Category Archives: Boise Mental Health

Boise Mental Health

Why Am I Having Nightmares?

Image from Dreams.co.uk.

What causes nightmares, anyway?

Nightmares tend to crop up when we’re stressed, anxious, depressed, on certain medications, or when our sleep is being consistently interrupted (hello, parents of a newborn!). Occasional nightmares are normal, but consistent nightmares can be indicative of a larger problem.

The most common mental health disorder associated with nightmares is Post Traumatic Stress Disorder (PTSD), whether it be from traumatic life events or military service. (In fact, frequent nightmares have become a criteria used to diagnose PTSD.)

What’s happening in your brain?

To understand nightmares, we need to look into human sleep patterns, especially REM sleep. A Harvard neurobiology article describes  REM sleep in layman’s terms: when you’re deeply asleep you have rapid eye movement (REM), irregular heartbeat, and your breathing rate increases.

REM sleep signals begin with the pons, which is an area at the base of the brain. The pons shuts off neurons in the spinal cord to suspend movement, all the while sending signals to the thalamus, which then boomerangs them to the cerebral cortex because that’s where the brain learns and organizes information.

REM sleep isn’t continuous–it’s a cycle that repeats through the night, only making up 20 percent of your total slumber–but it is in REM sleep that nearly all vivid dreaming takes place.

When do nightmares become a problem?

The occasional nightmare is normal, but here are some symptoms that may be indicative of a nightmare disorder:

  • Frequency (having nightmares several times a week)
  • Anxiety or persistent fear to go to sleep
  • Problems with concentration or memory
  • Daytime fatigue or sleepiness
  • Problems functioning in social situations
  • Persistent fear of the dark

What can I do about recurring nightmares?

Name your fear. Identifying and managing the biggest stresses in your life can go a long way toward your peace of mind. Ask yourself: what are your biggest worries? What can you do about them right now? Are you willing to make those changes to address the problem?

Evaluate your lifestyle. What you take into your body can affect your quality of sleep. The National Sleep Foundation discourages drinking, smoking, or eating large meals late in the day. They also caution against ingesting large sources of caffeine as it acts as a stimulant for your brain. The highest sources of caffeine are in energy drinks, coffee, chocolate, diet drugs, soft drinks, non-herbal teas and some pain relievers, such as Excedrine.

Rewrite the ending. The Harvard neurobiology article describes a treatment called image rehearsal therapy (IRT). It’s a cognitive therapy where individuals with recurring nightmares write it out, then give it a positive ending. They rehearse this rewritten version before going to sleep.

See an APRN, doctor or specialist. If you believe you are having medication-induced nightmares, you may need the dosage adjusted. If you have persistent nightmares or sleep terrors, you may need to have a sleep study done to identify a problem.

If you think your nightmares are linked to anxiety, depression or past trauma, counseling can be helpful in identifying and managing those fears. Please let me know if I can help you.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Forgiveness and Mental Healing

Image from MyJewishLearning.com

“We are not responsible for what breaks us, but we can be responsible for what puts us back together again. Naming the hurt is how we begin to repair our broken parts.”
― Desmond Tutu, The Book of Forgiving: The Fourfold Path for Healing Ourselves and Our World

What wounds do you carry?

You may have emotional wounds from your past, kept open by guilt and shame. Some wounds are a result of someone else’s violence, cruelty or betrayal toward you. Some wounds you may carry for the people you love, and their suffering.

Why should I forgive?

Whatever the wound, forgiveness can be a powerful healer, both mentally and physically. It can relieve stress, alleviate mental distress, even lower risk of heart disease. Anger can be a powerfully destructive and toxic emotion when sustained over time, physically as well as emotionally.

An article from the American Psychological Association links forgiveness to “reduced anxiety, depression and major psychiatric disorders, as well as with fewer physical health symptoms and lower mortality rates.”

What are the steps to forgiveness?

There is extensive research of forgiveness as a mental health practice, and commentary from religious and spiritual communities on how and why to forgive.

Here are my suggested steps toward forgiving:

1. Tell your story. Remember the initial quote by Desmond Tutu? “Naming the hurt is how we begin to repair our broken parts.” This advice may seem counter intuitive to the work of forgiveness, as it dredges up old pain. Here’s Tutu’s defense of telling your story:

When we ignore the pain, it grows bigger and bigger, and like an abscess that is never drained, eventually it will rupture. When that happens, it can reach into every area of our lives—our health, our families, our jobs, our friendships, our faith, and our very ability to feel joy may be diminished by the fallout from resentments, anger, and hurts that are never named.

Don’t ignore this pain. Even if you only tell yourself, speak the truth of what happened to you. Write it down. Let the pain out.

2. Put yourself in the other person’s chair.  When offense is on both sides, look at the argument or event through the other person’s eyes. This perspective can give you sympathy and compassion for the other person, which leads to forgiveness.

3. Commit. Stick to forgiveness. You will undoubtedly remember the offense again, but you can make the choice to remember that you forgave and release the anger and hurt yet again.

What about forgiving people for abuse?

I need to make this clear: if you are in an abusive relationship–emotional, physical or sexual abuse–you need to establish clear boundaries for yourself first before doing the work of forgiveness.

Forgiveness does not mean reconciliation.

Forgiveness does not mean returning to an abusive situation.

Forgiveness does not mean the abuse committed against you (or your loved ones) was warranted.

In the words of Dr. Sharie Stines, a psychologist who specializes in trauma recovery, “forgiveness means surrendering your right to hold your abuser accountable forever.”

If you are holding onto old wounds, release them. Release the pain for your own mental healing’s sake.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Memory and Sexual Abuse

Image from Medical XPress.

 

Last week Christine Blasey Ford and Brett Kavanaugh testified before the Senate judiciary committee about allegations of sexual abuse. This sparked discussions about sexual abuse in news and social media across the United States. (Several victims even called into C-SPAN to share their stories after watching Dr. Ford’s testimony.)

The Senate Judiciary Committee questioned Dr. Ford about holes in her memory of the alleged assault. Why didn’t she remember what day it happened, exactly who was there, or even how she got home afterwards?

The way Dr. Ford presented her memories is consistent with my experience working with men and women who have been sexually abused. Some details of the abuse–the smell of the carpet, a dog that won’t stop barking, a song playing in the background–are clear, while other seemingly important details are more fuzzy.

Dr. Tracey Shors, a neuroscientist and professor at Rutgers University, wrote:

“It is interesting to me that Ford says she remembers the context and the layout of the bedroom, the bathroom where she hid and the stairwell to the room. We just published a study showing that women with sexual violence history experience vivid memories of the spatial and temporal context of their most stressful life event.

And what the other people who were supposedly there? Kavanaugh denied attending the party, as has one of Dr. Ford’s friends. Doesn’t that mean Dr. Ford made it up?

Not necessarily. Consider this bit of information from Dr. Shors:

[T]he people at the party who were not assaulted or stressed by the event are not as likely to remember it. For her, it was a memorable event; for them, it may have just been another time hanging out with few friends hanging at a house. This applies to the people downstairs but perhaps even for the two boys, especially if they were intoxicated.

But why can’t Dr. Ford remember the date of the event? This may seem like a huge clue to the veracity of her claims, but memories surrounding sexual abuse are not very tidy.

Richard McNally, a psychologist at Harvard University and the author of the book Remembering Trauma, gives an example of being a clerk at a convenience store and robbed at gunpoint.

Which parts of that memory get encoded into the brain?

Not all the details, even important ones. Here’s what McNally wrote in an article for NPR:

The person may often encode the features of the weapon, the gun pointed at him, but not recall whether or not the person was wearing glasses…When somebody has an experience such as this, they’re not necessarily saying, ‘I better get down the address.’ They’re preoccupied with trying to escape this terrifying experience.

Why Don’t People Report Sexual Abuse Right Away?

Image from TinyBuddha.com.

There’s a debate swirling in American politics right now about Supreme Court nominee Brett Kavanaugh and Dr. Christine Blasey Ford, a woman who alleged that Kavanaugh attempted to rape her at a party when they were both teenagers.

The arguments have been fierce on both sides: is Ford lying? Is Kavanaugh lying? If it’s true, does it matter? Why didn’t she speak up sooner? Doesn’t that mean she’s lying?

I’m not sure if Ford’s claims are true; time will tell. But I do know how common it is for victims of sexual abuse not to report. It may take years for the truth to emerge.

Just a month ago, a grand jury in Pennsylvania compiled a report of six Catholic dioceses where 1,000 adults had come forward to testify against 300 priests who had sexually abused them. Some of these victims had waited decades to speak of their abuse to anyone.

The statistics on sexual abuse are grim.

  • One in four girls and one in six boys will be sexually assaulted before age 18.
  • One in five women and one in 71 men will be raped in their lifetime.
  • In eight out of 10 cases of rape, the victim knew the perpetrator.
  • Fewer than 10 percent of those victims will tell anyone what happened to them (see the full statistics on the National Sexual Violence Resource Center site).

Why don’t victims speak up sooner?

There are many reasons a victim may stay silent. Here are some I have seen in my career:

  • The victim was abused as a child, sometimes repeatedly, by a family member.
  • The abuser is the victim’s spouse.
  • Victims are ashamed of the circumstances surrounding the abuse, such as underage drinking or drug use and they didn’t want to get in trouble.
  • The abusers tell the victim the abuse was their fault, and the victim believed them.
  • The abusers threaten to kill the victim or their family if they said anything.
  • The abuser was in a position of power over the victim, such as a clergy member, a boss, a coach, etc.

How can I report sexual abuse?

Tell someone you trust if you’ve been sexually abused. (If you’re not sure what sexual abuse entails, you can read more about types of sexual violence here.)

It can be frightening and overwhelming to report sexual abuse. The process may dredge up painful memories. You may think that no one will believe you. But telling your story is an important first step to healing.

If you or someone you know has been sexually abused and you want to get help, please contact me. If you are not comfortable sharing your story yet, you can call the Rape, Abuse and Incest National Network (RAINN) at (800) 656-4673 or live chat with them at https://www.rainn.org/.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

New to Boise State Athletics: A Mental Health Director

Stephanie Donaldson, R. Photo from the Idaho Statesman

When athletes battle mental health struggles alone, the consequences can be disastrous.

Tyler Hilinski, a Washingston State quarterback took his own life in January 2018, only four months after an incredible triple-overtime victory over Boise State.

Hilinski’s death started a crucial conversation at Boise State: what more could they do for college athletes who struggled with mental illness?

Boise State hired Stephanie Donaldson, a local professional counselor to be the first full-time mental health expert for the athletics department.

“No one denies here in athletics there’s a need, we’re trying to foster a culture where it’s OK to talk, [and] reduce that stigma,” Donaldson said to the Idaho Statesman.

Donaldson seems to be an excellent fit for the position, not only because of her counseling experience but because she knows the pressures of college athletics from her days as a Division I swimmer for Pepperdine University.

We wrote about this recently, how more men in media and sports are speaking up about their mental health. Hopefully as Boise State develops this resource, other college programs will do the same.

“One thing about this position is that once athletes are open to discuss it, it’s in their nature to be motivated to want to change and to improve,” Donaldson said. “… As more and more athletes are speaking up, I think it trickles down and affects every level.”

I think this is wonderful work on Boise State’s part. Go team!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Dads’ Mental Health Affects Their Children

Image from LiahonaAcademy.com

We’ve written about this before: treating depression can be a family affair. Recent studies are focusing on why a father’s mental health is just as important on their children.

This 2017 study out of the United Kingdom drew a strong correlation between depression in fathers and their teenagers, while acknowledging that that past research hadn’t taken a fathers’ mental health into consideration.

“Our results…suggest that the mental health of both fathers and mothers is important for the mental health of their children,” the study reads. “Interventions to improve adolescent mental health should therefore target both parents, irrespective of their sex.”

Dr. Gemma Lewis, the study’s lead author, encourages men with depression to seek treatment for the sake of their children.

“If you’re a father who hasn’t sought treatment for your depression, it could have an impact on your child,” Lewis said in a news article.  “We hope that our findings could encourage men who experience depressive symptoms to speak to their doctor about it.”

But how can dads know if they have depression? Here are a list of common symptoms of depression:

  • Persistent “low” mood for more than two weeks
  • Lack of interest or pleasure in activities you usually enjoy
  • Food doesn’t taste as good
  • Unable to fall asleep, waking up multiple times a night and being unable to fall back asleep, or sleeping more than usual
  • Feeling exhausted or lacking the energy to get up and move around
  • Lack of concentration: you may not be able to read easily, follow the plot of a movie
  • Focusing on past mistakes
  • Feeling worthless
  • Desire to hurt yourself physically
  • Desire to take your own life

If you are a father experiencing these symptoms, please contact me. I want to see you get the help you need.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

When Boys’ Anxiety Comes Out as Anger

Photo from AnxiousToddlers.com.

The sullen teenage boy is everywhere, so common it’s almost a cultural cliché. But what if it’s actually anxiety?

This article from the Deseret News presents another side to the story, where several young men share their stories of grappling with feelings of anxiety, then helplessness, then anger.

“There is a difference, culturally, for a boy,” said Mary Alvord, a psychiatrist and author of “Conquer Negative Thinking for Teens.’ “Especially a high school boy who’s trying to be macho. For him to say, ‘Yeah, I’m afraid of being home by myself,’ or ‘I worry all the time about getting things perfect,’ it’s just not cool.”

The Child Mind Institute, a New York-based nonprofit, says anxiety in boys can look like angry, disruptive behavior, ADHD or even a learning disorder.

While there can be a cultural expectation for girls to share their feelings and seek help, the opposite sometimes holds true for boys. Boys are taught by father figures or peers to be tough and not ask for help. This in turn can make them more likely to just give up, withdraw and avoid situations that may make them uncomfortable (such as school or social situations).

And when these teen boys act out at home, the article reads, they are “projecting their distress….[which] confuses parents, who may see their son not as anxious, but belligerent, uncooperative or angry — and may punish him for bad behavior.”

So what’s a parent of a teenage boy to do?

  1. Help him understand he’s not alone. There are more and more men in the public eye who are coming forward to share their stories: Dwayne Johnson and his depression, Cleveland Cavaliers All-Star forward Kevin Love who had a panic attack in the middle of an NBA game, even Olympic gold-medalist Michael Phelps.
  2. Be willing to talk through things with your kids. Help them understand you’re willing to listen when they’re ready to talk.
  3. Help them tackle their fears. If they are scared of speaking in public, find an opportunity for them to speak to a small audience. If they are scared of heights, take them rock-climbing in a gym with an instructor.
  4. Remind them that it’s a process. When they conquer small fears, they can find the courage to tackle a bigger fear. Even if the outcome is bad, the anxiety will slowly begin to lose its grip when they see they can still survive the worst.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Having Back to School Jitters? Tips for You, the Parent

Image from Netbase.com

If you’re dreading the back-to-school transition, you’re not alone. We are well aware how difficult it is to shift a kid from from late night barbecues and lazy mornings into waking up at 6:30 a.m.

Juggling earlier bedtimes, packing lunches and managing after-school activities can leave kids and their parents sleep-deprived and a little snarly.

Thanks to this article, we used it to make a list of practical tips for parents to transition kids back into school:

One: Eat breakfast. You need it, and so does your kid. Whether it’s cereal, oatmeal, eggs, or dinner leftovers from the night before. That first meal is important for helping kids settle in and get ready to learn.

Two: Make sleep a priority, and lead by example. Remember that humans of all ages need a lot of sleep: adults and teens need at least 8 hours (some teens may need 10 or more), children under twelve need 9-12 hours a day, and preschoolers may need up to 13 hours a day (including naps).

Three: Make a bedtime routine for your kid. Take a bath, brush teeth, read a story, etc.

Four: No electronics before bedtime. This article from the Sleep Foundation suggests a digital curfew for adults and kids alike. If you have trouble falling to sleep, the Foundation suggests reading a paper book or non-backlit e-reader (like a Kindle Paperwhite) by lamplight, which doesn’t have the same stimulating effect on your eyes and brain as a backlit screen.

Five: Take a good look at your kids’ after school activities. Dr. Gwynetta M. Luckett, a pediatrician at Blanchfield Army Community Hospital in Kentucky, said that overscheduling can cause anxiety, stress and irritability.

“Children should be allowed to wind down and have downtime and possibly a snack after school prior to extracurricular activities,” Luckett said. “If they are showing signs of stress or are not enjoying particular activities, it may be time to prioritize or reduce some activities.”

Last, but not least: Talk to your kids. Ask them how they’re doing, then sit back and really listen. Make that time to sit with them without any distractions every single day.

You’re doing a good job, parents. Good luck jumping back into the school year with both feet.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Neuroimaging: A New Approach to Eating Disorders?

Diagram from ScienceNews.org

To treat eating disorders or even obesity, scientists have been turning to neuroimaging–scans of the brain–to teach patients how to understand the path between mind and stomach.

In a 2015 study, scientists used neuroimaging to identify what they called “biological markers” or “neural vulnerabilities” in the brains of patients with eating disorders or obesity. In this study they presented real-time functional MRI (rtfMRI) as “powerful tool to better understand the complexity of human brain-behavior relationships.”

From our understanding, doctors could use rtfMRI as a type of cognitive therapy, pointing out brain function in reward centers of the brain and then working with patients to alter learned eating behaviors and “restore healthy cognition” when it comes to food.

More recently, an upcoming review from the University of Birmingham (UK) suggests that neuroimaging, along with an intranasal administration of insulin and oxytocin, may work to help patients combat obesity and weight gain.

The fact that doctors could use MRI to train your brain into a healthier relationship with food is so cool. Way to go, science!

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.

Understanding Emotions in Left-Handed People

Image from the Wall Street Journal

Studies on emotion in hemispheres of the brain may have been skewed exclusively toward right-handed people, according to a new study from Cornell University.

In hundreds of studies conducted since the 1970s, research has shown that the left side of the brain manages how we approach the world, responding with emotions such as happiness, enthusiasm and determination. The right side manages associations of avoidance, such as disgust and fear.

The catch? The subjects were overwhelmingly right-handed.

Daniel Casasanto, an associate professor of human development and psychology at Cornell, says the old model doesn’t apply to lefties and instead presents a new theory: the “sword and shield hypothesis.”

When a left-handed person uses their dominant hand (the “sword hand,” as it were) the right half of their brain registers it as an approach action. When they use their right hand (the “shield hand,” for protection) the left side of their brain registers it as an avoidance action.

Casasanto conducted research stimulating the right side of the brain for strong lefties, who reported increased happiness and determination. And strong righties, when the left hemisphere of their brains were stimulated, felt the same positive results.

Understanding that a person’s emotions may not be so tidily divided holds promise for a better response to “neural therapy,” a treatment for anxiety and depression that involves a mild electrical or magnetic stimulation to the approach-related side of the brain: right hemisphere for lefties, left hemisphere for righties.

And what about the ambidextrous?

“…[T]he stimulation won’t make any difference for them, because their approach emotions are distributed across both hemispheres,” Casasanto said. “[S]trong righties should get the normal treatment…[s]trong lefties should get the opposite treatment, and people in the middle shouldn’t get the treatment at all.”

Studies like these are so fascinating, helping the scientific and mental health community come together to better treat mental illness.

Satu Woodland is owner and clinician of Mental Health Solutions, an integrative mental health practice located at Bown Crossing in Boise, Idaho. If you would like to discuss the information in this blog further with her, please call 208-918-0958. She sees adolescents and adults. Information in this blog is not intended as medical advice. Please consult your health care provider about decisions regarding your health.