Monday, April 13, 2015

Don’t Over-Tax Yourself Over Tax Season!

With the April 15 tax deadline looming, it’s an anxious time for many people. Try these tips to keep your financial stress under control at tax time ­— and all year round.

Break It Up. A mountain of paperwork for your tax return or for any other financial responsibility, like applying for a college loan or mortgage, can seem overwhelming. Break up the process into smaller chunks, such as gathering pay stubs, finding your home mortgage interest statements, or organizing your receipts. Then tackle each task one by one. But before you do so…

Make a Plan. This is even more important when you’re on a tight deadline (like being just a few days away from April 15). Once you’ve broken down what you need to accomplish into pieces, put those steps in order and write down how and when you’re going to make each one happen. This will help you feel like you have control over the process. Being out of control is very stressful!

Keep Mentally Fit. Eat well, get a full night’s sleep, find a way to exercise every day, and connect with friends and loved ones. Financial deadlines may have you feeling like you need to lock yourself away and pull an all-nighter with a bag of potato chips and your 1040, but you’ll just raise your stress level, and you probably won’t accomplish your goal anyway.

Resist Unhealthy Temptations. When stress arises, it’s tempting to cope in unhealthy ways such as binge eating, smoking, or drinking alcohol. Avoid these negative coping strategies. Instead of a cigarette or a glass of wine, take a walk or call a friend to vent.

Don’t Go It Alone. It’s not too late to get help. Ask for help from a spouse, a trusted friend, or ideally, a financial professional like a certified public accountant. Some tax professionals will even save you the step of visiting their office and will review your documents and calculations online. Having too much on your shoulders and no help is a recipe for anxiety.

Request an Extension. If you’re utterly overwhelmed and you feel like there’s no way you’ll have it all together by April 15, talk to a tax professional about how to request an extension on filing. You’ll still have to pay your estimated taxes on time (or pay interest), but you’ll have an extra six months to get your paperwork in order.

Plan Ahead for Next Year. If you’ve procrastinated about your taxes this year, use the stress you’re experiencing now as you try to get everything together at the last minute for a good cause: Keeping you on track to plan ahead for tax time 2016. Set a realistic budget and stick to it, and keep track of your finances as you go along. Having a plan and living within your means makes your life much less stressful.

by David Ginsberg, M.D., clinical associate professor and vice chair for clinical affairs, Department of Psychiatry, and chief of the Psychiatry Service, NYU Langone Medical Center in New York City.

Thursday, April 9, 2015

Giving Kids a "Sip" of Alcohol Can Send the Wrong Message About Drinking

That little sip of wine or beer that some parents offer their kids at a wedding or on New Year’s Eve may muddle messages about alcohol, according to a new study by researchers at the Center for Alcohol and Addiction Studies at Brown University. The scientists surveyed middle school students for three years to learn whether even a taste in early childhood was a predictor of risky behavior in high school.

The Internet-based study, published in the April 1st issue of the Journal of Studies on Alcohol and Drugs, included more than 500 Rhode Island school students. More than one-third of the kids surveyed reported trying their first sip of alcohol by the sixth grade, and most said that their first taste took place at home. Wine and beer were the most commonly tried beverages, usually at a special occasion, such as a wedding or a holiday, and adults were the primary source of the alcohol. Nearly three-quarters of the children were offered sips by their own mom or dad.

The study also showed that kids who sipped alcohol by the sixth grade were five times more likely to down a full alcoholic beverage by the time they reached 9th grade—26% of sippers consumed a full drink versus 5.5% of non-sippers. The earlier sippers were also four times more likely to get drunk or binge drink by early high school, and trying alcoholic beverages earlier in life also raised a child’s risk for trying other substances.

Even when the researchers controlled for other factors, such as risk-taking behavior, the drinking habits of parents, and a history of alcoholism in a parent, kids who’d sipped before sixth grade had higher odds of alcohol use by their freshman year of high school.
The take-home message: Offering a child a sip of your beverage may send the wrong message, says study author Kristina Jackson, Ph.D., associate professor in the Department of Behavioral and Social Sciences at Brown School of Public Health.

"Parents should provide clear, consistent messages about the unacceptability of alcohol consumption for youth,” Jackson advises. “Younger teens and tweens may be unable to understand the difference between drinking a sip and drinking one or more drinks. Certainly there are exceptions, such as religious occasions, so the most important thing is to make sure that children know when drinking alcohol is acceptable and when it is not.”

The context of alcohol use is important, says Oscar G. Bukstein, M.D., M.P.H., medical director at DePelchin Children’s Center and a clinical professor of psychiatry at Baylor College of Medicine and the University of Texas Health Science Center-Houston, who was not involved in the research. “Often, by allowing children to sip or try alcohol on ‘special occasions’, the message delivered may be one of ‘this is how we celebrate’, we drink,” Buckstein says.

He says that sipping may be associated with increased access to alcohol, too, or more lax parent attitudes and that undermines any anti-drinking messages kids hear.

April 21st is the national day to talk with your kids about alcohol. Visit Mothers Against Drunk Driving’s (MADD) Power of Parents page to learn more.

by Mary Brophy Marcus, health writer, APA

Wednesday, April 1, 2015

Autism Awareness Month: Learning more about a complex condition

You probably know someone with autism—in your neighborhood, in your workplace, in your school, in your family.   In fact, an estimated one in 68 children in the U.S. has been identified with autism spectrum disorder, according to the Centers for Disease Control and Prevention.   The data on adults is less clear, but the numbers are growing. 

April is Autism Awareness Month – a chance to raise awareness and learn a little more about this complex condition affecting so many.  Here are just a few sources that might help answer some questions.
Want a good quick overview of what autism is?  Check out the CDC’s main autism page.

Looking for a good app to help someone with autism function better?  There are many apps available to help people with autism with communication, behavior, organization, creative arts, and more. In fact, there are so many apps that it can be hard to know where to start or what might be useful for a particular person. Check out Autism Speaks’ searchable resource on autism apps – with information on function, device, target age, and the research data that’s been gathered to evaluate or inform the app.

 One resource you may be familiar with already is Siri, the personal assistant on the iPhone. See a New York Times column by a mom of a child with autism who has made good use of Siri, “To Siri, With Love: How One Boy With Autism Became BFF With Apple’s Siri.”  Siri is not only tirelessly patient in responding to repetitive questions (common among some with autism) but lets you know she doesn't understand (leading to practice with phrasing and enunciation) and will gently encourage polite language.

Want to know how to talk with parents of children with autism?  See a recent article on “11 things never to say to parents of a child with autism (and 11 you should).”
Want to know a little about what it’s like for some people with autism and sensory sensitivity issues to experience their environment? (Note of caution:  Every person with autism is different. No two experience sensory sensitivity in the same way.) View the short video from the UK-based National Autistic Society, Experience For 60 Seconds How The World Looks, Sounds, And Feels To Someone Who Has Autism.” Some people with autism have difficulty processing multiple sensory experiences at once. An animated video by the Interacting with Autism project gives a glimpse into sensory overload and how sensory experiences intertwine in everyday life.

Want to know more about the latest research on autism spectrum disorders or the latest clinical trials? Find out how your family can participate in research  or find out about clinical trials.

Have more questions? Visit national organizations, such as Autism Speaks and the Autism Society of America, or federal agencies, including the CDC and the National Institute of Mental Health.  Join the conversation #autismawareness, #autism, #mentalhealth.

by Debbie Cohen, health writer, APA

For more news and wellness info from APA, follow us on Twitter and Facebook.

Wednesday, March 25, 2015

Are Some Jobs More Stressful Than Others?

Everyone has bad days on the job—a project that you put hours into bombs or a task you need to accomplish is difficult and stressful. But are some jobs harder overall on our mental health than others? Depression may be more likely to occur in some professions, research suggests. And according to a new study by researchers at the National Institute for Occupational Safety and Health, suicides in the workplace, while not commonplace, are on the rise. Their research, published in the March 16 online edition of the “American Journal of Preventive Medicine,” showed that 270 people committed suicide in the workplace in 2013, a 12% increase over 2012.

Men and those over 65 were more likely to commit suicide in the workplace than others. Law enforcement jobs -- police officers, firefighters, and detectives -- had the highest rate of workplace suicides with 5.3 suicides for every 1 million workers. Farmers, ranchers, fishermen, and forestry workers came in next with 5.1 suicides per one million. The authors also noted that minorities may be at a greater risk for workplace suicide compared to non-workplace suicides. Their research did not include military jobs.

This month’s “JAMA Psychiatry” also addressed the topic in a “Viewpoints” op-ed co-authored by two medical interns from New York who said that being a physician, especially a young intern, may leave some people vulnerable to mental illness and suicide. Doctors are twice as likely to kill themselves compared to non-physicians, and female doctors are three times more likely to do so than their male counterparts, according to the American Foundation for Suicide Prevention (AFSP). According to AFSP, though, the workplace can be an ideal place for suicide prevention programs. Their Interactive Screening Program (ISP), for example, is an anonymous online survey that IDs at-risk people and connects them with support. The NFL and the Boston Police Department have used the program. The authors of the “Lancet Psychiatry” op-ed say some work programs, like one at the U.S. Air Force, have successfully addressed workplace depression and mental illness in a variety of ways. One initiative: The USAF designates certain supervisors as mental health “gatekeepers.” Their job is to identify at-risk employees and channel them to screening and mental health services.

Want more info on managing workplace stress? Read about APA’s Partnership for Workplace Mental Health. Learn more about the American Foundation for Suicide Prevention’s ISP program by contacting the Program Director at Read Mayo Clinic’s article: Work-Life Balance: Tips to Reclaim Control.

by Mary Brophy Marcus, health writer, APA

For more news and wellness info from APA, follow us on Twitter and Facebook.

Saturday, February 28, 2015

A Psychiatrist’s Take on “Fifty Shades”

By Kenneth Paul Rosenberg, MD

I am neither a film critic, nor a sociologist, but to me, “Fifty Shades of Grey” is neither groundbreaking cinema, nor does it herald a new cultural shift in sexual mores. It is, nonetheless, a fascinating narrative for any student of psychology, let alone for a psychiatrist with a specialty in treating sexual disorders. Hence, when asked to write about the movie, it was my pleasure to offer a few thoughts.   

“Fifty Shades” is the story of Christian Grey and college-aged Anastasia Steele, whom he sweeps off her feet and into his den of bondage, whipping and domination. Christian is a concert-level classical pianist and helicopter and glider pilot.  He is ridiculously handsome, under 30 and a billionaire. His Achilles’ heel is that he is the unfortunate victim of childhood physical and sexual abuse at the hands of older women, and, as a consequence, can only connect by inflicting sexual pain on the beautiful virgin, Anastasia. 

For all his power and sadism, Christian is also partly a victim himself. He teaches us about the lingering effects of childhood abuse, and introduces the audience to the practices of bondage, domination, sadism and masochism (BDSM).   Although being a “dominant” is Christian’s ‘thing,’ clinically, one would expect Christian to be a submissive who would seek out reenactments of his abuse at the hands of an older woman. 

Ana is essentially a young woman who falls in love with an older, extremely powerful and rich man – a story taken out of the Harlequin romance novels of a previous era. But there is a psychological twist as well. Ana lost her dad when she was young, and her mother appears to be an unrepentant romantic. Mom is so enthralled by handsome men that she smiles when Christian arrives unannounced, even though he is stalking her daughter. Hence, Ana’s psychological backstory is that she is vulnerable to an older, abusive man because of her own losses and trauma. 

There is a debate in the popular media how evil Christian is, and about the degree of abuse that Ana tolerates. Certainly, the fictional relationship between Christian and Ana could hardly be called healthy. Spoiler alert: if it’s any consolation they both leave the relationship with higher levels of insight and knowledge, ending up in better places than they started. (No doubt, their plots will thicken in the sequels!)

It may be pointless to discuss Christian and Ana in psychological terms since they are Hollywood creations. Yet, in the real world, BDSM is a group of accepted sexual practices among consenting adults and common among those seeking BDSM sex workers (or Dominatrices as they are called.) Often BDSM involves more pain than gain – in other words more tying up and humiliation with less emphasis on the sex and orgasm for the seeker or submissive. When occurring with little harm, most psychiatrists see BDSM as a variant of normal. When it consumes the person and prevents intimacy, the practice may rise to the level of a sexual disorder, sexual compulsivity or even addiction.  When the person focuses on a particular inanimate object, like a whip or stiletto heel in lieu of any other sexual or romantic contact, the diagnosis of a fetishitic disorder may apply.  

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), once an unusual sexual practice causes impairment and harm to oneself or others, it is labeled as a paraphilic disorder with subcategories such as sadism and masochism. The American Psychiatric Association has made it clear that non-normative or unusual sexual behaviors are not, in of themselves, signs of mental illness unless the behaviors cause great anguish or real harm to the participants. This distress has to be beyond the guilt and distress that comes from engaging in behaviors that deviate from societal norms. In the case of BDSM, the DSM-5 is careful to discourage labeling atypical behaviors as mental conditions. However, when the behavior rises to the level of causing grief or harm, DSM-5 offers the diagnoses of sexual sadism disorder and sexual masochism disorder.  Psychiatrists can treat these sexual disorders with a variety of modalities ranging from psychotherapy, medication, peer support groups and family counseling with excellent outcomes.  As psychiatrists, we need to make the public aware that when these sexual illnesses occur, real help is available.

Whatever we may think about the sex and stories depicted in “Fifty Shades of Grey,” as psychiatrists, the popularity of the movie provides us with an opportunity to educate the public about the possibilities of improving the lives of those who have serious illnesses and who may suffer in silence and shame.

Kenneth Paul Rosenberg, MD, is Director of Upper East Health (, a comprehensive practice in Manhattan that focuses on addiction and sexual disorders.  Dr. Rosenberg is also Clinical Associate Professor of Psychiatry at the Cornell Weill Medical Center.