Category Archives: Psycological Health

When does your mental health become a problem?

When does your mental health become a problem?

2013-07-03

People often experience sadness in response to difficult life events, but when does this become a mental health problem?

One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

How do we define mental health?

A person who is considered ‘mentally healthy’ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

Breast-Fed Babies Achieve Higher Social Status

Breast-Fed Babies Achieve Higher Social Status

2013-06-26

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Studies suggest that breast-feeding can be good for a baby’s health, and now there’s fresh evidence that it may help children to climb the social ladder as well.

What does breast-feeding have to do with social status? According to the researchers from University College London, who reported their findings in the journal BMJ, breast-feeding can impact cognitive development, and that accounted for just over a third of nursing’s effect on improvements in social status. What’s more, the practice also seemed to lower the chances of downward mobility.

To assess the impact of breast-feeding on later social status, the researchers compared two cohorts of people, including more than 17,400 individuals born in 1958, and over 16,700 people born in 1970. When their kids were about 5 years old, mothers in both groups were asked if they had breast-fed their children. The researchers used the children’s fathers’ income and job to determine the youngsters’ initial social status when they were about 10 to 11 years old and compared this with their social status decades later, when they reached age 33 or 34. And to get some idea of the way in which breast-feeding might be influencing social status, the scientists also evaluated the children’s cognitive skills and stress responses when they were about 10 or 11.

Continue reading Breast-Fed Babies Achieve Higher Social Status

Talk Therapy or Antidepressant? A Brain Scan Predicts Which Works Best for Your Depression

Talk Therapy or Antidepressant? A Brain Scan Predicts Which Works Best for Your Depression

2013-06-24

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There hasn’t been much in the way of hard science to help doctors or patients decide on the best treatments for depression — until now. For the first time, brain imaging may be able to help determine who will get better in therapy and who improves more on medication.

Depression affects an estimated 1 in 5 people over a lifetime, and talk therapies and antidepressant medications can help a significant proportion of those patients. But figuring out who will benefit most from which treatments remains a major challenge; while nearly 22 million Americans take antidepressants, 40% of people are not helped by the first treatment — drug or talk therapy — they try. And since it often takes weeks to relieve symptoms, choosing the wrong first treatment can lead to extra months of suffering.

Continue reading Talk Therapy or Antidepressant? A Brain Scan Predicts Which Works Best for Your Depression

Are You Happy or Horny? A Brain Scan Can Tell

Are You Happy or Horny? A Brain Scan Can Tell

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What are you feeling?  For the first time, a brain scan might be able to answer that question.

It’s not exactly mind reading, but a new program can identify emotional states— from happiness to sadness, lust to disgust— simply by analyzing brain activity, according to a recent study.

The technique isn’t just a parlor game; since emotional disturbances lie at the center of most psychiatric problems, a reliable way to detect feelings from brain scans could help researchers to better understand what goes wrong in cases of depression, autism, schizophrenia, anxiety disorders and many other conditions, as well as offer new insight into how emotions work.

Continue reading Are You Happy or Horny? A Brain Scan Can Tell

How Money Makes You Lie and Cheat

How Money Makes You Lie and Cheat

2013-06-20

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Money corrupts, they say, and now there’s a study that shows why people get so sneaky when it comes to making a profit.

The research, which was published in the journal Organizational Behavior and Human Decision Processes, revealed that people doubled the number of lies they told in order to earn extra cash if they were first prompted to think about money. The study involved more than 300 business students who participated in several experiments, all of which showed that cuing people to consider money increased either unethical intentions or actions.

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Viewpoint: Losing a son to suicide

Viewpoint: Losing a son to suicide

2013-06-14

The suicide of Dick Moore’s 21-year-old son Barney led the former headmaster to immerse himself in the emotional wellbeing of adolescents. Here he tells Barney’s story and questions whether schools do enough to protect adolescents with mental health problems.

Have you got children? It’s a standard dinner party question, often an area of common ground. But it’s a question that I find hard to answer.

Friends, relatives and teachers all say that our four boys are delightful, but they haven’t half put us through the mill over the last 30 years!

Numerous visits to head teachers’ offices on disciplinary matters (including my own when I was their headmaster), drink, body piercings, dodgy cars and dodgier women, African bandits, police helicopters, South American conmen and any number of calls for help. Is this par for the course for parenthood? Or have we made some ghastly mistakes?

It seems to me that the pleasures generated by children are largely passive – a warmth that gently glows deep within like a large sip of whisky on a cold day – while the pain they provoke is anything but passive. It strikes hard and low (and usually by telephone) and when you least expect it. You’re left breathless, emotionally battered and several years older. But still your love as a parent remains unconditional.

Let me tell you a little about Barney, the third of our four sons.

He was reluctant to enter the world, arriving late and by Caesarean section, bawling as if to say: “Put me back. I don’t want to be here.” He was long, slim and, as babies go, beautiful.

Growing up he was challenged by the new – indecisive, gentle, wilful, kind, but painfully shy. His friends, and there were many, called him “The Gnome”. He was always there, reliable and unassuming, but saying very little.

He could laugh at himself, too, for example at his inability to pronounce the word “bulb”. His brothers teased him about “belbs”, to be rewarded with his infectious grin and chuckle.

Following his 15th Christmas, Barney entered a dark depression where going to school was not an option.

Stubborn, unhappy and uncommunicative, he would not be moved. In the weeks and months that followed and with the support of friends, family, kind doctors and medication, the true extent of his difficulty in coping with growing up – becoming independent and mixing with his peers – became apparent.

A longed-for girlfriend he met on the internet helped him to join the sixth form at the local school. A-levels and a place at university followed. During his gap year he qualified as a master scuba diving instructor and all seemed set fair.

Yet confidence was still a big issue and when he fell deeply in love again, he seemed to retreat from the world at large, devoting his whole self to his beloved.

When she, not unreasonably, wanted to spread her wings, Barney resented the perceived implication that he was not enough. He wanted them to live forever in their own little box. The relationship ended at the beginning of August 2011 and there followed a month of deepening depression and desperation.

Sunday, 11 September 2011, was a beautiful autumnal afternoon. The grounds of the girls’ boarding school where my wife and I lived and worked were bathed in soft, warm sunlight.

Suddenly, the peace was shattered by four police vehicles careering up the drive between the main school buildings. They had responded to our frantic call about Barney who was threatening to kill himself if his girlfriend did not return to him. The police were lovely, bumbling and well-meaning, telling Barney in firm but friendly tones to be more considerate to his parents.

The next day, Barney drove away from us in his little red car. During the five days that followed we received some texts in which he tried everything to cajole us – and especially his mother – to persuade his girlfriend to get in touch.

Eventually, in the early hours of Sunday, 18 September, having told us that he no longer had a family and that his mother was unfit for purpose, he informed us that the final deadline for his girlfriend to contact him was noon.

Monday, 19 September, was unremarkable. At 6pm I was working in the staff room when a colleague poked his head around the door. “Some people are here to see you,” he said quickly.

The people turned out to be a gentle policeman and a very beautiful young policewoman. It’s funny how you can notice such things at such moments. My world tilted.

My wife and I sat down. Barney had been found in a hotel room in Reading. It appeared that he had taken his own life. I remember thinking how sensitively these two people had delivered their terrible message and I apologised to them for their having such a foul job to do.

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Warning signs of depression

If you, or someone you know, experience at least four of the following symptoms over a period of weeks, professional advice should be sought, usually from your GP:

  • Decreased energy
  • Appetite and weight loss
  • Restlessness
  • Insomnia/Irregular sleep
  • Difficulty making decisions
  • Tearfulness
  • Persistent sad, anxious, or empty mood
  • Thoughts of death or suicide
  • Changes in mood
  • Feelings of hopelessness or pessimism
  • Feelings of worthlessness or guilt

Twenty months have passed since that awful day. There has been much soul-searching and many tears. Each of us – my wife and I, and Barney’s three brothers – deal with Barney’s death in our own ways. I find the word “death” difficult to dwell upon.

Waves of grief still roll in from time to time and there isn’t a day that goes by that a memory is not stirred, a wistful thought provoked by a smell or a song or a photograph. But we are OK; we have survived and, perhaps oddly, we are able to enjoy life again.

For me, that restorative process has been directly linked to my search for knowledge about the emotional wellbeing of young people. And with knowledge has come some understanding. Not about how Barney’s story may have had a less tragic ending, but about the epidemic of emotional turmoil that can threaten to engulf some young people. About the efforts of some to make a difference. About the apparent lethargy of others in positions to make a difference but who fail to do so.

I can remember my mother and father telling the 15-year-old me that they hoped that my headmaster was correct in his assurance that I would emerge from this “horrid phase”, this “adolescent tunnel”, and that I would become the charming young man they yearned for.

Adolescence, which presents huge and frightening challenges, begins with the onset of puberty but it doesn’t end until as late as 25. It is only then that the part of the brain responsible for decision making, planning and organising, for common sense, catches up with that area of the brain which develops earlier and which, amid contortions of shape and size, is responsible for our developing emotions.

Depression, anxiety, self-harm, eating disorders and suicidal thoughts are now common place among young people.

Seventy-five per cent of mental health disorders originate in adolescence.

The statistics are horrendous:

  • About 13% of sixteen year olds have self-harmed. Why?
  • Suicide is now the most common cause of death – above even road traffic accidents – in men aged 17 to 34. Why?

Too many schools appear to prioritise academic results above the emotional wellbeing of their pupils, without seeming to appreciate that the former rely on the latter.

They won’t admit as much, of course, but sticking plasters don’t work – bolt-on counsellors and one-off training are a drop in the ocean. Real progress requires long-term commitment and a genuine desire to change the culture in our schools, our universities, our politics, our medical services and our homes – not least so that those suffering from emotional distress don’t feel too embarrassed and stigmatised to access help and support.

Distressed young people often need to trust before they will engage. Such trust is no longer conferred by status, by labels such as “father”, or “doctor” or “teacher”. GPs are often the first point of referral. But it is increasingly likely that the GP will not know their patient. If they do, it is a 50/50 call whether they have any mental health training. How, then, can they be expected to earn the trust, the engagement, of a person in an average consultation of 11.1 minutes?

School staff, too, are often overwhelmed by planning and targets and emails and paperwork. Young people need to be listened to too, patiently, regularly and non-judgementally. Parents may try, but the sting of emotional involvement makes such listening difficult.

Some schools have been triggered into action by tragedy – just as I have. But some have their heads stuck firmly in the sand. Some schools have invested in a sophisticated network of preventative measures, and support services – a full time counselling psychologist, a retained psychiatrist, health education specialists attached to each group of pupils, open and structured communication between medical and pastoral staff, and a structured programme of training for all staff.

Too many other schools, judging by their websites and their policy documents, have no such provision and prefer instead to talk proudly of their excellent sports injury rehabilitation clinic.

Regrettably, too many schools are akin to the council who fail to respond to the village campaign for a speed limit outside the local school until a child is killed by a speeding motorist. We need to act before the tragedies happen.

The stiff upper lip was arguably indispensable in the 20th Century. Talking about our emotions may not have helped in times of world war and widespread carnage. But the world has changed. The stiff upper lip is a deformity and it’s causing so much damage.

I implore school leaders, politicians, and parents to remove their heads from the sand and smell the heartache. Life is not wholly about grades even during this, the exam season. It is time to reassess priorities. It is time to talk. It is time to act. It is time to educate. It is time to invest – for there can be no health without mental health.

Life is not about waiting for the storms to pass. It is about learning to dance in the rain – a lesson our Barney didn’t manage to master and which led him to leave the world with more determination than when he joined it.

This piece is based on an edited version of Dick Moore’s Four Thought on BBC Radio 4

Coming out — as a couple

Coming out — as a couple


Between celebratory parades for Pride Month and increased calls for marriage equality, it would seem that, for the lesbian, gay, bisexual and transgendered community, things are indeed getting better.

But what happens if you’re in relationship with a partner who just isn’t comfortable being “out” with his or her sexual identity? Does the desire to keep your sexuality private create tension, or can an LGBT couple still succeed when one person isn’t ready to go public? I recently asked some of my colleagues for their insight on this issue.

“With most of the LGBT couples that I see, both partners are out, but to varying degrees,” said New Jersey-based psychotherapist Israel Martinez, who specializes in LGBT therapy. “One partner may be out with his or her family but not at work, and the other is out in both situations but is shy about holding hands in public, for example.”

That may not always pose a problem for couples, but it can certainly be an issue when one partner doesn’t publicly acknowledge being homosexual at all.

“In my experience, the partner who is more ‘out’ tends to see the partner who is more ‘closeted’ as less emotionally healthy,” explained Gordon Powell, a psychotherapist in New York. “Meanwhile, the closeted partner may feel judged and criticized.”

Such emotions can simmer, creating tension for even the happiest couples. “If the couple is closeted because of one partner, that person often feels guilt, anxiety and fear of abandonment,” sex therapist Margie Nichols added. “And the ‘out’ partner may feel anger and eventually distance and disconnection from the relationship.”

Obsessive Compulsive Personality Disorder: A Philosophy of Perfection

Obsessive Compulsive Personality Disorder: A Philosophy of Perfection

2013-06-07

Television has entertained us for decades with their more than extreme characterization of people who have obsessive compulsive personality disorder. First, there was Felix Unger, the anxious, perfectionistic, and above-board neurotic character played by Tony Randall who drove his messier roommate Oscar Madison (played by Jack Klugman) crazy with his OCPD behavior (The Odd Couple). Next, we had TV’s lovable, neurotic detective Tony Shalhoub as Adrian Monk and also TV psychiatrist Dr. Niles Crane (played by David Hyde Pierce) of Frazier. And, today, we have Bravo reality star  Jeff Lewis of Flipping Out; the OCPD real-estate developer who will not let his employees use the bathroom in his home office if they have to make a bowel movement.

These highly intelligent, neurotic and very lovable characters wipe seats with napkins before sitting, neurotically honk their noses without cause, and also possess dogged will when it comes to living up to their standards. They have an obsessive-compulsive personality disorder that like all disorders of personality has both its strengths and weaknesses.

But, don’t think just because I’m mentioning television’s famously fussy who seem to be primarily men does not mean that women are immune to this disorder. The rates of OCPD appear to be the same for men as they are for women. About 1 in 100 people in the United States is estimated to have OCPD with a lifetime prevalence rate of 7.8% (National Center for Biotechnology Information; and OCFoundation.org).

OCD or OCPD?

People often mistake Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) as the same conditions. But, they are very different disorders in cause, symptoms, and treatment (National Institute of Mental Health).

Obsessive Compulsive Disorder (OCD) is an anxiety disorder that is a dysfunction of brain chemistry rather than personality development. Unreasonable thoughts and fears lead to intrusive ideas (obsessions) and repetitive behaviors (compulsions), like chronic hand washing or door checking that are unrealistic, irrational, and foreign to the person’s sense of who he or she would be normally. These symptoms cause them disabling anxiety and stress. They obsessively worry about harm coming to them or loved ones, and have unreasonable fears of contamination, and unwanted religious, violent, or sexual thoughts randomly popping into their heads. These symptoms disrupt their ability to function normally at home, work, or school. And, if their symptoms are severe enough or left untreated, the risk for suicide increases  (MayoClinic.com).

In contrast, OCPD is primarily a disorder of personality development that has no single cause. But, it is generally considered to be a disorder brought about by the effects of childrearing. The parent’s childrearing style squelches their children’s spontaneous self-expression. Either personality conflicts from their own past or social and economic pressures cause the parents to be intolerant of less than perfect behavior in their children. They may withdraw approval and affection or even punish the child, when the child’s behavior doesn’t live up to their standards.

In contrast, some OCPD persons were labeled the family savior by their parents. The child takes on the oppressive burden of either having to raise the family out of some adverse social or economic situation or having to bring happiness to a narcissistic, depressed parent who is using the child to fulfill unrealized desires of his or her own. OCPD traits arise in the child’s attempt to accomplish this formidable task.

No matter the particular relationship dynamics between parent and child, OCPD children learn that there is little room for imperfection, so that they begin to obsessively calculate every thought, feeling, and action to minimize the risk of falling below the  impossible standards they set for themselves.

But, what is this risk really all about? At its heart, it is the risk of disappointing themselves by falling below a standard of behavior that is really a consolidation of their parents’ hopes, fears, and expectations. This is what drives OCPD character traits. OCPD persons are trying to avoid disapproval, withholding of affection and love, or punishment, even more so than achieving perfection. They take on superhuman characteristics to assure that they feel good about themselves. All of their traits are meant to support a rigid ego that has only one way of dealing with the world. That is perfection. Anything that gets in their way of fulfilling this goal makes them highly anxious and fearful.

Because OCPD people run a tight ship on themselves, they usually excel at their professions and often become leaders of society. But, they also put impossible standards on family, coworkers, and friends. Thus, intimate relating can be problematic for them. They don’t know there is anything unusual or wrong about their behavior until lovers, family, and friends begin to point it out to them. But, intimate relating can actually become their greatest vehicle for emotional growth. They are fiercely loyal and want to do the right thing, so that it is possible to get them to negotiate needs, although they may kick and scream along the way.

Treatment of OCPD

The treatment of OCPD can be lengthy because their difficulties have become part of their general life philosophy. Their character traits are deeply entrenched in ego-behaviors that have brought them considerable reward in life. Research shows that one of the best treatment approaches for OCPD is cognitive-behavioral therapy. This therapy treats symptoms that disable the person rather than deep psychological complexes. Cognitive therapy needs to help these patients to identify distorted thinking that reinforces their philosophy of perfection, undermines relationships, and leads to a rigidity that actually thwarts their relationships and goals. Also, stress management can help them to deal with anxiety that results from their fears of letting go of OCPD ways.

But, I also recommend psychodynamic exploration so that the person can bring into full awareness the developmental contributions to their belief system and character traits. The goal of therapy is to help these persons to cope with change and unpredictability better, manage anxiety and stress, and become more spontaneous and comfortable with feeling. The aim is to get their character traits to loosen up enough to allow for new learning and emotional growth.

Remember, there’s usually an upside to our weaknesses and emotional problems. And, this is true of OCPD. These persons have an uncompromising standard of excellence, an unshakable commitment to their beliefs that helps them to endure suffering and opposition. Their nose to the grindstone mentality, integrity, and high intellect can be used as a treatment tool for personal change. OCPD people love to understand, so that a treatment that increases their awareness and ability to be in the world in new, more functional ways will hold their interest. Therapy can become a powerful vehicle for becoming better—only, now, in a healthy way.

To learn more about OCPD, you may want to explore the links in today’s post. There’s a wealth of information on OCPD on the internet, today. Some of these websites include Psychcentral.com; MentalHealth.com; OCFoundation.org; and The Gift of OCPD.

I hope you liked today’s post and gained some new understanding into OCPD and the making of a personality disorder. If you did, please let me know by selecting the Like icon that immediately follows. You can also Tweet or Google+1 to let your friends know about it. Take good care friends. Warmly Deborah.

Teens who text and drive more likely to take other risks

Teens who text and drive more likely to take other risks

2013-05-15

High school students who acknowledge texting while driving are more likely to engage in other risky behaviors, such as riding with a driver who has been drinking alcohol; not wearing a seat belt; or drinking and driving themselves, according to a new study.

“This suggests there is a subgroup of students who may place themselves, their passengers and others on the road at elevated risk for a crash-related injury or fatality by engaging in multiple risky MV (motor vehicle) behaviors,” wrote the authors of the study, published Monday in the journal Pediatrics.

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How You Deal With Your Emotions Can Influence Your Anxiety

How You Deal With Your Emotions Can Influence Your Anxiety

2013-05-14

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When faced with a challenge, whether you deny the problems it poses or dive in to solve them in a positive way may determine how much anxiety you feel overall.

According to the National Institute of Mental Health, about 40 million Americans aged 18 and older are diagnosed with an anxiety disorder every year. To dig deeper into who may be at greatest risk, investigators from the University of Illinois at Urbana-Champaign surveyed 179 healthy men and women and asked them how they dealt with their emotions and how their answers correlated with their level of anxiety in a variety of settings.

Continue reading How You Deal With Your Emotions Can Influence Your Anxiety