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Individuals can locate a mental health screening site or take an online screening by visiting www.HelpYourselfHelpOthers.org (beginning September 1, 2014).

WHAT: National Depression Screening Day (NDSD), held annually on the Thursday of the first full week in October, is dedicated to raising awareness and screening people for depression and related mood and anxiety disorders. This year, Lindner Center of HOPE is a sponsor of the screening day efforts. NDSD is the nation’s oldest voluntary, community-based screening program that gives access to validated screening questionnaires and provides referral information for treatment.
WHERE: Individuals can locate a mental health screening site or take an online screening by visiting www.HelpYourselfHelpOthers.org (beginning September 1, 2014).
WHEN: NDSD is October 9, 2014, but screenings may be available in your area as early as September 1, 2014.
HOW: Thousands of organizations nationwide register to host a NDSD event each year. The organizations, including hospitals, community centers, social service agencies, government organizations, older adult facilities, colleges, secondary schools and military installations, provide information about mood and anxiety disorders and offer screenings—in-person or online—to their community. After completing a screening, those who score positive receive referral information to local agencies that offer further evaluation and treatment if needed.
WHY: Depression screening is effective. Results from a 2009 independent research study by the University of Connecticut, commissioned by Screening for Mental Health, states that depression screenings are effective in connecting at-risk individuals with treatment. The study showed that 55% of participants, who completed an online depression screening and who agreed to participate in a follow-up survey, sought depression treatment within three months of the screening.

Screening for Mental Health, Inc. (SMH), the pioneer of large-scale mental health screening for the public, provides innovative mental health and substance abuse resources, linking those in need with quality treatment options. SMH programs, offered online and in-person, educate, raise awareness, and screen individuals for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, eating disorders, alcohol use disorders, and suicide. Thousands of organizations worldwide including hospitals, military installations, colleges, secondary schools, corporations, utilize our educational and screening programs, and in turn, have reached millions of people ranging from teenagers to adults.

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By:  Erik Messamore, MD, PhD

Dr. Messamore is both a clinical psychiatrist and psychiatric researcher at the Lindner Center of HOPE. He reviews new or little-known clinical research findings at his website – DrErik.com

 

Borderline personality disorder is characterized by mood disturbance and impulsivity. Moods in borderline personality can shift rapidly and are often intense. Anger problems are common. In its most severe forms, people with borderline personality may dissociate or experience brief episodes of psychosis. Self-injury (often from cutting) and frequent suicide attempts are common. Borderline personality disorder affects about 3% of the adult population and accounts for over 20% of outpatient psychiatric visits.

Psychotherapy is the treatment of choice for borderline personality disorder, and Dialectical Behavior Therapy (DBT) is often the most well suited form of therapy for patients with borderline personality. DBT fosters mindful awareness and teaches coping skills that can significantly improve emotional regulation.

Unfortunately, there are no medications specifically designed to treat borderline personality disorder. Antidepressants, or “mood-stabilizing” agents, or antipsychotic medications may help reduce the severity of some of the symptoms. However the response to these treatments is highly variable. There is strong need for more options with less risk for side effects. Emerging research points to a possible benefit from omega 3 fatty acids.

Omega-3 fatty acids are important components of cell membranes, and they seem to be particularly important in brain function. Omega-3s such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are present in the brain and exist in relatively high concentrations in the nerve terminal regions, where most cell-to-cell communication takes place. Depression is less common in people whose regularly consume omega-3-rich foods such as fish. Even schizophrenia appears to be less disabling in countries with higher consumption of vegetables or fish. Laboratory research has firmly established that experimental creation of omega-3 deficiency causes abnormal behavior in lab animals. And in human studies, researchers have repeatedly discovered associations between omega-3 fatty acid levels and symptoms of psychosis, depression, impulsivity and self-harm.

Emerging research suggests that omega-3 fatty acids can be used therapeutically in borderline personality disorder. In treatment studies, researchers rely on just two omega-3 components: EPA and DHA. Silvio Bellino and colleagues from the University of Turin in Italy showed that EPA (1200 mg per day) plus DHA (800 mg per day), when added to therapeutic doses of Depakote, reduced impulsivity, anger, and self-harm in a group of patients with borderline personality disorder. In a separate study from Harvard University, Mary Zanarini and Frances Frankenburg showed that an 8-week course of treatment with EPA (1000 mg per day) outperformed placebo treatment in reducing depression and aggression in women with borderline personality. Research from Brian Hallahan’s group in Dublin, Ireland showed substantial reductions in suicidal thoughts and depression among patients with a history of multiple self-injury attempts (70% of the study sample had borderline personality disorder). Treatment in this study consisted of 12 weeks of daily EPA (1,220 mg per day) and DHA (908 mg per day). And finally, Paul Amminger led a study at the University of Vienna in Austria. The study focused on a group of adolescents with borderline personality disorder whose symptoms also suggested high risk of progression to psychosis. Volunteers in the study received either placebo capsules or active treatment with daily EPA (700 mg) plus DHA (480 mg) for twelve weeks. The EPA+DHA produced large decreases measures of depression, tension, anxiety, and impulsivity. The omega-3 fatty acids also prevented psychosis in the high-risk patients.

Side effects from omega-3 fatty acids are usually very mild. They are “generally regarded as safe” in the eyes of the FDA at the doses used in these studies. Scientists still have much work to do in figuring out which types of patients may most benefit from this kind of treatment, and what would be the best doses or durations of treatment.

Borderline personality disorder is a potentially severe condition that can be improved substantially with treatment. Psychotherapy is the most effective evidence-based treatment for borderline personality. It is encouraging to learn that EPA and DHA may help to reduce symptoms. These natural substances may prove to be useful parts of a combined biological and psychological treatment approach.

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Millions of individuals live each day in fear – not of an actual physical threat, but imaginary dangers, remembered trauma, inanimate objects, or something as simple as walking outside their front door.

The most common psychiatric illnesses today are anxiety disorders.  Estimates place the number of affected Americans at up to 40 million. At least 18% of adults and 13% of children suffer from some type of anxiety disorder in a given year.

The Nature of Anxiety Disorders

We all experience brief moments of anxiety during stress.  In order to be considered an actual disorder, anxiety symptoms must be intense and frequent.

Mental health professionals recognize six different types of anxiety disorders:

  • Obsessive-compulsive disorder – continual disturbing thoughts and/or the need to perform ritualistic behaviors;
  • Generalized anxiety disorder – excessive, unrealistic worry or tension without apparent cause;
  • Post-traumatic stress disorder – frightening thoughts and memories after a traumatic event, often with emotional numbing;
  • Social anxiety disorder – overwhelming self-consciousness or phobia about being in social situations;
  • Panic disorder – sudden feelings of terror, often with incapacitating physical symptoms;
  • Specific phobias – intense fears of specific situations or objects.

Excessive fears or feelings of dread are common to all types of anxiety disorders.

Common Symptoms

While clusters of symptoms vary with the type of anxiety disorder, individuals with severe anxiety may experience:

  • Persistent feelings of panic, fear, or dread;
  • Obsessive thoughts;
  • Ritualistic, compulsive behaviors;
  • Flashbacks to traumatic experiences;
  • Feelings of losing control;
  • Frequent nightmares;
    • Intense fears in public situation;
    • Intense fears of certain objects or activities;
    • Physical symptoms such as shortness of breath, heart palpitations, nausea, muscle tension, dizziness, or dry mouth.

Causes and Risk Factors

Many factors may influence the development of an anxiety disorder.  They include genetic tendencies as well as such environmental factors as repeated exposure to stressful events or one major traumatic event. Even certain medications, including antihistamines, oral contraceptives, and insulin, have been found to trigger anxiety.  As with most mental illnesses, anxiety disorders appear to develop from an interaction of many medical, genetic, psychological, and environmental factors.

Anxiety disorders can affect anyone and often occur in conjunction with other physical and mental illnesses. Women are diagnosed with anxiety disorders more frequently than men.  No differences in prevalence have been noted across races or cultures.

Anxiety Treatment

Treatment of anxiety can greatly reduce or eliminate symptoms in most individuals.  Primary treatments for most anxiety disorders include medication and psychotherapy.  Treatment can usually be provided on an outpatient basis, although brief residential or inpatient treatment is sometimes needed, depending upon the individual’s unique needs.

Medications used to treat anxiety disorders include a variety of antidepressants and anti-anxiety drugs.

Cognitive-behavioral therapy is the preferred type of psychotherapy for severe anxiety.  Through therapy, patients learn to recognize unhealthy thought patterns and behaviors associated with their anxiety and to change both faulty thinking patterns and their reactions to “trigger” situations.

In addition to medication and psychotherapy, treatment may include relaxation therapy, changes in diet and lifestyle, and education on the illness for both patients and their families.

While anxiety disorders cannot be prevented, people can often reduce symptoms by limiting caffeine consumption, avoiding over-stimulating medications or supplements, and seeking immediate support or counseling after a traumatic experience.

Through proper treatment and symptom management, millions of individuals affected by anxiety disorders can lead fulfilling lives again.

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When another episode of senseless violence occurs, such as a school shooting, mental health advocates hold their collective breaths as they wait to find out more about the perpetrator of such tragedy. If a mental health diagnosis is found, it fuels renewed public debate about violence and mental illness.

While discussion on finding better predictors of sudden, violent behavior can be valuable, what often gets lost in the noise of accusation and outrage is that mental illness is NOT closely associated with violence.  The exceptions, profiled on television screens and across the front pages of morning newspapers, stoke public fears and increase stigma about mental illness.

A look at a few facts about mental illness and violence, however, can help separate speculation from reality. Consider these facts:

  1. Individuals with mental illness are not generally violent. When examining the incident of violent behavior, researchers have found that mental disorders are not a major cause. Only an estimated 3 – 5% of violent acts appear due to the presence of a serious mental illness. The MacArthur Violence Risk Assessment Study1 found that having a severe mental illness alone was not a predictor of violence. Other factors, such as an individual’s past history of violence, social conditions, and substance abuse, were much greater predictors.
  2. Treatment of mental illness further reduces the risk of violent behavior. Mentally ill individuals who undergo treatment are statistically no more likely to be violent than the general population. One study looked at psychiatric hospital patients one year after discharge and found that they had no higher rates of violent behavior than individuals without a psychiatric disorder.
  3. The general public is not statistically at risk for aggression by the mentally ill. Isolated incidents may lead people to believe that they may be a likely victim of a deranged attacker, the MacArthur study also found that the infrequent acts of violence by those with mental illness were much more likely to occur with family members or close friends in the home. Such a finding is true of most violence in American society, regardless of one’s health status. Discharged psychiatric patients have actually been found to be less than half as likely as individuals without a mental illness to target complete strangers for aggression.
  4. People who are mentally ill are more likely to be victims of violence. In one study, almost two thirds of hospitalized psychiatric patients reported that they had been physically victimized in the past year by someone they dated. Half of those who lived with family members reported being physically victimized. Another study compared the rate of criminal victimization of individuals with severe mental illness versus the general population. Over a four-month period, it was found that mentally ill individuals had a victimization rate of 8.2%, as compared to 3.1% in the general population. Untreated mental illness makes an individual more vulnerable to exploitation and violence by others. Much like some victims of child abuse, individuals may more likely to become part of a cycle of violence, sometimes reacting to violence with aggression. But they are also more than twice as likely to be a victim than a perpetrator.

Based upon the facts, it appears that individuals with serious mental illness need treatment and protection from violence more than suspicion and stigma. While horrible acts by individuals should not be defended, being armed with the facts can help the general public be less likely to give in to fear or to perpetuate myths that maintain stigma. Such stigma make it more difficult for individuals with mental illness to seek the treatment they so need.

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1 Monahan, J., Steadman, H., Silver, E., Appelbaum, P., Robbins, P., Mulvey, E., Roth, L., Grisso, T., & Banks, S. (2001). Rethinking Risk Assessment: The MacArthur Study of Mental Disorder and Violence. New York: Oxford University Press.

 

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Adolescence is a critical time when physical, cognitive, and social changes allow a teenager to develop the identity that will serve as a basis for their adult lives. Unfortunately, research indicates this is also the time when psychiatric illness develops and becomes more present. The significant impact of these illnesses in the developmental years, makes finding the right care environment even more critical.

Struggles with mental health and addiction issues can be complex and complicated, so much so that typical inpatient and outpatient assessment and treatment options may not be able to get to the root of the issues.

The Adolescent Comprehensive Diagnostic Assessment and Intensive Treatment Program, which opened May 12, 2014, offers a specialized and intimate treatment setting within the Lindner Center of HOPE, focusing on intensive assessment and treatment of patients, age 11 through 17, suffering with complex, co-morbid mental health issues. As adolescence is such a tender time, accurate diagnosis, effective treatment planning, and the development of a solid blueprint for treatment success and realistic future focus is even more crucial. A 21-day diagnostic stay for adolescents results in a detailed but concise diagnostic picture, which includes the results of genetic testing for the development of the optimal psychopharmacologic treatment plan. Additional treatment weeks, beyond the diagnostic assessment, feature a strengths-based approach to treatment helping adolescents build skills readying them for next steps in treatment and life.

Serving patients ages 11 to 17 with:

  • Depression & Bipolar Disorders
  • Anxiety & Obsessive Compulsive Disorders
  • Disorders of Thinking & Related Conditions
  • Complex, Co-morbidity
  • Eating Disorders
  • Addictive and Co-Occurring Psychiatric Disorders

The Adolescent Comprehensive Diagnostic Assessment and Intensive Treatment Program, a private pay program, features:

  • A quick and smooth referral and intake process.
  • A safe and welcoming environment that meets the adolescent where they are.
  • A highly credentialed treatment team, with access to 45 clinical consultants.
  • Specialization in complex mental health and addictive disorders.
  • An evidence-based compilation of psychological and neuropsychological testing.
  • A comprehensive assessment resulting in a detailed but concise diagnostic picture.
  • Genetic testing for developing the optimal psychopharmacologic treatment plan.
  • A structured milieu model with CBT and DBT as a foundation.
  • A strengths-based approach to treatment recommendations and development of future focus.
  • A licensed teacher collaboratively working with the treatment team and home school contacts.
  • Parent and family involvement and education.
  • Follow-up support for up to 3 months after discharge.
  • A network of HOPE for further treatment referrals for patients and families.

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Everyone’s talking about bullying these days – on the playground, in cyberspace – and, yes, even in the workplace. Bullying among adults? Is the term just being overused, or does bullying in the workplace really exist?

The answer is, unfortunately, yes. According to one survey, as many as 40% or more of workers have experienced bullying during the past year. Other polls found that at least 34% of women have been bullied in the workplace and that 13% of American workers experience psychological aggression on at least a weekly basis.

The Nature of Workplace Bullying

The Workplace Bullying Institute (WBI) defines workplace bullying as “repeated, health-harming mistreatment of one or more persons by one or more perpetrators. It is abusive conduct that is:

  • Threatening, humiliating, or intimidating, or
  • Work interference – sabotage – which prevents work from getting done, or
  • Verbal abuse.”

Workplace bullying is a series of repeated actions, designed to humiliate, undermine, or intimidate the targeted employee.  Examples of bullying behaviors include: giving constant unwarranted criticism, creating social isolation, excessively monitoring, giving unrealistic deadlines, or cursing or verbally humiliating an employee.

Workplace bullying usually involves a misuse or abuse of power, and most bullying is done by supervisors or managers — although work peers may “go along to get along” when a colleague is being singled out for abuse. An estimated 73% of bullies are executives, managers, or supervisors of the bullying victim. The majority are male and typically have Type A personalities, being highly competitive and driven. Workplace bullies crave power and control and become impatient and frustrated easily.

And what about the bullies’ targets? Victims of workplace bullying are often singled out because they are seen as potential threats. Unlike playground victims, the targets of office bullies aren’t the less confident or newer employees. They tend to be competent, experienced, and popular. Ironically, these qualities make them an unintended threat to insecure bosses. Accomplished, veteran employees are not easily controlled and intimidated, so bullies often escalate their negative behaviors to achieve control.

Workplace targets are likely to be non-confrontational by nature and oriented toward a desire to help and nurture others. Unfortunately, these qualities can be misperceived by as weakness or submissiveness by bullies.

The Effects of Bullying

Workplace bullying can have profound effects on the employee in many areas:

  • Physical – The stress of chronic bullying can create significant health problems. One study found that employees who had inconsiderate managers were up to 60% more likely to suffer heart attacks or other cardiac problems.
  •  Emotional – Victims of bullying can develop problems such as chronic anxiety, depression, or PTSD. Several studies have found that bullying can be extremely detrimental to one’s mental health.
  •  Social – Victims are often ostracized at work, experiencing abandonment or rejection by colleagues.  In one study, only 37% of co-workers were identified as providing any type of support to victims.
  •  Economic – Bullying victims often lose their jobs or are forced to resign or transfer. An estimated 40% of victims quit their employment to escape the continued threats to their wellbeing.

Bullying also creates a toxic environment for the entire workplace.  Hidden organizational costs of bullying include increased staff turnover, absenteeism, and workers’ compensation claims; decreased productivity and morale, and associated legal costs.

Dealing with Workplace Bullies

Given the huge impact of bullying on individuals and organizations, it may be surprising to learn that at least 40% of victims never report bullying to their employers. Of those who do, most feel their complaints are ignored. An estimated 81% of employers either do nothing to address bullying or actively resist taking action when requested. Such findings may be less surprising when one remembers that the majority of perpetrators work in positions of organizational authority.

So what is an employee to do when he or she is being bullied at work? Experts haven’t reached a clear consensus on the most effective way to cope with workplace bullying. In reality, most victims either continue to endure the problem or leave the organization, voluntarily or involuntarily.

But being proactive can be potentially beneficial. A few suggestions if you are dealing with workplace bullying:

  • Acknowledge the situation. Recognize when you are being bullied and realize that you aren’t the source of the problem – it’s about control, not performance.
  •  Keep a paper trail. Document the perpetrator’s behavior in detail each time bullying occurs, and keep copies of relevant documents; e.g., threatening memos by a supervisor, time sheets, etc. Such documentation may help support your claims, but it may also help you regain some sense of control in your work environment.
  •  Get the facts. Find out your company’s policy on workplace bullying or its codes of conduct.  Consider checking with your organization’s employee assistance program or even consulting with an attorney to determine your rights. If dealing with your HR department, keep in mind that it is part of management and works on behalf of the organization rather than the individual employee.
  •  Report the problem.  Once you have done your homework, be prepared to report your concerns. If you decide to talk first with the aggressor, try to have a witness with you, or put your concerns in writing. Follow any complaint policies your company provides.
  •  Hedge your bets. If the bullying does not stop or the organization doesn’t respond to your concerns, it may be time to look elsewhere. Don’t quit prematurely, but consider checking other employment options. Establish your own tolerance level, but remember that no job is worth putting your safety or health at risk.

A bit of good news: more and more organizations are recognizing the need to establish zero-tolerance policies on workplace bullying, and at least 20 states are considering legislation that would make workplace bullying illegal, much like such practices as discrimination or sexual harassment. For today’s employees, suffering in silence is no longer the answer.

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To most parents, the idea of talking with their teens about suicide provokes a great deal of anxiety.  If you are the parent of a teenager, you may feel awkward about broaching the subject or wonder why you should even bring it up.

The reality is that such a discussion can be literally life-saving.  Suicide among adolescents has tripled over the last 25 years and is currently the third leading cause of death for this age group. And for every completed suicide, there are approximately 60 unsuccessful adolescent suicide attempts.

Whether your teenager shows signs of suicidal risk or not, it’s worthwhile to have a conversation about the issue.  A natural opportunity for such dialogue can occur with the suicide death of an acquaintance or public figure.  You can begin a discussion about how young people particularly find it difficult to make the best decisions when they are under stress, as their sense of perspective is still developing. Tell your teenager that you know that he or she will suffer a difficult loss someday or make what seems to be a horrible mistake. Let your loved one know that, when that day comes, you will be there for them, and that they will get over the pain.  You can even brainstorm about positive alternatives to suicide.

But what if you are worried than your own teen may be considering suicide? First, be aware of the common signs, such as:

  • Recent talk about death, suicide or “going away;”
  • Expressing thoughts of guilt, hopelessness, or extreme sadness;
  • Giving away possessions;
  • Avoiding friends, family, and favorite activities;
  • Having difficulty concentrating or thinking logically;
  • Changes in sleeping and/or eating habits;
  • Being self-destructive; e.g., cutting, abusing alcohol or drugs.

If you are concerned that your teen may be at risk, don’t be afraid to raise the subject immediately.  It’s absolutely untrue that discussing suicide increases one’s risk – keeping silent is the greater danger. Start with a comment or two about your concern, such as: “You have seemed really sad to me lately – can you tell me what’s going on?”

If your teen doesn’t open up, you can probe further and take a more direct approach; e.g., “I’m concerned about how you’re feeling.  Do you ever feel like you just don’t want to go on?” Or: “You seem really depressed.  Are you having any thoughts of hurting yourself?”

Following are a few “DOs” and “DON’Ts” to consider when talking to your teen:

DO:

  • Encourage your teen to talk about his or her feelings.
  • Let your teen do most of the talking – be a good listener. Let them vent, cry, or emotionally unload however they need to.  No matter how negative the emotions, communicating them is a positive step.
  • Provide reassurance and hope; e.g., “We’re in this together; I know you can get through this and will help in any way I can.” Remind them of your love and support, and reassure them that help is available and they won’t always have to feel this way.
  • Develop an action plan. Try to get your teen to agree to a constructive course of action, such as seeking professional help, obtaining further information on coping with depression, etc. Ask your teen to try to hold off for just one more day or hour when they feel like they want to give up.
  • Praise your teen for opening up and having the courage to talk about their problems.

DON’T:

  • Make judgments about your teen’s feelings or thoughts; e.g., “What do you have to be sad about? You’ve got it made.”
  • Use unkind words or criticisms; e.g., “I always have to worry about you” or: “Why can’t you get your act together?” Avoid arguments, lectures, or moral judgments.
  • Minimize your teenager’s concerns; e.g., “You’re just overreacting. You’ll feel better in the morning.”
  • Be afraid of silence. Wait calmly and patiently for your teen to reply to your questions.
  • Offer pointless advice.  Your job at this point is not to “fix” your loved one’s problem but to provide support and a listening ear.

If your teen is in an immediate crisis, try to assess the situation. Find out if your teen has an actual suicidal plan or the means of committing suicide. If so, seek immediate help through your local crisis center, mental health center, or emergency room.  Make sure that any dangerous objects such as guns or knives are not in the vicinity, and do not leave your loved one alone under any circumstances until they are in professional hands.

Just as it sometimes takes courage to live when ending one’s life might seem less painful, it is an act of emotional courage for a parent to open up the difficult subject of suicide with their teenager. By starting the discussion, you may provide valuable support and information that will help your teen with future life choices.

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Millions of Americans suffer from depression each year.  While medication and psychotherapy can provide great benefit to those suffering from the disorder, researchers have found that less traditional treatment methods are worth another look.  In particular, exercise has been found to boost mood and contribute to overall mind/body wellness.  Whether used as a supplement to traditional methods of treatment for those with clinical depression or as a quick mood booster for a case of the blues, physical activity can pay dividends in anyone’s wellness routine.

The Power of Exercise

The effect of physical activity in easing depression has long been documented, and exercise is a wellness movement cornerstone for patients with mental illness.  Exercise is considered a self-care strategy that is frequently recommended to help patients manage their depression.

There are numerous ways in which regular exercise helps reduce depression, including:

  • Releasing endorphins and neurotransmitters that boost mood;
  • Reducing chemicals in the immune system that tend to worsen depression;
  • Raising body temperature, which can have a calming effect;
  • Decreasing stress and insomnia, both associated with depression;
  • Improving self-confidence as body image improves and exercise goals are met;
  • Providing distraction from negative thoughts;
  • Creating opportunities for social interaction.

Traditional exercise, ranging from brisk walks to team sports activities, can provide psychological benefits to everyone, including those who struggle with depression. As little as twenty minutes of exercise per day can have a meaningful impact on one’s mental health.

Exercise and Mindfulness

Research points to the particular benefits of exercise that combines physical activity with mental focus. “Mindfulness” activities use such techniques as deep breathing or meditation to help clear the mind of distracting or stressful thoughts.

Mindfulness refers to a state of having open and active attention to the present, without judging one’s thoughts and feelings. It means truly living in the moment and being more awake to one’s experiences.

Today, several practices combine tools from exercise, meditation, and mindfulness principles to offer physical fitness routines that are also calming to the mind.  Two popular examples are yoga and tai chi.

Yoga therapy has long been known to provide many health benefits, including pain and stress reduction.  Now researchers and practitioners have found that yoga can help individuals who suffer from depression.  Its calming and gentle nature is appealing to many for whom rigorous physical exercise may seem more challenging.

Yoga practice emphasizes concentration, breathing, and smooth movements that may calm both the mind and body.  Participants are often encouraged to focus on positive images or to block negative thoughts, thereby reducing stress and anxiety.

One way in which yoga appears to impact depression is through the increase of serotonin, an important brain chemical that is often deficient in individuals with depression.  Higher levels of serotonin in the brain can boost mood – a principle utilized by many modern antidepressant medications.

Tai chi is another type of workout that has been found to ease depression.  While this Chinese practice was originally developed centuries ago as a form of self-defense, tai chi is now used as a particularly gentle and graceful form of exercise.  It is often utilized for stress reduction and many health conditions.

Tai chi is designed to promote serenity through its flowing, stretching movements, which are performed in a focused and slow manner.  Deep breathing accompanies the movements. Classic tai chi combines elements of meditation, exercise, and focused breathing, all of which are associated with reductions in depression and anxiety. Numerous research studies support the mood benefits of practicing tai chi.

The practice of tai chi is often promoted among older adults because it is such a gentle, low-impact exercise.  Tai chi has been found effective in reducing depression in older adults with major depression, as well as improving cognition.

Almost any form of exercise can be a valuable part of a wellness routine for those who suffer from depression.  But exercises which also incorporate mindfulness activities may offer superior benefits for both physical and mental health.

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Evening to feature a screening of Boys and Men Healing, a Big Voice Pictures Production, and Howard Fradkin, PhD, LICDC-CS, author of Joining Forces:  Empowering Male Survivors to Thrive

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Mason, OH – March 21, 2014 – Lindner Center of HOPE at 4075 Old Western Row Road in Mason is hosting Dare to Dream: An Evening of Public Awareness about Male Sexual Victimization on Thursday, April 24, 2014 from 7 p.m. to 9:30 p.m. in its gymnasium/conference center. Doors open at 6:30 p.m. The program and parking are free.

One in six men in the United States are survivors of childhood sexual abuse. The April 24th event will feature a screening of the transformational documentary Boys and Men Healing, directed by Kathy Barbini, a Big Voice Pictures Production. A community conversation will follow to discuss healing and the resources available for male survivors and their loved ones. The discussion will be led by Howard Fradkin, PhD, LICDC-CS, co-chairperson, MaleSurvivor Weekend of Recovery and author of Joining Forces:  Empowering Male Survivors to Thrive.

This evening is an opportunity for male survivors, their partners and family members, professionals from diverse fields who work with male survivors, and interested community members; to join forces to increase public awareness about male sexual victimization. Again, 1 in 6 men have a history of sexual victimization before the age of 16, and 1 in 8 rape victims are men, but it is still a silent epidemic for many men. The program is intended to break the silence and help audience members understand the complex and often misunderstood dynamics of being a male survivor and some of the unique challenges that can hinder recovery. Most of all, this event is about offering healing, hope and support for survivors and their families. The audience will be introduced to local, statewide and national resources that can empower men to heal with the support they have always deserved. Again, the program includes viewing the film, Boys and Men Healing, directed by Kathy Barbini, a Big Voice Pictures Production, and will be followed by a panel discussion featuring Dr. Fradkin and three courageous male survivors who will share their experience of recovery and hope. Audience members will have ample time to share their own experience and ask questions which will help them better understand the problems and the solutions.

Two continuing education credits will be available for psychologists, therapists and social workers.

Attendees should register by April 11 by contacting Pricila Gran at [email protected] or 513-536-0318.

Lindner Center of HOPE  provides excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic and short-term residential services for adults, intensive outpatient program for substance abuse and co-occurring disorders for adults and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

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Narcissistic Personality Disorder (NPD) is one of the most difficult and frustrating mental disorders to understand, experience and treat. Its name comes from the Greek myth about Narcissus, a handsome young man who saw his reflection in a pool of water and fell in love with it.

We all have known individuals who seem to be snobbish, are self-important, or patronizing with others. In its extreme, such behaviors may be symptomatic of a narcissistic personality. This article will help with understanding narcissistic personality disorder.

The Nature of Narcissistic Personality Disorder

NPD is a condition characterized by an overwhelming need for attention and admiration, a heightened sense of self-importance, and a lack of empathy toward others. For all their boastful and entitled behavior, individuals with narcissistic personality disorder have problems with self-esteem.Their self-importance hides a deep, underlying sense of insecurity.

For all their feelings of superiority, individuals with NPD have great difficulty with relationships and managing life’s everyday problems. Friends and loved ones also find it difficult to cope with the selfish and showy behaviors that are part of the disorder.

NPD is classified as a “dramatic” personality disorder, characterized by a distorted sense of self and unstable, intense emotions. Typical symptoms include:

  • Exaggerated sense of self-importance
  • Preoccupation with fantasies of power, success, beauty, etc.
  • Belief that one is unique or special;
  • Need for excessive admiration from others
  • Strong sense of entitlement
  • Exploitative behavior, such as taking advantage of others to achieve one’s own goals
  • Lack of empathy or ability to identify with others’ needs or feelings
  • Feelings of envy or belief that others are envious of them
  • Regular displays of haughty or arrogant behavior

An individual must meet at least five of these symptoms to be diagnosed with NPD.

Who Does NPD Affect?

NPD is believed to occur in over 6 percent of the general population. It usually emerges in late adolescence or early adulthood and is more common in males than females. Its cause is unknown, but most professionals subscribe to a bio-psychosocial view, believing that a combination of biological, genetic, psychological, and environmental factors lead to the disorder. 

Early interactions with family; e.g., lack of affection or over-indulgence, may partially shape narcissistic behaviors. There is also a somewhat increased risk for the disorder in children of those with NPD.

Coping with Narcissistic Personality Disorder

NPD symptoms tend to peak in early adulthood. By middle age, many people experience fewer intense symptoms. But waiting out the progression of the disorder is not an ideal solution for individuals or their families.

Although there is no known cure for NPD, individuals can respond successfully to long-term psychotherapy. The most beneficial therapies for patients include:

  • Cognitive behavioral therapy, to identify negative, unhealthy beliefs and replace them with healthier ones.
  • Family therapy, to explore interpersonal conflicts and communication problems and better manage family relationships.
  • Group therapy, to facilitate communication with patients with similar conditions and promote listening skills and support for others.

In addition to the therapies listed, a doctor may also prescribe medication to help with the symptoms of NPD.

Self Help for Narcissistic Personality Disorder

There are several “self-help” methods that can be used to manage narcissistic personality disorder actions. 

  • Identify the actions you want to change. Naming actions you want to change makes them easier to control.
  • Learn to set goals. Start small at first, setting goals that are easily achievable. For example, say a certain action triggers you to lose your temper. Make a goal to react differently in those specific situations. 
  • Practice. Think about those actions you want to change. Envision it happening again but this time you’re reacting in a way that you can control.
  • Track your success. It can take time to overcome NPD so it’s important to celebrate the positive steps you make on your journey.

Committing to NPD Treatment

Personality traits are difficult to alter, so therapy can take several years. Short-term treatment goals focus on reducing damaging effects of narcissistic personality disorder as substance abuse, depression, and shame. Long-term therapy strives to reshape the individual’s personality and develop a more realistic self-image.

Family Members: A Key NPD Treatment Partner 

Family membersmay also need assistance in coping with the effects of NPD. Suggestions include:

  • Learn about the disorder. Understanding the nature of narcissistic personality disorder can make it less mysterious and frustrating.
  • Adjust your own mind-set. You may need to change your own way of dealing with the person, as it is not likely they will make changes for you.
  • Have realistic expectations. Don’t ask for more than a loved one with NPD can give.
  • Avoid emotional dependence. Don’t try to constantly please a loved one with NPD. Maintain your own self-worth.
  • Set clear boundaries. Don’t be afraid to say no, or to cut unproductive conversations short.
  • Practice effective communication. When talking to someone with NPD, suggestions are more effective than requests. Offer praise when warranted. (Remember that people with NPD have poor feelings of self-worth deep inside.)
  • Rely on a support system. Opening up to others will help you be more objective and reduce your emotional reliance on the person with NPD. Formal support can also be obtained through counseling and family support groups.

Lindner is Here to Help

Understanding and dealing with NPD can be frustrating to all parties. But with proper treatment and support, the disorder can be managed as individuals learn to function more effectively and become more emotionally stable.

If you are concerned that you or someone you know is struggling with symptoms of NPD, the experienced medical professionals at the Lindner Center of HOPE can help. For more information and resources on understanding narcissistic personality disorder, or for treatment options, contact the Lindner Center of HOPE. 

Remember, there is hope, and seeking help is the first step toward a brighter future.