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Keeping Your Family Functional in the Wake of COVID 19

Tracy S. Cummings, MD Psychiatrist, Lindner Center of HOPE Chief of Child and Adolescent Psychiatry Medical Director of CCHMC Services at LCOH

On a large scale, our world continues to adjust to the new normal enacted for our safety in the wake of COVID19. And while we may be interested in global responses and big picture outcomes, this tends to pale in comparison to the level of concern a family holds for its members and home. Our definitions of “family” may vary, and our abilities to handle stress can be wide-ranging, but we all likely share our desire to see the system succeed. Having tangible options to put into action in our households right now can give us a sense of purpose and accomplishment while keeping those that mean the most to us moving forward in positive directions through this uncertain time. Consider the following acronym, HELP, to help keep your family functional:

H– Heed the advice of our trusted medical and community leaders.

  • Staying up to date on current safety recommendations from the CDC, WHO and governmental leaders is important.
  • Understanding what local resources may be needed and taking the time to consider your home’s personal emergency plan is worthwhile.
  • Creating a sense of control over those things that are within your grasp will feel rewarding, even if there is some anxiety around the situation.
  • Once you have the general information you need to proceed with helping your family, limit exposure to crisis-related media.

E– Enact the recommendations of the leaders and your personal plan.

  • In order for this to be successful for families, there will need to be good communication about its importance. Talking about the virus in a way everyone can understand (particularly if there are young children in the home) will pose a worthwhile challenge. Consider this as an opportunity to demonstrate empathy and compassion for each other when our particular ways of acknowledging, responding to, and addressing stress becomes apparent.
  • Take the universal precautions immediately: good hand hygiene, covering coughs/sneezes, frequently clean/disinfect, maintain social distancing, wear a mask if in a public setting, stay home as much as possible and absolutely if sick.
  • Remember that younger members in the home will be watching those around them for cues on how to handle this situation, so reinforce the recommendations through modeling the appropriate behaviors as much as possible. If the adults in the home are struggling with how they are personally managing the stress of today, seeking assistance for mental health strength should not be delayed.

L– Listen to the needs of your individual household and make room for those in the necessary changes.

  • Label priorities for your family: academics, virtual lessons, family meals, general chores, and what needs to be done on a given day.
  • The use of a broad-strokes calendar may be helpful here, so as to set some daily standards and routines. With so much changing around us (ie. schools closed, remote working requirements, conveniences disrupted), having some predictability to the day can provide security to adults and children alike. Do you have to set up a strict schedule for every hour of the day and follow it militantly?  No, but knowing there is some allotted time for a few essential activities a day is reasonable, and IT CAN CHANGE as needed.
  • Emphasize flexibility over perfection these days.

P– Protect your unity.

  • Emotions can run high during this time of collective crisis. Accepting how difficult these changes are for us all can be freeing.
  • It is ok to grieve the loss of all the special moments and events that have been postponed or canceled due to COVID19. Whenever possible, consider ways to creatively experience those moments in an alternative fashion. Can’t go to Disney?  How about making a Disney movie night and riding some virtual rides that are posted for the park?
  • Keep in contact with those who are important to your family as much as possible. Use the technology available to your advantage. Virtual birthday parties and gatherings, like many current classrooms, are being readily utilized with success. Phone calls with or without video, texts, and even sending letters/cards are simple ways to avoid isolation while maintaining social distancing.
  • Staying connected doesn’t mean you have to spend every moment together, though. It might be nice, and likely necessary, for family members in the same home to have some time to themselves. Use these moments to recharge and encourage young ones in the home to appreciate this personal time as well.

These are uncharted waters for our families, our communities, our planet. We cannot expect to know how to handle our current circumstances flawlessly, but we can keep trying.  All we need is a little HELP.

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Coping With Stress During This Difficult Time

by: Tracy S. Cummings, MD, Psychiatrist, Lindner Center of HOPE

The outbreak of coronavirus disease 2019 (COVID-19) may be stressful for people. Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. Coping with stress will make you, the people you care about, and your community stronger.

Everyone reacts differently to stressful situations.  How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

People who may respond more strongly to the stress of a crisis include

  • Older people and people with chronic diseases who are at higher risk for COVID-19
  • Children and teens
  • People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
  • People who have mental health conditions including problems with substance use

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, or feel like you want to harm yourself or others call

  • 911
  • Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746. (TTY 1-800-846-8517)

Stress during an infectious disease outbreak can include

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Increased use of alcohol, tobacco, or other drugs

People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms.

Things you can do to support yourself

  • Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.

 

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Trauma and Mental Health

Jennifer L. Farley, PsyD
Lindner Center of HOPE, Staff Psychologist

When horrible things happen, things that we didn’t want or expect, they can have a significant – and sometimes devastating – effect on our lives. This is especially the case when the horrible event was perceived as a risk to our life or the life of someone we care about. A traumatic event can be shocking, scary, and/or dangerous. It can affect the way we perceive our environment, it can lead us to do things we would not normally do, and it can affect the quality of our relationships. Hence, a trauma can negatively impact many aspects of our well-being.

When someone experiences a trauma, the effects of it can depend on a variety of factors such as the age when the trauma occurred, the duration of which the the trauma occurred, and the intensity of the negative effects of the trauma. These factors do not mean, for example, that one who experienced a one-time traumatic event “should” have a better mental health outcome than someone who experienced a repeated trauma; rather, it is helpful to understand the nature of the trauma and how individuals can be affected.

When a traumatic experience occurs, the limbic system in the brain is activated and initiates the “fight, flight, or freeze” response to protect the person from harm. Interested in touring Sometimes these responses are so strong that a person may do something they would not have imagined was possible. Imagine being able to move something very heavy to protect a child from harm’s way or to run fast away from danger. Other responses can lead one to experience “shock” to where one cannot process their environment in a way to elicit any response. During this “fight, flight, or freeze” response, the individual is not focused on problem-solving or rational thought process, which are functions elicited by the frontal lobe of the brain (the “executive” center, if you will). Instead, the person is focused on survival and protection.

Feeling afraid is natural during and after a traumatic experience. Also,most people recover from initial symptoms they may have after a trauma. However, there are some people who may experience anxiety long after the traumatic experience, even when they are no longer in danger. Some of these individuals may develop symptoms associated with Post Traumatic Stress Disorder (PTSD). People may experience flashbacks that triggers them to feeling the same intensity of fear they had during the trauma. People may develop a strong mistrust of others.

They may also develop feelings of guilt, as if they were responsible for the traumatic event. Some people may avoid certain places or things associated with the trauma. Nightmares may be common. People may also develop very unhealthy ways to cope with their symptoms of PTSD, for example, by “numbing” their feelings with alcohol and/or drugs or with self-harm behaviors. It is estimated that 7 or 8 out of every 100 people will experience PTSD at some point in their lives. When a traumatic event is experienced in a child, the negative effects upon that child’s social and emotional development can be even more profound. The attachment that child has to his or her loved ones can be severely impacted. They struggle to form healthy relationships with others. Their academic performances can be hindered, especially if they become focused on their worries instead of their school work.

For these reasons, seeking psychological treatment as soon after a traumatic is experienced is highly recommended. Psychotherapy can help a person become more empowered over their fears through cognitive and behavioral strategies. Medication also can be indicated for people with PTSD, especially to help regulate sleep, reduce anxiety, and minimize depression. The goal for treatment would be to help the individual function better in several ways (e.g., socially, emotionally, and behaviorally) and to reduce the long-term impact that a trauma might have.

People may experience a traumatic event, but the symptoms associated with experiencing the trauma can be overcome.

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Getting Past Your Past

Chris Tuell Ed.D., LPCC-S, LICDC-CS
Clinical Director of Addiction Services Lindner Center of HOPE
Assistant Professor, Department of Psychiatry & Behavioral Neuroscience University of Cincinnati College of Medicine

In 1987, Francine Shapiro went for a walk. While on her walk, Francine was contemplating some very upsetting personal events that were occurring in her life at the time. But as she began to focus on this upsetting information, she noticed that her eyes began to flicker from side to side. More importantly, she noticed that the once upsetting information was no longer as upsetting. Shapiro felt that she had stumbled on some aspect of how the mind processes information. Eye Movement Desensitization and Reprocessing, better known as EMDR, was born.

For the past 30 years EMDR has become one of the most effective therapeutic approaches in the treatment of trauma. EMDR is not only approved by the American Psychiatric and Psychological Associations, but also by the United States Department of Defense and the Veterans Administration, as an effective therapy in the treatment of post traumatic stress disorder (PTSD). Dr. Shapiro believes that one of the major theories behind EMDR is the bilateral stimulation of both hemispheres of the brain. When we sleep at night, our brain continues to process information. This occurs during rapid eye movement sleep or better known as REM sleep.

The brain processes the events of the day, keeping what is important (e.g. family, work, school, friends), and purging what is unimportant (e.g., What I had for dinner last Tuesday). How many times have we have been faced with a tough decision and resorted to, “I’ll just sleep on it,” only to awake the next morning with a better idea of what to do? But when a traumatic event occurs, the processing of this information becomes disrupted. The brain becomes unable to process and clear the event or information, resulting in the trauma experience continuing to occur as if it is happening all over again. In this playing-out, the right hemisphere of the brain, the part of our brain that experiences emotions such as fear and anxiety, continues to be activated by the unresolved trauma. The patient experiences this activation through intrusive thoughts, flashbacks, and disturbing dreams, the basic elements of PTSD.

EMDR involves the bilateral stimulation of both hemispheres of the brain while targeting the upsetting aspects of the trauma. In therapy, the therapist recreates what happens naturally during REM sleep, with the movement of the eyes as they follow the therapist’s hand, stimulating both hemispheres of the brain. Over the years, additional bilateral stimulation methods have been found to be effective (i.e., tactile, audio). This targeting involves, not only activating the image of the event, but also identifying the negative thoughts, emotions and sensations experienced by the patient from the trauma. During the reprocessing of the trauma experience, the logical, rational part of the brain, the left hemisphere, is integrated with the right emotional hemisphere. This results in the patient having a more adaptive response to the trauma. The patient may still have memory of the event, but the emotional aspects of fear and anxiety have dissipated. During EMDR, the left hemisphere of the brain, the rational, logical part, is integrated with the emotional right hemisphere of the brain, resulting in the patient feeling and knowing that, “The trauma is no longer happening to me now; The trauma is in the past; I am safe now.”

EMDR is not a wonder cure nor is it a quick fix. EMDR involves hard work by the patient and it takes a good amount of clinical skills in order to implement. This is not about touching the person’s forehead and he or she is better. The patient and therapist have to be responsible and work at this process, but it does appear to go much more rapidly than traditional types of therapy. If a trauma can occur within a few moments, why do we automatically accept that it has to take years to undo it?

More than 20,000 practitioners have been trained to use EMDR since its discovery. The use of EMDR has been found to be beneficial in other areas of mental health besides, PTSD. Areas such as panic disorders, anxiety disorders, grief, pain, stress, addiction, and abuse, have shown to be responsive to this unique therapy. One aspect of EMDR that I have found to be valuable is the fact that it is unnecessary for me, as the clinician, to know all the details and specifics of a patient’s trauma in order for EMDR to be helpful. Many individuals who have experienced trauma stay clear of therapy for fear of reliving the memories and feelings. The EMDR protocol allows for such traumatic episodes to be addressed and reprocessed without describing the details of the trauma. As a practitioner, I have found EMDR to be a valuable therapeutic tool in assisting patients in moving past one’s past.

For more information about EMDR: https://www.emdria.org

 

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An Overview of Maternal Mental Health Issues

 

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

May is Maternal Mental Health Awareness Month.  One in five women will develop a maternal mental health disorder.  They are also referred to as perinatal mood and anxiety disorders (PMADs) to emphasize that women experience more than postpartum depression during pregnancy and after birth.  Women who have symptoms of PMADs might not seek help because of guilt, shame, or embarrassment for feeling something different than the expected norms of motherhood.  Awareness and education are important to reduce stigma so mothers and babies get the help they need.

PMADs can occur during pregnancy or up to one year after giving birth. The most common PMAD is the “baby blues”, affecting up to 80% of new mothers.  Symptoms include sudden mood swings, loneliness, sadness, crying spells, loss of appetite, problems sleeping, irritability, restlessness, and anxiety.  These symptoms are a normal adjustment to changes in hormones and resolve without treatment in two to three weeks.

About 10% of women experience depression during pregnancy and about 15% during the first year postpartum.  Feeling sad, hopeless, helpless, or worthless; fatigue, difficulty sleeping or sleeping too much, appetite changes, difficulty concentrating, crying, loss of interest or pleasure; lack of interest in, difficulty bonding with, or excessive anxiety about the baby; feelings of being a bad mother, and fear of harming the baby or self are symptoms of peripartum depression.  Risk factors include poverty, being a teen mother, advanced maternal age; personal or family history of depression, anxiety, or postpartum depression; premenstrual dysphoric disorder, inadequate support, financial stress, relationship stress; complications in pregnancy, birth or breastfeeding; a history of abuse or trauma, a major recent life event, birth of multiples, babies in neonatal intensive care, infertility treatments, thyroid imbalance, and diabetes.

Anxiety can occur alone, or with depression, in 10% of new mothers.  Symptoms include constant worry, racing thoughts, inability to sit still, changes in sleep or appetite, feeling that something bad is going to happen; and physical symptoms like dizziness, hot flashes, and nausea.  Some mothers may also have panic attacks with shortness of breath, chest pain, dizziness, a feeling of losing control, and numbness and tingling.  Risk factors are a personal or family history of anxiety, previous perinatal depression or anxiety, and thyroid imbalance.

Post-traumatic stress disorder (PTSD) can occur in up to 6% of mothers following a traumatic childbirth.  Possible traumas are prolapsed cord, unplanned C-section, use of vacuum extractor or forceps to deliver the baby, baby going to NICU; and feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery.  Women who have experienced a previous sexual trauma are also at a higher risk for developing postpartum PTSD.  Intrusive re-experiencing of the traumatic event, flashbacks or nightmares; avoidance of stimuli associated with the event; increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response); anxiety and panic attacks, and feeling a sense of unreality and detachment are symptoms of PTSD.

Obsessive-compulsive disorder (OCD) can occur in 3% to 5% of new mothers.  Obsessions are persistent, repetitive thoughts or mental images, often related to the baby. Obsessions can be so bizarre or disturbing that they can be mistaken as psychosis.  Compulsions are repetitive acts performed to reduce obsessions.   Mothers are distressed by the obsessions which can lead to a fear of being left alone with the baby or hypervigilance in protecting the baby.  Mothers with postpartum OCD know that their thoughts are out of the ordinary and are unlikely to ever act on them.

Postpartum psychosis is the most severe of the PMADs.  It is often associated with an episode of bipolar disorder. It is rare, occurring in 1 to 2 per 1000 women.  The onset is abrupt, within 48 to 72 hours and up to two weeks after delivery. This is a psychiatric emergency, requiring immediate treatment.  Mothers may experience hallucinations (hearing voices or seeing things) and/or delusions (believing things that aren’t true.)  If psychosis occurs as part of a bipolar manic episode, there might be additional symptoms such as irritability, hyperactivity, decreased need for or inability to sleep, paranoia and suspiciousness, rapid mood swings, difficulty communicating, and confusion or memory loss. Risk factors are a personal or family history of bipolar disorder or a psychotic disorder.  Most women with postpartum psychosis do not have violent delusions but there is an up to 5% rate of infanticide or suicide due to acting on delusions or having irrational judgement.

PMADs are the most common complication of pregnancy and childbirth.  They are treatable with psychotherapy and/or medication and early intervention provides relief for the mother and ensures the baby’s wellbeing.

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The Benefits of Residential Assessment.

On October 28, 2015, Dr. Elizabeth Wassenaar, Lindner Center of HOPE Psychiatrist and Williams House Medical Director, joined Lon Woodbury on the Woodbury Report radio show.  Their discussion focused on outlining the benefits of a residential assessment for mental health concerns in adolescents.

Click here to listen.

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Understanding Post-traumatic Stress Disorder (PTSD)

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.

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Mental Illness a Leading Cause of Disability in the U.S.

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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Co-Occurring Disorders Complex But Treatable

Diagnosing specific mental health problems and disorders is not always easy. The human mind is very complex. Even highly-trained and vastly experienced mental health professionals may occasionally experience some difficulties in pinning down a definitive diagnosis.

This is especially true in regard to co-occurring disorders. Also referred to as “dual disorders” or a “dual diagnosis,” a co-occurring disorder exists when a mental health condition is accompanied by at least one other disorder.

Co-occurring disorders are relatively common. It is often the case where the symptoms of one condition will present themselves while other conditions lie beneath the surface. This is the challenge for psychiatric professionals; to determine whether there are underlying issues that may be affecting or exacerbating what appears to be a particular mental illness.

For example, it is not uncommon for ADHD to be accompanied by anxiety or mood disorders; or Post Traumatic Stress Disorder (PTSD) to coexist with depression. The symptoms of these illnesses can play into each other, overlap or display themselves as a result of the other.

Such is the case with addictive disorders that are well-known for existing with other conditions. Many who struggle with depression or mood and anxiety disorders turn to substance abuse to relieve their symptoms.

Treating Co-occurring Disorders

To effectively treat co-occurring disorders, each condition must be isolated and addressed. Every patient has their own unique background and set of circumstances. Therefore a treatment plan must be tailored to meet the needs of each individual.

After initial evaluation and assessment, an “integrated” approach to counseling and psychotherapy is usually preferred when treating co-occurring disorders. This is where substance abuse counselors, psychotherapists and anyone else involved in the treatment process will coordinate efforts and share information regarding the patient’s condition, care and progress.

An integrated program for those with co-occurring disorders is usually administered in stages. Various avenues of treatment are incorporated into a comprehensive strategy that includes helping the patient understand their condition, establishing goals and guiding the patient toward the development of healthier behavior patterns. Group therapy and aftercare can also play an important role in an overall plan to help a co-occurring disorder sufferer heal.

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Chronic Stress Can Take a Toll on One’s Mental Well-Being

Stress is a normal reaction to situations and frustrations that we occasionally experience during the course of our lives. Career concerns, deadlines, financial troubles and kid-related issues can all cause us moments of worry and degrees of anxiety. Normal stress can also be beneficial to us in some ways. For instance, it heightens our awareness in dangerous situations and boosts our ability to perform in an athletic endeavor.

But when feelings of apprehension and distress become perpetual, and there aren’t many moments in a day when we’re not feeling stressed or anxious, it can eventually wear us down and have a negative impact on our health. Stress can affect us both physically and mentally. Some of the physical manifestations of stress are tension, an elevated heartbeat, sweatiness and an upset stomach. Continuous stress can also lead to high blood pressure and heart problems.

The Effects of Chronic Stress on Mental Health

Post-Traumatic Stress Disorder (PTSD) is a well-known condition in which a traumatic event or the circumstances surrounding that event can cause recurring bouts of extreme stress. But constant, long-term stress can also have devastating consequences if not properly addressed.

Many people with chronic stress are unaware that the almost ceaseless worry and anxiety in their everyday lives may be turning into a deeper issue. They may feel that stress is just a part of their daily existence, and that the irritability, forgetfulness, trouble sleeping and fatigue, among other symptoms that can accompany chronic stress, simply come along with it.

However, “nervous breakdowns” or the development of anxiety disorders, eating disorders, sleep disorders, panic attacks and clinical depression that can result from persistent, long-term stress are serious conditions which require proper mental health treatment. This may consist of learning techniques to better manage and alleviate stress, or, depending on the severity of the situation, may involve psychotherapy and medication.

If there are indications that an individual may be experiencing chronic stress and they are beginning to show signs that there may be worse problems on the horizon, it’s time for them to get help. They shouldn’t hesitate to consult with a professional at one of their local mental health centers and begin to learn how to achieve some peace in their lives and get themselves back on track.