Category: Depression

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

Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared.

Not all children and teens respond to stress in the same way. Some common changes to watch for include

  • Excessive crying or irritation in younger children
  • Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
  • Excessive worry or sadness
  • Unhealthy eating or sleeping habits
  • Irritability and “acting out” behaviors in teens
  • Poor school performance or avoiding school
  • Difficulty with attention and concentration
  • Avoidance of activities enjoyed in the past
  • Unexplained headaches or body pain
  • Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child

  • Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child or teen can understand.
  • Reassure your child or teen that they are safe. Let them know it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
  • Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
  • Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
  • Be a role model.  Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members.

The emotional impact of an emergency on a child depends on a child’s characteristics and experiences, the social and economic circumstances of the family and community, and the availability of local resources. Not all children respond in the same ways. Some might have more severe, longer-lasting reactions. The following specific factors may affect a child’s emotional response:

  • Direct involvement with the emergency
  • Previous traumatic or stressful event
  • Belief that the child or a loved one may die
  • Loss of a family member, close friend, or pet
  • Separation from caregivers
  • Physical injury
  • How parents and caregivers respond
  • Family resources
  • Relationships and communication among family members
  • Repeated exposure to mass media coverage of the emergency and aftermath
  • Ongoing stress due to the change in familiar routines and living conditions
  • Cultural differences
  • Community resilience
For 7 to 10 year olds

Older children may feel sad, mad, or afraid that the event will happen again. Peers may share false information; however, parents or caregivers can correct the misinformation. Older children may focus on details of the event and want to talk about it all the time or not want to talk about it at all. They may have trouble concentrating.

For preteens and teenagers

Some preteens and teenagers respond to trauma by acting out. This could include reckless driving, and alcohol or drug use. Others may become afraid to leave the home. They may cut back on how much time they spend with their friends. They can feel overwhelmed by their intense emotions and feel unable to talk about them. Their emotions may lead to increased arguing and even fighting with siblings, parents/caregivers or other adults.

More on taking care of your family

Disasters and other crisis events have the potential to cause short- and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. It’s important that pediatricians, and all adults in a position to support children, are prepared to help children understand what has happened and to promote effective coping strategies. This will help to reduce the impact of the disaster as well as any associated bereavement and secondary stressors.

Stress is intrinsic to many major life events that children and families face, including the experience of significant illness and its treatment. The information provided about how to help children cope after disaster and crisis is therefore relevant for many encounters that pediatricians will have with children, even outside the context of a disaster.

Talk about the event with your child. To not talk about it makes the event even more threatening in your child’s mind. Silence suggests that what has occurred is too horrible to even speak of. Silence may also imply to your child that you don’t think their reactions are important or appropriate.

  • Start by asking what your child has already heard about the events and what understanding he or she has reached. As your child explains, listen for misinformation, misconceptions, and underlying fears or concerns, and then address these.
  • Explain – as simply and directly as possible – the events that occurred. The amount of information that will be helpful to a child depends on his or her age. For example, older children generally want and will benefit from more detailed information than younger children. Because every child is different, take cues from your own child as to how much information to provide.
  • Encourage your child to ask questions, and answer those questions directly. Like adults, children are better able to cope with a crisis if they feel they understand it. Question-and-answer exchanges help to ensure ongoing support as your child begins to understand the crisis and the response to it.
  • Limit television viewing of disasters and other crisis events, especially for younger children. Consider coverage on all media, including the internet and social media. When older children watch television, try to watch with them and use the opportunity to discuss what is being seen and how it makes you and your child feel.

Healthy Children. Org provides additional insights

  • Recognize that your child may appear disinterested. In the aftermath of a crisis, younger children may not know or understand what has happened or its implications. Older children and adolescents, who are used to turning to their peers for advice, may initially resist invitations from parents and other caregivers to discuss events and their personal reactions. Or, they may simply not feel ready to discuss their concerns.
  • Reassure children of the steps that are being taken to keep them safe. Terrorist attacks and other disasters remind us that we are never completely safe from harm. Now more than ever it is important to reassure children that, in reality, they should feel safe in their schools, homes, and communities.
  • Consider sharing your feelings about the event or crisis with your child. This is an opportunity for you to role model how to cope and how to plan for the future. Before you reach out, however, be sure that you are able to express a positive or hopeful plan.
  • Help your child to identify concrete actions he or she can take to help those affected by recent events. Rather than focus on what could have been done to prevent a terrorist attack or other disaster, concentrate on what can be done now to help those affected by the event.

AACAP Recommendations for talking to children about COVID-19 :

Talking to Children About Coronavirus (COVID19)

  • Remember that children tend to personalize situations. For example, they may worryabout their own safety and the safety of immediate family members. They may alsoworry about friends or relatives who travel or who live far away.
  • Be reassuring, but don’t make unrealistic promises. It’s fine to let children know that they are safe in their house or in their school. But you can’t promise that there will be no cases of coronavirus in your state or community.
  • Let children know that there are lots of people helping the people affected by the coronavirus outbreak. It’s a good opportunity to show children that when something scary or bad happens, there are people to help.
  • Children learn from watching their parents and teachers. They will be very interested in how you respond to news about the coronavirus outbreak. They also learn from listening to your conversations with other adults.
  • Don’t let children watch too much television with frightening images. The repetition of such scenes can be disturbing and confusing.
  • Children who have experienced serious illness or losses in th
  • Although parents and teachers may follow the news and the daily updates with interest and attention, most children just want to be children. They may not want to think about what’s happening across the country or elsewhere in the world. They’d rather play ball, go sledding, climb trees or ride bikes.

 

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Susan L. McElroy, MD

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

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

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

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

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

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

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

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

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

https://lindnercenterofhope.org/research/

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

For further information on BPD:

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

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Jennifer Farley, PsyD

Lindner Center of HOPE, Staff Psychologist

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

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

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

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

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

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

 

Innovations in Mental Health Treatment

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

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

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

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

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

http://www.monarch-etns.com/ 

https://www.zulresso.com/ 

https://www.spravato.com/

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

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

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

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

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

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

 

 

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

 

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Several suicides among local high school students has the Cincinnati community mourning these losses and searching for answers. WCPO’s Tanya O’Rourke spoke with Lindner Center of HOPE Medical Director of Inpatient and Partial Hospital Program Services Dr. Tracy Cummings about what families need to know about suicide prevention for themselves and their children.

According to Dr. Cummings, suicide has become more prevalent in recent years. “It’s striking actually – up to almost 30% increase since 1999.” This may be a conservative estimate due to stigma discouraging people from self-reporting suicide attempts.

Cummings cites risk factors that correlate with suicide attempts, including a family history of suicide, previous attempts, or a recent loss among close relatives or friends. Dr. Cummings also refers to a “contagion effect,” where one suicide within a community may trigger additional attempts by people who are suffering.

Social media use can also affect teens. Suggestions are offered on how parents can approach their kids on the topic of self-harm. Parents should not worry about “implanting” thoughts into their children’s minds by asking them directly about suicide. Rather, it is imperative that parents start a direct conversation with their children.

 

 

 

Watch both parts of Dr. Cummings’ two-segment interview on WCPO’s YouTube Page

Part 1

 

Part 2

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

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

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

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

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

 

Watch more:

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

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November is Family Caregivers Month.

A growing number of Americans are taking roles as caregivers for loved ones suffering with a variety of illnesses and disabilities. At least 60 million have a caregiving role – most caregivers are middle-aged adults.

Caregivers can be anyone doing a broad range of tasks for loved ones who are unable to perform everyday duties like picking up groceries, getting dressed in the morning, or driving to medical appointments. These caregivers are often unpaid and untrained.

By giving so much for others, it is easy to neglect self-care and caregivers often suffer burnout that leads to higher rates of mental illness like depression and anxiety. Exhaustion and fatigue can lead to more serious health issues. Recent studies show 40-70 percent of caregivers have clinically significant symptoms of depression and anxiety due to chronic stress associated with providing care

Some self-care strategies can include:

  • Eating right, exercising and getting enough sleep (7-8 hours) is always important
  • Make a self-care calendar and share that plan with someone else
  • Don’t base your identity on your care for others. Caring is acting, not being
  • Be mindful: Recognize how an activity reenergizes you and fully participate in it
  • Keep a victory journal
  • For more tips, view:  http://www.fox19.com/video/2018/11/16/national-caregivers-month/

The Lindner Center of HOPE has some of the nation’s leading physicians experienced in depression treatment and self-care. If caregivers are experiencing symptoms of depression or anxiety, they can schedule an evaluation at the Lindner Center of HOPE Rapid Access Service, which is an outpatient service for patients 18 and older, open Tuesday and Thursday afternoons from 12:30 pm to 4 pm. This service enables patients in need to have a scheduled appointment, within days of the call. The appointment includes a thorough outpatient assessment with a psychiatrist and social worker, a care plan, recommendations with referrals and a written after-visit summary. Call 513-536-0639 to schedule.

 

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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