when they don’t.

Hyperactivity is, of course, one of the defining symptoms of attention deficit hyperactivity disorder. It is in the disorder’s name and is usually the first symptom that parents, teachers and others notice. Most of us may be unable to gauge precisely how well a child concentrates. But we can tell if he or she can — or cannot — stay still.

But the relationship between hyperactivity and children’s concentration problems has been less clear. Does their hyperactivity intensify the attention deficit? Are the two problems — hyperactivity and attention deficits — unrelated except that they happen to occur together? Or could hyperactivity play some other role in the thinking and behavior of children with attention problems, possibly even a beneficial one?

Those questions intrigued Julie Schweitzer, a professor of psychiatry and behavioral sciences at the MIND Institute at the University of California, Davis, and her colleagues.

Past studies had suggested that children with A.D.H.D. concentrate better and improve academically if they are physically active during the school day. But that research had focused primarily on how to re-channel the children’s hyperactivity.

Dr. Schweitzer, who treats many children with A.D.H.D., had begun to wonder whether that emphasis was misplaced. Perhaps experiments should look into why the children were so hyperactive in the first place.

To find out, she and her colleagues gathered 26 boys and girls between the ages of 10 and 17 who had been diagnosed with A.D.H.D.; the researchers independently confirmed that diagnosis. Then they recruited an additional 18 children without A.D.H.D.

All of the children visited the group’s lab and were outfitted with an unobtrusive activity monitor on one ankle that could track how often and how intensely the children bobbled their leg, which is a good marker of fidgeting.

Then the scientists had the children complete a simple computerized test of attention and cognitive control, during which they had to note the direction an arrow was pointing and push a key showing that direction. The arrow in question was flanked by other arrows, which sometimes pointed in the same direction as the primary arrow and sometimes did not.

The children were told to respond as quickly as possible to the test, punching the proper key as soon as the arrows appeared on screen.

Then they repeated that same test more than 200 times in rapid succession, while the arrows shifted directions and each child’s ability to concentrate was sorely strained.

Afterward, the scientists compared the accuracy of the children’s responses during each of the more than 200 trials with the corresponding data from the activity monitors. In effect, they were examining how much and how intensely each child fidgeted every time they punched the key to indicate the arrow’s direction.

They found that the more intensely that the children with A.D.H.D. wiggled and fidgeted — the more ferociously they bobbled their legs — the more accurate their answers were. When these children were relatively still, their responses were much more likely to be wrong, indicating that they had had trouble concentrating then.

Meanwhile, fidgeting had played no discernible role, positive or negative, in the performance of the children without A.D.H.D., most of whom didn’t fidget much anyway.

These results suggest that hyperactivity is fundamentally beneficial for children with attention deficits, Dr. Schweitzer said, and probably developed to help them cope with their inability otherwise to focus.

“Hyperactivity appears to be a mechanism for cognitive self-regulation,” she said. In other words, children with A.D.H.D. may be hyperactive because the physical restlessness helps them to sharpen their mental control.

Dr. Schweitzer speculated that this constant movement probably increases mental arousal for children with A.D.H.D., much as stimulant drugs do. (Most of the children with A.D.H.D. in this experiment were taking such medications.)

Of course, this was a small, short-term study, involving only one type of cognitive test.

But its message seems straightforward, if unsettling, for weary parents and teachers who must deal with hyperactive children: let them squirm and fidget and bounce and jiggle and generally maintain that constant, disconcerting restiveness, if you want them also to be better able to concentrate.

The accommodations can be fairly discrete. Maybe install elastic bands beneath children’s desks, Dr. Schweitzer suggested, so that they can pull and play with them in a way that shouldn’t bother other children. Or use yoga balls as chairs, so the children can bounce. Even encouraging them to stand more often may help.

“I know it’s difficult to accommodate hyperactivity,” Dr. Schweitzer said, but it may really help children whose fidgeting bodies seem to contribute to calmer, more focused brains.

By Kyle J. Norton
With either mental or physical stimulation, your brain signals the nerve ending in the penis to release nitric oxide. Nitric oxide relaxes or dilates blood vessels, enabling them to open up and bring more blood to the penis and helping to create an erection. In this article, we will discuss what causes erectile dysfunction in men.

1. Aging
Starting at the age of 40 the levels of prolactin increases, stimulating the conversion of dihydro-testosterone, causing enlarged prostate and erection difficulty in some men.

2. Uncontrolled diet
Uncontrolled diet that is high in saturated fat and trans fat causing excessive fat build up in the arteries and veins in the penis. Remember that fat is required for function of the brain but excessive intake of fat causes fat to build up in the arteries as well as small veins in the penis and brain. That is also the reason that some experts indicate that erectile dysfunction in men is one of many symptoms of heart diseases and stroke.

3. Smoking
Nicotine is a stimulative, it causes the depletion of oxygen in the bloodstream resulting in the heart to beat faster than usual so that it can carry more oxygen to the cells in our body. It also causes the deduction of the amount of nitric oxide (the substance that relaxes or dilates blood vessels, enabling them to open up and bring more blood to the penis and helping to create and maintain an erection) released from the head of the penis resulting in erectile dysfunction. Cigarette fume contains high amounts of cadmium, the harmful and toxic substance causing calcium to stick on the arterial wall resulting in blocking blood flow to the penile veins creating erectile problems.

4. Excessive alcohol drinking
Excessive alcohol drinking over a long period of time not only damages the liver but also raises the levels of triglycerides in the blood. It also leads to high blood pressure, heart failure and an increased calorie intake causing the arteries and vessels in the penis to be clogged up by harmful cholesterol resulting in erection difficulty.

5. Enlarged ProstateStudies found that there are strong relations between lower urinary tract symptoms and the rate of erectile dysfunction in men with symptoms of enlarged prostate. The main role of the prostate gland is to squeeze fluid into the urethra as sperm moves through during sexual climax. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose resulting in prostate gland muscles surrounding the prostate making it contract and shrink down, increasing the erectile problem.

6. High levels of LDL
The hardening and narrowing of the arteries, causes a reduction in blood flow throughout the body including the vessels in the penis, leading to impotence.

7. Hormone imbalance
Testosterone deficiency can result in a loss of libido and loss of erection. An excess of the hormone prolactin also reduces levels of testosterone. Hormone imbalances can also result from kidney or liver disease.

8. Diabetes
Chronic high levels of blood sugar often damages small blood vessels and nerves throughout the body, impairing the nerve impulses and reducing the blood flow needed for erection.

By Christine Hammond
A bad outcome of a mid-life crisis tosses people into counseling. They report that the person they knew became entirely different over night. It is almost cliché that with a mid-life crisis comes the impractical sports car, the extramarital affair, late nights at bars, new friends who are twenty years younger, hipper clothes or a dramatic career change. They never thought it would happen to their spouse or friend, but it did. How?

Erik Erikson defines his seventh psychosocial stage as Generativity vs. Stagnation which occurs in the late thirties until the mid-sixties. This time period in an adult life encompasses the mid-life crisis years which can begin and end anytime in between. So what is a mid-life crisis? It is when an adult evaluates where they are in life compared to the dreams and goals they once had for themselves, to the status of others they desire to be more like, and to their potential to leave their mark on the world around them.

The Psychology. If a person sees how their contribution to home, work, church or community adds value to the lives around them, then they develop generativity. Generativity is expressed through concern for guiding the next generation, desire to leave a positive mark on the world, making a difference in the life of another, creatively using gifts and talents for the benefit of others, and feeling successful regardless of financial status. If a person don’t see how their contribution adds value, then they become stagnate or stuck.

Mid-Life Crisis and Generativity. Not all mid-life crisis’ need to end in disaster, some are actually for the better and can motivate a person to live up to their full potential. For instance, perhaps they are in a profession which they “fell into” mostly by accident but dream about another profession. This may just be the time to go back to school and get a desired new degree to work in a profession they are passionate about doing. By now as opposed to twenty years ago, they have a better understanding of their capabilities, talents, gifts and purpose in life along with responsibilities, time constraints, and natural limitations. This combination enables a person to be more focused on reasonable goals that are not selfish in nature but add value to the lives around.

Mid-Life Crisis and Stagnation. On the flip side of a mid-life crisis is the potential to become even more self-involved and to alienate others. This mid-life crisis is very different from the one mentioned above however it begins the exact same way. An evaluation of life leads to an even greater desire to satisfy all the needs, wants, and desires that have been put off. To justify the behavior, a person may say, “I deserve it” or “I have given so much to others, it’s time to give to myself”, or “I’m tired of sacrificing for others”. This is a heart issue more than anything. If someone really give out of a desire to show love to others, then no strings would be attached. This includes any anticipation of thanks, appreciation, or returning the favor. In essence, they expect nothing in return. If however giving is out of a desire for some type of reward, then the gift is selfish and manipulative. This includes verbal (a thank-you), physical (touch, hug or sex), emotional (happy feelings or feelings of obligation), or mental (think nice things about you or need to return the favor). This thinking is the seed from which a negative mid-life crisis grows.

The Cure. Since at the base of a mid-life crisis is the condition of a person’s heart, there is no other cure other than a complete change of it. It is not unusual for a trauma or crisis during this period to spark a dramatic change in direction. Unfortunately, this cannot be manifactured, rather it needs to be a more natural outcome, otherwise it will not be a real change.

Sometimes, something as simple as a 360 evaluation can help to spark change. When a person has the opportunity to see themselves how others see them, this creates discussion which can lead to change. It well is worth the effort to guide a person in the positive direction of a mid-life crisis for them, their family and the community as a whole.

By Rick Nauert PhD

New research suggests that even when depressed people have the opportunity to decrease their sadness, they don’t necessarily try to do so.

The finding is somewhat perplexing given that depression is characterized by intense and frequent negative feelings, like sadness. Consequently, it might seem logical to develop interventions that target those negative feelings.

But the new findings, published in the journal Psychological Science, suggests this may not always be an appropriate plan of action.

“Our findings show that, contrary to what we might expect, depressed people sometimes choose to behave in a manner that increases rather than decreases their sadness,” said the study’s first author, Dr. Yael Millgram of the Hebrew University.

“This is important because it suggests that depressed individuals may sometimes be unsuccessful in decreasing their sadness in daily life because, in some sense, they hold on to it.”

Millgram and colleagues couldn’t find any research that had examined the direction in which depressed people try to regulate their emotions, perhaps because it seems logical to assume that they would try to decrease their sadness if they could.

The researchers set out to conduct their own series of studies to find out whether this was actually the case.

In the first study, 61 female participants were given a well-established screening measure for symptoms of depression. Participants who scored on the very low end of symptoms were classified as “nondepressed” for the study, while those who scored in the middle to high end of the range and who were also diagnosed with a major depression episode or dysthymia were classified as “depressed.”

All of the participants were then asked to complete an image selection task — on each trial, the participants saw a particular image and could press one key to see it again or a different key to see a black screen for the same amount of time. The images were presented in random order and were drawn from a group of 10 happy images, 10 sad images, and 10 emotionally neutral images.

Comparing across the three types of images, the data showed that both depressed and nondepressed participants chose to see happy photos again more often than they chose to re-view the sad or neutral photos.

But, when the researchers looked specifically at how the groups responded to the sad images, they found that participants who were depressed chose to view those images again more often than the nondepressed participants did.

These findings were confirmed in a second study involving music selection. Again, the researchers found that depressed participants were more likely to choose sad music to listen to later in the study than happy or neutral music. The sad music clip was chosen by only 24 percent of the nondepressed participants but by 62 percent of the depressed participants.

“Depressed participants indicated that they would feel less sad if they listened to happy music and more sad if they listened to sad music, but they picked the sad music to listen to,” said Millgram.

“We were surprised that depressed participants made such choices although they were aware of how these types of music would make them feel.”

And a third study showed that when participants were taught how to use cognitive reappraisal as a strategy for increasing or decreasing their emotional responses to stimuli, the depressed participants chose to increase their emotional responses to sad images more often than the nondepressed participants did.

Researchers discovered that these efforts were effective: The more participants chose to use reappraisal to increase their emotional reactions to sad images, the more their sadness increased.

The findings suggest that developing effective tools isn’t enough to help people regulate their emotions in beneficial ways; they also have to be motivated to use those tools.

“The most urgent task for us is to try to understand why depressed people regulate their emotions in a manner that increases rather than decreases sadness,” said Millgram.

The researchers also plan on investigating the real-world implications of choosing to increase sadness as people respond to stressful events in their daily life.

Source: Association for Psychological Science

By Rick Nauert PhD

Prevailing opinion is that consciousness — the internal dialogue that seems to govern one’s thoughts and actions — is associated with free will and helps guide us to decisions.

Dr. Ezequiel Morsella, a San Francisco State Psychology professor, disagrees with this standard interpretation of consciousness, believing that it is far less powerful than people believe, serving as a passive conduit rather than an active force that exerts control.

Morsella’s “Passive Frame Theory,” suggests that the conscious mind is like an interpreter helping speakers of different languages communicate.

“The interpreter presents the information but is not the one making any arguments or acting upon the knowledge that is shared,” Morsella said.

“Similarly, the information we perceive in our consciousness is not created by conscious processes, nor is it reacted to by conscious processes. Consciousness is the middle-man, and it doesn’t do as much work as you think.”

Morsella and his coauthors’ groundbreaking theory — which contradicts intuitive beliefs about human consciousness and the notion of self – appears in the journal Behavioral and Brain Sciences.

Consciousness, per Morsella’s theory, is more reflexive and less purposeful than conventional wisdom would dictate. Because the human mind experiences its own consciousness as sifting through urges, thoughts, feelings, and physical actions, people understand their consciousness to be in control of these myriad impulses.

Morsella argues however, that consciousness does the same simple task over and over, giving the impression that it is doing more than it actually is.

“We have long thought consciousness solved problems and had many moving parts, but it’s much more basic and static,” Morsella said. “This theory is very counterintuitive. It goes against our everyday way of thinking.”

According to Morsella’s framework, the “free will” that people typically attribute to their conscious mind — the idea that our consciousness, as a “decider,” guides us to a course of action — does not exist. Instead, consciousness only relays information to control “voluntary” action, or goal-oriented movement involving the skeletal muscle system.

Compare consciousness to the Internet, Morsella suggested. The Internet can be used to buy books, reserve a hotel room, and complete thousands of other tasks. Taken at face value, it would seem incredibly powerful.

But, in actuality, a person in front of a laptop or clicking away on a smartphone is running the show; the Internet is just being made to perform the same basic process, without any free will of its own.

The Passive Frame Theory also defies the intuitive belief that one conscious thought leads to another. “One thought doesn’t know about the other, they just often have access to and are acting upon the same, unconscious information,” Morsella said.

“You have one thought and then another, and you think that one thought leads to the next, but this doesn’t seem to be the way the process actually works.”

The theory, which took Morsella and his team more than 10 years to develop, can be difficult to accept at first, he said.

“The number one reason it’s taken so long to reach this conclusion is because people confuse what consciousness is for with what they think they use it for,” Morsella said. “Also, most approaches to consciousness focus on perception rather than action.”

The theory has major implications for the study of mental disorders, Morsella said. “Why do you have an urge or thought that you shouldn’t be having? Because, in a sense, the consciousness system doesn’t know that you shouldn’t be thinking about something,” Morsella said.

“An urge generator doesn’t know that an urge is irrelevant to other thoughts or ongoing action.”

The study of consciousness is complicated, Morsella added, because of the inherent difficulty of applying the conscious mind to study itself.

“For the vast majority of human history, we were hunting and gathering and had more pressing concerns that required rapidly executed voluntary actions,” Morsella said. “Consciousness seems to have evolved for these types of actions rather than to understand itself.”

Source: San Francisco State University

By Rick Nauert PhD

Results from a new study suggests that errors on memory and thinking tests may signal Alzheimer’s up to 18 years before the disease can be diagnosed.

For the study, 2,125 European-American and African-American people from Chicago with an average age of 73 without Alzheimer’s disease were given tests of memory and thinking skills every three years for 18 years.

Rush University Medical Center researchers have published their finding in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

“The changes in thinking and memory that precede obvious symptoms of Alzheimer’s disease begin decades before,” said study author Kumar B. Rajan, Ph.D.

“While we cannot currently detect such changes in individuals at risk, we were able to observe them among a group of individuals who eventually developed dementia due to Alzheimer’s.”

Twenty-three percent of African-Americans and 17 percent of European-Americans developed Alzheimer’s disease during the study. Those who scored lower overall on the memory and thinking tests had an increased risk of developing the disease.

During the first year of the study, people with lower test scores were about 10 times more likely to be diagnosed with Alzheimer’s disease than people with higher scores, with the odds increasing by 10 for every standard deviation that the score was lower than the average.

Based on tests completed 13 to 18 years before the final assessments took place, one unit lower in performance of the standardized cognitive test score was associated with an 85 percent greater risk (relative risk of 1.85) of future dementia.

“While that risk is lower than the same one unit lower performance when measured in the year before dementia assessment, the observation that lower test scores 13 to 18 years later indicates how subtle declines in cognitive function affect future risk,” said Rajan.

The findings support conceptualizing Alzheimer’s disease as a progressive condition that has mild or subtle beginnings.

“A general current concept is that in development of Alzheimer’s disease, certain physical and biologic changes precede memory and thinking impairment. If this is so, then these underlying processes may have a very long duration.

Efforts to successfully prevent the disease may well require a better understanding of these processes near middle age,” Rajan said.

Source: American Academy of Neurology/EurekAlert

By John M. Grohol, Psy.D.
For most people, relationships are fairly easy things. They come as naturally to life as breathing or making a meal.

For some, however, relationships are not so easy. In fact, they present such a challenge to the individual, that a person can be said to have relationship anxiety, a fear of relationships, or suffer from “commitment phobia.”

Commitment issues in relationships are nothing new. But our understanding of how the fear of commitment for some people can be paralyzing has increased. And while you won’t find “commitment phobia” in any diagnostic manual, it is a very real experience of anxiety and fear.

Here’s the lowdown on commitment phobia and relationship anxiety.

People who have commitment issues, commitment phobia or relationship anxiety (I’ll use these terms interchangeably) generally have a serious problem in staying in a relationship for the long-term. While they still experience love like anyone else, the feelings can be more intense and scary than they are for most people. These feelings drive increased anxiety, which builds upon itself and snowballs as the relationship progresses — and the expectation of a commitment looms larger.

People with a commitment phobia long and want a long-term connection with another person, but their overwhelming anxiety prevents them from staying in any relationship for too long. If pressed for a commitment, they are far more likely to leave the relationship than to make the commitment. Or they may initially agree to the commitment, then back down days or weeks later, because of their overwhelming anxiety and fears.

Some people with relationship anxiety may confuse positive feelings of excitement for another person and the potential of a relationship with the feelings of anxiety. For instance, normal feelings of anticipation or may be misconstrued by the person as a panic reaction, or general negative anxiousness. Some may also just have a difficult time resolving the inherent conflict of romantic relationships — the craving of intimacy while wanting to retain their own individuality and freedom.

People with commitment issues come in all shapes and sizes, and their exact dating and relationship behaviors can vary. Some refuse to have any serious or long-term relationships longer than a week or a month, because of their fears. Others may be able to be involved with one person for a few months, but as the relationship becomes more serious and deeper, their old fears again come to the forefront, driving the person away.

Both men and women can suffer from relationship anxiety and commitment phobia, although traditionally it was thought primarily to be a male problem.

The Causes of Commitment Phobia

The causes of commitment phobia are as varied as the people who suffer from it. Typically, however, many people with commitment issues have complained of having experienced poor romantic relationships, either first-hand or through observation of others (such as their parents’ acrimonious relationship or divorce while growing up). Other common causes of commitment phobia may include:

Fear of, or having had, the relationship end without notice or signs
Fear of not being in the “right” relationship
Fear of, or having been in, an unhealthy relationship (characterized by abandonment, infidelity, abuse, etc.)
Trust issues because of past hurts by those close to the person
Childhood trauma or abuse
Unmet childhood needs or attachment issues
Complicated family dynamics while growing up
How to Help One’s Fear of Relationships

No matter what the specific cause of commitment phobia, it can be helped. A person who suffers from relationship anxiety doesn’t have to suffer from it their entire lives. There is help, but a person needs to want to change and find a way to overcome their relationship anxiety. It cannot be done by others.

There are many strategies to help someone with commitment phobia, depending on the severity of the anxiety. If it’s so severe it’s preventing one from even considering dating, much less finding the person of their dreams, then it may be time to seek out psychotherapy. A trained therapist who’s experienced in working with people with commitment issues can help a person understand the cognitive distortions they’re telling themselves, and how to turn them around.

Counseling may also be appropriate for anyone who’s gone through a round of serious relationships, only to have them end when the person couldn’t take the relationship to the next step. A therapist will help a person understand there is no “perfect” relationship, and that all relationships need nurturing, care and constant attention. A person will also learn in therapy that open communication with their partner will reduce the likelihood of there being any future surprises or trust issues.

Some people with milder commitment issues may benefit from getting support for their concerns through an online support group for relationship issues. And while self-help books vary in their usefulness and practice advice, these may of particular consideration to check out:

He’s Scared, She’s Scared: Understanding the Hidden Fears That Sabotage Your Relationships
Men Who Can’t Love: How to Recognize a Commitmentphobic Man Before He Breaks Your Heart/
Getting to Commitment: Overcoming the 8 Greatest Obstacles to Lasting Connection (And Finding the Courage to Love)
The fear of commitment can be overcome. The first step is being open to change, and wanting to make the changes in your life and your thinking that can help you be less anxious in future relationships.

By Mike Bundrant
Mike Bundrant is co-founder of the iNLP Center, which offers training in Neuro-Linguistic Programming.

There’s nothing like the overwhelming attraction of a new romantic interest, is there?

Hormones take over and you’re swooped into a dream world filled with pleasure and hope. The stars are aligned, calling you to dare human nature and take the plunge into a lifelong commitment.

When you wake up a few months later, will you be happy with your choice? Chances are good that if you make the following mistakes, you’ll wake up into a new reality that punches you in the gut.

Romantic relationships are like fire. They can warm your world or they can burn it down.

When playing with fire, be sure to avoid the following:

1. Overlooking behavioral red flags, large and small.

This may be the most important principle when it comes to forming new relationships. Countless divorced and broken-hearted people tell themselves, “I should have known better….I did know better, but I did it anyway.

Don’t do it. If you’ve noticed red flags; a flash of anger at something small, a dismissive tendency, a lie, an irresponsible streak; the thing to do is confront it early on. Don’t pretend it’s not happening. Ask your partner what’s going on. Don’t take excuses. Give him or her a chance to explain and don’t accept lame explanations.

Small red flags are infamous for turning into giant failure banners over time. If you have a habit of ignoring red flags, you are just looking for trouble.

2. Commitment based on emotion only.

No romantic relationship is complete without passion. Feeling the deep joy of your beloved is the fuel that keeps things going. On its own, however, it is not enough. Running on emotion only is like driving a car without a steering wheel. You’ve got the engine revved up, but no way of getting where you want to go.

So much more goes into relationship compatibility! According to Jake and Hannah Eagle’s Dating, Relating and Mating online program, you need four primary areas of compatibility: Chemistry, mutual values, mutual dreams and compatible communication styles. If one area is significantly out of alignment, your relationship may be in serious trouble.

Jake and Hannah have counseled couples over the last 25 years. I used their protocol when choosing my mate and I can tell you, it’s the best relationship compatibility test there is. Make your commitment last by taking you and your partner through this program.

3. Aligning with someone who has a very different communication style.

communication romantic• She thinks and speaks quickly. He thinks and speaks slowly.

• She’s a busy body. He’s a couch potato.

• He likes to get things out in the open and confront problems. She tends to bury her feelings and avoid conflict.

• He’s an extreme extrovert. She’s an extreme introvert.

• She speaks her thoughts as they happen. He broods on things and only discusses them once he has come to conclusions.

• He makes decisions quickly. She makes decisions slowly.

Communication styles are present throughout every interaction, every single day. Differences are fine. However, can you adapt to your partner’s style? Can you accommodate without going nuts?

Don’t think that you’ll learn to deal with it in time, no problem. Learn to deal with it before making the commitment, or don’t commit.

4. Aligning with someone who has different values.

• He’s motivated by money and success. She’s motivated by learning and spirituality.

• He values security and safety. She values adventure and freedom.

• He’s an atheist. She’s a Christian.

• She prizes her health and nutrition. He loves beer and pizza.

• He’s a lifelong learner. She’s a partier.

• He loves to travel. She’s a home body.

We make decisions based on our values. Because couples need to make decisions together and often, conflicting values lead to conflicted relationships. Conflicted relationships are stressful.

Don’t think that you are going to change your partner’s values. It’s very rare that this happens according to plan. Find someone who shares your values.

5. Overlooking chemistry.

You’d think that this basic biological response would be an obvious deal-breaker when it’s not present. However, plenty of people overlook a lack of physical attraction in favor of securing a relationship.

The chemistry will come in time.

No, it won’t. So, don’t count on it.

Chemistry is discovered early and easily. Just hug, hold hands, kiss, or even smell each other. You won’t need to think about it. You’ll feel the chemistry, or not. No chemistry, no romance. In this case, you’ll have a steering wheel, but no fuel in your engine.

6. Taking a chance on finances.

So you want to be together but you’re broke. My advice: get the money figured out securely, then move your relationship to the next level. After all, without money, you cannot build a life together. Worse, you don’t have any evidence of financial

viability or responsibility in your relationship.

If your partner is the financial risk; in other words if your partner can’t keep a job or make money, then don’t count on that changing as you move ahead. Someti

mes relationships begin with the understanding that only one will make the money.

If you’ll be depending on your partner’s contribution, then see the evidence that it will be consistent before making a commitment. Otherwise, you’re rolling the dice and you shouldn’t base your financial future on luck.

7. Disregarding your nagging doubts.

How many people struggle with nagging doubts even as they walk down the aisle? More than you’d imagine.

Manchester News reports that nearly half of divorcees believed their relationship was doomed right up to the wedding day. Instead of enjoying the big day, 45% of people surveyed by Slater and Gordon struggled through it with a worried mind.

The cure for nagging doubts is to express them to your partner and work through the issues. If you can’t work through them, then you’ll save yourself years of pain by enduring the more immediate separation.

8. Ignoring the need for boundaries.

Establish your boundaries up front. You’re an individual. You need time alone. You may have hobbies that differ from your partner’s likings. You have friends, a family and personal interests. When you blend your life with another, you’ll be part of something greater. Yet, you maintain your individuality. This needs to be respected.

If you don’t establish this up front, it only gets harder to do so as time passes. You don’t need to do everything together. You don’t need to enjoy the same things all the time. It’s OK to be separate some of the time. When you need your time, take it. Make sure your partner is strong enough to handle that. Otherwise, you’re looking at a lifetime of resentment when you sacrifice your personal wants over and over.

9. Excusing poor treatment of others.

Don’t overlook reality when your partner is mistreats others. One client of mine married a bully. In her naivete, she thought that if was fine if her fiance was mean or rude to others. After all, she wanted to be with someone strong who would protect her.

She was shocked, after the marriage, when he turned his bullying on her. She was now his primary target. For years she walked on eggshells, fearing verbal abuse at the slightest misstep. Finally, she left him in an ugly divorce.

Ask yourself if you’d want to be on the receiving end of your partner’s behavior. You will be one day, rest assured.

10. Justifying someone’s past in hope for a better future.

Everyone has a track record. Do you know your partner’s history? You should. Interestingly, most people share their personal histories too early in the relationship, often on the first date. Instead of laying the foundation for a friendship (which should come first), they dive into the deep stuff.

If someone wants to share the depths of their historical issues and struggles in life with YOUR FUTUREyou (a stranger) on the first date, that should be a red flag in and of itself.

At any rate, your partner’s past will contribute in a meaningful way to his or her future. If that future involves you, then you want to know how much they’ve had to overcome. And if they have truly overcome it. Financial struggles, addiction, relationship issues (abandonment, betrayal, abuse), legal issues – all these affect the present.

Don’t write off the history in favor of a fantasy future. Reality will strike soon!

In short, don’t sabotage yourself!

Self-sabotage is probably the most overlooked aspect of forming relationships. When you overlook red flags, remain silent and move ahead in spite of your doubts, you’re setting yourself up for pain. And this is the nature of self-sabotage. We keep returning over and over to the familiar pain of rejection, being controlled and deprived.

If self-sabotage might be an issue for you, then begin to learn about it by watching this free and enlightening video.

You can learn more about the Dating, Relating and Mating program here. Much of this article is based on insights gained from this program.

By Jonice Webb PhD

Father’s Day is easy for all of the people who feel loving, loved and close with their dads. If your relationship with your father is strong and uncomplicated, I hope you will give him the wonderful Father’s Day that he so deserves.

But the world is full of people who have more complex relationships with their dads. If you feel either confused or disappointed about your father, there’s a fairly good chance that it’s because of hidden CEN (Childhood Emotional Neglect).

Do you get irritated or snap at your father for apparent no reason?
Do you cringe a little inside when you have to talk to your dad?
Does being alone with your father make you feel awkward or uncomfortable?
Are you uncertain whether your father loves you and/or is proud of you?
Do you sometimes feel that your dad doesn’t actually know you very well?
Do you look forward to seeing your father, and then often feel vaguely let down or perplexed afterward?

All of these questions are designed to highlight something that is missing from your relationship with your father; something that’s invisible and typically hard to pinpoint, but which is absolutely vital for a healthy father/child relationship:

Emotional Connection

When you grow up emotionally disconnected from your father, you don’t necessarily realize it. Yet there are many fathers who don’t directly damage their children by actively abusing them. They may provide well materially, and they may even love the child. But they don’t know how to emotionally connect, often because their own fathers didn’t emotionally connect either.

Men are subject to emotional discrimination in today’s world, but that discrimination was far worse in previous generations. Our fathers and our fathers’ fathers were trained to hide their feelings from the world. Emotion is weakness, they were told. Legions of men raised their children caught between two opposing forces: Be tough; and be a good father. Unfortunately tough, emotionless men do not make very good fathers.

If your dad was abusive, toxic or mean during your childhood, has never taken responsibility for how he hurt you, and continues to harm you to this day, then you owe him nothing. just do whatever helps you feel better to get through the day. Father’s Day is your day to focus on yourself. No guilt allowed.

Follow these Steps to help you get through Father’s Day with your emotionally neglectful dad:

Acknowledge that your father, however well-meaning, failed you in one very important way. A way that matters and has impacted you greatly.
Acknowledging this basic truth does not make your father bad. You are not trying to blame him; only to understand him, and yourself.
Put a special focus on yourself this day. Recognize that it may be a more complex day for you and your father than it is meant to be, and that’s okay. Make sure to take care of yourself today.
Make a promise to yourself that you will deal with your own empty spaces and blind spots; the areas left vacant by your emotionally neglectful dad.
Today, decide that you will not pass insidious, invisible Emotional Neglect down to your children. You will give yourself what you never got, so that you can also give it to your children.
Your father gave you a lot, but also failed you. Both are true. Today, try to focus on what he did right.

That will be your Father’s Day gift to him.

Happy Father’s Day.

To learn more about how to fill in the empty spaces and blind spots left by Childhood Emotional Neglect, and how to make sure you do not pass it on to your children, see EmotionalNeglect.com and the book, Running on Empty.

By Janice Wood

A new study has found that low-energy activities that involve sitting are associated with an increased risk of anxiety.

“Anecdotally we are seeing an increase in anxiety symptoms in our modern society, which seems to parallel the increase in sedentary behavior,” said Megan Teychenne, lead researcher and lecturer at Deakin University’s Centre for Physical Activity and Nutrition Research (C-PAN) in Australia.

“Thus, we were interested to see whether these two factors were, in fact, linked. Also, since research has shown positive associations between sedentary behavior and depressive symptoms, this was another foundation for further investigating the link between sedentary behavior and anxiety symptoms.”

For their study, C-PAN researchers analyzed the results of nine studies that examined the association between sedentary behavior and anxiety.

The studies varied in what they classified as sedentary behavior from television viewing and computer use to total sitting time, which included sitting while watching television, sitting while on transport, and work-related sitting. Two of the studies included children and adolescents, while the remaining seven included adults.

It was found in five of the nine studies that an increase in sedentary behavior was associated with an increased risk of anxiety, the researchers reported.

In four of the studies it was found that total sitting time was associated with increased risk of anxiety.

The evidence about screen time — TV and computer use — was less strong, but one study did find that 36 percent of high school students who had more than two hours of screen time were more likely to experience anxiety compared to those who had less than two hours, according to the researchers.

The C-PAN researchers suggest the link between sedentary behavior and anxiety could be due to disturbances in sleep patterns, social withdrawal theory, and poor metabolic health.

Social withdrawal theory proposes that prolonged sedentary behavior, such as television viewing, can lead to withdrawal from social relationships, which has been linked to increased anxiety.

The researchers note that more follow-up studies are required to confirm whether anxiety is caused by sedentary behavior.

“It is important that we understand the behavioral factors that may be linked to anxiety in order to be able to develop evidence-based strategies in preventing (and) managing this illness,” Teychenne said.

“Our research showed that evidence is available to suggest a positive association between sitting time and anxiety symptoms, however, the direction of this relationship still needs to be determined through longitudinal and interventional studies.”

The study was published in the open-access journal BMC Public Health.

Source: Biomed Central

BY DR. TRINA READ
FDA advisers have offered their endorsement of a new sexual enhancement druf for women, here’s how it works.
Getting aroused is more than a physical act, it also requires a readiness of the mind.

“ Our biggest sex organ—the brain—plays an important role in regulating a woman’s sexual desire.”
Sex and relationship expert, Dr. Trina Read, is ready to answer your questions.

How does this new female sexual enhancing drug Flibanserin work?

Flibanserin was created as an anti-depressant, but trial testers quickly noticed it enhanced women’s sexual desire.

Our biggest sex organ—the brain—plays an important role in regulating a woman’s sexual desire. Flibanserin helps brain chemicals increase the downstream release of feel-good dopamine and norepinephrine while reducing stress-inducing serotonin in the parts of the brain dealing with sexual desire.

However, there are many factors at play when it comes to women and desire including: relationship issues, boredom and discomfort during sex.

Therefore, Flibaserin is meant to treat Female Sexual Interest/Arousal Disorder (FSIAD) which is when a woman’s lack of sexual desire is ongoing and causes her distress; it can’t be directly caused by a non-sexual mental disorder, severe relationship distress (like abuse), other stressors, a drug, or other medical condition.

Meaning, the right candidate is someone who used to have a great libido, but now doesn’t and there’s no explanation as to why. She’s in a loving relationship and her lack of sexual desire is negatively impacting her quality of life.

A chat with your doctor and/or sex therapist can help you decide if Flibaserin is right for you.

Great Sex Tip: According to the North American Menopause Society, FSIAD might be more common in peri-menopausal women than post-menopausal women, but FSIAD can be found among all age groups.

I caught my husband wearing my underwear and it’s completely freaking me out.

Okay. First take a deep breath. Although it is shocking to see a man wearing women’s lingerie, it’s certainly not uncommon.

Your biggest question might be, why would he wear your underwear? Men wear lingerie for the same reason as women: it feels sexy. But because there is a massive stigma most men would rather sneak rather than admit it.

You need to ask yourself: Was it the secrecy, or him actually wearing lingerie that upsets you. I would guess it’s mostly the secrecy.

Unfortunately, 99 percent of the population is conditioned to believe how genders should dress. Accordingly, we believe a man isn’t manly if he wants to wear lacy undies.

Looking at this in another way, a big part of a happy, healthy marriage is your husband not being afraid to be himself. I will go out on a limb and say he got caught on purpose because he didn’t know how else to bring this up to you.

Tell him you love him and want to understand this. If you can reserve judgment and listen you will probably see this is really nothing more than a (pretty harmless) kink.

With time and acceptance—and an open mind—it may eventually become a positive sexual enhancer.

Great Sex Tip: Men’s lingerie is so popular there’s a clothing line of lingerie for men called Homme Mystere.

Dr. Trina Read is the founder of VivaXO.com; a leading relationship and sexual health expert and educator; and is a best selling author, media expert, syndicated blogger, international speaker, magazine columnist, and spokeswoman. Trina has just launched Sensual Tastes Events, an interactive workshop blending the pleasures of food and sex education. Follow her on Twitter and Facebook.

By Therese J. Borchard
The other day a child psychologist was telling me about a very rigid, perfectionistic patient of hers.

“I want to control what other people are thinking,” the patient explained.

“How do you think you are going to do that?” the therapist responded.

The 11 year-old brainstormed but couldn’t come up with a solution. Finally the therapist interrupted her thought process and said, “Do you know what you CAN control?”

“What?”

“What YOU are thinking.”

The young girl paused to think.

“No, that’s not good enough.”

I laughed when I heard the story. As an adult child of an alcoholic, I especially have difficulty when someone doesn’t like me or approve of something I’m doing. And if I like and respect that person, the pain is even deeper. It feels as though the floor under me has disappeared, that I have no grounding or security, and I’m free falling to an unknown landing spot, where wild animals will probably eat my body.

I’ve had enough years of therapy to know that it is a leftover wound from childhood crap. The discomfort and panic that I feel at times doesn’t necessarily have that much to do with the person who doesn’t like me or approve of me as much as it does that I was never truly loved unconditionally as a child, and therefore spend so much of my adult life trying to win love and approval of everyone, including baristas, mail carriers, the women at the deli, the guys at the blood lab, and, of course, my doctors.

I call it my knee scab — the pain I feel at times when someone doesn’t like me or approve of something I’m doing. It’s an old wound that is vulnerable to being opened whenever I start to have a difficult conversation, whether it is in person, on the phone, or online.

When I was in the fourth grade, my left knee stayed bloody the whole year because I kept on falling on it. I’d think I could finally put the Band-Aids away when, bam! Again the same spot. The Law of Attraction people probably would say that I wanted a bloody knee and therefore attracted my accidents. But I think the spot was just tender, so any accident I had — and I was very clumsy — would break open the scab. It never had a chance to heal.

Yesterday I had another bloody knee. I felt the floor beneath me disappear again, and the rush of painful emotions from years past came over me. I lost my breath and my appetite, as the panic of not being loved or approved settled in. The night previous I was as authentic as possible in an email exchange with someone, sharing from my heart as best as I know how, and the response hurt my feelings. It was a little like the scene in Star Wars when Princess Leia yells to Hans Solo, “I love you!” And he responds, “I know!”

Harriett Lerner, PhD, writes in The Dance of Connection: “Truth is, nothing you can say can ensure that the other person will get it, or respond the way you want. You may never exceed his threshold of deafness. She may never love you, not now or ever. And if you are courageous in initiating, extending, or deepening a difficult conversation, you may feel even more anxious and uncomfortable, at least in the short run.”

That’s right, being courageous or authentic can create even more anxiety. However, to hide behind my truth isn’t an option. Lying makes me depressed because it causes all sorts of guilt. Remember, I’m Catholic. Although authenticity is more difficult in the short-term, I will get over this hollow feeling and scabbed knee. However, if I duck from all kinds of difficult conversations, I’m moving toward becoming a wuss. A depressed, guilt-ridden Catholic wuss.

As I was trying to breathe through the difficult emotions yesterday, I asked myself, “What would happen if this person absolutely hates you, despises your whole being, never wants anything to do with you again? Think worst possible scenario: you respect her, but she thinks you’re scum. Can you live with that?”

I imagined the two people in my life who love me unconditionally — who would love me even if I robbed a bank tomorrow or was on the news for completely losing it this holiday season, riding a horse in the middle of the mall, wrecking all the Christmas decorations, yelling profanities — my husband and my foster dad/writing mentor, Mike Leach.

I closed my eyes. I held on to a glove with each hand that I imagined was their hands. Together we walked up to the person who I think doesn’t like me. She spit on me. Mike said to me, “It’s okay.” I grabbed the gloves tightly and I felt their love over me. The unconditional love that was absent when my little brain was forming and I’ve been desperate to get it ever since.

I was okay. Forehead a little moist. But I was okay.

I was loved.

Eventually, if your recovery is going in the right direction, self-help experts say you don’t need to clutch gloves filled with imaginary hands because you have enough self-compassion to fill that place in your heart. Well, I am not there yet.

I’m ahead of the 11-year old. I have accepted the fact that I can’t control what other people think.

But I still have to nurse a bloody knee every now and then.

By Traci Pedersen

Sleep disturbances and undiagnosed sleep apnea are common issues among middle-aged and older adults in the U.S., and these sleep problems occur more often among racial and ethnic minorities, according to a new study published in the journal Sleep.

“Our findings underscore the very high prevalence of undiagnosed sleep disturbances in middle-aged and older adults, and identify racial/ethnic disparities that include differences in short sleep duration, sleep apnea and daytime sleepiness,” said lead author Dr. Xiaoli Chen, research fellow in the Department of Epidemiology at Harvard T.H. Chan School of Public Health in Boston.

The study involved 2,230 racially/ethnically diverse men and women who were between the ages of 54 and 93 years. Data was gathered by the following means: polysomnography, a sleep study that measures brain waves, oxygen levels in the blood, heart rate, and breathing patterns; actigraphy, a non-invasive measuring device worn by patient to monitor gross motor activity; and validated questionnaires.

The researchers found that 34 percent of participants had moderate or severe sleep-disordered breathing as measured by polysomnography, and 31 percent had short sleep duration with less than six hours per night measured by actigraphy.

Questionnaires also showed that 23 percent reported having insomnia, and 14 percent reported excessive daytime sleepiness. Only nine percent of participants reported being diagnosed with sleep apnea by a doctor.

Blacks were most likely to have short sleep duration of less than six hours, and they were more likely than whites to have sleep apnea syndrome, poor sleep quality, and daytime sleepiness. Hispanics and Chinese were more likely than whites to have sleep-disordered breathing and short sleep duration, but Chinese were least likely to report having insomnia.

The study is believed to be the first to comprehensively evaluate objective measures of sleep apnea, short sleep, and poor sleep, as well as subjective measures of habitual snoring, insomnia, and daytime sleepiness in a multi-ethnic U.S. population that includes Chinese Americans. The findings suggest that sleep disturbances may contribute to health disparities among U.S. adults.

“As sleep apnea has been implicated as a risk factor for cardiovascular disease, stroke, diabetes, and mortality, our findings highlight the need to consider undiagnosed sleep apnea in middle-aged and older adults, with potential value in developing strategies to screen and improve recognition in groups such as in Chinese and Hispanic populations,” said senior author Dr. Susan Redline, professor of medicine at Harvard Medical School and Division of Sleep Medicine at Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center in Boston.

Source: American Academy of Sleep Medicine

By John M. Grohol, Psy.D.

According to the Center for Collegiate Mental Health 2014 annual report, anxiety is the number one concern of college students’ mental health needs today, with depression placing second. As college counseling centers continue to deal with ever-expanding workloads and needs of the college students they serve, it’s concerning that so many students are facing serious mental illness, such as anxiety and depression.

University counseling centers were originally setup to help students primarily with academic and relationship concerns, as well as just the issues that arise from living on your own for the first time in your life. But in the past two decades, these centers — whose services are usually provided at little or no cost to students, covered by their student fees — have begun serving more and more students with serious mental illness.

The most recent data comes from a survey that was conducted in 2013-2014 and included over 101,000 college students seeking services from 2,900 clinicians providing services at 140 college and university counseling centers.

In the survey, clinicians identified that for clients who sought out counseling services, anxiety was the top-most concern of nearly 20 percent of all college clients. Nearly 16 percent of students complained of depression, while another 9 percent came to the counseling center for a relationship issue.

http://g4.psychcentral.com/blog/wp-content/uploads/2015/06/graph-image-college-students.jpg

Stress was the top issue for nearly 6 percent of college students, while nearly 5 percent of students complained that their academic performance was their main issue. Family, interpersonal functioning, grief/loss and mood instability rounded out concerns expressed by more than 3 percent of college students seeking services.

The New York Times also covered the story, noting the rise of anxiety concerns among students:

Anxiety has become emblematic of the current generation of college students, said Dan Jones, the director of counseling and psychological services at Appalachian State University in Boone, N.C.

Because of escalating pressures during high school, he and other experts say, students arrive at college preloaded with stress. Accustomed to extreme parental oversight, many seem unable to steer themselves. And with parents so accessible, students have had less incentive to develop life skills.

“A lot are coming to school who don’t have the resilience of previous generations,” Dr. Jones said. “They can’t tolerate discomfort or having to struggle. A primary symptom is worrying, and they don’t have the ability to soothe themselves.”

The good news is that due to mental illness stigma becoming more and more of a non-issue amongst younger generations, more young people have no problem seeking out services for these concerns. The bad news is that we live in a society where providing coordinated and integrated care for mental illness remains firmly stuck in the past.

College counseling centers are usually not well-integrated within their local community of care. And students often are reluctant to seek care away from their university, since such care might only be affordable by using insurance — usually, their parents. Despite the reduction in stigma and uptick in those seeking care, there still are limits on what a person might want to share with their parents, including their mental health battles.

Counseling centers are equipped (and funded) only to offer fairly short-term treatments. Yet more and more students are turning to these under-funded centers for their care, resulting in long wait lists, or less-than-ideal short-term care.

In an effort to cater to the rise in the number of students seeking services, more colleges are offering workshops (for psychoeducation) and groups to help treat these rising numbers. It’s no wonder — the students coming to them are more informed and better-educated about mental health treatments than at any previous time in history. As the Times article notes, “Half of clients at mental health centers in their most recent report had already had some form of counseling before college. One-third have taken psychiatric medication.”

We hope universities continue to expand their services and get creative in better serving their young adult students. After all, these are some of the most important, formative years for the students.

By Brian Cuban
I am just one guy out of many men and women who struggles with Body Dysmorphic Disorder( BDD), a condition that often begins in adolescence and affects as many as 1–2% of the population. For potentially millions of Americans, depression, addiction, steroid abuse, eating disorders, and broken relationships are common byproducts.

So what is the down and dirty of BDD? Experts characterize BDD as a condition marked by sometimes disabling preoccupation with imagined or exaggerated defects of physical appearance. Many experts consider BDD a form of obsessive-compulsive disorder, or OCD. The disorder is fairly common, affecting as many as 2% of the population, and has been known to psychiatric experts for over a century.

Is there an exact point in life that I can point to and say “this is when my thought process changed, this is when I developed BDD?” No, I can’t. I was bullied as a child. I grew up in a family sometimes in conflict, with a pattern of verbal abuse on my mother’s side, passed through generations. I was a fat kid. I was the middle child and shy to begin with as a matter of biology and genetics. Psychologists, psychiatrists, and other treatment professionals will tell you that there is no one cause.

What does it feel like? Here are some of the behaviors that have defined my struggle with BDD. To a casual observer some of these may seem narcissistic, “quirky,” or eccentric. They may sound familiar to others at risk for BDD:

The shower inspection. I have been doing it as far back as I can remember—a detailed inspection of the areas of “concern” on my body when I shower. I know I am doing it, but it has become integrated into my daily routine. Like breathing, I just can’t stop. With the palm of my hand I press down on my stomach and try to flatten it. Of course it always bounces back, but I feel like I can actually measure if there has been any increase in my waist size.

Verifying body defects through touch. I do it all the time. I rarely notice it. Primarily my chest area. This is a remnant of a past steroid addiction. I could be walking down the street, in a mall, sitting at dinner. For a split second I will touch my chest. It may even cause concern among those around me if it occurs more than once in a short period—I have had that happen. The person will ask if I am okay. They may think I am having chest pain, on the verge of a heart attack.

The pants carousel. Women are stereotyped as trying on numerous outfits before they go out. It’s part of their mystique and what we love about them. And we all want to look good in what we wear. No big deal. But is it common for a guy to try on numerous outfits before he goes out at night? What about before he leaves the house in the morning? What about trying on every pair of pants in the closet to make sure they all still fit as a daily routine while getting ready for work?

A love-hate relationship with mirrors. Don’t we all have that? Nothing out of the ordinary. The difference is that growing up, I traditionally did not see my reflection. I saw over-exaggerated love handles. A receding hairline seemed completely bald. The reflection in the mirror showed scarring that did not exist in real life. My chest seemed deformed and unattractive. I was even able to “see” stupidity. I saw a monster.

The hanging shirt. I hate to tuck in my shirts. Fortunately it has become kind of a style statement so it does not seem too weird. For me, however, the un-tucked shirt is not an attempt to be stylish. The very act of tucking the shirt and creating less space between my stomach and my clothes is stressful for me.

Fear of crowds/Social Anxiety. This could be going to a party, nightclub, bar, or anywhere else that I expect people to be sizing each other up. Any situation where in my mind the entire scene is about judging and comparing my looks and “defects” to other people, forging romantic relationships, or being scrutinized based on looks has always been a terrible problem for me. And the way I’ve coped with social anxiety has sometimes been worse than the anxiety itself. In the past, I’d always be drunk or high before the event.

Plans to artificially fix the “defects.” Any other BDD sufferers out there who have contemplated lap band surgery even though they are not medical candidates for it? When the Bariatric Weight Loss commercial comes on the tube, I quickly think, “Will Lap Band be okay for me or do I need a gastric bypass?” What? I weight 220 lbs at 6 foot 2 inches! Of course I don’t need that. My mind for a split second says something different.

Inner critic; outer-critic. I would see flaws not just in myself, but in everyone I met as well. When I was at my worst, this was a terrible problem for me and hurtful to others. When you obsess over defects in yourself, zooming in 10X on even the most minute flaws, you tend to do the same when you look at others. When I was younger, this sometimes turned me at times into what I despise—a bully.

One Word: Plastics. Multiple visits to the plastic surgeon are common for BDD sufferers. I am no exception. As of the writing of this book, I have had four hair transplants, one liposuction, and lasik at a total cost of about twenty thousand dollars. Not too extreme by BDD standards, but the only reason I did not have more procedures is because I could not rack up any more debt to get them.

Self-medication. Using drugs to try to change how you feel about yourself, how you see yourself, how you perceive others seeing you. I excelled in this. Alcoholic. Cocaine Addict. Abuse of weight loss drugs laxatives and anabolic Steroids. All of them gave me a brief self-image high the moment I took them, but in the end they all led toward vicious cycles of destructive behavior.

Disordered Eating Behaviors. Eating disorders are something that many BDD sufferers are intimately familiar with. I am not an exception here, either. About thirty percent of those with BDD will also develop and eating disorder.

Depression. Depression has always gone hand in hand with my BDD, and when it’s at its worst, depression has robbed me of the will to live. To make my life better and put an end to self-destructive habits.

Suicidal thoughts. I am very lucky to be above ground to write this book. I had a Spanish made .45 automatic. I almost wasn’t. Some are not.

Am I cured? The climb out was a long, slow, hard process. It started with putting one small step forward. There were setbacks. There were times when it seemed easier to go backwards than forwards. There were times when simply giving up was within hand. I now have the strength to face my path in life independant of what I see in the mirror? What do I see? I see something I did not see for so many years. I see Brian. Heavy, thin, bald, pimples, love handles and all. It’s ok. I am enough.

Today, I am addiction free except for my daily Starbucks Vente Blonde coffee. (In the world of addiction, the Vente seems a good trade-off from my old routine of coffee with a cocaine chaser to get going in the morning. or jabbing a steroid needle in my butt) I can face the world of people and social interaction—with some stress, yes, but not life-disabling stress, without the need to artificially change the image in the mirror. I love and have loved. I have been rejected. I have let go. I have forgiven. I am alive. I am okay. You can be as well. Take that step forward. It all starts with dropping that wall of shame and allowing yourself to be helped.

Resources: The Broken Mirror by Dr. Katharine Phillips.

By Traci Pedersen
Recurrent major depressive disorder (MDD) is associated with lower bone mineral density (BMD) in men, according to a new study from the University of Eastern Finland in collaboration with Deakin University, Australia. The use of antidepressants is also associated with lower BMD, but this link is dependent on weight and site of bone measurement.

Osteoporosis is a common health problem, particularly among postmenopausal women, and an underlying factor in fragility fractures. In the elderly, susceptibility to fracture and serious hip fractures can result in long-term hospitalization and decreased state of health.

Risk factors include low levels of physical activity, smoking, low intake of calcium and vitamin D, as well as certain medications and diseases. Lower bone density has also been linked to depression.

This might be due to depression-induced long-term stress and increased secretion of inflammatory markers. Selective serotonin reuptake inhibitors (SSRIs) used to treat depression have been shown to weaken bone health as well.

Although most studies have focused on postmenopausal women, the new study analyzed the association of single and recurrent MDD episodes and the use of antidepressants with bone density in men.

Between 2006 and 2011, 928 male participants (aged 24-98 years) completed a comprehensive questionnaire and had BMD assessments at the forearm, spine, total hip, and total body. MDD was identified using a structured clinical interview.

Nine percent of the study population had experienced a single MDD episode, and five percent had suffered from recurrent MDD. Furthermore, seven percent of the study participants reported the use of antidepressants at the time of assessment.

The findings showed that recurrent MDD was associated with lower BMD at the forearm (-6.5 percent) and total body (-2.5 percent) compared to men with no history of MDD, while single MDD episodes were associated with higher BMD at the total hip (+3.4 percent).

Antidepressant use was tied to lower BMD only in lower-weight men and varied across the bone sites. For example, the use of antidepressants was associated with reduced bone density in the hip in men weighing less than 242 pounds.

In the forearm, however, the association of anti-depressants with reduced bone density was not observed in men until their body weight was under 165 pounds.

Finally, the findings show that recurrent major depression may increase the risk of osteoporosis in men. Furthermore, the use of antidepressants should be taken into account as a potential risk factor of osteoporosis especially in men with a low body weight.

The study constitutes part of the Ph.D. project of Researcher Päivi Rauma, focusing on the effects of depression and antidepressants on bone health. The findings are published in the Journal of Musculoskeletal and Neuronal Interactions.

When a potential client calls psychologist Shoshana Bennett, Ph.D, the first thing she does is congratulate them. “I say, ‘good for you. You did something great for yourself and those around you.’”

That’s because seeking professional help takes strength. But we rarely see it this way. We feel overwhelmed or burnt out. We feel vulnerable, exposed — a gaping wound. We beat ourselves up, believing we should be able to solve our own problems. We should be able to tough it out. And we berate ourselves endlessly because we can’t. What’s wrong with me?!?!

Maybe you were raised to believe you should be completely self-reliant, Bennett said. You were taught that you shouldn’t need anyone else, and if you do, then you’re inadequate, she said.

Maybe you were raised to see limitations as “she’s not really ill” or “he just lacks the guts to finish,” or “she’s just playing the victim, again,” said Ryan Howes, Ph.D, a clinical psychologist in Pasadena, Calif. Maybe you were raised to think that people who couldn’t overcome their emotional issues (their invisible limitations) on their own didn’t have the guts, willpower or strength of character, he said.

Or maybe you’re worried that others will see you as weak, incompetent, lazy or crazy. Either way, this kind of thinking stops people from going to therapy.

“Nobody would expect themselves or somebody else to power through their cardiac issues, cancer or diabetes and avoid seeking treatment,” said Joyce Marter, LCPC, founder and CEO of Urban Balance, a large insurance-friendly counseling practice with multiple locations in the Greater Chicago Area.

“I wish people had the same awareness of the seriousness of mental health issues and the importance and benefits of seeking professional help.” Mental health issues are serious, and not seeking help is dangerous.

“[M]illions of people who have legitimate needs for help avoid it in order to save face,” Howes said. Millions of people needlessly suffer because they believe that seeking help makes them weak.

“The longer one lives with a mental health issue of any kind, the more dangerous it becomes,” said Bennett, author of four books on depression, including Children of the Depressed. For instance, a person with depression stops sleeping well, eating properly and going to doctor checkups, she said. “It affects their entire being … They start thinking this is how they are. ‘I’ll never be happy. I’m just meant to be this way. Since it hasn’t gone away on its own, this is just me for the rest of my life.’”

They become hopeless. And hopelessness leads to suicide, said Bennett, a survivor of two suicidal depressions. “[E]very year we lose friends, family and loved ones to suicide,” Marter said.

People also self-medicate mental health issues with drugs or alcohol, she said. This “creates a downward spiral that can be life threatening.” Untreated mental health issues can impair job performance and wreck financial well-being, Marter added. For instance, she’s worked with many clients who’ve racked up serious debt during manic or hypomanic episodes.

Seeking help is smart. “We’re not experts in all areas,” Bennett said. It’s a wise decision to turn to people with expertise in one area, no matter what area it is, she said. We see doctors when we’re sick and dentists when we have a cavity. We hire contractors to renovate or repair our homes. Just like we can’t operate on our teeth or fix a broken roof, we can’t treat depression on our own or know how to change deeply entrenched thought patterns.

Seeking help is healthy and courageous. “It takes courage to face our issues and make a commitment to address them consciously and move through them to the best our ability,” said Marter, who pens the Psych Central blog The Psychology of Success.

It simply means we are human, Howes said. “It’s impossible for a person to be strong in all areas all the time, we’re people not gods or perfect robots.”

He also noted that we naturally need others. “Attachment research shows that the healthiest, most secure people are both capable of meeting their needs and reaching out for help from time to time.” They’re not lone rangers who don’t need anyone, he said. Instead, “they’re aware of their limitations and able to ask for help when they need it.”

We think it’s stronger to deal with our issues completely on our own. But suffering and not getting help only make it harder on our loved ones, Bennett said. Our mental health concerns interfere with our daily functioning. They sabotage our communication and create needless conflict. We may be unable to take care of ourselves and our kids. “When you do what’s best for you [and get whatever assistance you need], you’re automatically helping those you love,” Bennett said.

Seeking help is problem-solving, she said. It means you’re doing what you need to do to fix a concern, she said. By seeking professional help you also model healthy behavior to your kids. When Bennett’s clients worry if working with a therapist makes them weak, she asks them if they’d like their kids to reach out for help when they’re having a rough time. They reply: “Of course, I would.”

Seeking professional help is a courageous, compassionate and smart decision. Seeking help takes self-awareness, work and commitment. It means confronting challenges and working to overcome them — whether you’re seeking help because you have a mental illness or you’re feeling stuck. Aren’t these the very signs of strength?

Seek help if you need it. Support others in doing the same. In fact, as Howes said, “Imagine how strong individuals, couples, families, businesses and our nation would be if people felt free to ask for help when they need it.”

By Janice Wood

After a concussion, a person can be left with disturbed sleep, memory deficits and other cognitive problems for years, but a new study shows that sleep can still help them overcome memory deficits.

According to researcher Rebecca Spencer, Ph.D., at the University of Massachusetts Amherst, the benefit is equivalent to that seen in individuals without a history of mild traumatic brain injury (TBI), also known as concussion.

Spencer, with graduate student Janna Mantua and undergraduates Keenan Mahan and Owen Henry, found that individuals who had sustained a mild TBI more than a year earlier had greater recall in a word memorization task after they had slept.

“It is interesting to note that despite having atypical or disturbed sleep architecture, people in our study had intact sleep-dependent memory consolidation,” she said. “Supporting opportunities to sleep following a concussion may be an important factor in recovery from cognitive impairments. The changes in sleep architecture we observed are in an optimal direction, that is, more rich, slow wave sleep and less light or Stage 1 sleep, (which) is a shift in the positive direction.”

The researchers did notice differences in sleep in the participants who had a concussion. They spent a significantly greater part of the night in deep, slow-wave sleep, a sleep stage where memories are replayed and consolidated to long-term storage. However, their memory and recall ability was not significantly different from the participants who had not suffered a concussion, the researchers noted.

“Overall, sleep composition is altered following TBI, but such deficits do not yield insufficiencies in sleep-dependent memory consolidation,” the researchers wrote in the study.

For the study, researchers recruited 26 young adults 18 to 22 years old with a history of diagnosed TBI an average three to four years earlier, and 30 people with no history of brain injury. All slept more than six hours a night, took few naps, drank moderate amounts of coffee and alcohol, and had no neurological disorders other than participants who had a TBI, the researchers reported.

Participants learned a list of word pairs and their memory for them was assessed 12 hours later. Half in each group learned the word pairs in the morning and their memory was tested in the evening, while half were tested in the evening and their memory was tested in the morning after sleep.

Sleep stages were identified by polysomnography, attaching a set of electrodes to the head for physiological recordings during sleep.

While slow wave sleep was greater in those with a TBI, they also had less non-REM stage 1 sleep, a form of very light sleep seen during the wake-to-sleep transition, according to the study’s findings. This suggests that those with a concussion history can reach deep sleep sooner and get more of it, the researchers said.

For both those with a history of concussion and those without, recall was better following sleep than being awake in the daytime, according to the study’s findings.

“We know this is not just a matter of the time of day we tested them at as they were able to learn equally regardless of whether we taught them the task in the morning or the evening,” Spencer said.

Source: University of Massachusetts Amherst

by Sari Solden
Only a mental health professional can tell for sure if you have ADHD, but reviewing this handy checklist will give you an idea.

ADD symptoms in women look different than they do in men

Do you have ADD? Does your daughter? Only a mental-health professional can tell for sure, but completing a do-it-yourself symptom checklist will give you an idea. The more questions you answer in the affirmative, the more likely you are to have ADD. Be sure to share your completed checklist with a doctor.

Do you feel overwhelmed in stores, at the office, or at parties? Is it impossible for you to shut out sounds and distractions that don’t bother others?
Is time, money, paper, or “stuff” dominating your life and hampering your ability to achieve your goals?
Are you spending most of your time coping, looking for things, catching up, or covering up? Do you avoid people because of this?
Have you stopped having people over to your house because of your shame at the mess?
Do you have trouble balancing your checkbook?
Do you often feel as if life is out of control, that it’s impossible to meet demands?
Do you feel that you have better ideas than other people but are unable to organize them or act on them?
Do you start each day determined to get organized?
Have you watched others of equal intelligence and education pass you by?
Do you despair of ever fulfilling your potential and meeting your goals?
Have you ever been thought of as selfish because you don’t write thank-you notes or send birthday cards?
Are you clueless as to how others manage to lead consistent, regular lives?
Are you called “a slob” or “spacey?” Are you “passing for normal?” Do you feel as if you are an impostor?
Symptom checklists are available at addvance.com/help/women/girl_checklist.html and addresources.org/article_adhd_checklist_amen.php, as well as at sarisolden.com/checklist.html (the site from which the questions above are adapted).

ADHD and Depression
People with ADHD are three times more likely to develop depression than the general population. Depression and ADHD share some symptoms, such as inattention, sleep problems, and lack of motivation, but the causes of symptoms are different. With ADHD, you may lack motivation because you are overwhelmed. With depression, you may not want to do anything at all. If feelings of sadness, lethargy, or insomnia persist, despite ADHD treatment, talk to your doctor.

ADHD and Learning Disabilities
ADHD impacts learning and behaviors in school, but the condition is different than a learning disability. Children with ADHD are three to five times more likely to develop a learning disability as those without ADHD. Around one-half of all those with ADHD also have some type of LD. Those with an LD may have trouble organizing thoughts, finding the right word to use when speaking, mastering reading, writing, or math, or having difficulty with memory.

ADHD and Anxiety
About one-fourth of those with ADHD also have an anxiety disorder. As with depression, the two share common symptoms, such as lack of focus and insomnia. Nervousness is also a possible side effect of stimulants. If you have unexplained and persistent fears, or experience panic attacks, and feel that your ADHD treatment is not working, talk with your doctor about an anxiety disorder.

DHD and Oppositional Defiant Disorder
Symptoms of oppositional defiant disorder (ODD) include repeated temper tantrums, excessive arguing with adults, being uncooperative, deliberately annoying others, seeking revenge, being mean and spiteful. Research shows anywhere from 45 to 84 percent of children with ADHD will develop ODD. Treatment for ODD includes psychotherapy and medication.

ADHD and Bipolar Disorder
Bipolar disorder is characterized by mood swings—high, euphoric periods (mania) and low periods of depression. The mania stage is sometimes seen as hyperactivity and the low states as inattention and lack of motivation, all of which are common with ADHD. Those with bipolar may lose touch with reality or have a distorted sense of reality; their moods, both mania and depression, may last for weeks. About one-fifth of those with ADHD also have bipolar disorder.

ADHD and Sensory Processing Disorder
Sensory processing disorder (SPD) is an inability to sort out external stimuli—making the smallest stimuli unbearable—or the need to search out high-stimulus activities to arouse sluggish senses. When researchers looked at children who showed symptoms of ADHD or SPD, 40 percent showed symptoms of both. It is important that both conditions are identified and treated early.

ADHD and Autism
A new study suggests that ADHD kids are 20 times more likely to exhibit some signs of autism compared with non-ADHD kids. There isn’t a lab test to diagnose autism. Because symptoms of both conditions overlap, diagnosing and separating the disorders can be hard. Autism is characterized by social and communication difficulties and repetitive behaviors. Some early symptoms are delayed speech and avoiding eye contact. Early detection and treatment are important.

DHD and Substance Abuse
Twenty to 30 percent of adults with ADHD go on to develop substance abuse problems at some point in their life. Some use drugs or alcohol to combat symptoms of ADHD—to sleep better or improve mood. People with substance abuse problems have a higher risk of depression and anxiety. Misusing drugs and alcohol makes treating ADHD more difficult.

ADHD and Tourette’s Syndrome
Stimulant medication was previously thought to cause Tourette’s syndrome in ADHD kids. Recent research has shown that both disorders have similar risk factors—smoking during pregnancy, being born prematurely, and low birth weight. Those with Tourette’s exhibit motor and vocal tics—rapid, repetitive movements and sounds. About 90 percent of those with Tourette’s syndrome also have another disorder, the most common being ADHD.

ADHD and Conduct Disorder
Between 25 and 45 percent of ADHD kids develop conduct disorder (CD). Characteristics of CD include fighting, cruelty toward others, destructiveness, lying, stealing, truancy, and running away from home. Treatment for CD includes making sure ADHD symptoms are adequately treated, behavior therapy, and counseling. Your doctor may also suggest parental counseling to learn more productive ways of responding to your child’s behaviors.

By Annabella Hagen, LCSW, RPT-S

If you suffer from obsessive-compulsive disorder, you likely feel exhausted every day. The anxiety and tormenting thoughts may lead you to internal and external rituals. These compulsions provide relief — at least temporarily. You probably wish there was a magic pill or treatment that could take the suffering away permanently.

If you were told that the answer to a better life is found at the top of a high mountain, would you be willing to climb it? You would be warned, “It will be a stormy and an arduous ascent, but once you get to the top, you’ll find what you are looking for!” Would you take the chance and do what it takes to get there? It could be the hardest thing you’ve done in your life. Would you still consider it?

You might hesitate to sign up for such a challenge. You may hope that “things will get better.” After all, your compulsions grant you the relief you need daily. You may experience “good days,” and decide that climbing this mountain may not really be for you. It is human nature not to want to do hard things. If there are easier ways to obtain what we need, we usually opt for that. Why not?

Some OCD sufferers may choose to continue doing their compulsions. They may believe they are unable to do difficult things. Others may continue to endure in silence and may be unaware that there are answers to their misery. There are some who begin the climb and realize they aren’t ready to do it. However, if you are in search of an answer to your OCD challenges, consider these six things. They will enhance your chances to successfully find what you need.

Know that OCD is a physiological illness just like other illnesses. It’s not your fault that you have OCD. OCD may target what you care about the most, and your obsessions may be related to or triggered by an event in your life. However, OCD has nothing to do with your character and your worth. It has to do with a neurological dysfunction in some of the structures and chemicals in your brain. Research also shows that OCD is most likely a genetic predisposition. You may have a close or distant relative with OCD or related disorders. Know that medication is relevant in treating obsessive-compulsive disorder.
Understand that behavioral, cognitive, and environmental factors are also involved in OCD. Medication often is not enough. There might be some individuals who are fortunate to find relief from most of their symptoms once they start medication. However, this doesn’t happen often. You need to understand that medication doesn’t take care of the mental and behavioral rituals. A combination of medication and psychotherapy will provide best results.
Your compulsions heighten OCD symptoms. You need a treatment that will help you understand how to decrease and eventually eliminate those compulsions. You’ll also need to be aware of your thinking errors and learn how to address them. Studies provide evidence that cognitive-behavioral therapy (CBT) that includes exposure and response prevention (ERP) is the psychotherapy of choice for OCD. CBT that includes ERP will provide the best opportunity to change your brain pathways. Not all CBT skills that are adequate for treating depression, anxiety and other disorders are effective in treating OCD. OCD is a complicated illness and your provider needs to understand what elements of CBT are useful for treating OCD. Research is also showing that implementation of mindfulness skills will enhance the opportunity for success. The IOCD Foundation website is a great resource to keep you informed regarding evidence-based treatments for OCD.
“Doing” is the key to success. OCD sufferers often ask how they can make sure to remember what’s being taught. The answer is usually, “your OCD mind will ‘get it’ when you practice the skills.” This response may be difficult for some people who aren’t used to practicing the skills they are taught. Getting into new routines can be difficult and uncomfortable. This might be one of the more grueling segments of treatment.The effectiveness of CBT, ERP, and mindfulness skills are tested as individuals climb to the top of the mountain — one step at a time. When individuals “graduate’ from treatment, they are asked, “What made the difference in your progress? What helped you the most?” They usually answer, “It was the exposures. When I was proactive in doing exposures, my OCD mind finally got it!”
Trust the process. The research is there. If your treatment provider knows how to treat OCD, you will see the results. Put forth your best effort and you’ll have a meaningful and rich life despite OCD. It takes courage to climb up a mountain that you’ve never climbed before. But as you think of your life and where OCD has taken you or is taking you, it may be worth your effort. The climb may be arduous, but you and your loved ones will appreciate the results.
Take advantage of the relentlessness you have inherited from OCD. OCD is a stubborn illness and most likely you have a stubborn streak within you. Turn it into strength. Become determined to climb the mountain. Endure it the best you can as you learn new skills for life.
As much as you may wish for a magic pill and a treatment that won’t take much effort, OCD will continue to play a huge part in your life. The answer to your pain is out there, but you’ve got to work for it. The satisfaction you’ll find as you reach the summit will be priceless. You will find that the “magic” is in doing and becoming proactive in your treatment. Remember that many individuals have done it, and so can you.

By Támara Hill, MS

Last week I wrote about 8 Symptoms that should not always be labeled a mental illness. Life is life. We are all going to experience the worst of it and the best of it. We should not be so quick to label ourselves “disordered” until we evaluate every aspect of what could be happening to us. Clinicians and mental health professionals should also be careful not to quickly pathologize every client that comes through their doors. But sadly, there are way too many people in the world, including some mental health professionals, who either downplay or exaggerate mental health symptoms. There is often no in-between. Although we all would like to maintain the idea that most people are mentally healthy and well adjusted, we cannot ignore the fact that there are millions of people (children, adolescents, adults) who are struggling with mental health symptoms every single day of their lives. They are struggling with mild, moderate, and severe symptoms that seem to make their future grim. This article will discuss symptoms that should never be ignored or downplayed and possibly be evaluated by a mental health professional.

Unfortunately, the field of psychiatry and psychotherapy lacks a manual that would provide concrete direction on how to identify mental illness. Of course, we are all familiar with the DSM (and ALL of its many versions and revisions) but this is certainly not enough for the perplexities of life. The DSM provides minimal guidelines to help guide mental health professionals and to help them communicate, using a common language, more appropriately. But the manual does not provide the concrete answers many people seek about their lives and their health. Making a diagnosis using the DSM often includes a mediocre process of elimination. Sometimes this process is completely on point, while at other times is is completely off point. As a result, determining when a symptom (or constellation of symptoms) is a problem, can take a lifetime. For those individuals who are insightful about their psychiatric and emotional needs, deciding to pursue mental health treatment is often an easy process. But for those individuals who are often in denial, struggle with acceptance of reality, or lack a great deal of insight into themselves, pursuing mental health treatment is not something they are willing to do or even talk about. That’s why it’s important that others (family, friends, spouses, etc.) become knowledgeable about the symptoms and behaviors that signal that there is a very big problem.

Because it’s very difficult for many of us, primarily those without a clinical background, to identify when a symptom or behavior might indicate that psychiatric treatment is needed, I have compiled a list of symptoms and behaviors that should always prompt us to either seek treatment ourselves or encourage another person to seek treatment. This list is a list I often provide to parents and families who see me. Some of the problematic behaviors and symptoms include:

Frequent and dangerous sexual acting out: I have previously worked with juvenile delinquents within a mental health/juvenile agency. Most of these youths presented with high levels of anxiety, extreme traumatic histories, and frequent sexual acting out. Sadly, the children weren’t the only individuals sexually acting out. Many of their parents also engaged in similar behaviors such as sending nude pictures of themselves using their cell phone or Facebook accounts (“sexting”), prostituting, entertaining multiple partners, or maintaining an open marriage or relationship (without boundaries or sexual precautions). Although we are human beings who should not be ashamed of our sexuality, we must be appropriate, respect ourselves, and have some insight into how our sexuality affects our lives. For individuals who lack insight, there is a problem. The problem could be psychological (looking for approval, feeling rejected, etc), emotional (looking for love or companionship), or trauma-based (the result of a traumatic and abusive past).
Physical/Verbal aggression that is frequent: Some individuals are born with a difficult temperament that causes them to be easily triggered by minor things. Some individuals also have bad tempers that they just cannot control. However, an individual who frequently lashes out at others without considering the consequences of their behavior(s), puts others in harms way, is abusive (verbally, physically, or sexually), and jeopardizes their employment or living conditions, has a problem. There is something going on under the surface that causes the aggression. A mental health professional would be able to provide what is called a bio-psycho-social assessment to look at all aspects of the individual’s life. Biological/genes, social components, and psychological factors would all be assessed.
Self harm or suicidal thoughts with a plan and intent: Sadly, many of our youths today engage in self-injurious behaviors which include but are not limited to: cutting their arms, legs, thighs, or stomach with blades, knives, or other sharp object as a stress releaser or a way to fit in with others. Other kids engage in verbalizing a great deal of suicidal threats such as “I will kill myself,” “I want to leave this place,” or “I would be better off dead.” These kind of statements are known as passive death wishes because no mention of a plan has occurred and level of intent may be low. ALL suicidal statements should be taken seriously and evaluated, but the most severe form of suicidal thoughts are those that include a high degree of intent (on a scale from 1-10; 10=highest, an “8”) and a plan such as jumping off of a bridge tomorrow at 5:00 when people are too distracted to notice. If an individual (primarily children and teens) express both intent and give you an example of how they would complete the suicide, mental health attention is medically necessary. This is sufficient information to have this person 302’d or hospitalized.
Extreme fatigue or depressed mood: Life is hard and sometimes it simply gets you down. For many people in today’s fast-paced society where competition and callousness seems to have taken over, depression is likely to occur. Sleep and appetite disturbance, low self-esteem, hopelessness and helplessness, low mood, lack of interest in activities once enjoyed, irritability, weight loss or weight gain, and poor concentration are all symptoms of depression. Symptoms that interfere with daily life, result in job or relationship loss, and makes each day feel harder to navigate, will require therapy and possibly medication management. A mental health evaluation that screens for depression will be helpful.
Intense migraine headaches or bodily aches and pains: Some mental health disorders affect all aspects of our bodies. In many cases, mental health conditions can trigger medical conditions and vice versa. A mental health evaluation can help rule out psychological conditions so that you can focus on what the true issue is. For example, depression often triggers a lot of physiological symptoms such as headaches, bodily aches and pains, weight loss or weight gain, nausea or vomiting, arthritis or fibromyalgia, etc. However, some medical conditions such as thyroid disease can trigger depressed mood as well. So being able to get a mental health screening or evaluation will be important to ruling out conditions that may not be affecting your symptoms.
Extreme preoccupation with physical appearance, sex, money, or crime: Today’s society has become extremely narcissistic and self-focused. Most modern and popular movies, music videos, and songs include money, sex, crime, or some other illegal and immoral activity. Despite this fact, it’s important to understand when narcissism has turned into full blown clinical narcissism that interferes with daily life as a result of impulsivity (which can lead to risky sexual behaviors, substance abuse, gambling, infidelity, etc), immaturity, extreme vanity (which includes a lack of empathy for others and extreme preoccupation with physical appearance and self-importance), and a sense of grandiosity that appears delusional and unrealistic. Many of my previous colleagues worked with narcissism and anti-social personality disorder (sociopathy) and found that many of these clients have a delusional view of themselves which includes an unrealistic self-importance and grandiose perception of life in general. Someone like this can truly jeopardize your safety or harm you in some fashion. A mental health evaluation will help rule out any other mental health disorders that may be contributing to the behavior (such as oppositional defiant disorder for youths, ADHD, or bipolar disorder) and provide some direction on where to seek therapeutic intervention.
Terrible nightmares/night terrors or flashbacks: For young children, having nightmares (sometimes nightly) is not abnormal. Their little minds are hard at work trying to re-organize the world and make sense out of everything in life. But for individuals, including children and teens, who have experienced a traumatic history (abuse, neglect, rape, etc) or witnessed a traumatic event, flashbacks and nightmares are likely to occur. Flashbacks can feel very real to the person and affect the body and mind as if the trauma were happening all over again. Research studies have shown that during Eye Movement Desensitization and Reprocessing (EMDR) the individual who previously experienced a trauma will begin to show physiological signs of re-experiencing the trauma. The heart rate increases, the eyes may frequently blink, the body begins to shake, thoughts begin to race, and the person shows symptoms of not being able to tolerate the flashback or EMDR experience. Anyone can experience flashbacks or what is known as secondary trauma. You do not have to have a trauma history or be a veteran to experience flashbacks or nightmares/night terrors. A single incident such as witnessing your aging mother fall down the stairs, sustain a concussion, and struggle to recover can be traumatizing enough. Any of the above symptoms should be evaluated by a mental health professional who can rule out PTSD (Post Traumatic Stress Disorder) or secondary trauma.
Emotional lability, changeable moods, risky behaviors, and intense emotional reactions: Individuals who exhibit frequent changes in mood, struggles with emotion regulation and distress tolerance, engages in high risk behaviors and (substance abuse, gambling, infidelity, refusing to take necessary medications, sexually inappropriate behaviors, shallow and unstable romantic relationships, etc.) can all be possible signs of either borderline personality disorder or bipolar disorder. It’s important, because both disorders are identical in some ways, that a mental health evaluation be pursued so that a correct diagnosis and treatment can be obtained.

Sadly, it isn’t until a behavior, action, or symptom has gotten WAY out of control that psychiatric treatment is ever considered. This is mainly because of a fear of stigma, but the other piece of this puzzle involves a fear of reality. Some people think “Really…? How could this be me? I have always been active, strong, and self-sufficient. I couldn’t be depressed.” Others say things such as “My mother has worked all her life and is a very strong woman. How could she have borderline personality disorder?” Because of our habit of going into denial when it comes to mental illness, we miss the signs and symptoms that are often right in front of our faces screaming for us to pay attention.

All of the categories above must interfere in some way with daily life and prevent healthy social interactions. Can you think of a few “symptoms” or behaviors that might signal that there is a need for a psychiatric evaluation, medication management, or therapy? If you were to recommend psychiatric treatment or suggest that someone attend therapy, what symptoms would you point out? What would make you think the person would need professional intervention?