How to Recognize if Your Friend Is Suicidal

Written by Rachel Firster on October 26, 2022. Posted in Anxiety, Depression, Step-By-Step Guides.

Did you know that depression is at an all-time high in the United States? It’s true, and more alarmingly, suicide is the 12th leading cause of death in America. Though, it is important to keep in mind that suicide is preventable in many cases. Most importantly, a suicidal individual needs proper help before its too late.

In order to prevent suicide from occuring with a friend or a loved one, it is important that you understand the warning signs first. Let’s talk about the signs and struggles of suicide ideation that you may notice in a suicidal person.

Warning Signs Of A Suicidal Person

They have become very withdrawn and apathetic towards major problems.

One of the most common warning signs of suicide deals with the person’s behavior. If they have been struggling with depression or grief for a long time and then suddenly become calmer than usual, this can be a warning sign of suicide. Either way, depression, long periods of sadness, and moodiness are all major risk factors for suicide.

If you notice that the person in question starts to withdraw from others by choosing to be alone and avoiding friends and family, this can be a cause for concern. Many people considering death by suicide often experience a deepening sense of apathy toward the world around them, if this is the case encourage your loved one to seek professional help and remind them how much you care about their wellbeing.

It’s also worth noting that people experiencing suicidal thoughts may engage in dangerous behavior such as driving too fast or increasing their use of drugs and alcohol. If you notice these suicide symptoms, it may be worth confronting your friend about their thoughts and offer caring support.

They threaten suicide.

Suicidal threats should be taken seriously no matter the circumstance. Suicidal threats are actually found to be one of the most common signs of suicide in teens. Regardless of the situation, you should always take someone seriously if they express suicidal thoughts or explicitly say, “I feel suicidal.”

On a similar note, if the person references not being around in the future, this too can be a sign that an individual is experiencing suicidal ideation.

They mention that they feel like a burden.

Many suicidal people feel overwhelmed with hopelessness and despair. This often makes them feel that they’re a burden to people around them. Any time that you hear people mention that they feel like a burden, it’s time to hit the pause button and provide your support.

This is a frequent symptom of suicide ideation, so reach out to your friend if this happens and make sure they’re directed to the necessary resources.

Your friend started to give away a lot of their personal possessions, mentions final wishes, and more.

One of the most alarming signs of suicide deals with the person doing “prep work” for the end of their life. This can include doing things like giving away beloved items, mentioning final wishes in passing, making a will, or writing suicide notes.

If there are a lot of signs of post-mortem preparations, you should ask what’s going on and offer your support. If you notice a friend writing a suicide note, then it’s time to get them help they need.

They self-harm.

Self-harm is one of the most serious signs of suicide potential that you can find. More specifically, it is a sign of suicidal ideation that has turned towards suicidal actions. This means that the person has suicidal tendencies and may be far closer to killing themself than you think.

While some people who engage in self-harm may be suicidal, not everyone who self-harms does so with fatal intent. Most people who self-harm are not suicidal but there is a noteworthy correlation between these two different behaviors.

How You Can Help a Loved One in Need

Your friend is going through a major mental crisis right now, and it’s one that should not be ignored. They need your help as well as the help of a qualified professional. Now is a good time to do the following:

Remove objects or weapons that could be used in suicide attempt
Call a crisis hotline and encourage your loved one to do the same
Don’t leave them alone if their behavior is becoming highly concerning

If your friend is showing signs of suicide, don’t hesitate to ask if they are contemplating suicide and encourage them to seek the help of a professional. If your friend is in imminent danger of harming themselves, call 911 immediately.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Are You Too Depressed to Work? Here’s What You Should Do

Written by Rachel Firster on October 12, 2022. Posted in Depression, Work Life Balance.

Depression can feel like a dark cloud hanging over you, and it can be difficult to see past it to get things done. Living with this mental illness can be hard enough on its own, and the demands of work can make it feel even more greuling. Signs of working with depression often include missing work, difficulty concentrating, incomplete deadlines and goals, and even fatigue or lack of energy in the workplace.

It may feel like your depression can prevent you from working or holding down a job, but there are ways to help overcome these challenges — we’ll explore how depression affects your ability to work and what you can do if you need help getting back into the workforce.

Recognize That Depression Is Part of You, but Not All of You

One of the most common misconceptions about depression is that it defines who you are as a person. It’s not. Depression is just one aspect of your personality—it’s not who you are, and it doesn’t define your character in any meaningful way.

Know When to Seek Professional Help

Suicidal thoughts or behaviors. If you have thoughts that life would be better off without you, please seek professional help immediately
Hopelessness or despair. If you feel like nothing will ever get better or that there is no hope for happiness in the future, it’s time to seek help.
Thoughts of harming others (or yourself). If these thoughts are consuming your mind and causing distress in your day-to-day life, seek immediate help.
Trouble sleeping or eating due to depression symptoms.

Talk Openly With Your Family and Friends

Depression can be a lonely condition, so it’s important to talk about your emotions and needs with people you trust. This will help remind you that you’re not alone in this struggle.

Talking openly with family or friends can help them understand your condition and will allow them to offer support. You can share how you feel, what challenges you’re facing, what coping strategies are working for you, and any other information that you are comfortable with sharing to seek help and support.

Seek Out Mental Health Groups for Support

Joining a mental health group can be a great way to find support, especially if you’re still feeling lonely despite encouragement from family and friends. Making connections with those that have lived through similar experiences can be comforting when dealing with depression or other mental illnesses.

Oftentimes, many of the people in your mental health support group are also struggling to find the strength to work while suffering from depression. By surrounding yourself with people you can relate to, you will find that you’re not alone and have a safe place to express your thoughts and feelings.

If you’re interested in learning more about the benefits of mental health support groups, check out our blog post here.

Take Time for Yourself

It is important to take time for yourself. Whether you need a full day or just a few minutes, it’s essential to spend some time relaxing. Even if it’s not possible to completely relax at work, there are ways that you can recharge throughout the day and make sure that work remains enjoyable.

Take breaks during your work day. If you have an office job where people go out for lunch together, take advantage of this opportunity to get away from your desk and talk with coworkers in person. Also, try scheduling short walks during breaks—you’ll find yourself more productive afterward!

Better yet, talk to your employer about taking mental health days off of work. If your depression is consuming you and preventing you from being productive at work, taking a day or two off may be exactly what you need. While mental health days won’t cure your depression, they can certainly give you the recharge you need to return to work with a fresh perspective.

Set Small Goals and Build Up From There

Set small goals and build up from there. If your depression is severe, it may be difficult to focus on the small steps that will eventually lead to success. So start with something simple that can be completed in a day or less: making your bed, putting away clothes in their proper place, or organizing your desk. These simple tasks will help you feel like you’ve achieved something.

Ask People to Give You Space if You Need It

Let others know how much space they should give you. If a friend wants to check in with you but knows that’s not the best idea right now, maybe they can make plans for later in the week or month instead.

Everyone Deals With Depression in Their Own Way

Depression is a real illness that can be treated with therapy, medication, and lifestyle changes like exercise and good sleep habits. It’s important to remember that depression affects everyone differently, so the way that someone else might deal with it may not be right for you. You should never feel ashamed about reaching out for help if you are having trouble coping with your symptoms or would like to discuss treatment options with your doctor.

There are many resources available to those struggling with depression. These include:

A therapist who specializes in depression.
Support groups for those with depression (in person or online).
Friends and family members who can provide emotional support.

Depression is a serious health condition, but it’s one that can often be successfully treated. Dealing with depression is all about taking small steps, so it’s important to feel confident that you are equipped to deal with it. Most importantly, you should never feel like you are alone in your fight against depression.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

file cabinet containing files titled mental health, psychiatry, disorders, bipolar, depression, and anxiety

Myths About Mental Illness

Written by Rachel Firster on September 14, 2022. Posted in Anxiety, Depression, Mental Health Maintenance.

Mental illness is not a single condition, rather it is a broad term used to describe a variety of mental health conditions that affect people’s mood, thinking, behavior, and emotions. A mental illness diagnosis is essentially an indication of poor mental health. Mental illnesses include, but are not limited to:

Depression
Anxiety
Bipolar Disorder
Schizophrenia
Psychosis
Body Dysmorphic Disorder (BDD)
Borderline Personality Disorder (BPD)
Post-Traumatic Stress Disorder (PTSD)
Obsessive Compulsive Disorder (OCD)
Attention-Deficit/Hyperactivity Disorder (ADHD)

Depression and anxiety (as well as other mental illnesses) are serious medical conditions that affect millions of people every year. One of the challenges that survivors and their allies tend to face today is misrepresentation, as well as misinformation and myths associated with mental illness. Knowing the truth about mental illness will help you understand what it really is and how best to support friends or family members who are struggling with their mental health.

Myth 1: People with mental illnesses are violent and unpredictable.

Popular media portrayals of people suffering from mental illness have included ideas that these individuals are both violent and unpredictable. These mental health myths have led to fear and discrimination against people with various mental illnesses. The truth is, most people living with mental health conditions are not violent or dangerous at all. Although certain conditions can induce anger, those suffering from a mental illness are not any more likely to be violent than anybody else.

Myth 2: Mental illness is just laziness or weakness of character.

One of the most common misconceptions about mental illness is that people suffering from these conditions are just lazy or weak minded. Though, mental illnesses are not flaws in one’s character – they are illnesses and should be treated as such. Living with a mental illness does not mean that you cannot function, however, it may require some more effort and adaptiveness to live an independent and healthy lifestyle. It’s important to remember that no one chooses to become ill any more than they choose the color of their skin, so it is inappropriate to judge someone based on their mental health.

Myth 3: People with mental illness can totally control their emotions and choose to feel the way they do.

This is a dangerous myth about mental illness that leads many people to blame themselves or others for their symptoms. By placing blame on those living with a mental health condition, we end up stigmatizing the condition itself and alienating those who are living with it. This, in turn, causes many individuals to hesitate when it’s time to seek help. The fact is that mental illnesses like depression are often caused by an imbalance of chemicals in your brain, and these chemicals are out of your control. With that being said, people suffering from a mental illness have little to no control over their thoughts, feelings, or emotions.

Myth 4: Mental illness means serious dysfunction and disability.

While it’s true that some people with mental illnesses have difficulty functioning in day-to-day life, most individuals living with mental illnesses are capable of living very normal lives. In fact, if properly managed and treated, many people living with mental illnesses can become asymptomatic. While it’s true that some people who experience mental health problems have symptoms that are mild and manageable; others may deal with severe and disabling conditions.

Myth 5: If a person really wanted to, he or she could get better on their own.

One of the many myths associated with mental illness is that the condition will simply get better or go away over time. Though, mental health conditions are just as serious physical health conditions and should be treated properly by a professional. Mental health is a serious issue. It’s not something to be taken lightly and it’s not something that can be “fixed” simply by wishing it away. There are many different types of therapy available to those suffering from mental illness, including Cognitive Behavioral Therapy (CBT), Transcranial Magnetic Stimulation (TMS), and even Ketamine Therapy. These therapies help patients understand their symptoms better and teach them how to cope with their condition more effectively to prevent relapse or worsening symptoms. Medication is another common tool used in treating mental illness; however, it may take some time to find the medication that works best for you and your mental health condition.

By dispelling some of the stigma and misconceptions about mental illness, those living with mental health conditions are more likely to reach out for the support they need and the resources they deserve to live a healthy and happy lifestyle. There’s no shame in seeking help for your mental health; it’s not something you can just “get over” by trying harder or ignoring it. The sooner you seek help, the sooner you’ll start feeling better—and that’s what matters most!

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Treating Depression with Mushrooms: What You Need to Know

Written by W. Nate Upshaw M.D. on November 19, 2021. Posted in Depression, Mental Health Maintenance.

Although people have used psilocybin mushrooms ceremonially and recreationally for centuries, they’ve garnered new attention from researchers and mental health professionals as a possible treatment for depression and other psychological disorders.

It was the recent success of ketamine, a hallucinogenic anesthetic, as a safe, effective treatment for depression that prompted new studies into using mushrooms to treat depression. These new studies were permitted by the Food and Drug Administration (FDA) for the purpose of testing the usefulness of the chemical compound psilocybin in the treatment of depression.

What Are “Mushrooms?”

Psilocybin mushrooms refers to several species of mushrooms that contain a chemical called psilocybin. It’s psilocybin that gives mushrooms both hallucinogenic effects and therapeutic benefits for treating depression. People also report feelings of increased calmness, even tranquility, when under the influence of mushrooms.

In an exploratory study published in April 2021, psilocybin was found to be four times more effective than common antidepressants, as well as working about four times more rapidly.

Another study showed mushrooms to be as effective in relieving depression as escitalopram (Lexapro), a popular antidepressant. Patients made a far more rapid improvement from depression than they did with escitalopram. Furthermore, 6 weeks later, those treated with psilocybin reported increased feelings of well-being and better emotional control.

Other research conducted by the prestigious Johns-Hopkins Center for Psychedelic and Consciousness Research showed similar effects.

How Do Psilocybin Mushrooms Work?

Our brains are reliant on complex arrangements of nerve cells that signal each other using chemical messengers called neurotransmitters. Other brain cells called astrocytes produce hormones that affect blood flow in the brain, which in turn regulates activity levels. These two systems work together to make sure our thinking, behaving, and feeling are all in agreement—except when they’re not working well.

Psilocybin found in mushrooms briefly interrupts the brain’s activities causing a kind of “reset,” which results in better nerve signaling and communication, more normal levels of neurotransmitters, and improved blood flow to underactive areas of the brain.

Pros and Cons of Treating Depression with Mushrooms

As with all interventions in health, there are benefits and drawbacks to treating depression with psilocybin. As formal, standardized research has been observed for less than 10 years, a comprehensive pros-and-cons profile hasn’t been developed yet. Here’s where things stand now:

Pros:

Rapid response of a few hours to a week. In contrast, oral antidepressants may take up to 4 weeks to show results, especially in people with treatment-resistant depression.
Resets the brain’s natural chemical balances, restoring neurotransmitter levels.
Psilocybin provides long-lasting relief. Two doses of psilocybin gave study participants a month of relief from their symptoms of depression. In some patients, only a single dose was needed to give four weeks of relief.
Psilocybin is not addictive.
Psilocybin is safe when administered in a controlled clinical setting.
Psilocybin derived from mushrooms can relieve anxiety, even chronic anxiety that typically accompanies depression.

Cons:

There is limited access to psilocybin. In the United States, these types of mushrooms are a Schedule I drug and thus illegal, except when they’re used in FDA-approved research.
Psilocybin doesn’t produce long-lasting side effects. However, hallucinations are the most common side-effect. Although they can be very pleasant, they may also be frightening or distressing. They fade within hours of administration, but they can be confusing.

The Clinical Experience

Being treated for depression with psilocybin is drastically different from recreational use. In a mental health clinic, a person receives a purified, refined form of psilocybin. It’s administered in a controlled environment under the care of medical professionals to ensure that the treatment will be safe and effective.

Treatment for Depression

Since 2008, transcranial magnetic stimulation (TMS) has been used as a rapid, painless, and non-invasive treatment for depression. In TMS, a powerful and precise magnetic field is applied to an area of the brain that regulates mood. Many people experience no side effects and receive lasting relief from depression through TMS.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Carhart-Harris, PhD , D. R. L., Bolstridge, MD, M., Rucker, MD, J., Day, MD, C. M. J., Erritzoe, MD, D., & Kaelen, BSc, M. (2016, May 16). Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. Retrieved from https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30065-7/fulltext#articleInformation

Carhart-Harris, R.L., Bolstridge, M., Day, C.M.J. et al. Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology 235, 399–408 (2018). https://doi.org/10.1007/s00213-017-4771-x

Davis, A. K. (2021, May 1). Effects of psilocybin-assisted therapy on major depressive disorder. JAMA Psychiatry. Retrieved September 27, 2021, from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2772630?resultClick=1.

Gander, K. (2018, August 23). FDA approves magic Mushrooms depression drug trial. Newsweek. Retrieved September 27, 2021, from https://www.newsweek.com/fda-approves-psychedelic-magic-mushrooms-ingredient-psilocybin-depression-1086759.

George, M., Wassermann, E., Williams, W., Callahan, A., Ketter, T., & Basser, P. (1995, October 2). Daily repetitive transcranial magnetic stimulation (rTMS) improves mood in depression. Retrieved from https://insights.ovid.com/crossref?an=00001756-199510020-00008

Hatfield, R. C. (2019, December 12). Effects of Psilocybin Mushrooms: Hallucinogenic Shrooms. Retrieved from https://drugabuse.com/psilocybin-mushrooms/effects-use/

MacVicar, B. A., & Newman, E. A. (2015). Astrocyte regulation of blood flow in the brain. Cold Spring Harbor perspectives in biology, 7(5), a020388. https://doi.org/10.1101/cshperspect.a020388

O’Hare, R. (2017, October 13). Magic mushrooms may ‘reset’ the brains of depressed Patients: IMPERIAL News: Imperial College London. Imperial News. Retrieved September 29, 2021, from https://www.imperial.ac.uk/news/182410/magic-mushrooms-reset-brains-depressed-patients/.

Nichols, D.E. Psilocybin: from ancient magic to modern medicine. J Antibiot 73, 679–686 (2020). https://doi.org/10.1038/s41429-020-0311-8

Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., Su, Z., Corby, P., & Schmidt, B. L. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial. Journal of psychopharmacology (Oxford, England), 30(12), 1165–1180. https://doi.org/10.1177/0269881116675512

Serafini, G., Howland, R. H., Rovedi, F., Girardi, P., & Amore, M. (2014). The role of ketamine in treatment-resistant depression: a systematic review. Current neuropharmacology, 12(5), 444–461. https://doi.org/10.2174/1570159X12666140619204251

Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & III, C. F. R. (2014, July 1). Adding Psychotherapy to Antidepressant Medication in Depression and Anxiety Disorders: a Meta-Analysis. Retrieved from https://focus.psychiatryonline.org/doi/abs/10.1176/appi.focus.12.3.347

van Amsterdam, J., Opperhuizen, A., & van den Brink, W. (2011, April). Harm potential of magic mushroom use: a review. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21256914

two people sitting in a room and talking about mental health

Is BPD An Attention-Seeking Disorder?

Written by W. Nate Upshaw M.D. on November 4, 2021. Posted in Anxiety, Depression.

Borderline Personality Disorder (BPD) is much more than an extreme attention-seeking disorder. It’s a genuine psychological disorder with many symptoms, some of which involve attention-seeking behaviors. Like all mental health disorders, BPD causes significant problems that prevent a person from having a satisfying life. For this reason, among others, people with BPD are often seen in a less sympathetic light by others.

BPD impairs all areas of life, particularly interpersonal relationships. It’s a wide-ranging condition that involves an inability to control one’s behavior and emotions, highly volatile and unstable relationships, and problems with self-image. People with BPD usually have other mental health issues, like depression and anxiety.

What is Attention-Seeking Behavior?

Attention-seeking is common in children and younger adolescents, but in adults, attention-seeking behavior is troublesome and indicative of poor coping skills. In adults with BPD.

Attention-seeking involves behaviors such as:

Bragging and embellishing one’s accomplishments, or making up accomplishments.
Saying inflammatory or rude things to provoke a reaction—even if it’s a negative or hostile reaction.
Annoying others deliberately or starting fights.
Pretending to not know how to carry out a task.
Constantly bringing conversations back around to themselves.
Often posting one’s troubles on social media, particularly exaggerating their severity.
Self-harming behavior or suicide attempts.
Inappropriate flirting, inappropriate sexual displays.
Manipulating others to get attention.

Why Do Borderlines Need Attention?

Attention-seeking is a prominent aspect of BPD, but it’s only one symptom of borderline personality disorder in adolescents and adults. Attention-seeking in BPD is often dramatic and disruptive and originates from a deep need to be validated constantly.

BPD’s attention-seeking originates from the traumas they create. It’s not a character flaw on the part of the sufferer, and although sufferers from BPD are aware of their behavior and its effects on others, they lack the insight and ability to change their ways of behaving.

Symptoms of BPD

BPD can begin in childhood, although it typically emerges during adolescence. Typical symptoms include:

A consistent pattern of intense, unstable relationships, often idealizing the desired person, then believing that person is victimizing them, planning to leave them, or is cruel to them.
Extreme and unrelenting fears of abandonment. These fears often lead the individual to take drastic steps to avoid rejection.
Risky, impulsive behaviors, such as promiscuity, drug abuse, binging, and overspending. People with BPD may sabotage themselves when they’re succeeding, such as doing well at work or cheating on a loyal partner.
Self-injuring behaviors, suicidal threats, especially in response to rejection.
Chronic feelings of emptiness.
Abrupt changes in one’s self-image and identity. Values and goals may change rapidly and individuals lack a set of core beliefs beyond staving off abandonment.
Suicidal threats or behavior or self-injury, often in response to a spiking fear of separation.
Intense anger or rage with no appropriate cause. Sarcasm, extreme negativity, and physical fighting are common.
Rapid and extreme mood shifts.

Manipulative behaviors are plentiful and complex in borderline personalities. Borderlines tend to categorize people in their lives as victims, rescuers, or persecutors, with them typically in the victim role. They manipulate people to rescue them by portraying themselves as the victim of unfair treatment—when they’ve in reality experienced no such treatment. People with BPD most often create disagreements with someone they designate as a persecutor, who is usually innocent of wrong-doing.

Borderline individuals have a profoundly unstable view of reality and other people, seeing situations and individuals in terms of stark black and white. A person they idealize as their best friend, the most kind and caring friend or family member imaginable, can within hours become their most despised enemy.

BPD’s Causes

BPD’s causes are not completely understood, but there are many consistencies in the family histories and experiences of people with BPD.

Genetic inheritance. Studies of fraternal and identical twins raised separately indicate that there is a much higher likelihood of close relatives having BPD, regardless of how or by whom they were raised.
Neurological conditions. Brain scans of people with BPD show unusually high levels of activity in the amygdala.
Traumatic childhood. Many people with the disorder report being sexually or physically abused or neglected during childhood. Further, children who were not abused but were separated from their caregivers traumatically, in situations such as being orphaned or entering the foster care system, also have an increased incidence of borderline personality disorder.

BPD’s Effects and Concurrent Disorders

Complications of BPD are serious. The disorder interferes with a person’s ability to have good relationships of any sort with others. Other harmful issues include:

Trouble holding a job or establishing a career
Legal issues, including jail or prison sentences, from aggressive or violent acting out
Inability to get a good education
Constant stress in relationships
Stress from conflict with others
Physical issues related to self-injuring behavior
Conflict-filled relationships, marital stress or divorce
Abusive intimate relationships
Self-injury, such as cutting or burning, and frequent hospitalizations

The incidence of people with BPD to have another psychological disorder is high compared to the normative population. Common co-occurring disorders include:

Histrionic Personality Disorder (HPD)
Anxiety Disorders
Depression
Eating Disorders
Post-traumatic Stress Disorder (PTSD)
Substance abuse disorder
Alcohol abuse disorder

Treating Borderline Personality Disorder

People with BPD can benefit from psychotherapy (talking therapy). Medication can be useful, but only in conjunction with individual and family psychotherapy. One mode of therapy, dialectical behavior therapy (DBT), is particularly useful for treating BPD.

Dialectical behavior therapy (DBT) helps people redirect their attention to the present moment, a core feature of mindfulness. DBT also teaches people concrete skills to manage their emotions, particularly how to soothe and still anger, fear, and paranoia. For those with BPD, learning how to control intense, overwhelming feelings and irrational beliefs also sets the stage for learning helpful new coping skills.

New Approaches to Treating the Symptoms of BPD

TMS is an FDA-approved treatment for depression, in which a physician or clinician uses a magnetic pulse to gently stimulate the areas of the brain that are responsible for mood and emotional control. It’s a rapid, non-invasive treatment that’s carried out in a clinic, requires no hospitalization, and has no systemic side-effects. It requires no sedation and is medication-free.

Studies have shown that the symptoms of Borderline Personality Disorder may improve when treated with TMS.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Borderline personality disorder. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder/Overview. Accessed August 24th, 2021.

Herman, J. L., Perry, J. C., & Van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. The American Journal of Psychiatry, 146(4), 490–495. https://doi.org/10.1176/ajp.146.4.490

Mattocks, N. (2019, October 11). Borderline personality disorder myths and facts. NAMI. Accessed September 23, 2021, from https://www.nami.org/Blogs/NAMI-Blog/October-2019/Borderline-Personality-Disorder-Myths-and-Facts.

Reyes-López, J., Ricardo-Garcell, J., Armas-Castañeda, G., García-Anaya, M., Arango-De Montis, I., González-Olvera, J. J., & Pellicer, F. (2018). Clinical improvement in patients with borderline personality disorder after treatment with repetitive transcranial magnetic stimulation: preliminary results. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 40(1), 97–104. https://doi.org/10.1590/1516-4446-2016-2112

Skoglund, C., Tiger, A., Rück, C. et al. Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population. Mol Psychiatry 26, 999–1008 (2021). https://doi.org/10.1038/s41380-019-0442-0

Young JQ. Chapter 26. Personality Disorders. In: Feldman MD, Christensen JF. eds. Behavioral Medicine: A Guide for Clinical Practice, 3e. New York: McGraw-Hill; 2008. Accessed September 24th, 2021.

girl with psychosis seeing double of herself

Are You Experiencing Psychosis?

Written by W. Nate Upshaw M.D. on July 30, 2021. Posted in Anxiety, Depression, Mental Health Maintenance.

Psychosis is a psychological condition in which a person loses touch with reality. Psychosis isn’t an illness of its own; rather, it’s a syndrome made of symptoms of an underlying disorder. The symptoms of psychosis and the conditions causing it both require treatment.

https://www.youtube.com/watch?v=UEnEohiBqO0

Psychosis isn’t uncommon. About 3 percent of all Americans will experience at least one psychotic episode in their lifetimes. An episode of psychosis can be caused by a medical disorder, mental illness, drug abuse, or toxic chemicals. Psychosis can be acute, a single event, or can be chronic, coming and going for years. Psychosis is always a serious condition that disrupts a person’s ability to live a satisfying life.

Identifying Psychosis

These are some of the most common early warning signs that psychosis is developing.

You’re sure you’re being spied on or followed.
You think there might be a conspiracy to harm you.
Your thoughts seem disjointed and it’s harder to form a clear thought.
Your daily, familiar environment feels threatening or strange.
You’ve felt like your thoughts were not your own, or that your thoughts were being controlled.
You’ve been going off-topic and rambling to an unusual degree when trying to speak with others.
You hear distant hissing, clapping, or whispering that’s not due to your environment or a disorder like tinnitus.
You’re hearing voices or seeing things you can’t be sure are real.
You question whether or not you’re real.
You feel unusually mistrustful of people you normally feel comfortable with.

Some of the early warning signs of psychosis are the same as those of other psychological disorders. People experiencing psychosis for the first time usually know something’s wrong, but many won’t seek help for fear of being stigmatized or judged.

Early Psychosis

First-episode psychosis, also called early psychosis, is a person’s first episode of feeling disconnected, or losing touch with reality. Some of the early warning signs of psychosis include:

Withdrawal from family and friends
An unusual drop in grades or work performance

Marked decline in personal hygiene
Withdrawal from others, unusual self-isolating behavior
Seeing or hearing things that aren’t real (hallucinations)

Strong belief in bizarre things that are untrue (a belief the individual is being watched or spied on is common)
Increased paranoia, fear that others mean to harm them
Strong, inappropriate emotions or having no feelings at all

The hallmark symptoms of psychosis are hallucinations and delusions. Hallucinations involve hearing, feeling, or seeing things that aren’t present. These hallucinations are usually negative; that is, they seem harmful, hurtful, or dangerous.

Auditory hallucinations often involve hearing voices. These “voices” may denigrate or insult the person, or even give the person instructions to carry out actions.
Visual hallucinations may look extremely detailed and fully formed or might only look like colored dots or spheres.

Delusions are powerfully held beliefs or ideas that are patently false and irrational. A person suffering from a delusion will insist that it is true even when presented with overwhelming evidence that it is not. Common delusions in psychosis are:

Paranoid or persecutory. A person believes others are planning to harm them, plotting against them, or conspiring against them. Delusions of betrayal by a loved one are also common.
Thought control. The individual believes an outside entity is controlling their thoughts, even their behaviors, or that others can hear their thoughts.
Grandiosity. Delusions of grandeur involve a person thinking they’re uniquely chosen for a mission, supremely unique, on a mission from God, or even believing they are god themselves.

Psychosis deeply affects the way a person interprets information from the environment. In time, it distorts our internal narratives, which are the stories we tell ourselves that helps us frame the world and our place in it.

Causes of Psychosis

Psychosis is sometimes a part of disorders like depression and bipolar disorder. Extreme trauma can also lead to psychosis, which is common to a class of psychological disorders, fittingly called the psychotic disorders.

Exposure to toxic chemicals can lead to psychosis, as can drug abuse, but psychosis is most commonly found in schizophrenia and related disorders. In fact, psychosis is a distinguishing feature of schizophrenia.

Treatment of Psychosis

The acute phase of psychosis must be treated first. A person can’t get any benefit from other modes of treatment when they are actively psychotic. Medication therapy is ideal for stabilizing acute psychosis.

Over the last twenty years many new antipsychotics have been developed that are more effective and have fewer side-effects than the antipsychotics of the 20th century. These include:

Vraylar (cariprazine)
Latuda (lurasidone)
Risperdal (risperidone)
Zyprexa (olanzapine)
Seroquel (quetiapine)
Invega (2009)

Treating psychosis as close to its onset as possible is the best approach to recovery. As is the case for many psychological disorders, a combination of medication and psychotherapy is the most effective treatment approach that produces long-term remission of psychosis.

Psychotherapy for Psychosis

Cognitive Behavioral Therapy (CBT) is a useful type of therapy that examines how a person’s thoughts and feelings about situations molds our reactions and behaviors. A form of CBT, CBT for psychosis (CBTp) has been developed to help people de-escalate the fear and anxiety that comes from hallucinations.

The goal of CBTp isn’t to teach a person how to determine what’s real or not—after all, if a person were able to determine that, they wouldn’t be psychotic. CBTp helps people identify hallucinations as part of their disorder and not something to be acted on or feared.

An Effective Depression Treatment: TMS Therapy

Newer and highly effective treatments for psychological disorders are becoming available. One such treatment for depression and depression related anxiety is TMS Therapy, also known as, Transcranial Magnetic Stimulation (TMS). This form of treatment uses magnetic fields to precisely stimulate areas of the brain that are responsible for a person’s mood. TMS is FDA-approved for the treatment of Major Depression Disorder, produces no systemic side effects and is a medication-free treatment. TMS is eligible for coverage by most major health insurers, such as Medicare and Tri-Care.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Kiran C, Chaudhury S. Understanding delusions. Ind Psychiatry J. 2009;18(1):3-18. doi:10.4103/0972-6748.57851

Loewy, Rachel L., et al. (2011). Psychosis risk screening with the Prodromal Questionnaire—Brief Version (PQ-B). Schizophrenia research 12(1) pp. 42-46.

Miller, C. (2019, September 30). How does cbt help people with psychosis? Retrieved July 25, 2021, from https://childmind.org/article/cbt-help-people-psychosis/

The National Alliance on Mental Health: Psychosis. (2021, July 14). Retrieved July 14, 2021, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Psychosis

World Health Organization: Schizophrenia. (2019, October 4). Retrieved July 24, 2021, from https://www.who.int/news-room/fact-sheets/detail/schizophrenia

depressed man with head in hands with an open bottle of antidepressants in front of him

What is the Best Treatment Option for Depression?

Written by W. Nate Upshaw M.D. on July 21, 2021. Posted in Depression, Mental Health Maintenance.

Depression is a debilitating psychological disorder that affects over 17 million US adults every year. Characterized by disturbances in a person’s emotions, behavior, and thinking, depression drains all joy from life and leaves a person with either a near-total numbness or unrelenting, profound sadness.

https://www.youtube.com/watch?v=E_hcITwnvs4

The best treatment option for depression must be tailored to the unique needs of the individual. There are many kinds of depression and while treatment usually consists of medication, psychotherapy, or both, it’s important to understand a little bit about depression as a disorder.

Consider these common forms of depression:

Major depressive disorder (MDD).
Persistent depressive disorder (PDD)
Bipolar disorder
Situational depression
Seasonal affective disorder (SAD)
Premenstrual dysphoric disorder
Perinatal Depression (postpartum depression)
Atypical depression

The Biological Aspects of Depression

Depression can be the result of a person’s genetic history, their early childhood experiences, general health, social and economic factors, as well as their biology. Depression can follow a traumatic life event, such as the death of a loved one, or it may arise seemingly out of nowhere.

However, in many circumstances, there is commonality among the kinds of depression a person might experience based on the level of a person’s biology. The exact causes of depression are not completely known, but researchers believe that in some cases, depression results from changes in the way brain cells communicate with each other.

Our thoughts, emotions, and behaviors are formed from living circuits of brain tissue. Within these, the nerves rely on complex chemicals called neurotransmitters to signal each other. Correct signaling depends on just the right level of neurotransmitters. If something goes wrong with these levels of neurotransmitters, depression and other psychological issues are the result. Researchers also believe there are other factors influencing a person’s chances of developing depression, like hormones and a person’s genetic inheritance.

For most people who suffer from moderate to severe depression, antidepressant medications are effective at relieving the severity of depression symptoms, which is why they’re a good first-line treatment for depression.

Medical Approaches to Depression

A mental healthcare professional, such as a psychiatrist, can help evaluate whether you need medication, therapy, or both. Typically, the first-line treatment of moderate to severe depression includes a combination of psychotherapy and medication. Mild depression may sometimes be treated with monotherapy—medication or therapy alone.

Antidepressant Therapy

There are 60 known neurotransmitters, so finding the right antidepressant for a person’s depression may not happen on the first try. Antidepressant medications work by causing specific neurotransmitters to stay available to brain tissue longer, giving them more time to work.

This action is effective in treating depression, as people with depression or anxiety tend to eliminate neurotransmitters too rapidly from the brain tissues that need them.

Most antidepressants developed in the past 25 years work to increase levels of serotonin, norepinephrine, or both.

The following are two of the major types of antidepressant medications-

Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are the most common first-line medications prescribed for major depression. SSRIs work by causing serotonin, a vital neurotransmitter, to stay in brain tissue longer than it otherwise would. This allows more serotonin to be available to nerves. Examples of SSRIs include:

- Paroxetine (Paxil)
- Citalopram (Celexa)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)

Selective Norepinephrine Reuptake Inhibitors (SNRIs). SNRIs operate primarily on the neurotransmitter norepinephrine, but they also affect serotonin. Examples of SNRIs include:

- Venlafaxine (Effexor XR)
- Levomilnacipran (Fetzima)
- Desvenlafaxine (Pristiq)

Tricyclic antidepressants. These medications are an older type of antidepressant and work similarly to SSRIs and SNRIs, but tend to have more serious side effects. Examples of tricyclic antidepressants include:

- Amitriptyline (Pamelor)
- Imipramine (Tofranil)
- Desipramine (Norpramin)

Atypical antidepressants. As the name suggests, these antidepressants work by other means that aren’t as clearly defined as those above. Popular medications of this class include:

- Bupropion (Wellbutrin)
- Trazodone (Desyrel)
- Mirtazapine (Remeron)

Talking Therapy

Talking Therapy, sometimes called psychotherapy or counseling, involves meeting with a mental healthcare professional on a schedule to learn how to eliminate, reduce or control the symptoms of depression. This form of treatment is a great way to learn how to build more satisfying relationships, manage stress, and deal effectively with issues such as anxiety.

Most modern talking therapies take anywhere from 10 to 30 visits over the course of several months. Unlike older forms of therapy, such as psychoanalysis, modern therapy is focused on clear outcomes and is goal oriented toward problem-solving.

Therapy cannot “talk” someone out of purely biological depression, but for those people who lack a biological component to their depression, talking therapy is the best treatment option for depression.

Therapy can help a person:

Pinpoint the issues that drive one’s depression and make necessary changes
Identify and change habitual harmful thoughts, behaviors, and beliefs
Adjust and adapt to a crisis
Learn better ways of coping with stress
Learn skills for defusing anger
Learn to manage anxiety
Develop better ways of relating to other people
Gain control over their lives and improve their levels of satisfaction and happiness

Transcranial Magnetic Stimulation (TMS) for Depression

About one-third of all people with severe depression don’t receive relief from antidepressants alone, which makes therapy more challenging. Furthermore, depression may sometimes return, even after long periods of remission.

Fortunately, there’s a newer treatment for depression that provides long-lasting relief. Transcranial Magnetic Stimulation (TMS), is an FDA-approved, highly effective treatment for people with Major Depression Disorder, including medication-resistant depression and recurrent depression. TMS is also FDA-approved for the treatment of depression related obsessive-compulsive disorder (OCD).

TMS uses targeted magnetic fields to gently stimulate areas of the brain that are responsible for one’s mood. Multiple studies have shown that TMS gives relief from depression and other mental health conditions.

Other studies have demonstrated that TMS increases the effectiveness of antidepressant therapy and reduces the time it takes for them to deliver their maximum benefits. Timely relief is crucial, yet antidepressants alone can take four to six weeks before a person receives their maximum benefit. Studies have shown that TMS reduces this lag.

TMS has many advantages over traditional treatments:

TMS works faster than any other treatment option
TMS has superior results to the best traditional treatments
TMS is safe and has no systemic side effects
TMS requires no hospitalization
TMS is convenient, with sessions lasting from 30 minutes to an hour
TMS is FDA-approved for treating depression and other psychological issues

Other TMS facilities only provide TMS, but at NeuroSpa TMS®, we offer TMS Plus™, a unique and comprehensive suite of services that address every aspect of recovery from psychological disorders, including:

Cognitive Behavioral Therapy (CBT). CBT helps people understand how deeply established habitual patterns of thinking and responding to stress, depression and anxiety may be holding them back from the satisfying life they deserve.

Nutrition Counseling. Making healthy diet choices during TMS treatment is highly beneficial, as TMS therapy supports the brain as it builds healthier connections. Our nutrition counseling is provided by a registered dietitian who can help patients make lasting changes to their diet.

Blood Work. Our physicians determine if bloodwork is necessary to rule out issues like thyroid disorder or vitamin deficiency that are contributing to a patient’s depression.

Sleep Evaluation. As part of our comprehensive approach to mental healthcare, our physicians will determine if sleep apnea or insomnia are affecting a patient’s mental health.

Functional MRI Targeting. Functional MRI targeting allows our physicians to make any adjustments needed to the usual treatment areas to make sure patients get the best treatment possible.

NeuroSpa TMS® is pleased to be among the leading providers of TMS therapy in the country with the offering of TMS Plus™ and will continue to push the boundaries in order to make sure that all patients are provided with the safest most effective therapy possible. A better quality of life awaits you at NeuroSpa TMS®.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

American Psychological Association. (2017, July). What is Cognitive Behavioral Therapy? Clinical Practice Guideline for the treatment of Post-Traumatic Stress Disorder. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral.

Brody, D. J., Pratt, L. A., & Hughes, J. P. (n.d.). Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016. Centers for Disease Control. https://www.cdc.gov/nchs/products/databriefs/db303.htm.

Clinical Practice Review for Major Depressive Disorder. Clinical Practice Review for Major Depressive Disorder | Anxiety and Depression Association of America, ADAA. (n.d.). https://adaa.org/resources-professionals/practice-guidelines-mdd

Mayo Foundation for Medical Education and Research. (2019, October 5). Serotonin and norepinephrine reuptake inhibitors (SNRIs). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970.

Rupke, S., Blecke, D., & Renfrow, M. (2006, January 1). Cognitive Therapy for Depression. American Family Physician. https://www.aafp.org/afp/2006/0101/p83.html.

Sukel, K. (2019, September 19). Neurotransmitters. Dana Foundation. https://dana.org/article/neurotransmitters/. Retrieved July 20th, 2021.

Swedish Council on Health Technology Assessment. (2004, March). Treatment of Depression: A Systematic Review [Internet]. National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/28876724/. Retrieved July 20th, 2021

Symptoms of Depression Among Adults: United States, 2019, M. A., & Terlizzi, E. P. (2020, September 23). Symptoms of Depression Among Adults: United States, 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db379.htm.

Syvälahti, E. K. (1994, February). Biological aspects of depression. Acta psychiatrica Scandinavica. Supplementum. https://pubmed.ncbi.nlm.nih.gov/7914394/.

Thase, M. E., Jindal, R., & Howland, R. H. (2002). Biological aspects of depression. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 192–218). The Guilford Press.

bipolar disorder spelled out on a board with photos representing bipolar disorder around it

Experiencing Bipolar Disorder?

Written by W. Nate Upshaw M.D. on July 6, 2021. Posted in Anxiety, Depression.

Bipolar disorder is a common, serious psychological disorder experienced by about 6 million American adults every year. Formerly called manic depression, bipolar disorder has two groups of symptoms: mania and depression. In between these poles, or phases of bipolar disorder, people typically have a normal mood (euthymia). Depression in bipolar disorder is the same as that experienced by people with major depression. It’s the manic phase that differentiates bipolar disorder from major depression.

Bipolar Disorder: The Highs and the Lows

For a diagnosis of bipolar disorder to be made, a person must have significant symptoms of depression that have at least once alternated with a condition called mania, or its milder form, hypomania. A person doesn’t have to have alternating cycles of depression and mania, although some people do. Just one manic episode is enough for a mental health professional to diagnose bipolar I disorder, also called bipolar type I.

Symptoms of Bipolar Mania

A person having a manic episode feels intensely happy, even euphoric. They may become dangerously impulsive, energetic, and unable to control themselves. People in a manic episode often believe themselves to be capable of any feat and may become psychotic.

Other symptoms of mania include:

pressured speech (a person can’t get their words out fast enough)
many new ideas emerging all at once
high levels of enthusiasm
inability to sleep, sometimes for days at a time
elevated, even overwhelming levels of energy
leaping from one idea to another (flight of ideas)
delusions
unusually risky behavior, like promiscuity, overspending, gambling
flashes of irritability, anger, outbursts that look like rage
making impulsive, life-altering decisions, like quitting one’s job, with no planning
grandiosity

Hypomania, a milder form of bipolar mania, isn’t as extreme as full-blown mania, but it still constitutes a debilitating part of bipolar disorder. This combination of depression alternating with hypomania is called bipolar II disorder.

Symptoms of Bipolar Depression

Remember, for a person to be diagnosed with bipolar they must have experienced one episode of mania, with longer episodes of depression. Bipolar depression is quite similar to that experienced by people living with major depression. It involves the following symptoms:

Feelings of deep sadness that are present most of the time
Loss of pleasure in activities you used to enjoy or the inability to feel pleasure at all (anhedonia)
Feelings of emotional numbness
Lack of energy, persistent fatigue
Sleep problems (too much or too little sleep)
Difficulty concentrating, problems with memory, decreased ability to concentrate, or an inability to make decisions
Feelings of guilt and hopelessness
Preoccupation with death
Withdrawing from friends, family, and/or social situations

Bipolar disorder usually develops in a person’s early 20s, although it can affect teenagers. It’s vital to take action after a person’s first manic episode, as the earlier a person gets treatment, the better their mental health recovery will be.

I’m Bipolar—Now What? Living with Bipolar Disorder

While dealing with bipolar disorder can be challenging, this disorder responds well to proper treatment and is a manageable condition. Getting started with treatment is essential, as over 80 percent of all people with bipolar experience severe and disruptive symptoms. Managing bipolar disorder requires a combination of treatment approaches and lifestyle changes. Lifestyle changes alone won’t help bipolar disorder, as the causes are in part rooted in a person’s unique biology.

The most effective way of coping with bipolar disorder requires psychotherapy combined with medication. Great strides have been made in the last 20 years in developing medications that treat bipolar disorder without the side effects of lithium, the 20th century medication of choice for bipolar disorder.

Medication

Treating bipolar disorder with medication can be tricky, as antidepressants can trigger mania. Typically, bipolar disorder is treated with a mood-stabilizing medication. Lithium carbonate is exceptionally effective as a mood stabilizer but requires regular blood tests to ensure its levels are just right. It also has a narrow range of effectiveness, which can make getting the correct amount challenging.

Newer medications, like topiramate, lamotrigine, and divalproex sodium, have proven to be effective with fewer side-effects. Medication for bipolar disorder must be taken consistently to work correctly.

Therapy

Talk therapy, also called psychotherapy, helps a person deal with the issues that come from living with bipolar disorder. Common and effective types of talk therapy include:

Cognitive-Behavioral Therapy (CBT). CBT is helpful in identifying and changing habitual patterns of thinking that contribute to poor outcomes in a person’s lives. Automatic thoughts and judgements often keep a person from adapting to difficult situations, which is where CBT can be exceptionally effective.
Interpersonal and Social Rhythm Therapy (IPSRT). IPRST helps people understand how disruptions to the natural rhythms of life, like the sleeping and waking cycle, can make bipolar disorder worse. Its goal is to stabilize personal and social rhythms, which make a person more resilient.

Social Support

Social support is an essential part of recovery from bipolar disorder. Online forums for bipolar disorder, bipolar blogs, and bipolar support groups can all provide contact with others living with bipolar disorder. Connecting with people who are coping with similar situations can help you form a stronger support system while providing support for them as well.

Transcranial Magnetic Stimulation (TMS) for Bipolar Disorder

If you’re living with bipolar disorder and looking for treatment, transcranial magnetic stimulation (TMS) is a newer treatment approach. TMS uses high-powered magnetic fields to precisely stimulate areas of the brain that are responsible for a person’s mood. TMS is FDA-approved for the treatment of Major Depression Disorder, produces no systemic side effects and is a medication-free treatment. TMS is eligible for coverage by most private health insurers, as well as Medicare and Tri-Care.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Agarkar, S., Mahgoub, N., & Young, R. C. (2011). Use of transcranial magnetic stimulation in bipolar disorder. The Journal of neuropsychiatry and clinical neurosciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102108/.

Bipolar disorder. (2018, January 31). https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961. Retrieved July 18th, 2021

Bipolar Disorder: Age of Onset. National Alliance on Mental Illness. (n.d.). https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Bipolar-Disorder. Retrieved July 18th, 2021

Butler, M. (2018, August). Treatment for Bipolar Disorder in Adults. Treatment for Bipolar Disorder in Adults: A Systematic Review [Internet]. https://www.ncbi.nlm.nih.gov/sites/books/NBK532193/table/ch2.tab1/.

Hurley, K. (2020, November 24). Bipolar Disorder and Depression: Understanding the Difference. Psycom.net – Mental Health Treatment Resource Since 1996. https://www.psycom.net/depression.central.bipolar.depression.html#:~:text=Bipolar%20disorder%20is%20easily%20confused,disorder%20includes%20symptoms%20of%20mania.

Miklowitz DJ, Otto MW, Frank E, et al. Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program. Arch Gen Psychiatry. 2007;64(4):419–426. doi:10.1001/archpsyc.64.4.419 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210013

Miklowitz , D. J. (2019, April 12). Different Types of Therapy for Bipolar Disorder. NAMI. https://www.nami.org/Blogs/NAMI-Blog/April-2019/Different-Types-of-Therapy-for-Bipolar-Disorder.

NAMI (2021, June 28). What Is Mania, and What Does It Mean to Have a Manic Episode? Here’s What Experts Say. What Is Mania, and What Does It Mean to Have a Manic Episode? https://www.nami.org/Press-Media/In-The-News/2021/What-Is-Mania-and-What-Does-It-Mean-to-Have-a-Manic-Episode-Here-s-What-Experts-Say?feed=In-the-news.

U.S. Department of Health and Human Services. (2017, November 17). Bipolar Disorder: Statistics about Bipolar Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/bipolar-disorder. Retrieved July 18th, 2021

U.S. Department of Health and Human Services. Bipolar Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml. Retrieved July 18th, 2021

What are hypomania and mania? Mind. (n.d.). https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/. Retrieved July 24th, 2021

man walking outdoors to relieve depression

6 Positive Coping Methods When Struggling With Depression

Written by W. Nate Upshaw M.D. on June 11, 2021. Posted in Depression, Mental Health Maintenance.

When depression hits, it’s overwhelming and debilitating. Whether it’s your first or twentieth episode, you may never feel ready for it. Maybe you feel too depressed to get out of bed, too depressed to work, and even too depressed to sleep. Since depression often gets in the way of participating in your daily life, we often are desperate to find ways to “snap out of it.” Unfortunately, coping with depression takes time and energy to practice and implement the skills that will help you manage it. It can be hard to know what to do if you’re depressed when you’re still in the process of learning how to cope with it. Here are a few things that do help.

https://www.youtube.com/watch?v=XbsBzNrjM18

How To Regain Focus When Depressed

Stay connected with your loved ones. Depression can feel very isolating. Making sure you are connected to others is a great way to battle any loneliness. For example, setting up times to call, FaceTime, or meet up with friends and loved ones can give you something to look forward to as well as a way to structure your time. Asking friends to call or check in on you more frequently when you’re depressed can be uncomfortable, but any amount of social connection can be helpful in managing depression.
Exercise is a highly effective tool to help cope and manage depression. High-intensity exercise can release endorphins that result in a more positive mood. But, don’t worry if you don’t have the ability or energy to engage in high-intensity exercise. There are studies that show that low-intensity exercise can cause new nerve cells to grow in the brain, which make new connections and can result in improved brain function to make you feel better. Especially if you are feeling exhausted, too depressed to work, or have feelings of worthlessness, the idea of starting a new, intense workout regime can be overwhelming. That’s why it is important to find a form of exercise or activity that you enjoy or believe to be beneficial. That way, you are more likely to maintain this activity level throughout your life as a tool to manage your depression.
Stay consistent with your therapy. If you are seeing a mental health therapist or psychiatrist, continue to see them regularly. If you are taking medications, continue to take them consistently. It can be easy to stop seeing your providers or taking your medications if and when you are feeling better. Or, in some cases, feel too depressed for therapy. However, consistency is important in treating depression. Continue to meet with your providers until it is mutually agreed upon that you feel well prepared to discontinue treatment.
Make practicing gratitude a part of your daily routine. We know depression is really good at amplifying negative self-talk and making it the loudest and strongest among our thoughts. Working on challenging these unhelpful thoughts in the moment can give you some relief. Practicing gratitude can be a great reminder of things or people that you have in your life that provide you some sense of peace and contentment. Write these thoughts down in a journal to look at whenever you need reminders, or say them out loud. When we hear our thoughts, we may interpret them differently than when we simply think about them.
Practice doing activities that bring you pleasure. A common hallmark of depression is experiencing a lack of pleasure or interest in activities you once enjoyed. While you may not feel like doing any of these things when you’re depressed, encouraging yourself to do these activities that you know you enjoy can get you back into a routine, and hopefully assist you in experiencing small moments of joy and pleasure. These interests can be more active or social, such as a sport or meeting up with friends. They can also be as simple as listening to or your favorite music, TV show, or movie. Allowing yourself to do things that are genuine and valuable to you are great ways to give the depression a little less power.
Spend more time outdoors. There’s growing research that suggests that being outdoors can improve mental health and reduce stress. If you are able to go to a nearby park, go on a hike, or even open a window to hear sounds of nature, this may contribute to improving your mood. A study from the United Kingdom suggests that people who were able to be outdoors or explore nature for 2 hours each week reported significantly higher health benefits and well-being. Of course, living in urban areas may make connecting with nature more difficult, especially during the busy work day. Luckily, even finding an urban park or any kind of greenery can be beneficial.

Depression takes a toll on your mind, body, and spirit, and people who have depression know it is hard to regain your focus when you’re depressed and show up in our relationships the way we want to. We can’t “just snap out of” depression. But, intentionally engaging in these coping skills and activities can move you closer to getting out of a depressive episode.

What To Do If You’re Depressed

Chronic feelings that are getting in the way of everyday life can be a sign of clinical depression. There are many kinds of therapy that can help, including transcranial magnetic stimulation (TMS). TMS is a non-invasive procedure using magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS has become a great option for treatment, as it’s become widely available and is covered by many insurance providers. TMS is FDA-cleared and has no reported systemic side effects.

Works Cited

Harvard Health. (2021, February 2). Exercise is an all-natural treatment to fight depression. Retrieved June 23, 2021, from https://www.health.harvard.edu/mind-and-mood/exercise

-is-an-all-natural-treatment-to-fight-depression

Smith, M., Robinson, L., & Segal, J. (2021, June 17). Coping with Depression. Retrieved June 24, 2021, from https://www.helpguide.org/articles/depression/coping-with-depression.htm#

Weir, K. (2020, April 1). Nurtured by nature. Retrieved June 24, 2021, from https://www.apa.org/monitor/2020/04/nurtured-nature

person laying on their couch feeling lazy

What’s the Difference Between Being Lazy or Depressed?

Written by W. Nate Upshaw M.D. on June 7, 2021. Posted in Depression.

There are still some truly awful stigmas associated with having depression. As is common with many mental illnesses, people may ascribe issues of character to what is in fact a chronic illness. Oftentimes, those suffering from depression are referred to as unmotivated or lazy when the truth is entirely different. Depression is a psychological disorder that happens against a person’s consent and no amount of willpower can make it go away.

The Differences between Laziness and Depression

If you’re questioning whether you’re lazy or depressed, ask yourself if all you lack is motivation. “Laziness” is a matter of making a choice to not do a particular activity or activities, but depression is a chronic illness. Laziness may be a momentary state or an issue of character, but it is not a psychological disorder. Further, if you’re concerned you might be lazy, ask yourself if you’re feeling deeply sad, have disengaged from things you used to love, and are having problems with sleep, energy levels, or your ability to concentrate. These are all hallmark symptoms of depression.

What Is Depression?

Depression is a common psychological illness affecting a little over 8 percent of American adults. It affects all aspects of life, from how you think to how you feel and behave. Not only is depression characterized by deep, unrelenting sadness, but depression also causes people to lose the ability to feel pleasure. People lose interest in things they once enjoyed, withdraw from social life and relationships, may lose or gain weight without trying, and can suffer from a variety of physical problems.

Depression causes a person to feel tired and lethargic. It also ruins one’s ability to be interested in anything, particularly activities that were once enjoyable (anhedonia). Depression causes one’s energy levels to collapse as well, even though they may be sleeping much more than usual. In fact, hypersomnia (excessive sleeping) is one of the most common symptoms of depression.

For a depression diagnosis to be made, symptoms must be present for at least two weeks. The most common symptoms in their respective categories are:

Emotional:

Extreme sadness, mostly every day, usually without any identifiable cause
Feelings of guilt or worthlessness, in the absence of any cause
Loss of interest in activities once enjoyable (anhedonia)
Feeling cut off or unable to engage with others, activities or former interests
Feelings of emptiness
Excessive worry, rumination
Elevated anxiety
Snappishness, irritability

Cognitive:

Brain fog (muddled or fuzzy thinking)
Difficulty concentrating, inability to focus one’s thoughts
Diminished attention span
Problems with one’s memory
Negative outlook (“it’s all my fault, nothing will change, nothing will get better”)
Thoughts of suicide

Behavioral and Physical:

Persistent lack of energy
Restlessness
Slowed movements, difficulty with or reduced speed in simple physical tasks (psychomotor retardation)
Sleep disturbances
Social withdrawal
Self-isolation

What Causes Depression?

Our thoughts and emotions are regulated by complex chemicals called neurotransmitters and neuromodulators. Our nervous system, including the brain and spinal cord, is completely dependent on these chemicals for their proper functioning. Researchers believe that when the production of neurotransmitters falls outside of normal levels, depression, as well as other psychological disorders, are the result.

Without adequate levels of these chemical messengers, our brain works slower and less efficiently. One neurotransmitter, dopamine, is responsible for our ability to feel pleasure. Another serotonin, helps us experience and modulate our emotions. When brain tissue has a problem properly responding to or producing neurotransmitters, we suffer.

When approached in this way, it’s easy to see that although depression is experienced psychologically, it’s very much a physical ailment.

Treatment for Depression

There are several excellent treatments for depression, including psychotherapy and medication therapy. Since 2008, transcranial magnetic stimulation (TMS) has been used as a rapid, painless, and non-invasive treatment for depression. In TMS, a powerful and precise magnetic field is applied to an area of the brain that regulates mood. Many people experience no side effects and receive lasting relief from depression through TMS.

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.

Works Cited

Buyukdura, J., McClintock, S., & Croarkin, P. (2011, March 30). Psychomotor retardation in depression: biological underpinnings, measurement, and treatment. Progress in neuro-psychopharmacology & biological psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646325/.

Major Depression. (n.d.). Retrieved June 4th, 2021, from https://www.nimh.nih.gov/health/statistics/major-depression.shtml

Prevalence of Depression Among Adults Aged 20 and Over: United States, 2013–2016 Number 303 – February 2018. (2018, February 13). Retrieved June 2nd 2021, from https://www.cdc.gov/nchs/products/databriefs/db303.htm

Risk Factors and Warning Signs. (2018, November 14). Retrieved April 10, 2020, from https://afsp.org/about-suicide/risk-factors-and-warning-signs/

What are neurotransmitters? Queensland Brain Institute. (2017, November 9). https://qbi.uq.edu.au/brain/brain-physiology/what-are-neurotransmitters.

Warning Signs Of A Suicidal Person

They have become very withdrawn and apathetic towards major problems.

They threaten suicide.

They mention that they feel like a burden.

Your friend started to give away a lot of their personal possessions, mentions final wishes, and more.

They self-harm.

How You Can Help a Loved One in Need

Recognize That Depression Is Part of You, but Not All of You

Know When to Seek Professional Help

Talk Openly With Your Family and Friends

Seek Out Mental Health Groups for Support

Take Time for Yourself

Set Small Goals and Build Up From There

Ask People to Give You Space if You Need It

Everyone Deals With Depression in Their Own Way

Myth 1: People with mental illnesses are violent and unpredictable.

Myth 2: Mental illness is just laziness or weakness of character.

Myth 3: People with mental illness can totally control their emotions and choose to feel the way they do.

Myth 4: Mental illness means serious dysfunction and disability.

Myth 5: If a person really wanted to, he or she could get better on their own.

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