General

Where is Dignity for Rural, Low Income Countries Like Nepal?

This year's World Mental Health Day theme, "Dignity in Mental Health," reminds me of a particular patient that I had seen in my second year of residency in Nepal. For the sake of this story, let's call her Nina (not her real name).

Nina was a middle-aged woman from a hilly village of Nepal. According to her relatives, she had been showing some psychotic behaviors for the last three years. Because of these strange behaviors, most of the time she was restrained with a rope and shut in a shabby hut. This had been going on for more than two years. Her ropes were only undone for eating and toileting purposes.

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Addiction

Bipolar Disorder and Drug Abuse

It’s very common to find people with bipolar using drugs of one kind or another. If you were to experience the constant interference, disruption and pain that bipolar brings about, you would understand why one would resort to using drugs. Bipolar disorder makes it hard to get up in the morning, hard to hold a conversation and almost impossible for many to hold down a job. With problems like these it’s no wonder that medication is abandoned in favor of street drugs.

You see, medication doesn’t always quite hit the spot. Medical teams and patients spend years trying to find the right balance of medication. In the meantime, the patient suffers emotionally and psychologically. Often there is little support during this period as the patient is half better and looks okay -- so they must be okay, right? Wrong. That’s not the case at all. We can look fine and feel horrendous.
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Caregivers

Is Your Therapist Helping You Enough?

Is your weekly appointment just a time to vent? What do you do when your therapy seems to be going nowhere?

Chances are you came to therapy because you wanted something you felt you couldn’t achieve on your own. You were unhappy or discouraged; maybe you felt hopeless about your career or relationship. You sought change. So you searched for a therapist, paid your hard-earned money, and started examining your life.
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Depression

Can You Treat Depression with an App?

With the proliferation of health tracking apps, it's no surprise to see dozens being offered to help treat people with depressive symptoms. (No app has been FDA-approved or scientifically proven to actually treat depression.)

The New York Times asks four experts and researchers in this area whether you can treat depression with an app in their latest Room for Debate. It's an interesting discussion worth the read.

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Addiction

6 Surprising Myths of Inpatient Residential Rehab

We've all seen the commercials: gentle, soothing music playing over a reassuring voice that tells you that this specific rehab center is going to change your life. Because, after all, it's changed his.

Inpatient rehab centers offer treatment for people with substance abuse or alcohol disorders. Most are intensive, requiring patients to live in their facility 24 hours a day for 30 days. And it is a gold mine for those who run such addiction recovery centers.

The Carlat Report: Addiction Treatment's July/August 2015 issue is devoted to the topic of understanding treatment for alcoholism and substance abuse. It also offers an eye-opening interview with the former director of the National Institute on Alcohol Abuse and Alcoholism. Here we run down some of the myths we gleaned from the issue about residential rehab.

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Caregivers

10 Signs You Need a New Therapist

If you are in counseling now or consider seeking a therapist in the future, it is important to choose a counselor who is the right fit for you. I am always saddened to hear of an individual or couple giving up on counseling after one bad experience. Therapists are each unique in their specific approaches and you deserve one who is qualified to meet your needs.

Here are a few signs that you may need a new therapist.
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General

Focusing: A Path Toward Befriending Feelings

During the 1960’s, the psychologist and philosopher Eugene Gendlin asked a simple question: why do some people make progress in psychotherapy, while others don't -- and what is happening within those individuals who are benefiting from therapy?

After analyzing hundreds of taped therapy sessions, Gendlin and his team discovered that they could accurately predict after one or two sessions whether or not therapy would be successful. Surprisingly, positive outcomes were not linked to the orientation of the therapist, but rather to what these clients were doing within themselves.

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Bipolar

Destigmatizing Dependence in Therapy

When I wrote my first article years ago about the power of psychotherapy, I was stunned by the reaction. Seventy-five percent was positive, but a very vocal minority attacked me viciously for either not having cured the patient or promoting a pathological dependence. They reasoned that had the patient received proper therapy she would not have needed anyone to solve her problems.

I was treating a woman for bipolar disorder with mood-stabilizing medication and monthly to bi-monthly psychotherapy. Her cognitive-behavioral psychotherapist referred her because she couldn’t get out of bed. She didn’t want to need medication.
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Alternative and Nutritional Supplements

8 Things to Consider When Your Depression Is Not Getting Better

I keep getting the same email over and over again, and my heart aches each time I read it: “I have tried everything to overcome my depression, but nothing has helped. Is there anything else I can do or will I have to live the rest of my life plagued with sadness?”

First, hear these three words: There is hope. If there wasn’t any, I would not be alive writing my blog. I am one of the worst cases out there like you are. I have spent more years of my life fantasizing about death than wanting to be alive. I get it. But now I do enjoy some really good days -- where I feel better than I ever have. And those good days keep me motivated to get through the harder ones.
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