Category: Mental Health

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Technology capable of reaching deeper brain areas may provide relief of symptoms for patients resistant to medication

Cincinnati, Ohio – For more than four million Americans in the United States, the symptoms of depression are not relieved by the use of antidepressant medications. This class of depression falls into one of two categories, treatment resistant depression (TRD)or treatment intolerant depression (TID). The TRD group often tries and fails several different types of medications – either alone or in combination – while the TID group has medication side effects so debilitating that they cannot tolerate the treatment.

For these patients, an entirely new type of treatment is being studied at the Lindner Center of HOPE, led by John Hawkins, M.D., chief of psychiatry at the center. The technology, called multicoil repetitive transcranial magnetic stimulation (rTMS) or simply TMS, is a non-medication, non-systemic and non-invasive approach to treating depression.

“TMS offers patients that either do not respond to, or cannot tolerate medication, a new treatment option,” said Dr. Hawkins. “Our clinic is currently studying a new approach to this technology and we are hopeful that it will provide relief for these patients that have been suffering from depression in some cases for several years.”

Depression is thought to occur because of less than optimalchemical activity in the brain. TheTMS treatment currently under study by Dr. Hawkins and his team uses multiple magnetic fields, generated by coils placed on a patient’s scalp, to stimulate specific brain regions both on the surface and in deeper regions of the brain. This research is important in understanding whether TMS treatment restores normal brain chemical activity, thereby reducing the symptoms of depression. To date, more than 100 patients have been studied using this approach without the occurrence of serious side effects related to the device.

Depression is a mental disorder characterized by loss of interest or pleasure in activities that were previously enjoyable, a decrease in energy, feelings of low self-worth, disturbed sleep or appetite and difficultyin concentrating.1 Depression often comes with symptoms of anxiety and these problems can become chronic, substantially impairing the ability of an individual to take care of everyday responsibilities.  On a global scale, depression affects more than 350 million people and is the leading cause of disability worldwide.2

To find out more information about the TMS study at Lindner Center of HOPE contact 513-536-0712 or visit http://clinicaltrials.gov/ct2/show/NCT01909232.

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1Marcus, M. et al. Depression: A Global Public Health Concern. World Health Organization 2012, Department of Mental Health and Substance Abuse. http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf.Accessed 04.6.2013.

2Marcus, M. et al.

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Each year, millions of Americans find themselves caught in a cycle of addiction to alcohol, drugs, gambling, or other substances/ behavior.  They must struggle daily with the effort to become and remain free of the drugs or behaviors to which they feel uncontrollably drawn.

Affected individuals are diagnosed on the basis of the particular substance or activity to which they are addicted.  However, individuals with any type of addictive disorder may exhibit related symptoms, and both causes and treatment are similar.

The Nature of Addiction

An addictive disorder, as opposed to temporary reliance on a particular substance or behavior, can be distinguished by several distinct symptoms:

Tolerance. Over time, an individual requires increasing amounts of the preferred substance/behavior to achieve the same physical or psychological effects.

Withdrawal. When an individual tries to curb the addiction, withdrawal symptoms such as anxiety, rapid heartbeat, sweating, etc., will occur.

Lack of control. The individual has extreme difficulty cutting back or controlling the addictive behavior, even when aware of negative consequences.

Preoccupation. Cravings for the desired substance or behavior are constant.  Increasing amounts of time are spent planning, participating in, and then recovering from the addictive behavior, with employment and relationships often threatened.

Causes of Addiction

Are addicts “born that way,” or do they develop addictive disorders due to environmental factors?  In this nature vs. nurture debate, both answers may be true. Psychological, genetic, environmental, and other factors that determine a particular individual’s likelihood of developing an addiction may be interrelated.

Biological factors.  Studies have shown that the likelihood of twins developing the same addiction is 50-70%, and familial rates of such addictions as alcoholism are significant. Other research has pointed to such biological factors as abnormal dopamine levels influencing addictive behavior.

Psychological factors.  Is there such a thing as an addictive personality? While no such diagnostic code exists, many experts believe that certain personality traits make individuals more vulnerable to addiction.  They include: sensation seeking, impulsivity, poor coping skills, anxiety or depression, insecurity, and feelings of social alienation.

Environmental factors.  Stress may the factor that figuratively pulls the addiction trigger in an individual who is biologically or psychologically prone to develop one. A history of trauma, for example, is frequently found in individuals who develop an addiction, particularly any type of severe stress in childhood.  Physical or sexual abuse also increases the risk of developing an addictive disorder.

Treatment of Addiction

Numerous treatment approaches have developed that provide benefit to individuals in acute stages of addiction, and a robust recovery movement provides ongoing support and management of the illness. Treatment modalities include:

Medical approaches.  Depending upon the nature of the addiction, an individual may benefit from medical detoxification and an inpatient rehabilitation program.  While the use of medication is often discouraged, short-term use of medication is necessary in some instances.

Psychotherapy.  Many contemporary forms of “talk therapy” have demonstrated positive results in individuals with addiction, including the following:

  • Cognitive behavioral therapy;
  • Motivational enhancement therapy;
  • Dialectical behavioral therapy;
  • Relapse prevention therapy.

These therapies teach individuals better coping skills, including recognition of triggers to addictive behavior, stress reduction, relapse avoidance, and impulse control.

Psychotherapy may be conducted in an individual or group setting. Family therapy is often encouraged in order to reduce enabling of addictive behaviors, as well as to heal broken relationships.

Community and family supports. Peer support is a cornerstone of most successful recovery programs. Recovering individuals find ongoing support through a variety of community organizations such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or similar groups.  Many support groups are based on the twelve-step recovery model first established for AA.

In addition to counseling, families may benefit from support groups such as Al-Anon for assistance in dealing with a loved one’s addictive behavior.

Addictive disorders can be daunting, but with proper treatment and support, individuals can experience recovery and return to full function in their homes and communities.

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When we talk about wellness and the mind/body connection, we often think of the importance of exercise and healthy eating for good physical and mental health.  But did you know that one of the most helpful activities for promoting total wellness dates back thousands of years?  It’s the ancient practice of meditation, and its use is showing surprising results among 21st century researchers.

Because of its benefits, an increasing number of physicians are prescribing meditation as part of their patients’ healthcare routines.  Clinics and hospitals across the nation now integrate meditation and related mind/body techniques into their clinical practice.

Physical Health Benefits of Meditation

The daily practice of meditation has been associated with improvements in a variety of health problems, including hypertension, insomnia, irritable bowel syndrome, and chronic pain.  Just 20 minutes twice each day is sufficient.

Over 500 research studies have been conducted to determine the effect of regular meditation on health problems.  Current research is examining more long-term effects and looking at the role of meditation in preventing chronic diseases and increasing longevity.

Mental Health Benefits of Meditation

Because of its relaxing effects upon the mind and body, meditation has long been used to reduce stress and anxiety.  Meditation appears to help activate the parasympathetic nervous system.  As it slows the release of stress hormones as well as heart and breathing rates, it improves the body’s overall relaxation response.

Research now shows that meditation can also reduce depression in affected individuals.  In one study of family caregivers, it was found that research participants who meditated had lower levels of depression than those who only listened to relaxing music.

Additionally, meditation may increase brain alertness. Meditation appears to improve people’s cognitive abilities, including attention and memory.  Research using medical imaging has demonstrated that meditation improves the functioning of certain circuits in the brain, as well as potentially reducing shrinkage in older adults’ critical brain centers.

Moving Forward

At the National Institutes of Health, the Center for Complementary and Alternative Medicine has provided funding for several new studies to determine the effect of meditation on many health conditions.  It is anticipated that further research will bring new findings on the best types and frequency of meditation, along with other practice issues.

Most clinical practices today use meditation techniques based on Mindfulness-Based Stress Reduction.  This type of meditation was developed by the University of Massachusetts’ medical school and utilizes yoga, stretching exercises, and mindfulness meditation.  Mindfulness meditation pays close attention to breathing techniques while the individual sits in a restful posture.

Whatever the approach, making a commitment of no more than 40 minutes each day may be a small price to pay for improved physical and mental health.

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You may have heard the expression: “healthy mind, healthy body.”  But do you know what it really means?  For centuries, a connection has been theorized to exist between physical and mental health.  Modern science has now demonstrated that such a connection really does exist.

The role of a healthy diet, proper sleep, regular exercise, and other lifestyle practices in promoting better mental health is at the core of many behavioral health treatment regimens.  Such practices may also play a role in preventing future mental health problems.

Conversely, physical health is dependent upon one’s state of mind, as the body responds to the ways in which each of us feels, thinks, and acts.  This fact is at the heart of the mind-body connection. Emotional or mental imbalance creates physical symptoms, from aches and pains to elevated blood pressure.  These in turn can lead to chronic health problems and disease.

Ideally, an individual should strive for a state of total wellness, one in which there is a sense of balance in the mental, physical, spiritual, and social elements of his or her life. Following wellness principles can help one achieve increased resiliency, greater longevity, and overall better physical and mental health.

The Role of the Mind upon the Body

Mental or emotional problems are associated with the development of physical disease. An estimated 95% of all illnesses can be caused or aggravated by stress. Individuals with high stress levels are even more likely to catch colds. It is not uncommon for individuals to develop hypertension or an ulcer after particularly stressful life events.

Depression has been linked to a range of disorders, including strokes, heart disease, and diabetes.  Other mood and emotional problems can also take a toll. In one study, people who had difficulty coping with anger were found to have a ten times greater risk for the development of heart arrhythmias.  Anger-prone physicians have been found to have higher risks of heart attacks than even smokers or individuals with high blood pressure.

The right attitude and social supports can affect health in more positive ways, however. The old saying, “Laughter is the best medicine” is true, as it has been found to reduce pain, speed healing, and increase creativity. Being active in a group—even something as simple as a bowling club—can actually increase one’s longevity, regardless of other health habits. Social networks also provide needed support. In one study of women with metastatic breast cancer, participation in support groups doubled survival rates.

Scientists have found that individuals with mental health or substance abuse problems have a life expectancy decades lower than the general population.  Taking care of one’s physical health is a critical part of the recovery process for those with behavioral health problems.

The Role of the Body upon the Mind

Research supports the role of physical activity in helping manage mental disorders. Active people have been found to be less depressed than inactive ones, and people with chronic depression are more like to go into remission with regular exercise.

Due to increased levels of oxygen and endorphins, individuals who exercise regularly feel more alert and have more energy, better memory retention, and a greater sense of wellbeing. As little as 20-30 minutes of vigorous physical activity daily is sufficient to achieve results.

Yoga, meditation, and other relaxation strategies have been found to ease stress, depression, and sleep problems. There is growing evidence that the practice of meditation can even slow cognitive decline in older adults.

Eating healthy foods in moderation can increase emotional well-being and reduce many of the physical problems often associated with mental illness, such as fatigue and obesity.

Getting approximately eight hours sleep per night is a goal few adults achieve, but the benefits are worth the effort.  Adequate sleep improves mood and concentration, as well as decreasing physical health risks.

By following these healthy lifestyle practices, individuals may significantly improve both their mental and physical health.

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Statistics can be somewhat ambiguous when it comes to eating disorders. Over the years, there have been countless studies conducted surrounding the prevalence of illnesses such as anorexia nervosa, bulimia nervosa and binge eating disorder. Although many of these studies convey slightly different findings, one thing is certain: Millions of Americans struggle with eating disorders.

While the majority of eating disorder sufferers are young women and adolescent girls, research has discovered that more and more males — an estimated 10 to 15 percent — are struggling with eating disorders as well. Additionally, incidents of these disorders in older women have been on a steady incline in recent years.

Why the Upward Trend?

New information is surfacing in regard to women in their 40s, 50s and 60s maintaining a negative body image, and as a result, continuing unhealthy eating patterns or developing eating disorders. Recent studies have found that over 60 percent of women 50 years of age and older are acutely concerned about their weight. Roughly 13 percent of these women suffer from some type of eating disorder.

Some older women keep their eating-related struggles hidden for years. Others, after having addressed an eating disorder earlier in life to at least some degree, relapse as they approach middle age. There are of course a variety of other factors that may contribute to the development of eating disorders in middle-aged women. These include a divorce or the loss of a mate where a woman feels she needs to lose weight to regain a level of attractiveness. It’s also not out of the question for a woman to develop an eating disorder for the first time later in life.

Never Too Late to Begin Treatment

Regardless of age or gender, anorexia treatment, bulimia treatment and treatment methods for other eating-related illnesses have evolved throughout the years. The percentage of successful outcomes continues to increase. Treatment for eating disorders usually consists of a combination of nutritional counseling, individual or group therapy, and in many cases, medications.

With the discovery of eating disorders in so many older women, mental health professionals are realizing that life-long care may be required even after a young woman has shown significant signs of recovery. However, those who get help for eating disorders early do have the best chance at long-term recovery.

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This blog is written and published by Lindner Center of HOPE.

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Armodafinil - Donuts2

 

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This blog is written and published by Lindner Center of HOPE.

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When the subject of disabilities surfaces in our thoughts or conversations, it is common to first consider those caused by some type of physical ailment or affliction. Conditions such as arthritis, heart disease and back problems are certainly primary causes of long-term disabilities in our nation. However, mental illness is the leading cause of disability in U.S. citizens ranging in ages from 15 to 44, according to National Institute of Mental Health (NIMH) statistics.

What these numbers show is that many Americans and people around the world are affected by illnesses such as depression, bipolar disorder, schizophrenia and a host of other mood and anxiety disorders in the prime of their working lives. Unfortunately, these numbers show no sign of subsiding anytime soon. In fact, they continue to rise, as do the number of filings with the U.S. Social Security Administration (SSA) for disability benefits due to mental illnesses.

The SSA and Mental Illness Claims

The SSA has established specific criteria that qualify those suffering with mental disorders for disability benefits. Basically, it must be determined that an existing mental condition limits or impairs one’s ability to fulfill their work obligations. In most situations, assessments and evaluations must be performed by mental health professionals. Additionally, evidence must be submitted to the SSA that indicates the individual in question is unable to perform their assigned job duties as a consequence of their condition.

Getting Back on their Feet

It is important for those with mental health issues to make their employers aware of their situation. All too often, workers are hesitant or afraid to address their condition with their employers for fear of negative repercussions. But behavioral or productivity problems could lead to termination, which also often results in the loss of insurance, creating even more problems for these individuals in regard to receiving treatment.

When documented mental health issues are reported to an employer, they are obligated under Americans with Disabilities Act (ADA) regulations to accommodate that employee with whatever they need to successfully perform their job duties, or to make their working situation as comfortable as possible. In lieu of applying for disability benefits, this can allow an employee to continue to work while receiving mental health treatment and take measures that will eventually enable them to effectively manage their condition.

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This blog is written and published by Lindner Center of HOPE.

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Shire BP Depression - Blue Man - 11-17-10

 

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This blog is written and published by Lindner Center of HOPE.

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Anxiety affects many people, and sometimes it may seem impossible to stop worrying about things you cannot control. These questions and fears can be paralyzing and sometimes might affect your daily life. However, there is a way to push these fears aside and get on with your normal routine.

Start by letting yourself worry, but only for a certain amount of time. Set a time each day to go over these worries, for example 20 minutes each day at noon. It should be a time of day far from bedtime, but during this period you’re allowed to worry about whatever is on your mind.

Outside of this time however, no worrying allowed. If a worry comes up during the day, write it down and save it for your worry period.

During your worry period, ask yourself if this problem can actually be solved. If so, start thinking of ways you can solve the problem and find a solution. If it’s not a problem that can be solved, you must find a way to accept that, so you don’t continue to worry about it.

Another good way to combat anxiety is to be aware of how others make you feel. The way other people act around us can be contagious, so pay attention to they way other people affect you. Keeping a journal is a good way to take note of this behavior so you can avoid these people in the future.

When you start to notice certain people making you feel anxious, make an effort not to be around those people. Perhaps a certain conversational topic makes you feel anxious, so make note of it, and avoid that topic from now on.

By following these simple tips, you will be able to control and combat your anxious feelings from now on.

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This blog is written and published by Lindner Center of HOPE.

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Armodafinil

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This blog is written and published by Lindner Center of HOPE.