Getting through the Hard Days of Depression

Getting through the hard days of depression can be extremely difficult.  People diagnosed with Major Depressive Disorder often feel better pretty quickly once they begin treatment with therapy, medication, or both.  Unfortunately, even when the person is completely compliant with treatment recommendations, there can be relapses.  Patients can experience an unexpected setback as they are recovering.
major depressive disorder
Many times the patient is completely surprised and alarmed by this sudden drop in mood.  Illinois therapist and writer Jacqueline Marshall gives suggestions on how to handle those really bad days as part of her article on PSYWEB.com.

Ms Marshall’s techniques can provide relief for many people. Her suggestions include relaxation, breathing, distraction, and seeking support from friends and family.

It is important to remember, however, there may be a time when you do not find relief from any of these methods.  If you think you are in danger of hurting yourself, call 911 and ask for help.

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Treating depression in Cancer Patients

 

treating depression in cancer patientsCecelia Gittleson writes in Memorial Sloan-Kettering‘s Cancer Center newsletter about the importance of diagnosing and treating depression in cancer patients.  She discusses sources of support for patients, survivors, and their caregivers.

Ms. Gittelson quotes a physician who specializes in the psychological treatment of people with breast cancer and their families on the importance of psychosocial support, “We’ve learned that depressed people generally do less well in the oncology setting,” explains Memorial Sloan-Kettering psychiatrist Mary Jane Massie. “This is probably due in part to the fact that because they feel bad — psychologically, physically, or both —they decide it isn’t useful to take their medications. And there can be a domino effect: They stop filling their prescriptions and may even start to miss medical appointments. But there is a lot of help available.”

I encourage anyone who is struggling with a cancer diagnosis, no matter which stage of treatment, to reach out to a mental health professionals.  Ms. Gittelson’s article and her recommendations for sources of support are here.

Holly Scott, MBA, MS, LPC sees clients at Uptown Dallas Counseling. Holly is trained in the specialty of Cognitive Behavioral Therapy, and holds the position of Diplomate in the Academy of Cognitive Therapy. Holly works with clients to help them overcome challenges in their daily lives that may be preventing them from achieving happiness. She helps clients with stress management, depression, parenting, marriage counseling, and other mental health concerns. If you are looking for a counselor or therapist, explore this website to see if Holly may be able to help you. 

To make an appointment for therapy or counseling with Holly at her Uptown Dallas Counseling, you have the option of using the Online Patient Portal to register and schedule. 

Postpartum Depression: Tragic Consequences

Did Miriam Carey have Postpartum depression?

postpartum depression

From CBS News: Emergency personal help an injured person after a shooting on Capitol Hill in Washington, Thursday, Oct. 3, 2013. Police say the U.S. Capitol has been put on a security lockdown amid reports of possible shots fired outside the building. (AP Photo/ Evan Vucci) The small photo comes from what is believed to be the Facebook page of Miriam Carey, who according to multiple police sources, allegedly led authorities on a car chase near the U.S. Capitol on Oct. 3, 2013. / FACEBOOK / EVAN VUCCI/AP/FACEBOOK

We may never know whether Ms. Carey was suffering from postpartum depression when she drove from her home in Connecticut with her 1-year old daughter to Washington, DC., where she lost her life after being shot by police.  At approximately 2:00 in the afternoon on Thursday, October 3, Ms. Carey rammed her car into a temporary barrier in front of the White House, then lead officers on a chase down Pennsylvania Avenue.  Police cars surrounded Ms Carey’s car at Garfield Circle, just south of the Capitol.  Ms. Carey then rammed a Secret Service car (pictured below) in an attempt to escape.

postpartum depression

From USA Today

At this point, officers began to fire shots at Ms Carey’s car.  She then drove to Constitution Avenue before eventually stopping in the 100 block of Maryland Avenue NE, near the Hart Senate Office Building.  She fled from her car on foot and was shot and killed.  Her daughter, who had been in the backseat, was unharmed.
Ms. Carey’s mother, Idella Carey, stated her daughter had been suffering from postpartum depression and had been hospitalized once for the condition.  Other relatives stated Ms Carey believed her apartment was under surveillance and that she was being stalked by President Obama.  Amy Carey-Jones, a sister, spoke to Ms. Carey about a week ago and believed her sister was fine.
Postpartum depression can be difficult to diagnose and monitor.  It is possible Ms. Carey had a severe form of the disease, Postpartum Psychosis (PPP), a rare condition that affects only 1 or 2 women in 1000.  PPP can suddenly come out of nowhere and present any time up to one year after the birth of a baby.  Sufferers and their caregivers are usually totally unprepared with how to cope with the symptoms of this disease.
postpartum depression
Ms. Storrs recommends that family members and friends of a new mother immediately notify a healthcare professional or local emergency department if she suddenly starts showing any of the following signs:
• Acting very energetic or agitated
• Being unable to get out of bed
• Showing unusual or nonsensical behavior
• Acting fearful or paranoid
• Believing bizarre ideas, such as thinking that the baby is the devil

postpartum depression

printed with permission from deamstime

One of the most difficult aspects of PPP is that the new mother does not believe she is ill, and she will often be very resistant to treatment.   Additionally, the worldwide publicity surrounding some especially gruesome PPP outcomes (Andrea Yates drowning her 5 children in 1991) has added to the negative stigma associated with any postpartum mental illness.  Because there is so much misinformation, many new mothers with even slight symptoms can become scared and refuse to seek help.
The vast majority of women who do develop this rare illness are never a threat to themselves or their children.  Early treatment from a qualified mental health professional can have a significant impact on alleviating the symptoms and speeding the treatment of this disease.

 

Suicide Awareness Program.

Active Minds, an organization dedicated to spreading suicide awareness on college campuses, kicked off its tour of Send Silence Packing on September 10, 2013.  The tour is an exhibit of 1100 backpacks that represent the 1100 college students who die by suicide every year.  More details of the tour can be found here.

Are you in crisis? Please call the Suicide Prevention Lifeline 
at 1-800-273-TALK (1-800-273-8255)

suicide awareness

Active Minds traveling suicide awareness program of 1,100 backpacks representing the 1,100 college student lives lost to suicide each year is taking a heading to California. The tour is kicked off on September 10, World Suicide Prevention Day, at Riverside City College in Riverside, CA.

 
Suicide is one of the most frightening possible outcomes of mental illness. If you or someone you know needs help, call 1-800-273-TALK (8255) immediately. This is the number for the National Suicide Prevention Lifeline, a 24-hour service available to anyone in need of help. Never ignore or underestimate remarks about suicide. Take them seriously, and make certain that the person in crisis is cared for. And if you think your friend is in immediate danger, do not leave him or her alone—stay there and call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
Additional Information from Active Minds:
An extensive list of web resources can be found here:  http://www.activeminds.org/issues-a-resources/mental-health-resources

Fighting Suicidal Thoughts

Natasha Tracy writes in her blog, Breaking Bipolar, about the effect of her grandmother’s end-of-life struggle on her ability to fight off suicidal thoughts.   In her post, she shares her thoughts as she stood by her grandmother in the hospital and how those thoughts now help her in her struggle with bipolar disorder.

Breaking Bipolar

Your Brain Changes After "Talk Therapy"

colorful brain
As a Cognitive Behavioral Therapist, I am excited by any new research that demonstrates a biological brian change after patients undergo “talk therapy”.  A group of scientists just published a study showing:
  • biological brain changes after cognitive behavioral therapy
  • the effects of cognitive behavioral therapy can be studied empirically
The New York Times published an article by Eric R. Kandel on September 6, 2013 describing the biological basis of mental disorders.  He writes about scientists at Emory University who performed a study on depressed individuals looking for evidence of biological changes after psychotherapy and after anti-depressant medications.  They used brian scans before and after treatment to identify biological brain changes.  During this study, the scientists were able to accurately predict whether patients would respond to psychotherapy or medications for the treatment of their depression.
Dr. Kandel summarizes the significance of the study as:
First, the neural circuits disturbed by psychiatric disorders are likely to be very complex.
Second, we can identify specific, measurable markers of a mental disorder, and those biomarkers can predict the outcome of two different treatments: psychotherapy and medication.
Third, psychotherapy is a biological treatment, a brain therapy. It produces lasting, detectable physical changes in our brain, much as learning does.
And fourth, the effects of psychotherapy can be studied empirically. Aaron Beck, who pioneered the use of cognitive behavioral therapy, long insisted that psychotherapy has an empirical basis, that it is a science.
Other forms of psychotherapy have been slower to move in this direction, in part because a number of psychotherapists believed that human behavior is too difficult to study in scientific terms.  The entire article is posted on the New York Times website here.
Eric R. Kandel, a professor at the Mortimer B. Zuckerman Mind Brain Behavior Institute at Columbia, a senior investigator at the Howard Hughes Medical Institute and a recipient of the 2000 Nobel Prize in Physiology or Medicine, is the author of “The Age of Insight: The Quest to Understand the Unconscious in Art, Mind and Brain, From Vienna 1900 to the Present.”

College and Mental Health

Adolescents-2The Jed Foundation is a not-for-profit organization that promotes emotional health among college students.  The foundation’s Medical Director, Dr. Victor Schwartz, states “of the 20 million students in post-secondary education in the United States, 20 percent have received counseling or some type of mental health diagnosis.”

Many colleges and universities are reviewing and updating their comprehensive mental health and suicide prevention programs.  In an article based on an interview with Dr. Schwartz, Matthew Lynch, Ed. D. summarizes the Jed Foundation’s recommendations for schools to strengthen their mental health support systems.  The foundation recommends:

  • Engaging in campus-wide strategic planning to identify specific issues related to mental health and substance abuse and develop action plans to address them
  • Training new faculty, students and staff to identify at-risk students and refer them to appropriate counseling services
  • Advocating for mental health as a campus-wide issue
  • Creating a task force to promote mental health
  • Increasing programs to identify and support incoming at-risk students
  • Engaging in environmental safety scans of a campus to locate potential sources of danger
  • Building student affairs programs that enhance life skills and student connectedness
If you have a college student, I encourage you to explore the school’s mental health program.  Increasing awareness of resources available to students is key to their success.
  Dr. Lynch’s entire article appears in his HuffingtonPost blog here.

Does Cognitive Behavioral Therapy Work? Will it Work for ME??

CBT-therapy

As a Cognitive Behavioral Therapist, I believe in what I do, see daily results, and know that Cognitive Behavioral Therapy (CBT) can change lives.  My confidence in this type of therapy was strengthened when I came across a scientific study analyzing the effectiveness of CBT.  Experts in the psychology field reviewed the therapeutic results of using CBT when working with patients with differing mental health disorders.  The study was published in the Clinical Psychology Review 26 (2006) under the title:  The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.

The psychologists found CBT to be an effective treatment for:

Cognitive behavioral therapy
  • depression
  • generalized anxiety disorder
  • panic disorder with or without agoraphobia
  • social phobia
  • posttraumatic stress disorder
  • childhood depressive and anxiety disorders
  • marital distress
  • anger
  • childhood somatic disorders
  • chronic pain

(Savannah Krantz (Greenhill, 2014) provides a comprehensive summary of the study at the end of this post.)

These results are so encouraging to patients and treatment providers who deal with the pain of mental illness everyday.  This wide-ranging, scientifically significant study gives confidence and hope to people entering therapy.  If you are reading this post, and looking for help with a mental health challenge, consider finding a Cognitive Behavioral Therapist.  You can find more information and details about the treatment process by going to the Beck Institute of Cognitive Therapy.

If you live in the Dallas area, and would like to talk about treatment with a Cognitive Behavioral Therapist, please read my web page at Holly Scott, MBA, MS, LPC.

Effectiveness of Treatment with Cognitive Behavioral Therapy

by Savannah Krantz (Greenhill, 2014)

therapy for depression 
Cognitive Behavioral Therapy, also known as CBT or CT, has been closely examined in many psychological studies relating to treatment results. The cognitive-behavioral treatment of mental disorders is often compared and contrasted with other treatments. CBT differs from behavioral therapy because it suggests that cognitive thoughts produce aberrant behavior, and therefore, CBT focuses on cognation. In an attempt to determine whether CBT has a higher success rate than other treatments, this study required a meta-analysis. This type of research pulls results from previous studies, works to sort out their differences, and essentially combines them. Meta-analysis measures what is called the effect size, which is the measure of strength in statistics. This process aims to estimate the effect size with a large sample of studies rather than a single study, which would only provide data drawn from a single set of circumstances. Similar to using a large sample size in an experiment, using meta-analysis sharpens the precision of the effect size because it eliminates the involvement of erroneous factors.

therapy for depression

This CBT study examined many mental disorders: adolescent and adult unipolar depression, generalized anxiety disorder, panic disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, sexual offending, and chronic pain. Not only does the meta-analysis inspect the effects of CBT treatment, but the study also compares the results to other treatment results whenever possible. Out of these disorders, three used data from an uncontrolled effect size: obsessive-compulsive disorder, schizophrenia, and bulimia nervosa. Unlike a controlled effect size, the improvement was measured within its group, rather than being compared to other treatments and/or conditions.

In the results, the U3 score is provided next to the effect size. The U3 score is a percentage that indicates whether or not CBT was more successful than other treatments. If the U3 score is 50%, that means that on average, the CBT patient experienced the same results as the control patient who received other treatment. If the percentage is above 50% and the effect size is positive, the CBT patient’s outcome was superior. If the percentage is above 50% and the effect size is negative, the CBT patient’s outcome was inferior to the control. The higher the percentage, the more (if positive ES) or less (if negative ES) successful CBT was on average.

CBT was proved to be superior to all other treatments for adult and adolescent depression, but was only very slightly more successful than behavioral treatment, with a U3 score of 52%. CBT was more successful than all other treatments for general anxiety disorder, social phobia, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, anger, bulimia nervosa, internalizing childhood disorders, and sexual offending. Two exceptions, chronic pain and panic disorder (with and without agoraphobia), had either one or two elements that were proven to be less successful when treated by CBT.

couple couple

Overall, the meta-analysis proved that CBT appears to be the superior treatment for these sixteen mental disorders. This can be accredited in part to the fact that CBT differs from other treatments due to its ability to teach the patient therapeutic skills that the patient can then apply, without external assistance, into his or her everyday life.

Source:

Clinical Psychology Review 26 (2006), The empirical status of cognitive-behavioral therapy: A review of meta-analyses by Andrew C. Butler, Jason E. Chapman, Evan M. Forman, and Aaron T. Beck.

 

A View from the Roof | Rewire Me

Author Psychotherapist Pamela Milam shares inspirational thoughts on viewing others from a place of greater emotional generosity.

A View from the Roof | Rewire Mecounseling for happiness

I know someone who had a series of different jobs: clerk, cook, waitress, courier, even construction worker. She told me that she once had a stint as a roofer. She worked every day with the same guy, a blue-collar philosopher who used to take breaks sitting on the roof eating his sandwich and telling her stories: “People think they’re alone, that no one can see them, but up here I can’t help but see people living their lives—in their living rooms, bedrooms, backyards. The world’s a different place to me because of that.”

He felt a warmth and grace toward the people living in those houses, cooking barbecue, pushing swings for children, vacuuming rugs, fighting with spouses, clicking away on laptops, cooking spaghetti, or reading books by windows. He saw them in private moments and tried his best to honor that privacy. I might see, for instance, a client who is a tough businesswoman, but in fact is anxiety-ridden and worried about her young son’s autism diagnosis.

It struck me later that, as a therapist, my view can be similar. We are the roofers of the soul, seeing into hearts and minds and getting a look into the private lives and relationships of people who otherwise might seem like just “the guy in the next cubicle” or “that jogger I see every Saturday on the trail” or “the unassuming neighbor down the block.”

I might see, for instance, a client who is a tough businesswoman, but in fact is anxiety-ridden and worried about her young son’s autism diagnosis. Many of her colleagues write her off as being brusque and cold, but that’s nowhere near the truth. Or I meet the olive-skinned young model who radiates a golden beauty, but discover that he is wracked with self-doubt. I encounter the narcissist who admits that he feels empty in spite of his résumé of accomplishments, or the pregnant teen who pretends to look forward to motherhood but confesses that she’s terrified.

It’s helpful to get a different view, looking into their lives and seeing them, really seeing them live life: struggling, failing, succeeding, and managing to get through it all somehow.

Getting a new perspective—simply paying attention—helps me break free from assumptions or stale beliefs about neighbors, friends, colleagues, and even strangers.There’s a freedom that comes from getting an alternate view. The more you really notice other people, the less likely you are to write them off or pigeonhole them. Getting a new perspective—simply paying attention—helps me break free from assumptions or stale beliefs about neighbors, friends, colleagues, and even strangers.

For me, it’s important not to get locked into a mindset, one of judgment or negativity or willful oblivion. The key to unlocking my mind is the very same key to building good relationships: noticing people, taking my time, imagining how they might feel, making an effort to do no harm, and trying to do good when I can.

If I find myself taking a knee-jerk attitude toward a person or summing someone up based on one or two obvious traits, it’s a sure bet that I’m missing something that I might understand more clearly from a place of greater emotional generosity. I try to remember that I’m always free to take a fresh look. I’m the roofer casting a graceful look into their hidden lives.

Read about Pamela Milam.

– See more at: http://www.rewireme.com/explorations/a-view-from-the-roof/#comment-3827

 

A Great Web Resource on Teenage Suicide, written by Kurt Cobain’s cousin

Living Matters Website

Bev Cobain’s Living Matters website is an outstanding resource for anyone dealing with youth depression and/or suicide.  Ms. Cobain’s bio from this site reads:

Bev Cobain is a Registered Nurse, with credentials in psychiatric/mental health nursing. Her own struggle with depression and the suicides of three family members–most recently the 1994 death of her young cousin, Kurt Cobain, front man for the band, Nirvana–ignited a passion in Bev to educate professionals, lay persons, and youth about depression and the significant public health issue of suicide. Her desire to educate resulted in her writing the acclaimed book, “When Nothing Matters Anymore: A Survival Guide for Depressed Teens” and developing the Living Matters website site to provide an additional avenue to share her knowledge and experience of youth depression and suicide.

Latest Facts About Teen Suicide

The following statistics will probably surprise you.  Teen suicide is a serious problem in the United States.

  • Suicide is the 2nd leading cause of death in the U.S. for ages 15 through 19.
  • In this country, a child or adolescent dies by suicide every 80 minutes, and a youth attempts to take his/her life every 45 seconds.
  • One of ten high school students attempt suicide, while one in five has had suicidal thoughts within the previous year.
  • The suicide rate for 10 to 14-yr olds has tripled in the last three decades.

YOU CAN MAKE A DIFFERENCE and help change the current statistics on suicide.  Please take a few minutes to review this list.  If you, your friends, your family, or anyone you know has any of these symptoms, please reach out and share with someone.

Sadness (with or without crying)
Anxiety
Lack of energy and/or motivation
Temper outbursts and/or violent episodes
Easily irritated
Sleeping too little or too much
Little or no appetite, or eating too often
Withdrawal from friends and family
Loss of interest in activities usually enjoyed (including school activities)
Feelings of fear (even if there is no conscious reason)
Feelings of extreme guilt or shame
Inability to concentrate
Poor memory
Increased use of alcohol or drugs
Worsening grades
Skipping school or classes
Self-critical remarks
Feelings of helplessness to change a situation*
Feelings that things will never get better*
Comment(s) about death or dying*
Writing, drawing, or listening to music about hopelessness, guns, or death*
Threatening suicide (even in a joking manner)*

*These last 5 symptoms should be taken very seriously, do not wait to contact a parent, counselor, teacher, or other trusted adult.  Please let someone know right away.

For immediate help, call National Suicide Hotline Number:  1-800-273-TALK, or 9