Tag: psychotherapy

What is Depression?

What is depression?

 A Client is talking to a psychologist. 

A quote from Stephen Fry:

“If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.”

“Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.”

― Stephen Fry.    

Stephen Fry is an actor who has struggled with Bipolar Disorder.

I’m an experienced psychotherapist with 40 years of experience and a lifelong sufferer of depression. After all the facts are read below, depression is a miserable experience. It has been miserable not only for me but also for my family. I can report that medication and group and individual therapy were of enormous help. Suffering depression has made me fully understand my clients and be able to help them recover. My late wife, daughters, and friends gave me warmth, love, and support, which helped me through my dark times.

Bipolar Disorder

Bipolar disorder is a mental health condition affecting mood, energy, and activity levels. It is a mood disorder characterized by periods of depression and periods of mania or hypomania. 

The symptoms of depressive episodes in bipolar disorder are the same as those of major depression. They include:

  • Overwhelming sadness.
  • Low energy and fatigue.
  • Lack of motivation.
  • Feelings of hopelessness or worthlessness.
  • Loss of enjoyment of things that were once pleasurable for you.
  • Difficulty concentrating and making decisions.
  • Uncontrollable crying.
  • Irritability.
  • Increased need for sleep.
  • Insomnia or excessive sleep.
  • A change in appetite causes weight loss or gain.
  • Thoughts of death or suicide (suicidal ideation).

If you’re experiencing suicidal ideation (thoughts of suicide), seeking immediate care is important. Call 911 or the Suicide and Crisis Lifeline at 988. 

Major Depressive Disorder (MDD)

Major depressive disorder (MDD) was ranked as the third cause of the burden of disease worldwide in 2008 by WHO, which has projected that this disease will rank first by 2030.

  • Feelings of sadness, tearfulness, emptiness, or hopelessness
  • Angry outbursts, irritability, or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies, or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation, or restlessness
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions, and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts, or suicide
  • Unexplained physical problems, such as back pain or headaches

Symptoms of depression can cause serious issues with day-to-day activities. Some people may feel miserable without really knowing why.

Persistent Depressive Disorder (PDD)

Persistent depressive disorder is often known as dysthymia or chronic major depression. In the past, this condition was considered a personality disorder, which connotes a permanent, pervasive nature. However, it is likely better conceptualized as a temporary state that can change. 

Major depression includes intense sadness, hopelessness, fatigue, suicidal thoughts, and low mood. In dysthymia, one tends to experience fewer and milder symptoms.

Major depression occasionally happens, while dysthymia’s symptoms last longer and cause ongoing life disruption.

Treatment for major depression typically involves medication and therapy. Dysthymia is often treated with psychotherapy long-term. 

In major depression, the symptoms tend to prevent one from carrying out day-to-day functions, including going to work or daily routines. People with dysthymia often manage daily life and social relationships but have difficulty feeling positive emotions.

Despite the differences, both disorders impede one’s mental well-being, impairing social and occupational functioning. Early diagnosis and treatment can help improve the quality of life with major depression and dysthymia. Suppose someone suspects they have either major depression or dysthymia. In that case, it’s always best to consult a physician or mental health professional to assess symptoms.

Major depression has a range of causes, including biological, environmental, genetic, and psychological. Here are some of the primary factors that contribute to causing major depression:

Many studies have found that physical changes in the brain’s structure and function are linked to major depression. Neurotransmitter imbalances are linked to depression.

Family history can considerably affect a person developing major depression. Research shows that depression is more likely in people with relatives with the condition.

Traumatic events can lead to major depression.

How a person thinks and personality can make them more prone to experiencing major depression. For example, someone with low self-esteem or negative thinking patterns is more likely to develop depression. In contrast, someone with a positive self-image and a more optimistic outlook is less likely to experience depression.

Social isolation and lack of support can lead to depression. 

A combination of factors usually causes major depression. It affects different individuals differently, depending on their personal experiences and characteristics. Early recognition of the condition and timely intervention can help ease symptoms and provide a path to relief and recovery. Seek professional help if you or someone you know is experiencing depression.

Major depression is a common mental health issue that can harm work, social, and personal relationships. It is a serious medical illness that can affect a person’s mood, thoughts, behavior, and physical health. People with major depression may struggle with routine tasks because of overwhelming sadness.

Major depression is caused by genetic predisposition, neurotransmitter imbalance, stress, and environment. Some major life events, such as divorce, job loss, disaster, and negative events, might trigger major depression. 

Antidepressant medication such as SSRIs and SSRNIs is often recommended for people who suffer from major depression. Medication helps balance some of the chemical imbalances in the brain and helps ease many symptoms related to depression.

However, antidepressant medications eventually lose their effectiveness. That is why the MD replaces that prescription with another or adds something to the existing medication. The best recommendation is for a combination of medication and psychotherapy.

I urge anyone experiencing depression to get help. 

dransphd@aol.com

Children, Teens and Suicide

Suicides among young people continue to be a severe problem. Suicide is the second leading cause of death for children, adolescents, and young adults ages 15-to-24-year-olds.

Most children and adolescents who attempt suicide have a significant mental health disorder, usually depression. Among younger children, suicide attempts are often impulsive. They may be associated with feelings of sadness, confusion, anger, or problems with attention and hyperactivity.

Now, however, childhood and teen suicide statistics are complicated by the Covid Pandemic. Even though schools are now open in most communities throughout the United States, parents report that many young people do not want to return to school. While remote learning carried many disadvantages, some children found it reassuring to remain at home with the family.

Children’s suicide attempts have increased during the COVID-19 Pandemic.

 

COVID-19 has led to significant changes in the dynamics of children’s suicide attempts, according to the results of a cross-sectional study published in the Journal of the American Medical Association

.

“Recent studies have reported a deterioration in children’s mental health since the start of the COVID-19 pandemic in 2020, with an increase in anxiety and mood disorders,” Anthony Cousien, Ph.D., of the Department of Child and Adolescent Psychiatry at the University of Paris in France, and colleagues wrote. “Rates of suicide ideation and suicide attempts among children were also higher when COVID-19–related stressors heightened in 2020. 

The researchers analyzed data of 830 children aged 15 years or younger (mean age, 13.5 years; 1:4 ratio of boys to girls) with suicide attempt history admitted to the pediatric Emergency Department of a single hospital between January 2010 and April 2021. They defined a suicide attempt as “a nonfatal self-directed potentially injurious behavior with any intent to die because of the behavior.”

Cousien and colleagues speculated that children’s specific sensitivity to mitigation measures, adverse effects on family health and economic conditions, increased screen time, and social media use or bereavement may have affected this acceleration.

Social media is also a significant risk factor for teen suicide.

Suicide rates among teenagers have seen a drastic increase from 2007 to the present. Social media has become a prevalent way of life. Another risk factor may be media accounts of suicide that romanticize or dramatize the description of suicidal deaths, possibly leading to an increased number of suicides.

Among teenagers, suicide attempts come with feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss. For some teens, suicide may appear to solve their problems.

Depression and suicidal feelings are treatable mental disorders. The child or adolescent needs to have their illness recognized, diagnosed, and appropriately treated with a comprehensive treatment plan.

Thoughts about suicide and suicide attempts are often associated with depression. Besides depression, other risk factors include:

  • family history of suicide attempts
  • exposure to violence
  • impulsivity
  • aggressive or disruptive behavior
  • access to firearms
  • bullying
  • feelings of hopelessness or helplessness
  • acute loss or rejection

Children and adolescents thinking about suicide may make openly suicidal statements or comments such as, “I wish I was dead,” or “I won’t be a problem for you much longer.” Other warning signs associated with suicide can include:

  • changes in eating or sleeping habits
  • frequent or pervasive sadness
  • withdrawal from friends, family, and regular activities
  • frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • a decline in the quality of schoolwork
  • preoccupation with death and dying

Young people thinking about suicide may also stop planning for or talking about the future. They may give away important possessions.

People often feel uncomfortable talking about suicide. However, asking your child or adolescent whether they are depressed or thinking about suicide can be helpful. Specific examples of such questions include:

  • Are you feeling sad or depressed?
  • Are you thinking about hurting or killing yourself?
  • Have you ever thought about hurting or killing yourself?

Rather than putting thoughts in your child’s head, these questions can assure that somebody cares and will give your child the chance to talk about problems.

Parents, teachers, and friends should always err on caution and safety. Any child or adolescent with suicidal thoughts or plans should be evaluated immediately by a trained mental health professional.

 No matter which boat you are in, remember that it doesn’t help to blame yourself as a parent.

Whether you are a parent, helping your teenager prevent suicide, or have lost your teenager to suicide, find a community and gather them close around you. You may find that this community is people in the church, friends, or other parents who have faced the same challenges. Keep a close connection with safe people and walk on this journey with others. Remember that you are not alone.

National Suicide Prevention Hotline

800-273-8255

Lifeline

https://suicidepreventionlifeline.org

Catastrophic Thinking, Of Making Mountains out of Molehills

Do you make mountains out of molehills? This is a more severe issue that may appear on the surface. Whenever anyone spilled anything on the tablecloth, even just a glass of water, my grandmother would become furious when I was a boy. She was not unusual for having that reaction. Sometimes, the littlest things make people angry. One way of thinking about this concept is to realize that some of us turn the most minor incidents into catastrophes. Statistics show that altercations over trivial issues sometimes result in homicide.

To a certain extent, the tendency to make mountains out of molehills has to do with worrying and obsessive thinking. Because of the watch or clock not being precisely set on time, people with OCD become exceedingly uncomfortable, worrying about potentially terrible consequences. For those with OCD, everything must be perfect, or there can be catastrophic consequences. These people live in a world of “what if,” meaning what if the clock is set wrong, and my children get up late for school, and a terrible car accident occurs on the way to school.

This way of thinking and living makes life unbearable for those who worry and the loved ones who surround them. Graham C.L. Davey, Ph.D., conducted a piece of research on why we worry? Interviews of chronic worriers were conducted using questions such as “why worry about getting good grades in school?

*Here are some of the catastrophic consequences that chronic worriers came up with:

“I won’t live up to my expectations

I’d be disappointed in myself.                                           

I’d lose my self-confidence.                                                

My loss of self-confidence would spread to other areas of my life.       

I wouldn’t have as much control as I’d like.                     

I’d be afraid of facing the unknown.                                

I’d become very anxious.                                                   

Anxiety would lead to further loss of self-confidence.    

I wouldn’t get my confidence back.                                  

I’d feel like 1 wouldn’t control my life.    

I’d be susceptible to things that wouldn’t bother me.  

I’d become more and more anxious.                                

I’d have no control, and I’d become mentally ill.    

I’d become dependent on drugs and therapy.                

I’d always remain dependent on drugs.                          

They’d deteriorate my body.                                             

I’d be in pain.                                                                      

I’d die.                                                                                  

I’d end up in hell.”

* From Graham C.L. Davey, Ph.D. 

Another theory states that people men make mountains out of molehills when they feel aggressive and competitive. Aggressive reactions have to do with competing for status. Two men compete for the status of one over the other. In this primitive way of thinking, the most aggressive wins the girl. That is why, as stated above, some arguments over trivial things result in homicide.

Whatever way you choose to look at this, making mountains out of molehills results in frustration and misery for all concerned. It’s better the let these things go. What my grandmother should have done was smile and clean up the spill. Perhaps, if this had been her approach to life, she would not have had a heart condition. It was just an accident.

Instead of exploding, take deep breaths, say a mantra by reminding yourself, “it’s not worth it,” and see the humor in the situation.

Contact Dr. Schwartz at dransphd@aol.com

Aging and Loneliness, A Deadly Combination

“One is the loneliest number”

“Grow old along with me! The best is yet to be, the last of life, for which the first was made. Our times are in his hand who saith, ‘A whole I planned, youth shows but half; Trust God: See all, nor be afraid!”

Robert Browning

“One is the loneliness number that you will ever do.”

*The Beatles’ version is my favorite.

Aging and Socializing, An Important Connection

Two studies came to the same conclusion: as we age, socializing helps keep our minds sharp and, perhaps, even prevents dementia.

Study 1:

The first study was conducted by Dr. Karen Ertel, a post-doctoral fellow at this writing, at the Department of Society, Human Development and Health at the Harvard School of Public Health. Her team found that those socially integrated (socially active) had less than half the memory decline of those who were socially isolated.

Dr. Ertel’s team collected data from 17,000 Americans who were fifty years older. The subjects were studied for over six years.

Social activity included being involved in volunteer activities, interacting with neighbors and friends, and seeing children, grandchildren, and other family members. Interestingly, those who maintained social involvement also exercised, engaged in intellectual activities such as reading, and were careful about their diets.

Unfortunately, the death of a spouse presents older people with the risk of suffering and grief so much that they withdraw and become depressed. Widows and widowers gradually recover from the losses they suffered. Their ability to resume active lives depends upon the availability of a community to be involved with.

Study 2:

The second study was conducted by Dr. Valerie Crooks, director of clinical trials at the Southern California Permanente Medical Group.

This study focused on women at least 78 years of age who were free of dementia. The subjects were studied from 2001 through 2005 and included 456 women and their social networks.

The findings were that those women with the most robust social networks were less likely to develop symptoms of dementia over the five years of the research.

The strength of social networks included such criteria as to how frequently the subject contacted friends and family, how often they confided in a friend or friends, and whether they had the type of friends that could be confidants.

Discussion:

Both studies clarify that remaining involved helps people maintain physical and mental health. In addition, social isolation has adverse effects on physical and mental health as we age.

Not Only Age:

Some state and restated by mental health practitioners and researchers that social isolation is unhealthy for people of all ages. The research shows that isolation is closely associated with feelings of depression. Of course, the question is whether depression causes isolation or isolation causes depression? It is tempting to suggest that it does not matter because helping people to socialize, regardless of their stage of life, goes a long way toward reducing depression.

We are social creatures and feel better when involved with other human beings. 

1. For the elderly, it is essential to remain socially involved to reduce the chances of developing either dementia or depression.

2. For younger people, it is equally important to have a circle of friends with whom they can talk, have fun, and engage in productive activities.

Health and Education: It’s Heart Breaking to Not Finish Your Education

During the past twenty or more years, I have listened to the complaints of high school students, their families, and the public. The same complaint: “Why do we need a liberal arts education?” The question goes much further than a liberal arts education because it states that children should learn a trade. 

Recent events at one university in Colorado included eliminating language, arts, and other liberal arts classes. 

Research studies conducted during the last twenty or more years consistently show the same results. There is a direct connection between the level of education and heart disease. The lower the level of education, the higher the risk for cardiovascular disease and death. Regardless of race, ethnicity, culture, or nation, these results.

From the American Heart Association, 2019.

Education level may predict the risk of dying for people with heart disease.

By American Heart Association News

“How long people stay in school may play a significant role in predicting how well those with coronary heart disease will fare.

Education level has influenced people’s risk of developing cardiovascular disease. The new study examines just how much of a factor it plays among people with established coronary artery disease due to a buildup of cholesterol and fatty plaque deposits in the heart’s arteries.

Researchers looked at 6,318 older adults in three Atlanta-based hospitals who underwent a procedure to diagnose and assess problems in coronary arteries. Each person completed questions about the highest level of education completed. Other demographic details and medical history followed for four years.

Among the study’s participants, 16% had received a graduate degree, 42% had finished college, 38% had completed high school, and 4% had completed elementary or middle school.

Researchers found that compared to people with graduate degrees, those with lower educational attainment appeared to have a higher risk of heart attack, dying from a cardiovascular event, and overall death.

People with elementary or middle school education had a 52% higher risk of dying from any cause during the study than someone who attained a graduate degree. People who completed high school had a 43% increased risk. College graduates had a 26% higher risk than people with graduate degrees.

The higher risk remained even after adjusting for traditional cardiovascular risk factors like diabetes, high blood pressure and tobacco use, and other demographic characteristics, including sex and income level.

“We adjusted for everything that would be a risk determinant, and despite all that, just the educational level was an independent predictor of outcome,” said the study’s senior author, Dr. Arshed Quyyumi, a cardiology professor at Emory University School of Medicine in Atlanta.

“What’s striking is how important the role of education is,” he said. “Most of us practitioners, we don’t ask patients for their educational level when we’re seeing them – and we don’t take any added precautions when you find that somebody may not be as well educated as another person.”

The findings were presented Tuesday at the European Society of Cardiology Congress in Paris and published in the Journal of the American Heart Association.

Quyyumi said the results show a need for increased awareness among physicians to be more vigilant about following through with heart patients to make sure they’re taking medicine and making recommended lifestyle changes to lower risk. It also shows the link between a person’s health and social determinants, factors that influence where and how people live, learn, work and play.

Social determinants of health represent “a phenomenon outside of biology and genetics, outside of traditional risk factors,” said Dr. Clyde Yancy, professor and cardiology chief at the Northwestern University Feinberg School of Medicine in Chicago.”

Multiple studies done worldwide consistently show the same results.

The message is clear. Get an education! 

Help is Available. Contact Dr. Schwartz at dransphd@aol.com

http://www.allanschwartztherapy.net

Explorations in Psychotherapy

Explorations in Psychotherapy is a new book written by Allan N Schwartz, PhD.

The book encompasses issues and problems real people have consulted me about over the past thirty years. All identities are fully hidden and disguised in order to protect privacy. Explorations in Psychotherapy is available at Amazon.com in either paperback or kindle versions.

http://www.allanschwartztherapy.net Available for Purchase at Amazon.com
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