Treatment Articles

How a Mental Disorder is Diagnosed, Treated

Saturday, March 2nd, 2013

How a Mental Disorder is Diagnosed, TreatedSometimes you just need to know the basics. For instance, if you think something is wrong with your mind, your emotional life, and you want to get help for it, where do you even begin?

With today’s knowledge, the steps toward getting a valid mental disorder diagnosis and treatment are fairly simple. Unless otherwise required by your health insurance plan, you should generally start with a mental health professional — either a psychologist or psychiatrist. These are the specialists of mental health, and usually have the greatest knowledge and depth of experience to be able to diagnose you and setup a treatment plan with you that will be most effective.

If you haven’t seen your primary care physician or family doctor in some time, it never hurts to also see them at the same time — to rule out any possible physical causes of your symptoms. This is especially true if you have a health condition or family history of certain health problems (because sometimes physical maladies can mimic mental disorder symptoms).

New Anxiety, Bipolar and Depression Drugs in the Pipeline?

Thursday, February 28th, 2013

New Anxiety, Bipolar and Depression Drugs in the Pipeline? What happens when the drug pipeline for common mental health concerns — such as depression, anxiety and bipolar disorder — starts to dry up?

“Most psychiatric drugs in use today originated in serendipitous discoveries made many decades ago,” according to a recent article on Science News by Laura Sanders. And it’s true — we can trace back today’s most popular psychiatric drugs to discoveries made over 30 — and in some cases, 40! — years ago.

Because of the heady cost of drug development — costing hundreds of millions of dollars to bring a new drug to market — most pharmaceutical companies have been playing it safe these past few decades. They’ve been working on developing “me too” drugs — subtle molecular changes to existing compounds.

Which means the pipeline is darned near empty of truly new drugs likely to come out in the next 5 to 10 years for the most common types of mental illness.

The Psychology of Flossing

Monday, February 25th, 2013

The Psychology of FlossingWhy is it so tough to remember to floss?

I rarely run into patients who can’t remember to brush their teeth twice a day, but even the most conscientious among us come to their hygiene appointment anxious and awaiting the hygienist’s lecture about flossing.

Flossing can be icky and awkward — no one likes feeling like they’re shoving their entire fist into their mouth. But the reason why we don’t make flossing a habit is a bit more complicated and has its roots in psychology.

During the early 1900s, right around World War I, dental hygiene was so bad, it was said to be a national security risk. Why? People weren’t brushing their teeth, of course, and the 1900s marks the period when Americans first began to consume sugary, ready-to-eat processed foods, such as crackers, breads, and potato chips.

How to Pick an ADHD Therapist Who’s Right for You

Saturday, February 23rd, 2013

How to Pick an ADHD Therapist Who's Right for YouMedication is highly effective for treating ADHD. But it can’t teach you skills for living successfully with the disorder. And it can’t help you overcome common co-occurring concerns such as low self-esteem. That’s where psychotherapy comes in.

Psychotherapy targets specific ADHD symptoms that interfere with daily life, such as disorganization, distractibility and impulsivity. It helps you better understand your ADHD and improve all areas of your life, including home, work and relationships.

But not all therapists are created equal. That’s why it’s important to do your research, and be selective. Below, two ADHD experts share their tips on finding a good clinician.

The Curious Industry of Marketing Treatment, Rehab Centers

Saturday, February 16th, 2013

The Curious Industry of Marketing Treatment, Rehab CentersEveryday, when we open our electronic mailbox, we get our fair share of unsolicited email. Of course, the unsolicited offers have gotten a lot more subtle and duplicitous. A few years ago, dozens of marketeers tried to get us to post badly sourced and designed infographics.

Now they’ve moved on to something that, in my opinion, looks a lot like deception.

In today’s email box, we found an email from “Jeffrey Redd, Project Outreach Director” with an email address of jeff@va.gov.samhsa.net sharing with us “a guide about finding treatment, free of cost.” Wow, really? A new fantastic resource from the folks over at SAMHSA?

But wait, hold on a minute. That email address doesn’t look quite right…

Withdrawal from Psychiatric Meds Can Be Painful, Lengthy

Wednesday, February 13th, 2013

Withdrawal from Psychiatric Meds Can Be Painful, LengthyAlthough this will not come as news to anyone who’s been on any one of the most common psychiatric medications prescribed — such as Celexa, Lexapro, Cymbalta, Prozac, Xanax, Paxil, Effexor, etc. — getting off of a psychiatric medication can be hard. Really hard.

Much harder than most physicians and many psychiatrists are willing to admit.

That’s because most physicians — including psychiatrists — have not had first-hand experience in withdrawing from a psychiatric drug. All they know is what the research says, and what they hear from their other patients.

While the research literature is full of studies looking at the withdrawal effects of tobacco, caffeine, stimulants, and illicit drugs, there are comparatively fewer studies that examine the withdrawal effects of psychiatric drugs. Here’s what we know…

The Problems with the U.S. Addiction Treatment System

Monday, February 11th, 2013

The Problems with the U.S. Addiction Treatment SystemDid you know that most addiction treatment specialists have little formal education or training in addiction? Fourteen states require only a high school diploma or a GED to become an addiction counselor; 10 require only an associate’s degree.

But it gets worse — fully 20 states in the U.S. don’t require any degree, or don’t even require addictions counselors to be certified or licensed in any way.

Is it any wonder then that many addiction or rehab programs still rely on an outdated model that’s directly dependent upon how long companies are typically reimbursed for treatment — 30 days? Or that many programs still use treatment methods largely unchanged from the 1950s — not research-backed, modern approaches to treatment?

A groundbreaking report published last year from Columbia University lays out the sad facts of addiction treatment in the U.S. As the report notes, “Some [treatment programs] promise “one time” fixes; others offer posh residential treatment at astronomical prices with little evidence justifying the cost. Even for those who do have insurance coverage or can pay out-of-pocket, there are no outcome data reflecting the quality of treatment providers so that patients can make informed decisions.”

Transcranial Direct Current Stimulation: A New Electrical Treatment for Depression?

Wednesday, February 6th, 2013

Transcranial Direct Current Stimulation: A New Electrical Treatment for Depression?When electricity and the brain are mentioned in the same sentence, your mind might immediately jump to disturbing images of people receiving huge shocks while covered in electrodes, strapped to tables.

But electroconvulsive therapy (ECT) treatment has developed considerably since the days depicted in “One Flew Over the Cuckoo’s Nest.”  A current study at JAMA Psychiatry examines a treatment called transcranial Direct Current Stimulation (tDCS).

Could this fairly new form of electrical treatment for depression really be effective — and without the negative side effects of ECT?

Are We Over-Diagnosed and Over-Medicated?

Tuesday, February 5th, 2013

Over-Diagnosed and Over-MedicatedWhat used to be thought of as normal grieving, a sensitive personality or an emotional reaction to an unanticipated situation seems to become more and more routinely viewed as a “mental disorder.”

Once diagnosed, treatment often consists of nothing more than pill prescribing.

Sometimes responses to ordinary life events can be incorrectly diagnosed as mental disorders. Let’s look at a few examples…

“My husband passed away almost a year ago and I still miss him so much. There are times I feel like there’s not much purpose to my life anymore. We were married for 42 years. It’s tough to fall asleep without him at my side. And it’s tough for me to feel like cooking when I have to eat alone.”

This is a normal bereavement reaction. The proposed new Diagnostic and Statistical Manual code, however, states that these may be signs of a major depressive episode. Why? It’s as though our standard for bereavement is now quick, like everything else in our lives. Nothing to it! A piece of cake! Okay, mourn. But return to your old life in a week, a month, three months. You need more time than that? Well, perhaps you should take anti-depressants. Good for the drug companies. Not good for the bereaved individual.

Strategies for Common Problems That Strike Women With ADHD

Monday, February 4th, 2013

Strategies for Common Problems That Strike Women With ADHDAttention deficit hyperactivity disorder (ADHD) can take a heavy toll on women’s lives. Everything from the seemingly minute (such as arriving on time) to the very significant (raising kids) becomes more challenging. Add to that a co-occurring disorder, such as depression or anxiety, and just getting through the day is utterly exhausting.

But while ADHD comes with a variety of obstacles, there are just as many solutions to help you manage symptoms and lead a satisfying life.

Terry Matlen, ACSW, is a psychotherapist and author of the book Survival Tips for Women with ADHD.

Matlen also has ADHD. Below, she discusses the most common problems, along with strategies to try.

Judge Rotenberg Center: One Patient’s Story

Tuesday, January 29th, 2013

Judge Rotenberg Center: One Patients StoryThe Judge Rotenberg Center (JRC) is a controversial treatment facility right here in my home state of Massachusetts that uses a form of electroshock therapy in order to “treat” developmentally disabled teens and adults in its care. It’s one-of-a-kind in the nation for its aggressive use of shock therapy — ala B.F. skinner and rats from the 1960s.

Last month, the Center received a warning letter about the continued unauthorized use of “adulterated” shock devices, called GEDs (for Graduated Electronic Decelerators). The Center is the only treatment facility in the country that uses these self-manufactured devices.

They were approved for their intended use by the FDA in 1995. However, since at least 2008, the Center has been using revised versions of these devices — GED3A and GED4 — that deliver higher electrical charges. The FDA has told the Center — repeatedly — that these new versions need to undergo additional testing to demonstrate their safety (especially a concern, given the higher voltage levels the devices reportedly deliver).

And yet, for over four years, the Center has simply ignored the FDA and continues to use the devices — against the FDA’s rules and directives.

Meanwhile, patients in the Center’s care continue — every day — to be shocked against their will. Here is one patient’s story.

Women and ADHD: What To Do When You Feel Overwhelmed

Tuesday, January 29th, 2013

Women and ADHD: What To Do When You Feel OverwhelmedEven today, between work and home, women have a lot to juggle. “Though in recent years, men have been more hands-on with household and childcare responsibilities, the bulk of the work still, for many, lands on the woman’s shoulders,” said Terry Matlen, ACSW, a psychotherapist and author of Survival Tips for Women with ADHD.

Whether you have kids or not, balancing a slew of commitments can get overwhelming for women with ADHD, said Stephanie Sarkis, Ph.D, a psychotherapist and author of several books on ADHD, including 10 Simple Solutions to Adult ADD. That’s because the nature of ADHD makes it tougher to prioritize and schedule, she said.

And, unfortunately, it’s common for women with ADHD to beat themselves up for not getting things done. Many women feel incapable and struggle with low self-esteem, Matlen said. “Women with ADHD are well aware of their shortcomings, but often they don’t understand [them] in the context of their ADHD brain.”

Here, Matlen and Sarkis, who both have ADHD, offer their tips for coping with overwhelm when you have the disorder.

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