Stop apologizing for your mental health

(Picture: Ella Byworth for Metro.co.uk)

I read an opinion piece this week that was right on target. Its main point: We need to stop apologizing for our mental health.

The author recognizes how far we’ve come in reducing the stigma surrounding mental illness — those living with different conditions are posting about them on social media and even talking about them at work, while many athletes and other celebrities have addressed their own issues in public — but says the stigma will remain as long as we keep apologizing for the way mental health affects our lives.

If we stay in because we’re too depressed or anxious to go out — no need to apologize. If we are visibly hyper when having a manic episode — don’t say sorry. If we take medication for mental health in front of someone — no apology necessary.

Of course we need to apologize if we treat someone badly, but if we’re just acting oddly or showing symptoms of a mental illness, there’s no need to be embarrassed or regretful. Here’s how the column’s author puts it:

“It’s almost as if we’re just about comfortable enough to say, ‘yes, I have a mental illness’, but we’re not quite brave enough to do it without worrying about what other people might think, which leads us to apologising for every symptom that may come to light in front of other people.

“But I feel continuing to do so is just taking us two steps back from having complete and utter freedom to speak out about mental health issues.

“While I understand it can be an uncomfortable subject for many, especially if they don’t have any friends or family who themselves live with mental illness, I think we need to remember that it is just that: an illness.

“Much like a broken leg, the illness affects your way of life. It affects the way you think, the way you feel, the way you act, and the way you live your life.

“But as it’s an invisible illness, we’re so quick to forget this. The people around us forget this.

“And because of that, people who live with a mental illness go on to feel guilty about it, feeling as though the only way they can confidently talk about it is to apologise at the start of the conversation.

“But look at it this way. Would a person apologise to you before taking a paracetamol for a headache? Would they apologise to you because they broke a bone and can’t make it out that night? No, they wouldn’t.

“They would tell you they weren’t well, and they wouldn’t feel guilty about it – because there’s simply nothing they can do about it.”

The columnist has a lot more to say, too. It’s worth a read. Check it out here.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Conquering anxiety with exposure therapy

Recently I was talking to a family member about his struggles with anxiety, and I gave him this advice: Do one thing every day that makes you uncomfortable. 

Even the thought of doing that is distasteful, but the concept is the basis of something called Exposure Response Prevention (EPR), a therapy that works! I use it regularly with my patients suffering from OCD and anxiety, and I’ve seen great results.

The idea is that conquering these small uncomfortable tasks will lead you to taking on bigger anxiety-producing situations that are causing problems in your life. The anxiety will lessen as you regularly face it.

For example, let’s say you have social anxiety and it’s preventing you from having the romantic relationships you crave. In therapy, I would help you make a plan to do something every day that your anxiety would normally prohibit you from doing. You could start out by nodding to a stranger as you pass them on the street. Then you could move on to making a phone call and having a conversation with someone safe. You could talk to someone in line with you at the grocery store. As you do something like this every day, you’ll be emboldened to try a conversation with someone you find attractive, ask someone to dance, or invite someone on a date.

The important thing is to avoid “ritualizing” after the uncomfortable action. For someone with social anxiety, the ritual is often along the lines of obsessively rehashing the interaction in their head. Those with other anxieties or obsessions might google phrases related to their fear or wash their hands repeatedly, for example. Instead of indulging in the ritual, you should purposefully do something else after the experience.

It may be daunting to think of taking on the goal to do something every day that makes you uncomfortable, but it really works. An experienced therapist can help guide you through the process.

For people out there dealing with OCD, anxiety, and other mental disorders, there is hope! If you’re willing to accept help and set goals, you can come to lead the life you want to lead.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Use these for better sleep

Sleep is so important for your mental health, but 45 percent of Americans say lack of quality sleep regularly affects their daily activities.

A possible culprit these days, according to a recent study, is the blue light coming from the screens we all love. Blue light keeps us alert and regulates our internal clock. We get it naturally from the sun, but the light coming from our TVs, computers, and smart phones is stimulating our brains long past sunset.

The good news is there’s a simple solution. Either cut out screen time at night or start wearing special glasses for a few hours before bedtime.

In the study, participants wore blue light-blocking glasses for three hours before bedtime while continuing to use screens as usual. At the end of two weeks, their melatonin levels were up 58 percent — a huge increase. The participants fell asleep faster and slept better and longer than they had before using the glasses.

Just search “blue light blocking glasses” online and you’ll find plenty of retailers selling the product at various price points. Your newer devices may have a blue light-blocking setting that you could use for a similar effect.

If your mental health is not where you’d like it to be, come see me. We’ll talk about sleep and other lifestyle changes you can make to start feeling better.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

 

CEO’s A+ response to an employee’s mental health day

In a recent email to her colleagues, a Michigan software developer dealing with depression and anxiety wrote:

“I’m taking today and tomorrow to focus on my mental health. Hopefully I’ll be back next week refreshed and back to 100%.”

from businessinsider.com

Her CEO’s response was perfect:

“I just wanted to personally thank you for sending emails like this. Every time you do, I use it as a reminder of the importance of using sick days for mental health — I can’t believe this is not standard practice at all organizations. You are an example to us all, and help cut through the stigma so we can bring our whole selves to work.”

The employee, Madalyn Parker, tweeted about the interaction and it’s gone viral. More than 16,000 people have retweeted her original post.

Madalyn has written elsewhere about her experience being open about her mental health at work, and it sounds like her company is setting a high standard for caring about its employees on all levels. She says the company’s generally supportive and empathetic atmosphere gave her the courage to tell her bosses and coworkers about her struggles and how they affect her at work. In response, colleagues have learned how to recognize her dark episodes and how to help.

It’s wonderful to hear a story like this. Mental health has been so stigmatized for so many years, and it’s refreshing to see it coming out of the shadows. Mental health is health. As Madalyn’s CEO put it in a blog post, “When an athlete is injured they sit on the bench and recover. Let’s get rid of the idea that somehow the brain is different.”

If you work in a supportive and positive environment, consider being honest about your mental health needs. The more we open up, the more mental illness emerges as a real illness that needs attention and treatment. Your honesty may encourage other colleagues to take the time they need to focus on their mental health and get back to a place where they can — most importantly — feel good, but also contribute more fully to the company.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Depression: Physiological differences in teenage boys and girls

By the time they hit 15, teenage girls are twice as likely as teenage boys to suffer from depression.

This could be because girls tend to think more negatively, dwelling on social and body image stressors. They’re also more likely to have experienced sexual abuse and other negative events. On a biological level, their hormones fluctuate more and they’re more vulnerable to inflammation.

A group of scientists from the U.K. and the U.S. wanted to understand what was happening in the brains of depressed teenage boys versus depressed teenage girls. They hooked up both depressed and non-depressed boys and girls to fMRI equipment and gave them a task: Press a button when you see a happy word. Don’t press it when you see a sad word. (Such an activity puts something called cognitive control to the test. Impaired cognitive control has been associated with depression.) Then they watched what happened in the subjects’ brains.

To keep it simple, they saw differences between the sexes, specifically in the brain’s supramarginal gyrus (an area thought to be involved in emotional responses) and posterior cingulate (an area associated with control, awareness, and memory). When faced with a cognitive control task, there’s a lot less activation going on for males with depression compared to healthy males–depressed and healthy female brains were relatively similar in that situation.

So what does this new knowledge do for the study of depression? It emphasizes that teenage boys and teenage girls suffering from depression have different things going on in their brains. The way we treat –and try to prevent –the disorder should, therefore, be different.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Probiotics to treat depression?

It’s not official yet, but a new study suggests taking probiotics could relieve symptoms of depression.

Remember several months ago, when I wrote about the relationship between your gut and your mental health? I recommended changing what you eat to develop a healthier gut. Well, this new study is along those same lines: Taking a probiotic to treat irritable bowel syndrome (IBS–a gut affliction) can also treat depression and anxiety.

It was just a small study with 44 participants. Each had both IBS and mild to moderate anxiety or depression. Half the participants took a probiotic (Bifidobacterium longum NCC3001, to be specific), while half took a placebo.

In the end, 14 of the 22 probiotic takers reported improvement in their depression symptoms, compared to half that number in the placebo group.

The researchers took it further and scanned the participants’ brains: Those whose depression symptoms had improved also showed changes in areas of the brain associated with mood control.

We need to see a larger version of this study before we start jumping on board, but given the established connection between the gut and the brain, I think it’s a promising area of research.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

PTSD in children treatable with a few hours of therapy

A new study brings good news for young people who have suffered a traumatic experience: Children and adolescents with Posttraumatic Stress Disorder can be successfully treated with just a few hours of therapy.

Researchers timed the therapy with a stop watch. They found that 2 hours and 20 minutes of Eye Movement Desensitization and Reprocessing (EMDR) or 3 hours and 47 minutes of Cognitive Behavioral Writing Therapy were enough to reduce posttraumatic stress reactions, anxiety, depression, and behavioral problems for children between 8 and 18 years old.

And the results were lasting: A year later the children were still doing well.

While previous research has shown similar results for adults with PTSD, this is the first time these therapies have been demonstrated to be effective for children.

PTSD is relatively easy to treat, but it’s important to start as soon after the traumatic event as possible. Though only about 16 percent or less of children who have experienced a traumatic event develop the disorder, they should all be carefully screened for it.

Here are some symptoms to watch for:

  • Emotional numbing.
  • Avoidance of memories or situations that trigger memories of the event.
  • Flashbacks of the event.
  • Intrusive memories of the event.
  • Nightmares and night terrors.
  • Fears about death.
  • Worry.
  • Sadness.

Read more about childhood and adolescent PTSD here.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Good relationship with dad can make all the difference to kids with depressed moms

In honor of Father’s Day, I wanted to highlight a study that shows the wonderful impact a good dad can have on his family.

This relates specifically to families with depressed mothers.

A study published last month detailed the depressed mom’s typical parenting style. She tends to be less sensitive to her child’s needs, and she acts intrusively by taking over when a child could be acting independently, disregarding the child in favor of her agenda. The children in these relationships show lower social engagement when interacting with their mothers.

The dads in these families tend to mimic the mom’s parenting style. The overall result is a family that doesn’t function as well as families with healthy mothers do. There’s less cohesion (emotional bonding), warmth, and expressiveness. There’s more conflict and affectionless control.

Here’s the good news: When a father is sensitive and nonintrusive and engages his children socially, the effects of the mother’s depression disappear. Families can be warm and cohesive despite the mother’s mental health.

So here’s to dads everywhere who are listening to their children, showing love, and making time for their families. You’re making a difference.

Go here to read more on the father’s impact on mental health.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Lithium for depression: An oldie but a goodie

There are drugs far more fashionable than Lithium these days: Pharmaceutical companies pay their representatives big money to promote their latest offerings, both with mental health care providers and in advertising.

The thing is, I’m not convinced any new and fancy drug can beat tried and true Lithium in effectiveness.

John Cade, the psychiatrist who discovered Lithium’s effectiveness in treating mental health disorders.

Doctors started prescribing Lithium in the 1800s to treat gout, epilepsy, and cancer. In 1948, an Australian psychiatrist named John Cade stumbled upon its usefulness in treating mania. After testing it out on guinea pigs, who became quiet and relaxed with its injection, he took his experiment to the next level by taking Lithium himself for several weeks.

Once he determined it was safe, Cade administered the drug in liquid form to a psychotic man who had been living in a mental asylum for three decades. In three weeks, the patient began to show signs of improvement: He looked after himself, his speech slowed, and erratic behaviors decreased. At the end of two months, the man was released from the asylum and resumed normal life.

It was a game changer for psychiatry. It was one of the first success stories in using drugs to treat mental illness.

Almost 70 years later, those success stories continue — and not just with bipolar depression, its most famous application. It’s been shown to work extremely well with unipolar depression, too.

A recent Finnish study found taking Lithium significantly decreased hospital readmission for those who had previously been hospitalized for unipolar depression. Antidepressants and antipsychotic drugs lacked the same effect. Lithium alone was more effective than lithium in combination with another drug.

The study’s authors are recommending more research into Lithium as well as its wider use as treatment for depression.

Lithium does have a narrow window of effectiveness, so the dose must be carefully watched. Go here to read more about Lithium and its possible side effects.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Instagram the worst social media platform for mental health

I’ve written before about how social media can be bad for your mental health, but let’s get site specific: Instagram is the worst of the bunch.

A new study surveyed 1,479 teens and young adults in the U.K., asking them about how social media affects them both positively and negatively. They asked about five sites in particular: Facebook, Instagram, Snapchat, YouTube, and Twitter. Participants ranked how each site improved or worsened each of the following health factors:

  • understanding of other people’s health experiences
  • access to health information
  • emotional support
  • anxiety
  • depression
  • loneliness
  • sleep
  • self-expression
  • self-identity
  • body image
  • real world relationships
  • community building
  • bullying
  • fear of missing out (FoMO)

Adding the effects of all the factors together, YouTube was the only social media app to edge into the net positive range. Twitter was slightly negative, and Facebook, Snapchat, and Instagram got progressively worse.

Instagram was found to help with self-expression, self-identity, community building, and a few others, but it had big negative impacts on sleep, body image, FoMO, and several other factors.

In response to their study, the Royal Society for Public Health and the Young Health Movement are calling for the following changes:

  • Introduction of a pop-up heavy usage warning on social media
  • Social media platforms to identify users who could be suffering from mental health problems by their posts, and discretely signpost to support
  • Social media platforms to highlight when photos of people have been digitally manipulated

There are already apps out there you can download that will allow you to set time alerts and scheduled breaks to help you control your social media usage– search your app store for “social media time limit” or something similar. Taking time out to do things that will actually improve your mental health rather than damage it could have a big impact!

To improve your experience within social media, consider unfollowing users who make you feel bad, especially those who post photoshopped images. There are also plenty of positive accounts out there. My favorite is Beauty Redefined,  which posts frequent reminders about what matters more than how your body looks.

Take a look at the study’s report (download here). It’s packed with interesting information and cool graphics.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.