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Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is an anxiety disorder that can develop after a person has experienced or witnessed a major trauma.

Borderline Personality Disorder or Traumatic Stress Disorder

Borderline Personality Disorder – What if it is a traumatic stress disorder?

When most people think of Borderline Personality Disorder – they think of bad behavior.  It is someone that is very difficult to deal with, someone that you have to be on guard against, Borderline Disordersomeone who will try their best to manipulate you.
But, while that may be the outcome, just like most psychiatric disorders, it isn’t exactly their fault.

One of the problems with BPD is that since it is a “personality disorder“, there is often no recognized medical treatment.

We simply expect that the patient should self-monitor and control their behavior.  Therapy may help this, but how many of us (psychiatric patients, in general) really want to go to therapy.

Many of us have already spent hundreds of hours with a therapist – who may or may not help.  In addition, the best therapists are likely people who can “see through the bullshit” and refuse to be manipulated.  This obviously goes against the nature of someone with Borderline Personality Disorder.

In fact, the stigma is so bad that some therapists won’t even work with Borderline patients.

Co Morbid DisordersOne theory may help.  Some therapists have developed an automatic assumption that a Borderline patient is also a trauma victim.  While this co-morbid condition may not always be true, it can help some therapists feel more comfortable treating the patient.

Due to many soldiers returning from impossible battlefields in the Middle East, Post Traumatic Stress Disorder is fairly well recognized.  Remember; I am not saying that it is easily treatable, but to some extent, the stigma is less.

When therapists look at Borderline patients as truly a PTSD patient, they may be more willing to treat the disorder. And they will attempt to get to the underlying causes of abandonment, impulsive and destructive issues, loss of control and poor self-image.

While PTSD is well defined by the professional psychiatric community, a longer-term disorder currently known as complex traumatic disorder is not.  Most examples of CTSD still involve soldiers, or they may involve women who had difficult pregnancies or who were violently sexually abused, repeatedly.

However, what if you don’t fit any of those recognized categories?

There are more ways to treat traumatic stress disorders such as Cognitive Behavioral Therapy or a newer one, Dialectical Behavior TherapyDBT focuses on four major areas:

•    Regulation of emotionsPost-Traumatic Stress Disorder
•    Tolerance for distress
•    Interpersonal effectiveness
•    Mindfulness

Unlike CBT, there is no “processing” component – making it work well as an initial treatment, starting before the patient has developed coping skills.  It builds up the feeling of emotional safety so that coping skills may develop.

Differentiating between “plain” Borderline patients – and those whose behavior is brought on by traumatic experience may help to eliminate some of the stigma still associated with BPD.  It may also offer actual, more effective treatment than CBT or other approaches.

Melissa Lind

Getting Out of Depression

Some tips to get you out of depression

Major depression is the third most common mental disorder in the US.  Nearly 7 percent of the US population is affected in any one year.  Incidentally, if you are keeping track, the two most common mental disorders are Anxiety disorders and Phobia disorders, including Obsessive-Compulsive Disorder and Post-Traumatic Stress Disorder.

Major Depression, also called Major Depressive Disorder (MDD) has an average onset of 32 years of age and is more common in women than in men.  It is also called “unipolar depression” by those who are familiar with Bipolar disorder.  It may include a subset of depressive disorders such as Seasonal Affective Disorder (SAD), which affects people yearly – usually in the winter and Dysthymic Disorder, which is a less severe form of depression.

In order to be diagnosed with Major Depression, a person must meet the DSM criteria including at least five of the following for at least two weeks:
•    Depressed mood most of the day
•    Diminished interest in all or most activities
•    Significant, unintentional weight loss or gain
•    Insomnia or sleeping too much
•    Agitation or psychomotor retardation (slow movement) noticeable by others
•    Fatigue
•    Feelings of worthlessness or guilt
•    Diminished ability to think or indecisiveness
•    Suicidal thoughts

In some cases, depression can be relieved by changes in lifestyle or with psychotherapy, but in severe cases – medication may be warranted.  We are fortunate today in that there are a number of effective medications that have fewer side effects than previous treatments, and the category continues to evolve.

Even with medication – that may not begin working for at least several weeks – some lifestyle changes, and habits may help a person “emerge” from their depression and manage symptoms in the future.

Major DepressionLifestyle changes are difficult, particularly when depressed, but the effort it takes to “soldier through” is worth it in the end.  These tips for helping with depression are not easy – especially when you do not have any energy and don’t feel like getting up, but even though they may not provide a cure – they almost always provide some help.

  1. Get up and move – this is the hardest for most people to do.  It may take a tremendous amount of efforts but even simply getting off the couch or out of bed and walking around the house will help.  Getting up and moving around will increase your blood flow and heart rate will help increase blood flow to your brain and may convince your body that “hibernation” is over.
  2. Get dressed – you may have been wearing the same clothes for many days.  Changing into a “daytime” outfit can help regulate your time clock and may help you feel like you can accomplish something.  If you wear makeup or fix your hair, do so – and by all means, take a shower.
  3. Get out in the sun – don’t stay long enough to get a sunburn but studies have shown that bright light helps your brain wake up.  It resets your internal clock by adjusting your melatonin levels (a hormone responsible for inducing sleep).  It also triggers a “springtime” effect – that again tells your brain and body that winter is over, and it is time to come out of hibernation.
  4. Talk to a friend – making a phone call may not be tops on your mind, but even a wordless chat can help you feel like someone else is aware of your existence.
  5. Watch something enjoyable – even if you don’t want to enjoy anything, do something that would normally make you happy.  Just a little bit of happiness peeking through can go a long way.
  6. Go to bed and get out of bed at normal hours – sleep patterns are often destroyed by depression.  Reestablishing those normal patterns will help reset your internal clock to a natural level.
  7. Don’t take naps – again with both the normal sleeping hours and with the “getting up.”  Reinforcing physiologic habits will help establish normal brain functioning.
  8. Eat healthily – you may want to eat everything, nothing, or only certain foods.  Likely, no matter how much or how little you are eating, you are deficient in some of the necessary vitamins and nutrients – so eating a healthy diet and taking a multivitamin mineral supplement is a good idea.  B vitamins are especially helpful to restore nerve cell functioning, C and E are useful for combating inflammation that can cause sluggishness, D vitamins are useful to aid in the “sunlight” phenomenon discussed before, Calcium and Magnesium are good for the brain cells which are malfunctioning.

Most people who are depressed will find a lot of these activities difficult – and you may only be able to do one or two a day.  None of this is meant to be insulting, but there is science behind all of it – and others have been through it before.
With the help from the medication and the lifestyle adjustments – you will feel like you are coming out of the fog – and be able to do all of them – or sometimes, choose not to.  Choosing not to do something is different than feeling like you are unable to do something – and you want to have control of your life.

– Melissa Lind