Category: Blog

Return to blog >

If you are the parent of a teenager, dealing with moodiness may seem like a fact of life.  But for many teens, something more serious than moodiness is affecting their behavior. Today, at least one in eight teenagers may experience depression. Severe depression in teens can even lead to suicide, the second leading cause of death among adolescents.

As a parent, you may wonder what you can do to determine if your own teenager has problems with depression.  Learn more about the nature of depression and how to respond if your teen exhibits warning signs, and you may make a difference in the life of someone you love.

Signs and Symptoms of Depression

Depression can affect people of any age, and it often first strikes individuals in adolescence.  The disorder crosses all gender, racial, and socioeconomic lines.  Depression in young people is of particular concern because of the increased impulsivity adolescents often display, as well as the lack of a mature, grounded sense of self.

While most people tend to associate depression with sadness and tearfulness, teenagers often exhibit different symptoms than adults or express feelings in different ways. For example, depressed teens often:

  • Demonstrate rebellious behavior, such as skipping school, sexually acting out, or shoplifting. Rather than showing sadness, teens tend to demonstrate anger, frustration, and irritability.
  • Have many somatic or physical complaints, such as frequent stomachaches, headaches, or fatigue. Other physical changes can include sleep problems, such as insomnia or excessive sleeping, as well as changes in eating habits, often associated with sudden weight loss or gain.
  • Engage in underage drinking or abuse drugs. While teens may use alcohol or drugs to dull their negative feelings, their effects often have the opposite effect.
  • Spend increased time alone, behind closed doors. Teens normally enjoy time with peers and busy schedules, so loss of interest in friends and activities should be of concern.

In addition to the above behaviors, watch for any of the following in your teen:

  • Sudden drops in school grades
  • Restlessness or difficulty concentrating
  • Feelings of hopelessness, worthlessness, and/or excessive guilt
  • Frequent sadness, crying, or anxiety
  • Increased sensitivity to criticism

While any symptoms of depression or other sudden behavior changes should be taken seriously, parents should be particularly alert to warning signs of suicide, such as:

  • Preoccupation with death and dying
  • Giving away possessions to others
  • Talking as if no one cares about them
  • Expressing feelings of hopelessness about the future
  • Expressing suicidal thoughts or threats

How Parents Can Help

The most critical way a parent can help a depressed teen is by recognizing the above symptoms.  By knowing signs and symptoms and by maintaining regular communication with your teen, you can potentially identify depression in its early stages.

If your teenager displays any of the symptoms of depression for an extended period, or if symptoms seem severe, don’t be afraid to intervene.  Begin by talking with your teen. Don’t let depression be the elephant in the room. Explain what you have observed, acknowledge that you are concerned, and explain why.  Make sure you talk in a non-judgmental and caring way.  Encourage your teen to open up to you or another respected adult about his or her feelings.

If your teen is reluctant to talk to you, it may be time to consider professional help. The experience may be less threatening if you begin with a visit to the pediatrician or family physician.  Your doctor can conduct a depression screening, which may include a physical examination and an interview with your teen.  You may then be referred to a mental health professional for follow-up.  Include your teen in the decision-making process so that greater buy-in will be achieved. Treatment may include psychotherapy and/or medication.

While depression can be a confusing and frightening experience for both teens and their parents, prompt treatment is generally successful. A depressed teenager today can go on to live a normal adult life and learn to cope more successfully with both his or her own moods and life’s challenges.

Return to blog >

To the general public, psychotherapy is often seen as a mysterious treatment process — a type of therapeutic “mumbo jumbo.” Understanding the true nature and benefits of psychotherapy can help individuals who might benefit most to consider this valuable clinical treatment option.

Millions of Americans of all ages and walks of life have undergone psychotherapy and learned ways to better cope with life’s problems or with mental illness.

The Nature of Psychotherapy

Often referred to as “talk therapy,” psychotherapy is a type of treatment that relies on the patient and therapist talking together about the patient’s problems and concerns. During the course of psychotherapy, individuals learn more about their problems, as well as their thoughts, feelings, and behaviors.

Psychotherapy can be used with a wide variety of behavioral health problems, from depression to phobias, addictions, and serious mental illnesses such as bi-polar disorder. Whether issues are acute or chronic, psychotherapy is frequently a primary component of an individual’s treatment program.

A major element of psychotherapy is the therapeutic relationship that develops between the patient and the therapist. Trained, licensed professionals can create a safe and non-judgmental climate for helping individuals confront and deal with their innermost problems.  Trust and respect are critical for effective psychotherapy to take place.

In addition to individual therapy, patients can receive psychotherapy in group or family settings.

The Benefits of Psychotherapy

One of the major values of undergoing psychotherapy is the development of increased understanding of one’s problems and improved self-awareness.  Patients may be better able to manage their emotional problems, for example, if depression or anxiety is de-mystified for them.  Understanding the underlying motivations for dysfunctional thoughts, feelings, and behaviors can be very beneficial.

However, research indicates that gaining insight alone is not the most effective strategy for improved mental health.  Contemporary forms of psychotherapy also place an emphasis on helping patients learn new skills for coping with problems or managing their mental illness. The primary benefit of psychotherapy may be in showing individuals how they can learn to take control of their own lives.

The methods and focus of psychotherapy may vary depending upon the nature and cause of an individual’s presenting problems. An individual who has developed a mental illness due to a genetic predisposition, for example, might benefit from different strategies than an individual who has recently undergone a traumatic experience.

For individuals seeking assistance, a mental health professional will first perform an evaluation to assess the problem or disorder and determine the best course of action.  A treatment plan will then be developed to establish goals and therapeutic strategies, and the type, frequency, and duration of psychotherapy will be determined. Psychotherapy may also be used in combination with medication or other treatment modalities.

Patients can develop a sense of peace in their lives by reaching the goals set in psychotherapy.  Through better insight, perspective, and coping abilities, individuals can achieve greater hope for the future.

Return to blog >

An estimated one third of all children are bullied at some time, and with the advent of online or cyber-bullying, that percentage will only rise. Parents can take action to both help prevent bullying and help children cope with abusive behavior when it does occur.

Follow these ten tips to make a difference in your child’s life:

(1) Take bullying seriously. Bullying is more than harmless teasing.  It is the intentional tormenting of another through verbal, physical, or psychological means. It can have long-reaching effects on a child, including damaged self-esteem and a reduced sense of safety.  Severe cases of bullying have occasionally been associated with suicide, school shootings, and other violent responses.

(2) Know the warning signs. Kids are often reluctant to let their parents know when there are being bullied.  Be a vigilant parent and watch for such signs of trouble as increased anxiety or moodiness, changes in eating or sleeping habits, unexplained loss of possessions or money, avoidance of certain social situations, or poor performance in school.

(3) Create anti-victimization/ anti-bullying habits in your child. To some extent, you may be able to “bully-proof” your child by teaching habits that make someone less likely to be the target of abusive behavior.  Some of these include:

  •  Treat friends and classmates with respect; e.g., take turns in games and engage in fair play.
  • Avoid pushing, hitting, or teasing other children.
  • If someone bullies you, immediately tell him or her to stop, then walk away and tell someone.
  • Avoid known bullies.

(4) Teach your child how to respond to a bullying episode. If your child is being bullied, these pointers may help diffuse the situation:

  • Use a buddy system. Hang out with a friend when you are on the bus, in hallways, or going to your locker – anywhere you might run into the bully.
  • Don’t show negative feelings.  Hold back anger or hurt feelings in front of the bully.  Count to 10 or take deep breaths; learn to show a “poker” face.
  • If confronted, firmly say, “Stop,” then walk away and ignore the bully; e.g., pretend to text someone on your phone.
  • Tell an adult you trust.  Seek out a teacher, principal, or other adult, and let your parents know what is happening.
  • Talk about your feelings.  Confide in someone, such as a friend, counselor, or sibling.  Express your feelings, and listen to any helpful advice.

(5) Create an atmosphere of respect. Children learn how to respect themselves and others first by what happens in their own homes. Make sure you model respectful but assertive behavior with others, whether family members or other people with whom you and your children come in contact; e.g., sales clerks, neighbors or other drivers. Don’t lose your cool when conflicts occur, and don’t quietly accept aggressive behavior from others. At home, teach siblings to play fairly with each other.

(6) Listen to and talk with your child every day. Regular, positive communication creates a home atmosphere that makes children more likely to share when they have a problem.  Find time each day to talk with your children about what is going on in their lives.

(7) Help your child open up.  Children are often hesitant to share that they have been bullied, due to embarrassment or fear of the parent’s reaction. If you suspect your child has been victimized, broach the subject by talking about an experience you or another family member may have had.  Or use movies or TV shows that depict bullying as a way to begin the conversation.  Ask, “Has something like this ever happened to you?” Get problems out in the open so they can be dealt with.

(8) Provide comfort and support. If your child reports a bullying incident, keep calm, listen, and offer support and reassurance.  Understand that your child may feel ashamed or embarrassed that this has happened, concerned that you will be disappointed in them, or afraid that you will over-react. Instead, praise your child for confiding in you. Provide reassurance that you will figure out what to do together.

(9) Enlist other adults. If bullying occurs within the school environment; e.g., in classes, on the school bus, or at a sporting event, let school personnel know what has happened. Someone in authority can monitor the situation and take steps to prevent further incidents. In severe cases, you may need to contact legal authorities.  Many states and communities have anti-bullying laws.  Don’t be afraid to invoke them if bullying is persistent or severe.

10. Consider professional assistance. If your child appears frequently depressed or anxious and faced severe bullying, consider professional help. Children may internalize what has happened to them and believe that it’s their fault or that they are not worthy of positive treatment. While parental support can go a long way, some children may benefit from mental health intervention.

By following these tips, parents can better equip their children to handle bullying more effectively and build positive peer relationships.

Return to blog >

By its very nature, adolescence is a time of volatile moods.  Hormonal changes, social pressure, and the move toward greater independence can make navigating the teenage years a minefield for both teens and parents alike.  But how can a parent know when a teen is experiencing more than just routine moodiness?  The alarming suicide rate for adolescents – it is the third leading cause of death among 10- to 24-year-olds — makes it imperative that parents recognize the signs and symptoms of suicidal risk.

Risk Factors

While suicide and suicide attempts often seem unpredictable, there are some known risk factors associated with suicide among young people.  They include the following:

  • History of previous suicide attempt(s);
  • History of suicide by a family member or friend;
  • Family history of depression;
  • Presence of a mental disorder or substance abuse;
  • Presence of a physical illness;
  • Sexual orientation issues in an unsupportive environment;
  • History of abuse, bullying, or other mistreatment;
  • Social isolation or lack of social or parental support;
  • Recent loss; e.g., break-up with boyfriend/girlfriend, death of family member;
  • Access to means or methods of suicide.

Some risk factors are biologically or genetically based; e.g., up to 95% of people who commit suicide have a psychological disorder.  However, environmental risk factors can often be addressed directly.

Warning Signs

Regardless of underlying risk factors, teenagers are considered most at risk for a suicide attempt after a particularly stressful life event, such as a relationship break-up, death of a loved one, parental divorce, or school bullying.

If a teenager displays any of the following, particularly following a major stressor or trauma, it may be an indication of suicidal thoughts:

  • Feelings of hopelessness or worthlessness;
  • Increased agitation, impulsiveness, aggression, or risk-taking;
  • Poor concentration;
  • Confused thoughts;
  • Frequent talk about death or suicide;
  • Hints about not being around much longer;
  • Giving away treasured possessions;
  • Avoiding family or friends;
  • Losing interest in school, sports, or favorite activities;
  • Significant changes in eating or sleeping habits;

Reducing Suicidal Risk

While all suicides cannot be prevented, parents can take practical steps to help reduce adolescent risk:

Be watchful.  Parents should keep a close eye on a teenager who has recently experienced a loss or major stressor.  They should watch for warning signs of depression, in particular. NOTE: Symptoms of depression in adolescents often include irritability, sleep disturbance, or withdrawal, rather than crying and sadness.

Increase communication.  Even if they don’t show it, adolescents need parents’ concern, love, and support. Parents should encourage teens to confide in them and show that they deserve their trust. Minimizing concerns, making fun, or avoiding serious discussions will only increase a teen’s frustration. If unwilling to talk with a parent, teens should be encouraged to talk with another relative or a trusted adult such as a school counselor, physician, or minister.

Parents should not be afraid to ask if a teen is having suicidal thoughts.  Asking the question will not plant the idea in someone’s head, but may open the door to honest communication. If a teenager directly expresses suicidal intent, the threat should be taken seriously. While only 1 in 25 suicide attempts by teens are successful, those odds are not ones with which any parents should be comfortable.

Seek professional assistance.  If warning signs are present and parental intervention is not sufficient, it’s time to reach out for professional help.  Assistance is available through mental health centers, doctors’ offices, or clinicians such as psychologists, psychiatrists, social workers, or counselors.  Emergency assistance is also available by telephone; e.g., the National Suicide Prevention Lifeline at 1-800-273-TALK.

Both professionals and parents can assist teens in learning important life skills such as problem solving.  The more effectively a teenager can navigate through conflicts and social problems, the more resilient he or she will become. School counselors or healthcare professionals can direct parents to relevant training materials.

Restrict access to means and methods.  Suicidal risk increases dramatically with access to reliable means and methods. Almost 60% of suicides in the U.S. are committed with a gun, so any guns in the home should be locked up and out of reach. Prescription and non-prescription medicine overdoses are also common, so parents should monitor all medications in the home.

By being more aware, practicing reasonable precautions and seeking professional help when needed, parents can significantly reduce suicidal risk in their teenagers.  One impulsive act can have fatal consequences, but one act of parental concern can have far ranging and positive effects on a loved one’s future.

Return to blog >

A mental health condition triggered by an extremely stressful event, post-traumatic stress disorder (PTSD) affects over 5.2 million Americans each year, and almost 8 million will experience it at some point over their lifetimes. PTSD is a serious mental disorder that can develop at any age and last for years.  Once known as “shell shock” because so many soldiers in combat developed the disorder, PTSD is commonly associated with war veterans.  However, a variety of triggering events can lead to the onset of this disorder, which can affect anyone.

Causes and Risk Factors 

PTSD can be triggered by experiencing any sort of physical or psychological trauma, or even by seeing or learning about such an event.  Feelings of helplessness and intense fear bring on later symptoms.  Examples of traumas can include physical or sexual assault, life-threatening experiences such as combat or accidents, natural disasters, or the death of a loved one. First responders to emergencies, such as EMTs and other rescue workers, can develop the disorder due to exposure to others’ trauma.

Many people face terrifying or extremely stressful experiences in their lives, but not everyone goes on to develop PTSD.  What triggers the disorder in some individuals but not others?  It appears that the following factors may affect an individual’s relative resiliency when exposed to extreme stress:

  • Genetic factors, including inherited mental health risks;
  • Severity and amount of previous trauma, particularly in childhood;
  • An individual’s temperament;
  • How one’s brain regulates hormones and chemicals released during episodes of stress;
  • Presence of lack of a strong support system of friends and family;
  • Intensity and duration of the traumatic experience;
  • One’s gender – women develop PTSD more frequently than men, partially due to the fact their increased vulnerability to domestic violence, rape, and other forms of abuse;
  • Presence of existing mental health problems such as depression or anxiety.

Symptoms of PTSD

In order to be classified at having PTSD, an individual must have symptoms occurring for at least one month and affecting overall functioning.  Most individuals develop symptoms within three months of the traumatic event, but symptoms may not emerge until years later.

People who go through a traumatic event can have reactions that include anxiety, anger, shock, and guilt.  These are common responses that fade away over time.  For an individual with PTSD, these feelings don’t fade but actually increase.

Mental health experts classify post-traumatic stress disorder symptoms in three categories:

  • Reliving.  Flashbacks, hallucinations, and nightmares are common ways in which individuals relive their traumatic ordeals.
  • Avoidance. Individuals often avoid places, people, or situations that remind them of the trauma.  This behavior can lead to social isolation, emotional numbing, and loss of interest in activities.
  • Increased arousal. Individuals may experience volatile emotions, such as anger outbursts, and feel agitated or easily startled. Concentration is often poor. Associated physical symptoms include increased heart rate or blood pressure, rapid breathing, and muscle tension.

The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer.

Treatment of PTSD

While PTSD can be disabling, it is treatable – usually through a combination of medication and psychotherapy.

Medications are often used to control extreme symptoms of the disorder, including anxiety, nightmares, and sleep disturbance.  Antidepressants or anti-anxiety medications may be prescribed to manage anxiety and depression and improve sleep. On a short-term basis, antipsychotics may be given to control emotional outbursts and severe sleeping disturbance.

Other medications may be used to treat specific physical or psychological symptoms.  For example, Prazosin, a drug normally prescribed for hypertension, may also manage insomnia and recurring nightmares.

Professionals also recommend psychotherapy or “talk therapy” to help individuals learn to manage symptoms and cope better with memories and feelings. Common treatment approaches include individual, family, or group therapy. Cognitive behavioral therapies are particularly effective, as they help patients deal with negative thought patterns that trigger stress.

Two strategies often associated with PTSD treatment are exposure therapy and eye movement desensitization and reprocessing (EMDR).  The former is a type of cognitive behavioral therapy in which patients relive traumatic experiences in a controlled and supportive environment.  This technique allows patients to confront their fears and become more comfortable in anxiety-provoking situations. EMDR helps patients deal with traumatic memories by teaching a group of guided eye movements that assist in processing these memories.

A word about prevention: there is evidence that seeking treatment as soon as possible after a traumatic event can be highly beneficial.  Immediate support can often help an individual recover from trauma without developing full-blown PTSD. Whether a mental health counselor, minister, or other helping professional, a trained, caring individual can provide invaluable support at a critical time.

Return to blog >

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.

* * *

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.

Return to blog >

Lindner Center of HOPE today was named Top Performer on Key Quality Measures® by The Joint Commission, the leading accreditor of health care organizations in America. Lindner Center of HOPE was recognized by The Joint Commission for exemplary performance in using evidence-based clinical processes that are shown to improve care for certain conditions. The clinical processes focus on care for heart attack, pneumonia, surgery, children’s asthma, stroke and venous thromboembolism , as well as inpatient psychiatric services. New this year is a category for immunization for pneumonia and influenza.

Lindner Center of HOPE is one of 1,099 hospitals in the U.S. earning the distinction of Top Performer on Key Quality Measures for attaining and sustaining excellence in accountability measure performance. Lindner Center of HOPE was recognized for its achievement on the following measure sets:  Hospital- Based Inpatient Psychiatric Services. The ratings are based on an aggregation of accountability measure data reported to The Joint Commission during the 2012 calendar year. The list of Top Performer organizations increased by 77 percent from last year and it represents 33 percent of all Joint Commission-accredited hospitals reporting accountability measure performance data for 2012.

Lindner Center of HOPE and each of the hospitals that were named as a Top Performer on Key Quality Measures must:  1) achieve cumulative performance of 95 percent or above across all reported accountability measures; 2) achieve performance of 95 percent or above on each and every reported accountability measure where there are at least 30 denominator cases; and 3) have at least one core measure set that has a composite rate of 95 percent or above, and within that measure set all applicable individual accountability measure have a performance rate of 95 percent or above. A 95 percent score means a hospital provided an evidence-based practice 95 times out of 100 opportunities. Each accountability measure represents an evidence-based practice.

“Lindner Center of HOPE and all the Top Performer hospitals have demonstrated an exceptional commitment to quality improvement and they should be proud of their achievement,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president and chief executive officer, The Joint Commission. “We have much to celebrate this year. Nearly half of our accredited hospitals have attained or nearly attained the Top Performer distinctions. This truly shows that we are approaching a tipping point in the hospital quality performance that will directly contribute to better health outcomes for patients.”

“We understand that what matters most to patients at Lindner Center of HOPE is safe, effective mental health care. That’s why Lindner Center of HOPE has made a commitment to accreditation and to positive patient outcomes through evidence-based care processes. Lindner Center of HOPE is proud to receive this distinction of being a Joint Commission Top Performer on Key Quality Measures, says Dr. Paul Keck, President and CEO.

In addition to being included in The Joint Commission’s “Improving America’s Hospitals” annual report, Lindner Center of HOPE will be recognized on The Joint Commission’s Quality check website, www.qualitycheck.org. The Top Performer program will be featured in the December issues of The Joint Commission Perspectives and The Source.

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.

Return to blog >

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.

Return to blog >

Do you know someone who gambles excessively?  If so, perhaps you’ve wondered if this individual just had a bad habit or if he or she was actually addicted to gambling.  It’s a question that even the experts have debated.  But the latest diagnostic publication of the American Psychiatric Association, the Diagnostic and Statistical Manual (DSM)-V, confirms that excessive gambling can indeed be an addiction, just like substance abuse.

The Nature of Gambling Addiction

“Problem” gambling, also referred to as pathological or compulsive gambling, affects an estimated 2 – 4% of the population. Before recent changes by mental health clinicians, it was classified as in impulse control disorder.  Like kleptomania (uncontrollable stealing) or pyromania (impulsive fire setting), compulsive gambling was considered a mental disorder associated with poor impulse control.

With further research, a new classification of the disorder has been made.  In the DSM-V, compulsive gambling is considered to be one of the “substance-related and addictive disorders.”  Why the change?  There is growing clinical evidence that pathological gambling has much in common with traditional substance abuse disorders.

First, the effects of the respective disorders on individuals’ work, financial, and personal lives can be similar. Neurochemical testing and brain imaging have also made a case for the belief that gambling activates the brain’s reward system in a manner similar to drugs.  For example, compulsive gamblers report highs from gambling as well as cravings.  Furthermore, gambling problems tend to run in families, indicating potential genetic factors. Finally, pathological gamblers are more likely to abuse alcohol and other drugs.

Symptoms of Gambling Addiction

In order for an individual to be classified as having a gambling disorder, at least 4 of the following symptoms must be present:

  • Frequent preoccupation with gambling;
  • Tendency to gamble increasingly large amounts of money;
  • Using gambling to cope with feeling distressed;
  • Lack of success in controlling, cutting back, or stopping the behavior;
  • Lying to others to hide gambling or committing illegal acts to finance;
  • Restlessness or irritability when attempting to decrease or stop gambling;
  • Frequent and often long-term “chasing” of losses with increased gambling;
  • Loss of a job or relationship due to behavior;
  • Reliance upon others to get out of financial straits.

Many of these symptoms resemble classic addictive symptoms, such as withdrawal and loss of control.

Individuals with pathological gambling problems are more likely to exhibit symptoms of other psychiatric problems.  In addition to substance abuse, such problems may include mood disorders, anxiety, or personality disorders.

While the effects of pathological gambling should not be minimized, viewing the behavior as evidence of an addiction rather than a character flaw can be helpful in encouraging an individual to seek treatment.  It may also remove some of the stigma associated with the behavior.  With appropriate intervention, individuals with gambling addictions can recover and live productive lives. (And that’s a sure bet!)

Return to blog >

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.