Monday, April 26, 2010

Women's Mental Health: The Facts

By Gariane Phillips Gunter, M.D.

We have all heard the saying; Women are from Mars and Men are from Venus. Well, when it comes to our mental health we may not be from separate planets but there are differences.

For example*:

• Depressive disorders account for close to 41.9% of the disability from neuropsychiatric disorders among women compared to 29.3% among men.

• Leading mental health problems of the elderly are depression, organic brain syndromes and dementias. A majority are women.

• An estimated 80% of 50 million people affected by violent conflicts, civil wars, disasters, and displacement are women and children.

• Lifetime prevalence rate of violence against women ranges from 16% to 50%.

• At least one in five women suffers rape or attempted rape in their lifetime.

• Mental disorders following childbirth, including post-partum depression, are estimated to affect about 13% of women within a year of delivery.

• Eating Disorders are more common in women however this is a growing concern for males as well.

• Suicide is the top cause of death globally for women aged 20-59 years of age.

So why are women more at risk? Well, it is known that our genes play a role in ones susceptibility to developing a mental illness. However, environment is also a huge factor. Pressures created by women’s multiple roles, gender discrimination and associated factors of poverty, hunger, malnutrition, overwork, domestic violence and sexual abuse, combine to account for a woman's poor mental health in many cases. There is a correlation between the frequency and severity of such poor social factors and the frequency and severity of mental health problems in women. In addition, the presence or lack of support during difficult times is also a factor.

Stigma surrounding mental illness is a huge barrier that keeps both men and women from seeking help in many cases. However, even in cases where stigma is not a concern, there are still differences in the way that men and women seek help for psychological difficulties. According to the World Health Organization, women are more likely to seek assistance from their primary care physician while men may seek a specialist or use the hospital system. Also, gender stereotypes of women’s proneness to emotional problems versus men may lead health care providers in discussing symptoms with women or prescribing medication.

So whether you are from Mars, Venus or somewhere in between, women are more susceptible to certain mental illnesses, our environment plays a role and treatment options vary. So women, take the time to take care of yourselves, you are worth it! And please ask for help if you should need it.

* Stats are from the World Health Organization

Wednesday, April 21, 2010

The Value of Media Education for Kids

By Roberto Blanco, M.D.

Why do companies spend millions of dollars per second advertising during the Super Bowl? Because, as much as we may not like to believe it, direct advertising works in shaping people´s needs, wants, and product preferences. While children and adolescents may not always watch the Super Bowl, they are the population most susceptible to the effects of direct advertising.

This is likely because children and adolescents are still developing their senses of reality, identity, and morality, have limited life experiences and lack the skills or the developmental level to analyze the barrage of advertisements they are exposed to. All of these factors make the promise of happiness coming from a happy meal seem more plausible to a child.

I recently saw a story on CNN about the effects of an advertising campaign on the cigarette brand preferences of underage girls. The print ad in question paired lipstick, high heels, jewelry, fancy dresses and neon lights with a particular brand of cigarettes. After this ad ran in Vogue and Glamour magazine for a year, the percentage of underage girls that preferred this brand of cigarettes increased from 10% to 22%.

Experts also estimated that this advertisement was likely responsible for influencing 174,000 underage girls to start smoking. Seeing the results of this study, it is clear that in order for our children to remain healthy, happy, and safe, we must educate them on how to interpret and critically analyze media advertising.

Media can affect a number of behaviors in addition to those related to shopping. Numerous studies over the past 40 years have shown that exposure to dramatized violence leads to increased aggressive behavior. The evidence shows that the younger the child is when exposed and the more real the violence is, the more it will affect the child. Studies have been conducted for many forms of media, including TV, movies, and video games. Studies have also shown protective effects of counseling children regarding alternatives to the violence that they watched.

I recently wrote a blog on the topic of cybersafety for kids where I highlighted the value of communication, regular monitoring, and limiting the amount and types of internet access that a child is exposed to based on age and maturity. Well, the same rules should generally apply for other types of media such as TV, video games, movies, and magazines. In fact, all of these media are also readily available on the internet.

Media education and exposing our children to appropriate media are critical aspects to parenting. Doing so will allow your children to critically analyze what they are being exposed to. If you would like to learn more about media education or how to educate your kids you can go to Canada´s advanced media education program which provides more information. You can also direct your children to go to PBS´ media website to educate themselves.

Thursday, April 15, 2010

Pull The Plug! Television and Our Children

By Gariane Phillips Gunter, M.D.

Research and studies over the past 10 years have shown that heavy television watching may in fact lead to serious health consequences. According to the A.C. Nielsen Co. statistics, in a 65-year life, a person will have spent 9 years glued to the tube! However, what is becoming more and more evident, is our children’s excessive exposure to television. The following statistics regarding our children are astounding:

• Number of minutes per week that parents spend in meaningful conversation with their children: 3.5 minutes

• Number of minutes per week that the average child watches television: 1,680 minutes

• Percentage of parents who would like to limit their children’s TV watching: 73%

• Percentage of 4-6 year-olds who, when asked to choose between watching TV and spending time with their fathers, preferred television: 54%

• Hours per year the average American youth spends in school: 900 hours

• Hours per year the average American youth watches television: 1500 hours

The dates for TV Turnoff Week 2010 are April 19-25 and September 19-25. Let’s unplug our children!

During TV Turnoff Week families can:

• Go for a walk after dinner instead of watching TV,

• Dust off the board games in your hall closet and have a family game night,

• Grab a pen and paper and create your own game of charades,

• Read a book together,

• Or just talk with each other.

Tuesday, April 13, 2010

You are not Alone: Remembering the founder of NAMI, and Recognizing the importance of Support Systems

By Felicia K. Wong

I am a big fan of NAMI: National Alliance on Mental Illness. In honor of the late Harriet Shetler, co-founder of NAMI, who passed away last week, I would like to encourage you to learn more about this wonderful organization.

Since its inception in 1979, NAMI has been dedicated to improving the lives of individuals and families affected by mental illness. NAMI is a support, education, advocacy and research group. Over the past three decades, NAMI has established itself as the most formidable grassroots mental health advocacy organization in the country. NAMI recognizes that their greatest strength is the dedication of our grassroots leaders and members. On their  site, they state, “We are the families, friends and individuals that serve to strengthen communities across the country.”

If you, a friend, or family member, are affected by mental illness, please visit NAMI to learn more about the supports and services this organization offers. Support groups and organizations are important because they can provide emotional support, resources and helpful tools for people facing similar situations. Organizations like NAMI provide a voice for millions of Americans affected by mental illness and advocate to end discrimination, and to promote effective mental health services and supports.

Perhaps the most important thing that support systems can provide is a feeling that you are not alone.

Wednesday, April 7, 2010

What is Psychotherapy?

By Gina Newsome Duncan, M.D.

Medical treatments and therapies can take on many different forms in order to accomplish healing. Most involve some sort of physical interaction between a patient and a healthcare provider as occurs in physical therapy, surgery, and in prescribing medication.

Psychotherapy can be defined as a treatment in which healing of emotional distress is accomplished through the verbal interaction between a patient and a professional psychotherapist.

Psychotherapy can take on many different forms and is practiced by different types of mental health professionals including psychiatrists, psychologists, and social workers.

Upsetting life events like the death of a loved one, medical illness, trauma, job and marital stress, depression and anxiety can all be effectively addressed in psychotherapy. Research shows that psychotherapy is linked to positive changes in the brain and body. Most patients who receive psychotherapy experience symptom relief and are better able to function in their lives. Other benefits include fewer sick days, job stability, fewer medical problems, and improved relationships.

There are many different therapy styles and techniques including Psychodynamic Psychotherapy, Cognitive Behavioral Therapy (CBT), Group Therapy, and Couples Therapy, among others. The type and length of therapy will usually depend on the patient’s circumstances or preference and on the therapist’s training.

For example, let’s imagine that a 37 year old woman* with no history of psychiatric problems begins experiencing significant anxiety and panic attacks. She is referred by her family physician to a psychiatrist to begin psychotherapy. The therapy would likely consist of weekly meetings in the psychiatrist’s office that would last for 45 minutes each. During those sessions, the psychiatrist would gather a history from the patient and use this information to help develop goals for the therapy. The history may uncover, for example, that the patient has two young children, is arguing frequently with her husband, and is facing potential layoffs on her job. Depending on the type of therapy the psychiatrist practices, the patient’s concerns may be addressed differently.

In a psychodynamic approach, the psychiatrist may encourage the patient to talk freely about “whatever comes to mind.” This would include her present-day stresses as well as previous experiences from her past that may be impacting how she is coping. For many of us, unresolved issues from our past cause us to repeat unhealthy patterns, particularly in our relationships. It may be revealed that the patient’s parents divorced when she was young, and that she fears the same could happen to her. By talking through these fears with the therapist, she may be able to find effective ways to address them and prevent them from building up into debilitating anxiety.

A CBT therapist, on the other hand, would be more focused in the “here and now”, actively helping the patient to identify the pattern of negative thinking that is behind her anxiety. Examples of negative thoughts are: “I’m a failure” or “I’m unlovable.” The therapist would then teach the patient new skills to help her change her thinking and behavior.

If the patient’s symptoms are severe, medication may be prescribed. If interested, she and her husband may also be referred to a couples’ therapist.

Finding a Psychotherapist

Since the primary tool in psychotherapy is the relationship between the therapist and the patient, finding a therapist with whom you feel comfortable is crucial. Good sources of referrals include family physicians, local psychiatric societies, medical schools, community health centers, and your health insurance carrier.

For persons of color and ethnic minorities, finding a psychotherapist can present a unique set of challenges. The mental health field is making strides to build a workforce that looks more like the population we serve. However, minorities are overrepresented in mental health disparities, and underrepresented in the field. Language barriers can prevent even the most well-meaning therapist from being able to provide effective care. For people in different faith communities, there may be the concern that a therapist would try to talk them out of their belief system or “brainwash” them into a different way of thinking.

Do you have to go to someone who is of the same background as you in order to have a good therapy experience? The answer is no. However, it is important that you find a culturally competent provider.

Here are some things to keep in mind when looking for a psychotherapist:

• The therapist should be empathic, allowing you time to talk, actively listening to you, and making a sincere effort to understand where you’re coming from.

• Bad signs: If you feel easily dismissed, judged, or stereotyped. Or if the therapist seems reluctant to engage you.

Finally, it’s good to keep an open mind. We are all part of the human family; good and bad therapists come in all colors! You may find that talking to someone of a different background enables you to open up more fully.

You should be up front about what you are hoping to gain from the therapy. For example, if your faith is important to you and you feel it is relevant to your therapy work, do not be afraid to say so. The therapist should not try to change or judge you for your beliefs.

* not based on a real person