Friday, February 26, 2010

On learning to worry

By R. Scott Benson, M.D.

Mardi Gras is a big celebration in my town and after the parades and the parties everyone picks up the idea of Lent and sacrifice. The best one I heard was a friend who decided to give up worrying for Lent. A good choice.

Psychiatrists have long recognized the toxic effects of excessive worry but too often pick up the mantra – “don’t worry”. Good advice, but usually it’s not enough. Research in cognitive behavioral therapy (CBT) for obsessive compulsive disorder sent me in a different direction. Engage your worries! Give them the attention they demand! With a little discipline.

I instruct my patients –

1. Make a list of your worries. Watch for duplicates. Worries are like that. They change a little to try and sneak back into your thinking.

2. Set aside time twice a day to get out your “worry list” and read through it. Try for once in the morning, and again in the late afternoon. Think English tea time. Give each worry the time it deserves. Pay special attention to any that you can do something about today.

3. If a new worry comes up you can add it to the list. This is especially useful for those late night worries that make it hard to fall asleep.

4. If worries try to get on your mind outside of your “worry time” gently remind that worry that you already have worried about it, and it will have to wait until the next worry time.

Worriers believe that they worry about everything, all of the time. Putting order to their worries helps them reframe the problem and put it in a correct perspective.

Monday, February 22, 2010

A Happy Heart may be a Healthier Heart

By Felicia K. Wong, M.D.

Heart disease is the leading cause of death in the United States. The month of February, “American Heart Month”, is dedicated to raising awareness about heart disease and increasing knowledge about prevention. In this post, I will discuss the connection between mental health and heart disease.

Depression is a risk factor for heart disease

Many studies have shown that negative emotions such as depression, anger and stress are risk factors for heart disease. The February 2006 issue of the Harvard Mental Health Letter notes that, “the recurrence of cardiovascular events is more closely linked to depression than to high cholesterol, smoking, high blood pressure or diabetes”. Antidepressant treatment may benefit depressed heart patients and possibly reduce their risk for future heart problems. Cardiac rehabilitation programs that provide patients with stress reduction and wellness strategies may also help reduce the impact that depression has on heart disease.

Happiness may protect against heart disease

People with a tendency to experience positive emotions, such happiness, enthusiasm and contentment, are less likely to develop heart disease than those who tend not to experience it, suggests a new study published in the February 17 advance online issue of the European Heart Journal, led by Karina Davidson, Ph.D. of Columbia University Medical Center. Dr. Davidson’s research team followed 1739 healthy adults living in Nova Scotia for 10 years and examined the impact of positive personality traits on heart disease risk. They found that the people in the study with the most negative emotions had the highest risk for heart disease, whereas those who scored highest for happiness had the lowest risk for heart disease.

The researchers’ speculations about how positive emotions might confer long-term protection against heart disease include:

Happy people may have a healthier lifestyle that decreases cardiac risk - eating and sleeping better, exercising more, and smoking less.

Happiness may promote a host of positive physical and chemical changes - such a reduction in stress hormones -- that are good for the heart.

There may be a genetic component - people who are predisposed to happiness might also be predisposed to have fewer heart attacks.

Davidson’s findings suggest that preventive strategies may be enhanced not only by reducing depressive symptoms but also by increasing positive affect. However, she states that the findings should be confirmed via clinical trials before making any clinical recommendations.

In the meantime, those interested in these preliminary findings can begin to take some simple steps to increase their positive affect. Dr. Davidson recommends, "If you enjoy reading novels, but never get around to it, commit to getting 15 minutes or so of [daily] reading in. If walking or listening to music improves your mood, get those activities in your schedule. Essentially, spending some few minutes each day truly relaxed and enjoying yourself is certainly good for your mental health, and may improve your physical health as well."

For more on the study, including theories on how happiness may protect the heart, as well as tips on how naturally negative people can become happy, please see the following article.

Monday, February 15, 2010

Faith & Mental Wellness in the African American Community

By Gina N. Duncan, M.D.

For many in the African American community, faith is an integral part of life.  In one study, approximately 85 percent of African American respondents described themselves as “fairly religious” or “religious” and considered prayer a common way of coping with stress.   

My training as a psychiatrist coupled with my background enables me to have a unique perspective on the field of psychiatry as it relates to the African American community.  I come from a Southern, deeply religious African American family of educators.  My grandfather, a gifted musician, suffered from depression for most of his adult life.  While it did not prevent him from having a successful career as a school principal, civic leader, and church member, it did prevent him from enjoying his blessings more fully.  This has had a ripple effect in my family, which continues to be felt even three generations out.  Fortunately, because of the struggles we observed in our grandfather, the younger members of my family have become much more vocal about our own stresses, and are determined to not let history repeat itself.
For many of us, emotional issues and mental illness are inextricably linked to issues of faith.  Some may view depression as a punishment for sin, psychotic illness as the presence of demons, or anxiety as a lack of faith in God’s ability to provide.  As a person of faith myself, I can say that faith provides a holistic view of life and of the meaning behind our individual experiences and struggles.  However, that does not mean that we cannot make use of all the resources available to us.  After all, if we have a headache we take Tylenol, right?  And if your doctor tells you to take medicine for your diabetes and high blood pressure, you listen.
Some emotional problems can be fully resolved with talk therapy and support.  However, more serious problems such as recurrent depression, thoughts of suicideschizophrenia, or bipolar disorder often require medication in addition to other forms of treatment.  This is an exciting time in the field of psychiatry and brain science, as we learn more and more about the biological basis of many mental illnesses.  And the good news is that there are many proven, effective treatments.
African Americans are a resilient people.  In honor of Black History Month, let’s make a commitment to living our best lives.  That means getting the help you need.  If you think you are suffering from depression, anxiety, or another mental illness, please know that it does not affect you alone.  It impacts your spouse, your children, and your community.  There are a lot of resources on to help you get started.
Let your light shine—don’t let it be diminished by a treatable condition!

Friday, February 5, 2010

Cybersafety for Kids Online and What to Do When You Child Says "I want a spacebook account"

By Roberto A. Blanco, M.D.

I was in a kindergarten class the other day on an in-school child evaluation when I overheard a little girl talking with a friend. She was explaining how her brother and mother played on "Spacebook" all of the time and that she wanted one too. Her friend nodded enthusiastically in agreement. I thought to myself that only in the 21st century would 5 year-olds be having such a conversation.

Currently, more than 8 out of 10 adolescents/young adults have an active social networking account such as Facebook, MySpace or Twitter. But what is the right age or developmental level for a child to have a social networking account? Most people would probably agree that children shouldn't have these types of accounts until they are teens. But, should all teens who want an account be allowed?

A recent study on social media use by teens conducted by University of Virginia Psychologists showed that the psychological health and social adaptation of teens dictated whether they used social media sites appropriately. The study showed that well-adapted youths use social media to enhance their existing positive relationships. On the other hand, those who were poorly adapted, evidenced by behavioral problems or difficulty making friends, used social media sites in more inappropriate ways or not at all. They were more likely to post nude photos, use excessive profanity, or show more overt aggression or hostility in their postings.

Safety issues are still a large concern when it comes to the internet. As parents, it is important that your child use the internet appropriately for his or her own physical and psychological safety. Posting the wrong things or giving out sensitive information on-line could lead to significant consequences. Here are some things that you can do to make sure that your child uses the internet and social networking sites appropriately:

Introduce your child to the internet. Like any other topic (e.g. the "birds and the bees talk"/sexual education, handling bullying, etc.) you, as the parent, want to be doing the educating. You should be setting the stage for your child’s relationship with the internet.

Explain that on the internet, even though your child may be in a room alone, that he or she is not necessarily free from harm. Remind him or her that people can sometimes find their location, identity, and information stored on computers and to be careful with what information they share.

Make time to explore the internet together. Visit sites that are specifically designed for children or that are associated with your child’s particular interests.

Monitor your child's access to the internet from time to time. You may also want to install parental internet guards or filters that won't allow kids to unknowingly go to inappropriate or dangerous Web sites.

Limit the amount of time that a child can be on the internet on a nightly basis. Spending too much time on-line can lead to symptoms of depression, social isolation, and obesity. If your children are spending time on the internet also make sure that they are getting adequate exercise and completing their homework, responsibilities, and chores.

If your teenager wants a social networking account, assess whether he or she is ready for one. Is your child old enough or mature enough to use a social networking site appropriately? As the University of Virginia study described, behavior in face-to-face interactions is a good indicator of behavior on social networking sites.

After assessing if they are ready, have an open conversation about the privileges and consequences regarding behaviors on social networking sites. Clearly lay out expectations and what would be deemed appropriate and inappropriate behaviors.

Monitor how your child is using social networking through intermittent conversations and open communication. If your child is exhibiting impulsive or out-of-control behavior, consider closing accounts or only allow them if they are closely supervised (such as having their login information or being "friends" with them on-line).

Taking these steps can help ensure that your child will have a fulfilling and safe internet experience. For more information on how to discuss internet safety with your children go to the National Crime Prevention Council and School District 129.