Category: Disorders

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William Hartmann, MD; Lindner Center of HOPE Psychiatrist, Medical Director, Willliams House

Navigating the realm of psychiatric medications can be challenging, often hindered by common misperceptions. Managing and understanding expectations can go a long way in ensuring treatment success. Seeking out help is often complicated by preconceived ideas. Preconceived notions about psychiatric medication often get in the way of successful treatment. Building a trusted relationship paves the way for educational opportunities, treatment adherence, and recovery.

5 Common Misperceptions of Psychiatric Medications

1 – “It’s just a chemical imbalance.” 

The advent of serotonin reuptake inhibitors (SSRIs), with their efficacy for depression and anxiety and reduced side effect risk compared to their predecessors, remains a major milestone in psychiatric care. It became increasingly commonplace to hear of the “chemical imbalance” of these illnesses. For as much as “chemical imbalance” helped spread the word that this is a brain disorder, not a moral failing, this wording unfortunately has promoted an overreliance on the power of the medication. The medications do alter brain chemistry and lead to a chain of biochemical events influencing symptom reduction and recovery. What the medication will not do is eliminate stressors, change one’s lifestyle, or cause satisfaction with an otherwise unhealthy situation. I find that those with the greatest success are those who recognize that medication helps facilitate deeper work in psychotherapy and making constructive changes to promote wellness. The medication may help substantially, but it will not do all of the work.

2 – “I don’t want to be a zombie.”

Many will fear that medication will change their personality substantially, or cause them to feel or appear sedated. The goal of treatment is to help a person function as their best self, not change who they are, or make them void of emotional response. While any effective medication has side effect potential, most patients can work with their prescriber to find the right fit for them to manage the illness with success.

3 – “I don’t want to take happy pills.”

Addressing the stigma associated with psychiatric medications, particularly antidepressants, is crucial. Depression is more than the usual sadness one inevitably encounters from time to time. Treatments for mood disorders are not instant “uppers” nor are they performance-enhancers. 

The effects of antidepressants are gradual and usually occur over about 4-6 weeks. Moreover, they will not make you “happy” so much as reduce and resolve symptoms of clinical depression. They aim to restore the capacity for contentment and joy. Treatment allows reduction of the “thought constriction” which limits one’s perspective to seeing few options. One may then see the broader opportunities to connect with core values in a rewarding way. It is about getting back to being your best self. Psychotherapy helps bring this together.

4 – “I don’t want to be dependent on a medication.”

The fear of dependency on medication is a valid concern for many. Taking medication may be a constant reminder of the illness, but the illness exists whether taking the medication or not. The majority of psychiatric medications, except benzodiazepines, do not produce true physical dependence. Turning the focus to the goals of recovery, and how the medication is part of the process, can help.

5 – “Don’t you put everyone on medication?”

There is not a one-size-fits-all approach. A common misconception is that every psychiatric patient is put on medication. Correct diagnosis is essential and, for some conditions, medication may not be the appropriate first line of treatment. A large portion of a psychiatrist’s work involves evaluating and managing the use of psychiatric medications. Most people will not come my way unless they have reached a point where medication appears necessary. A person may be experiencing sadness, grief, anxiety, milder depression, or an adjustment problem that is better suited for psychotherapy. A person might make gains in exposure response prevention for anxiety without the aid of medication. There may not be adequate or applicable evidence for medication helping a particular problem. Evidence is weaker for antidepressants in milder major depressive disorders, for example, but antidepressant treatment is recommended for moderate to severe depression. In some conditions, such as bipolar I disorder or schizophrenia, medication is crucial for the treatment and prevention of recurring episodes of illness. In opiate use disorders, prescription medications such as naltrexone and buprenorphine have emerged as a best practice, something that was not the case decades ago.

Ultimately, the decision regarding the role of medication for a given individual is between patient and prescribing clinician. Addressing attitudes and expectations early in the process can make a better experience for everyone. Empower yourself with knowledge to make the best choices for your mental health journey.

For more information and resources on psychiatric medications, contact us at Lindner Center of HOPE.

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Susan L. McElroy, MD

Lindner Center of HOPE, Chief Research Officer and Consultant to Eating Disorders Team

Borderline personality disorder (BPD) is a mental disorder consisting of a pervasive pattern of instability in regulation of emotions, impulses, interpersonal relationships, and self-image. Symptoms of BPD include frequent mood changes and excessive anger; feelings of worthlessness, insecurity, loneliness, and emptiness; periodic distortion of reality; and unhealthy social relationships.  Individuals with BPD are prone to self-harm (including suicidal ideation and behavior, self-cutting, and completed suicide), aggression, problematic alcohol and drug use, and other dangerous behaviors. The cause of BPD is unknown but thought to involve both genetic and environmental factors. Diagnosis is made clinically based on symptoms.

BPD is very common. It occurs in up to 5.9% of the general population and represents 15% to 29% of patients in psychiatric clinics and hospitals. Because the personality of children and adolescents is developing, the features of BPD do not become recognizable until late adolescence or early adulthood. Once the disorder appears, its course is often chronic. Though BPD is more common in women, a substantial number of men have the disorder as well.  There is a high comorbidity of BPD with other psychiatric disorders (approximately 85%), including anxiety disorders, mood disorders, impulse-control disorders, substance-use disorder, and eating disorders.

The present standard of treatment of BPD is psychotherapy, especially a form of psychotherapy called dialectical behavior therapy, to help individuals with tolerating distress and managing mood changes, impulses to self-harm, and relationships.  Most patients with BPD also receive psychiatric medication to target mood instability and excessive anger, impulsive and self-harming behavior, and cognitive and perceptual distortions. Small studies suggest medications that affect the dopamine and serotonin systems, particularly atypical (or second generation) antipsychotics (such as aripiprazole, quetiapine, and olanzapine), can be helpful for these symptoms. However, no medication has been approved by the United States Food and Drug Administration for the treatment of individuals with BPD.

The Research Institute at the Lindner Center of HOPE is participating in two important studies of one such medication, brexpiprazole, for treating BPD (clintrials.gov identifier NCT04100096 and NCT04186403) and is actively seeking individuals with BPD for participation. The first study is a 12-week, double-blind, placebo-controlled trial to evaluate the efficacy and safety of brexpiprazole for the treatment of individuals diagnosed with BPD. The second study is a six-month open-label trial of brexpiprazole in individuals who have completed the first study. (Open-label means all participants will receive brexpiprazole; no one receives placebo).

Otsuka Pharmaceutical Development and Commercialization, Inc., the manufacturers of brexpiprazole, is sponsoring the studies. Of note, brexpiprazole already has approval from the United States Food and Drug Administration for the treatment of schizophrenia and major depressive disorder (the later in combination with an antidepressant).

Please see the following links to get more information about the study:

https://clinicaltrials.gov/ct2/show/NCT04100096?term=Rexulti&cond=Borderline+Personality+Disorder&draw=1&rank=2

https://clinicaltrials.gov/ct2/show/NCT04186403?term=rexulti&draw=1&rank=8

https://lindnercenterofhope.org/research/

You may also contact Morgan Pond at [email protected]  or (513) 536-0704.

For further information on BPD:

https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

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Jennifer Farley, PsyD

Lindner Center of HOPE, Staff Psychologist

The holiday season can be an enjoyable and peaceful time for many of us. We adults know that this can also be a busy, tense, overstimulating, overindulgent, and overwhelming time. Any of these experiences can be triggered, for example, by holiday memories of the past, our current experiences, or worries about the future. We also may have expectations for how our holidays “should” be, which can bring about even more stress in planning them or sadness or anger if our experiences fall short of what we wanted.

Using mindfulness, or focused attention on the “here and now,” can be helpful in making the holiday season more tolerable and, hopefully, more enjoyable. Mindfulness involves being self-aware of one’s thoughts or feelings or behaviors in the current moment and without judgment. Why the current moment? Because thinking about the past can bring about sadness (and depression) and thinking about the future can bring about worry (and anxiety). Being mindful without judgment is also important – it helps prevent an emotion from being experienced more intensely. For example, telling oneself, “I’m a horrible friend for not giving them a gift,” is far different than, “I have the thought that I am a horrible friend for not giving them a gift.” Similarly, reflecting, “I’m sad that my family member isn’t here,” is experienced differently than “I have the feeling of sadness about my family member not being here.” The without judgment part also comes from not judging oneself or anyone else for having a particular thought, feeling, or behavior. Telling oneself, for example, that they’re “bad” for thinking or feeling a certain way is a judgment – having a thought or feeling simply makes one human. What we do with a thought or feeling is what matters more.

Thoughts about how the holidays “should be” can intensify people’s emotional experiences further. Many people, for instance, experience “shoulds” surrounding holiday traditions. While these can bring comfort to our holidays, “shoulds” can also weigh people down with guilt, burden, or anxiety. Family traditions are important, but so is the consideration of how a specific tradition might be unreasonable to expect – for oneself or others. Letting go of the word “should” allows more flexibility and adaptability to an experience, and as such, can bring about more joy and a lot less tension. Do you really “need” to host Christmas dinner? Or is it that you prefer it but can adapt to having someone else host?

Mindfulness can be practiced by observing and describing one’s current thought(s) or feeling(s). Mindfulness can also involve doing something with intention. Consider how you might – with focused intention – wrap a present, look at Christmas lights, drink your cup of coffee or hot chocolate, hug a loved one, sing a Christmas carol, hang ornaments on your tree, watch a favorite holiday movie, or study the fire in the fireplace. Doing something with intention helps you remain in the present moment. Be aware of how your phone or other distractions prevent you from being fully present with others. If you find yourself diving deeper into a holiday memory, try to catch yourself first, and mindfully reflect if it’s a happy or heartwarming memory or one that could bring about sadness or hurt or anger.

One classic holiday movie (A Christmas Story) features Ralphie and his myriad of Christmas-related incidents. There are two scenes that highlight mindfulness practice: 1) when Ralphie looks with amazement at the snow-covered scene outside his bedroom window on Christmas morning, and 2) when Ralphie’s parents sit together in the dark and gaze at their Christmas tree. Another movie (Elf) depicts a father making a choice to fully participate in singing a carol with his family. These pop culture references may help highlight ways you might practice mindfulness in your own ways this holiday season. As a result, may your next month or so be experienced with mindful moments that bring self-awareness, peace, and joy.

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By Danielle J. Johnson, MD, FAPA
Lindner Center of HOPE, Chief
of Adult Psychiatry

 

Innovations in Mental Health Treatment

By Danielle J. Johnson, MD, FAPA
Lindner Center of HOPE, Chief
of Adult Psychiatry
The past year has brought exciting innovations in treatment options for people with attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), and obsessive-compulsive disorder (OCD.) The U.S. Food and Drug Administration (FDA) approved the marketing of two devices which offer non-medication alternatives for the treatment of OCD and ADHD.  In August 2018, the Brainsway Deep TMS (Transcranial Magnetic Stimulation) system was approved for the treatment of OCD.  Deep TMS uses specially designed magnets to stimulate specific larger volume areas of the brain beneath the surface of the skull.  It is a non-invasive treatment that involves five 20-minute sessions per week for six weeks while sitting in a chair wearing a helmet with a sensation of tapping during the treatment.  Patients can continue medication and psychotherapy while receiving deep TMS.  According to the National Institute of Mental Health (NIMH), the lifetime prevalence of OCD among U.S. adults is 2.3% and 50% of these have had serious impairment.  Having another treatment option will bring hope to many people with severe OCD.

In April 2019, the Monarch eTNS (external trigeminal nerve stimulation) system was approved for the treatment of pediatric ADHD as monotherapy in children ages 7 through 12 years old who are not currently taking prescription ADHD medications. The Monarch eTNS System is intended to be used at home under the supervision of a caregiver when the child is sleep. The cell-phone sized device generates a low-level electrical pulse that feels like a tingling sensation and connects via a wire to a small patch that adheres to a patient’s forehead, just above the eyebrows. The system delivers electrical stimulation to the branches of the trigeminal nerve, which sends therapeutic signals to the parts of the brain thought to be involved in ADHD. The NIMH reports that the prevalence of ADHD is increasing, and severe ADHD is being diagnosed at an earlier age. This can be a treatment alternative for parents who prefer to avoid medications at an early age. Clinical response is expected in four weeks.

The mechanism of action of most antidepressants involve the neurotransmitters serotonin, norepinephrine, and dopamine. In March 2019, two antidepressants with novel mechanisms
of action were approved. Zulresso (brexanolone) was the first drug specifically approved for postpartum depression. Postpartum depression affects about 15% of women. Zulresso modulates the neurotransmitter GABA. It is administered as a 60-hour intravenous infusion in a registered healthcare facility. Symptom improvement was seen at the end of the infusion and at the end of 30-day follow-up. There has never been a medication that treats the symptoms of postpartum depression so rapidly, so this can significantly improve the quality
of life for the mother, infant, and her support system.

Spravato (esketamine) nasal spray was approved for treatment-resistant depression in conjunction with an oral antidepressant. Patients must have tried at least two antidepressant treatments at adequate doses for an adequate duration in the current depressive episode before trying Spravato. The spray must be administered in a certified medical office where the patient can be monitored. Spravato is taken twice a week for four weeks then once a week for a month, then once a week or once every two weeks. It is an antagonist of the NMDA receptor, a type of glutamate receptor. Approximately 30% of people with MDD are considered to have treatment-resistant symptoms and have the potential to benefit from esketamine.

For more information about these treatment options: https://www.brainsway.com/treatments/obsessive-compulsive-disorder 

http://www.monarch-etns.com/ 

https://www.zulresso.com/ 

https://www.spravato.com/

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By Nicole Bosse, PsyD
Lindner Center of HOPE, Staff Psychologist

What is panic disorder? Panic disorder consists of recurrent unexpected panic attacks, specifically a spike of intense anxiety
or discomfort that reaches a peak in minutes that is followed by four or more of the following symptoms: racing heart/palpitations, sweating, trembling/shaking, shortness of breath, feelings of choking, chest pain or discomfort, nausea, dizziness, chills or heat sensations, numbness or tingling in the hands or feet, derealization, fear of losing control or going crazy, and fear of dying. This has to occur in combination with fear and worry about having additional attacks, and a significant change in behavior related to the attacks, such as avoiding situations or activities that might bring on panic.

When treating panic disorder, it is treated mostly from a cognitive behavioral approach. The cognitive piece targets the person’s misappraisals about the panic. Individuals with panic disorder tend to overestimate the likelihood of panic occurrence, underestimate one’s ability to cope with panic, and exaggerate the negative consequences of panic attacks.

By helping the individual to identify the misappraisals and working on challenging them, individuals are less fused with their thoughts and can start to think differently about things rather than buy into their thoughts as facts.

The behavioral piece of the approach involves exposure therapy, specifically exposure to what situations they avoid, but also interoceptive exposures. Interoceptive exposures involve gradually exposing oneself to the physical sensations of the panic attack that are feared. Working with a therapist to identify the exposures that rank from low to high is important. Once this is identified, the patient and therapist work from the least distressing to the most distressing. The following are some examples of possible interoceptive exposures:

* Running in Place

* Holding breath

* Head shaking (side to side)

* Spinning in a chair

* Mirror staring

* All over muscle tensing

* Straw breathing

* Over breathing

* Head between legs

The therapist and the individual work to complete just one of these exposures, five times during the day for about 30-60 seconds. This is done repeatedly every day until the person habituates to that sensation before moving on to the next exercise.

 

Another exposure idea that is sometimes used is pretending to actually have a panic attack in a public area. This strategy is brought in when the person’s fear centers around the social consequences of having a panic attack, such as not wanting others to crowd around them or being embarrassed. For example, I have suggested that individual’s go to a store and practice sitting down somewhere to pretend they are dizzy or cannot catch their breath. This is a great strategy for teaching the person that what they typically fear in that situation is not as bad as they make it out in their mind. It actually usually ends up being pretty uneventful.

 

Exposures for the avoidance of situations is a little more specific for the person and their unique avoidances. Some common examples of avoidance that I have come across are the following: avoiding caffeine, avoiding intense exercise that increases their heart rate, avoiding being in a car, avoiding driving, avoiding going into stores, avoiding traveling far distances from one’s house, avoiding going places alone, avoiding going places without safety items (i.e., water, benzodiazepine, food, etc.), and avoiding places where the amount of time being there is uncertain (i.e., waiting in lines, sitting down at a restaurant, etc.)

Once the individual’s unique avoidances are identified, the therapist and individual work to create another hierarchy, ranking from low to high distress. For example, if someone avoids going certain distances from their house, some exposures could consist of walking down the street and gradually increasing the distance. A similar strategy could also be used for driving, gradually increasing the distance of driving from a person’s house. Similarly, for line waiting, the individual could practice waiting in lines and gradually increase the amount of time they wait in line, working up to actually waiting in the entire line and being uncertain of when it when it will end.

As you can see by the above described therapy, the main component is facing what the individual fears and letting the body learn that their anxiety will decrease without having to escape the situation. Panic disorder is a very treatable disorder, especially when engaging the correct therapy for it and when combined with the appropriate medication.

 

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Trevor Steinhauser’s struggle with mental illness began at an early age, but thanks to receiving early help and support for his symptoms, Trevor is feeling better and is now four years sober.

Trevor and Tracy Cummings, MD, Medical Director of Inpatient and Partial Hospital Program Services at Lindner Center of HOPE, spoke with Local 12’s Liz Bonis about mental illness warning signs to watch for in children, such as anxiety and panic attacks.

Trevor credits the Lindner Center of HOPE for helping him overcome his own issues with mental illness and substance abuse. By employing a team approach and giving him a voice in his own treatment, Trevor says the Center was the first to help him learn coping skills for lifelong problems, such as depression and anxiety.

According to Dr. Cummings, behaviors that lead to addiction often present in a person’s youth.

“The reality is that, in any given year, one in five of us are experiencing mental illness. About half of those cases started before age 14, so a lot of people have been having symptoms for a long time. They’ve just figured out ways to either adapt to those or not talk about those,” Dr. Cummings said.

Lindner Center of HOPE has a comprehensive program that treats both substance abuse and co-occurring mental health disorders. Learn more about our Intensive Outpatient program here.

 

 

Watch the full story from Trevor and Dr. Cummings’ sit down with Liz Bonis interview on local12.com

 

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Elizabeth Mariutto, PsyD
Clinical Director of Partial Hospitalization and Intensive Outpatient Adult Eating Disorder Services and Staff Psychologist, Harold C. Schott Foundation Eating Disorders Program, Lindner Center of HOPE

“Every time I try a diet, I do okay for a while, and then I go back to my usual eating.” According to the National Eating Disorders Association, this is an incredibly common phenomenon, as 95% of those who diet regain any weight lost within one to five years. Despite the ineffectiveness of dieting, those that fall under the overweight category on BMI charts are often encouraged to do so by the medical community. Not only is this ineffective, but dieting has been found to be associated with increased binge eating and greater weight gain.

So what is the alternative? Mindful eating.  Research has found that those who struggle with binge eating, diabetes, and/or obesity may benefit from mindful eating. Keep in mind, mindful eating is not recommended for patients in the process of weight restoration or food exposure, specifically for those with Anorexia Nervosa, or those with gastrointestinal symptoms that may complicate hunger and fullness cues.

Author and psychologist Susan Albers defines mindful eating as awareness of the physical aspects of eating, the process of eating, and triggers for mindless eating. Individuals who eat mindfully slow down and take pause in their busy schedules to pay attention to their bodies and cues of hunger and fullness. The emptiness of one’s stomach, irritability, low energy, and difficulty concentrating can all be signs of hunger. When one eats, one should feel full but not stuffed, satisfied yet comfortable. Many who struggle with unhealthy eating have been so disconnected from their bodies that either they do not have awareness of these cues, or they wait until they are famished before eating and eat until they feel as if their stomachs could explode. They may focus on external cues to start and stop eating, such as if others around them are eating, rather than the internal cues of their body. To start the practice of mindful eating, it can be helpful to focus awareness on how long it has been since one has eaten and the content of what one ate at that time. Regular eating should take place within one hour of waking up in the morning, then at three to four hour increments throughout the day. Meals should balance carbohydrates with lipids and protein sources.  Starting with these guidelines can help one’s body self-regulate so that the hunger and fullness cues can kick in.

Mindful eating also distinguishes physical from emotional hunger.  Food has become tied to emotions in our society. People celebrate birthdays by baking a cake, revel in a promotion by going out to dinner, and calm themselves down after a stressful day by getting ice cream.  While all of these can still occur within mindful eating, a mindful eater will be intentional about this, as well as develop other self-soothing strategies. A mindful eater will tune in to the qualities of the foods he or she is choosing and ask him or herself, “Does this taste good? Does this food energize me or make me sluggish? Does my body thrive when I eat this?” A mindful eater will balance cravings with nutrition, allowing oneself to have all foods in moderation. This does not always mean choosing the “healthy” choice, but rather having self-compassion and flexibility around food. Mindless eaters may overeat sweets, chips, or fast food, tell themselves that they are a failure for consuming these items, and fall into hopelessness and despair, only to lead them back towards these foods repeatedly.  In fact, many comment that they do not even enjoy what they are eating. In contrast, a mindful eater may pick up fast food on a road trip, have a handful of chips with a sandwich, or try a coworker’s chocolate chip cookies; however, he or she will savor these items and consume them as part of a well-balanced diet. If one is full, one will stop eating, even if there is food left on the plate.

Lastly, mindful eaters set up an environment for success. They sit down at a table for meals rather than eating in front of the TV or grazing in the pantry. They do a lap at buffets prior to plating their food. They fill their house with diverse foods and ingredients and avoid buying trigger foods in bulk.  While it takes work, many learn to gain control over their eating with the principles of mindful eating.

References:

Albers, S. (2008). Eat, Drink and Be Mindful. Oakland, CA: New Harbinger Publications, Inc.

National Eating Disorders Association (2018). Statistics & Research on Eating Disorders. Retrieved from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders.

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Lindner Center of HOPE Clinical Director of Addiction Services Dr. Chris J. Tuell joined Fox & Friends on January 28, 2019 to talk about a new program at the Lindner Center designed to identify and treat Internet addiction.

“This program helps those struggling with a loss of control to re-center their lives to avoid additional complications,” said Dr. Tuell.

According to Mental Health America, children with Internet addiction often struggle with other mental health problems like alcohol and substance use, depression, and/or aggression.

Addiction experts at the Lindner Center of HOPE assess if patients are suffering from one or more co-occurring disorders, like depression, in addition to unhealthy Internet habits. Studies have suggested pre-existing depression or anxiety could lead to a gaming addiction. Identifying underlying mental health conditions can help personalize treatment plans for each “Reboot” patient.

Your donation can help the Lindner Center of HOPE continue similar services to help patients find help on their road to wellness. Donate here:

 

 

 

Watch more: https://video.foxnews.com/v/5995373867001/#sp=show-clips

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Michael O’Hearn, MSW, LISW-S

Odum’s Paradigm

Odum’s (1988) Self-Organization, Transformity, and Information is a conceptual framework for this intervention.  It is supported by two traditional pillars of economic theory: (1) the production-consumption model (“supply and demand”), and (2) production-consumption growth equilibrium.  This is a social currency system, not a monetary system; the currency is energy and information.  Odum adds “recycling” to the first component, constituting the following model:

Source > Production > Consumption > Recycle >

The output from production-consumption-recycle iterations is recycled into more concentrated and refined products (components) and by-products (process fractals).  Both are recycled as source input of subsequent iterations, and simultaneously constitutes a control parameter fortifying production (Odum, 1988).  Products and by-products of partner interactions are recycled as source input, control production, and either fortify or inhibit development over time.

Production components are contributions and defections; each generates products and by-products.  Gottman (2012) outlines behavioral correlates that sustain or erode cooperation and trust in relationships.  These are discerned as inventories of contribution products and by-products, and defection products and by-products.

Contributions.  Contribution products and by-products can help regulate autonomic nervous system (ANS) triggering, fortify cooperation, and trust in relationships.  Four advantages of demonstrated trust in relationships are: (1) trust reduces complexity of all transactions, (2) trust permits action with incomplete information (benefit of the doubt), (3) trust minimizes transaction costs, and (4) trust increases relationship resilience as complexity naturally increases over time (Gottman, 2012, p.78).

Some partner contribution products can include: (1) neutral narrative of subjective views, (2) minimum 4:1 positive to negative interaction frequency, (3) soft start to difficult conversations, (4)  accept influence, change behavior to meet partner’s needs, and recognize partner’s change efforts, (5) tolerate partner’s negative emotion, and focus on the problem at hand, (6) set limits on behavioral expression of negative emotions, (7) accept responsibility and apologies, and (8) make positive statements of needs (Gottman, 2012).

Examples of contribution by-products can include: (1) overall positive perspective and “us-ness,” (2) shared meaning, purpose, fondness, and admiration, (3) eye contact and touch are soothing in conflict, (4) prioritize understanding, (7) non-defensive listening to partner’s negative emotion, (8) effective dialogue and problem solving on perpetual issues, (9) offer and accept apologies, and (10) cooperation and trust (Gottman, 2012).

Defections.  Defection products and by-products reinforce elevated and protracted ANS activation, entropy conservation, and erosion of cooperation and trust in relationships.  Criticism, contempt, defensiveness, and stonewalling are correlates of marital dissatisfaction and divorce (Gottman, 2012).

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Dr. Nicole Bosse appeared on FOX19’s Morning Show (Cincinnati) to talk about Seasonal Affective Disorder and how local residents can recognize the signs of SAD in themselves and others, help themselves avoid seasonal depression and find help through treatment at the Lindner Center of HOPE.

Seasonal affective disorder (SAD) is a form of depression triggered by a change in seasons.

In fact, more than half a million people in the U.S. suffer from SAD.  In fact, 4 in 5 people who suffer from SAD are women.

“It is important to not think of seasonal depression as a minor case of the “winter blues,” said Nicole Bosse, PsyD, staff psychologist and member of the OCD and anxiety team at the Lindner Center of HOPE. “SAD is a type of depression and needs to be treated seriously. We urge people to seek professional help if they feel their mood is atypical this time of year.”

Your donation can help the Lindner Center continue state-of-the-science research and treatment to help patients get the care they need for a number of conditions, including SAD. Donate here:

 

Watch more:

Link: http://www.fox19.com/video/2019/01/11/how-combat-seasonal-affective-disorder-sad/