Archive for the ‘Mental Health’ Category

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Aquaphobia

Thursday, August 5th, 2010

Six teenagers drowned Monday in Louisiana’s Red River while attempting to save a friend who had slid into deeper water. The teenagers were wading in a popular recreation area where sandbars give way to 20 foot depths.

Sandbar

Sandbar

Those who drowned were the Warners: Takeitha, 13; and her brothers, JaMarcus, 14; and JaTavious, 17. Their cousin, Dekendrix Warner, 15, was rescued. The others killed were the Stewarts: Litrelle, 18; LaDarius, 17; and Latevin, 15.

Neither the teenagers or the adults watching knew how to swim.

Dekendrix Warner, the lone survivor, was wading near the shore when he slipped on a slick, clay surface and fell into deeper water. The other teens came to his aide but were tragically overcome.

Shreveport Assistant Fire Chief Fred Sanders said, “According to the divers, there was about 12 to 15 feet of water that slowly graded off from ankle depth to about three feet. It’s very slippery and so if you start hitting that bank, it’s very hard to find traction.”

“If you don’t have a swimming capability, you could find yourself slipping down that angle all the way to the 28 feet at the bottom of the river.”

A friend of the families, Marilyn Robinson, told a local newspaper that she watched helplessly as the victims went under. She said a large group of family and friends, including 20 children, were at the sandbar to barbecue.

Robinson claimed that the children were familiar with the water, but “none of us could swim.”

According an USA Swimming survey, lacking swimming skills is far too common. 40 percent of white children have low to no swimming ability; 70 percent of black children have little to no swimming ability, followed by 58 percent of Latino children.

Experts attribute the high numbers to a lack of access to pools, lack of financial means for swimming lessons, and the fact that non swimming parents are significiantly less likely to raise swimming children.

However, the most common reason for not swimming is a fear of drowning. A fear of drowning is closely related to the fear of water, which is known as Aquaphobia. This type of fear can make it nearly impossible to enjoy swimming, whether as a swimmer or spectator. Experts believe that this fear stems from a previous unpleasant experience with swimming.

Common symptoms of Aquaphobia include: high anxiety, dizziness, nausea, trembling, increased heart rate, sweating, the overwhelming desire to flee, and the feeling that if one enters the water they will drown.

Aquaphobe.

 Small first steps can be taken to overcome your fear, such as dangling one’s legs in the pool or walking on a beach with someone you trust. Ultimately, behavior therapy can help with this phobia.

With behavior therapy, one of the best treatments may be finding the original source of the fear. If you fear drowning, you have to know where the fear stems from if you want to overcome it. Your counselor will help you learn whether the beliefs surrounding your original fear are real or fake.

If an Aquaphobe can rationally understand and accept the general irrationality of their fear, one will ultimately be able to rethink how they view the water. A fear of drowning doesn’t have to be debilitating or life threatening. Swimming is a necessary survival skill.

As stated earlier, behavior therapy is extremely beneficial. Your therapist at Apex Behavioral Health will help you take small steps in treatment until you can take that giant leap into the pool.

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Recalling distant events can help ward off intrusive thoughts

Thursday, July 29th, 2010

Want to forget something disturbing?

Try to remember an overseas trip rather than a domestic one, or a memory in the more distant past.

When you are daydreaming, it is difficult to remember what was going on before you stopped paying attention. Well, psychologists say that context is important to remembering. If you leave the place where the memory was made - the context of it - the memory will be harder to recall.

Previous studies have also found that thinking about something else, whether it’s daydreaming or mind wandering, will block access to memories of recent past.

Psychological scientists Peter F. Delaney and Lili Sahakyan of the University of North Carolina at Greensboro and Colleen M. Kelley and Carissa A. Zimmerman of Florida State University studied if the content of your daydream affects the  ability to access a recently acquired memory.

Participants were told to look at a list of words as they appeared on the computer screen, one at a time. Next, they were told to think of either home (where they’d been that morning) or their parents house (where they were several weeks ago). The participant was then shown a second list of words.

At the end of the test, participants were asked to recall as many words possible from the two lists.

Partipants who thought about home, the place they’d been two hours ago, remembered more of the words from the first list than participants did who thought about several weeks ago.

The same was true for memories about place, which was tested in a similar second experiment.

People who thought about a vacation in the US remembered more words than those who thought about a vacation overseas.

A practical application of the research may be helpful for people who are trying to forget things.

“If there’s something you don’t feel like thinking about, you’re better off remembering a more distant event than a close event, to try to put it out of your mind for a while. It can help you feel like you’re in a different situation,” said Delaney.

The study was  published in Psychological Science, a journal of the Association for Psychological Science.

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Postpartum Depression in Fathers

Thursday, May 20th, 2010

A recent study published in the Journal of the American Medical Association found 10% of men have prenatal and postpartum depression; more common than previously thought.

James Paulson, the author of the study who works at the department of pediatrics at Eastern Virginia Medical school, said “It’s not screened for and caught enough in women, and I would say in practice it [depression in new fathers] is virtually unknown. Most clinicians and most moms and dads aren’t aware that there’s an increased risk of depression for fathers.”

Depression in fathers has potential negative implications for the family, along with the child’s development, behavioral, and emotional health.

The study also found that depression in fathers had an association with depression in mothers; when moms were more depressed, so were dads. However, more research is needed to see how the two are related, for one parent’s mood has not been proven to cause the other’s.

Researchers analyzed 43 studies of documented depression in fathers between the first trimester and the first year after childbirth between January 1980 and October 2009, which led to data on more than 28,000 participants.

The study found that about 25% of new fathers had depression in the first 3 to 6 months after childbirth. While the study did not examine causes, the author suggests that leaves of absence from work normally expires around 3 months; care for the infant changes as do sleep schedules.

The United States had the highest rates of fathers’ depression at 14%, while countries abroad had depression rates of about 8%. The countries analyzed in the study were primarily from developed countries.

The reasons for the differences are unknown, but Paulson theorizes that the U.S. has comparatively stricter family-leave policies in the work place than some European countries do.

“In the U.S., there’s a known problem with men seeking help for depression and a documented stigma with mental health,” said Paulson, citing possible additional causes.

Limitations of the study are that it drew from a large pool of studies that had different methodologies and different ways of reporting and measuring depression. Therefore, the authors can’t determine what the prevalence of depression is in any specific time frame.  Additionally, the overall analysis may include bias inherent in the studies that put it together.

Regardless, the findings do point to a need for greater screenings of depression in expecting fathers. The authors wrote that the connection between parents’ depression suggests that depression in one parent should prompt clinical attention to the other.

The study said, “prevention and intervention efforts for depression in the parents might be focused on the couple and family rather than the individual.”

Depression rates among men of different age groups were not compared, and the study did not have any teen fathers.

Postpartum depression symptoms in men include sadness, anxiety, and worthlessness. Men may experience it more in the forms fo anger, irritabilty and withdrawal than in sadness, which is a common symptom in women.

Paulson says that the first step in addressing the problem is to get both spouses and physicians to recognize that new and expecting fathers are at increased risk for depression and may need treatment such as psychotherapy and medication.

“Actually getting fathers to the point where they’re talking to a doctor about it is the most difficult challenge,” he said. “Once fathers are in the appointment, I think they have a much better chance of getting effective help for depression.”

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No Job & 5 Kids, Man Wrote It Is “Better To End Our Lives”

Thursday, May 6th, 2010

Los Angeles - In late January 2010, a man fatally shot himself, his wife, and their five young children: Brittney, 8; twins Jaszmin and Jassely, 5; and twins Benjamin and Christian, ages 2 years and 4 months.  Before the killings, Ervin Antonio Lupoe faxed a note to a television station claiming him and his wife were fired from their hospital jobs and planned the killings together, as an escape for the whole family.

Lupoe Family

Lupoe Family

The station called the police after receiving the fax and a police dispatcher received a call from a man stating, “I’ve just returned home and my whole family’s been shot.”   The police believe the man was Ervin. Officers rushed to the home around 8:30 a.m., minutes after the killings, only to smell gun powder lingering in the air.

The fax alleged that Ervin’s wife, Ana Lupoe, helped plan the killings of the family but police Lt. John Romero said Ervin was the suspect; a revolver was found next to his body.  Ana’s body was found in an upstairs bedroom with the bodies of the couple’s twin 2-year-old boys. The bodies of an 8-year-old girl and twin 5-year-old girls were found alongside Ervin Lupoe’s in another bedroom.

Ervin removed three of his children from school a week and a half prior; the school prinicipal said that they were moving to Kansas.  

Kaiser Permanente Medical Center West Los Angeles released a statement confirming both Lupoe and his wife had worked there; both were medical technicians.

The letter indicated that Lupoe and his wife had been under investigation for misrepresenting their employment to an outside agency in order to obtain childcare. Ervin alleged that an administrator told the couple on December 23 that “You should have not even bothered to come to work today, you should have blown your brains out.” The couple complained to human resources and were offered an apology. However, they were fired two days later.

In his fax, Ervin wrote: “ They did nothing to the manager who stated such and did not attempt to assist us in the matter, knowing we have no job and five children under 8 years with no place to go. So here we are.”

In a statement, the hospital said it was  “saddened by the despair in Mr. Lupoe’s letter faxed to the media, but we are confident that no one told him to take his own life or the lives of his family.”

“After a horrendous ordeal, my wife felt it better to end our lives; and why leave our children in someone else’s hands? We have no job and 5 children under 8 years with no place to go. So here we are,” wrote Lupoe.

One news outlet reported Lupoe was $600,000 in debt.

The letter concluded with, “Oh lord, my God. Is there no hope for a widow’s son?”

“Today our worst fear was realized,” said police Deputy Chief Kenneth Garner. “It’s just not a solution. There’s just so many ways you find alternatives to doing something so horrific and drastic as this.”

According to the Center for Disease Control and Prevention, more than 30,000 people kill themselves each year. The CDC notes that there was a job loss or financial hardship present in a significant number of cases.  Researchers say that unemployment alone does not cause suicide, but can act as a stresser.

The loss of a job combined with financial uncertainty, loss of retirement savings, stress of overdue bills or debt, and mortgage or rent payments can leave the individual feeling that suicide is the only way out. For some, this may involve taking one’s family with them.

Several studies have found that suicide and domestic violence increase during unemployment.  A 1998 study in the British Medical Journal found “the link between suicide and unemployment is more powerful that other socio-economic measures.”

Unemployment can become harder to deal with when other stressers, such as losing the family’s house and loss of savings, are present. Economic turmoil may also lead to more frequent abuse and increasingly violent abuse when domestic violence already exists.

Jacquelyn Campbell at John Hopkins University School of Nursing found in 2003 that unemployment is the single strongest predictor in cases where men murder their wives. The study, published in American Journal of Public Health, stated that an abuser’s lack of a job increased the risk of murder.

The abuser’s access to a firearm increased the risk to more than five times, and threats to kill her and threats with a weapon also were strongly associated with homicide after taking the other factors into account.

“In the United States, women are killed by intimate partners more often than by any other type of perpetrator, with the majority of these murders involving prior physical abuse,” said Campbell.

Roughly 90% of people who commit suicide have some form of untreated mental illness which compounds their feelings of hopelessness and depression. Financial problems and job loss can be triggers, especially for men, reported the Association for Suicide Prevention.

“It creates a lot of anxiety,” said Mary Jane Landrock, a social worker at Torrance Memorial Medical Center. “People start feeling hopeless, or that their life is out of control. They feel trapped, like there’s no way out.

“Most people have no idea how much structure going to work provides to your day,” she said. “You go to work, typically where your friends are. Being laid off can be very shameful for people, a lot of anger involved.”

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Dual Diagnosis

Thursday, April 15th, 2010

A recent survey regarding the homeless people in the Detroit area found that 51% of the people questioned are at risk of dying on the streets, a 9% increase above the national average.

The Neighborhood Service Organization, in coordination with Detroit area homeless service providers, surveyed Detroit, Hamtramck, and Highland Park identifying and counting people to find those that are most at risk of dying on the streets. 211 people were surveyed during three nights during the hours of 4 and 7 a.m.

The survey found that the average number of years homeless is 5.38. 99 people reported a dual diagnosis of mental illness and substance abuse. 29 of the people surveyed were veterans and 32 people reported having a history of foster care. There were a total of 358 inpatient hospitalizations in the past year with a total of 456 emergency room visits in the past three months. 103 people reported having no insurance; 74 people reported having been in prison and 149 people reported having been in jail.

13% of the people were aged over 60, the oldest respondent being 72 years old.

Treating a dual diagnosis of mental illness and chemical dependency is very difficult. Some mental health services are not equipped to deal with patients having both disorders and as a result, only one  issue is identified. However, if both diagnoses are identified, the patient may be bounced between treatments for mental health and substance abuse.

Research studies have concluded that a minimum of 50% of the mentally ill population also have a substance abuse problem. People with mental illnesses may have a chemical dependency problem that their family is not aware of; or the family may underestimate the extent of drug dependency. It may be difficult to determine which behaviors are attributed to mental illness versus what behaviors are caused by chemical dependency.

 In order to have an accurate diagnosis of a mental disorder, the cause of behavior has to be determined. If a person is experiencing delusions or hallucinations, the delusions may be a result of schizophrenia, depressive  disorders, mania, Alzheimer’s related dementia, panic attacks, or drug or alcohol intoxication.  Treatment for schizophrenia is different from treatment for chemical dependency, which is why it is important to pinpoint the cause of behavior to ensure the most effective treatment.

Chemical dependency complicates treatment of mental illness. The individual may be difficult to engage in treatment, they may be in denial; and their diagnosis is further complicated because of the interacting effects of substance abuse and mental illness. Individuals may frequently relapse and require hospitalizations and may not be tolerated in community rehabilitation programs.

Some individuals may begin to drink or use drugs for recreational reasons, but their reasons for continuing use may differ. It is likely that many individuals continue using as a way to treat symptoms or side effects from the medication. Drug use may reduce the level of anxiety or depression, at least short term. It is possible that an underlying vulnerability exists in the individual that precedes mental illness and chemical dependency.

Social factors, such as living environment, may also account for continued drug use. People may find themselves living in neighborhoods where drug use is prominent. An individual may find himself more easily accepted in a social setting when the group’s activity is based on drug use, particularly if he or she has difficulty establishing social relationships.

Typically, there are separate treatment programs for mental health and substance abuse. Clients with a dual diagnosis are referred back and forth between the treatments, but hybrid programs that address both issues prove to be extremely beneficial. Such a program is available at Apex Behavioral Health, in our Westland office.

Drug program treatments are limited in helping mental illness patients because the programs are too confrontational and people with severe mental illness are too fragile to benefit from that particular type of treatment. Confrontation, emotional jolting, and discouraging use of medications has proven to be detrimental to mental health patients. The treatments may lead to stress which can cause relapse.

Desirable treatment programs for a dual diagnosis should be less confrontational and take a more gradual approach. Clients have to proceed at their own pace during treatment and credit should be given for any accomplishments regarding their drug use decreasing.

It is argued that substance abuse treatment programs are more geared toward the young male population. Rehabilitation, substance abuse, and gerontology literature pay little attention to elderly drug abuse and largely ignore it, therefore, little information is known about prevalence or occurrence about drugs in the elderly population.

The types and extent of drug and alcohol use among the elderly is elusive. Individuals aged over 65 make up 12.4% of the total US population; however, by 2030 this group is expected to double in size.  At that time, the elderly population will include baby boomers, many of whom have already been exposed to drugs or alcohol in the 1960s.

Researchers have noted that drug or alcohol symptoms seen in the elderly are often mistaken for various symptoms of aging, such as dementia or depression. It is unknown if elderly patients would require unique substance abuse treatment since little research has occurred on senior illicit drug use.

However, significant data is available for the elderly population on prescription drug use. Elderly adults consume more over-the-counter and prescription drugs than any other age group on a daily basis.  One researcher noted that elderly adults are 2-3 times more likely than younger individuals to be prescribed psychoactive drugs, including benzodiazepines.

The elderly population is not immune from chemical dependency;  there is not an age limit for addiction. Further research needs to be conducted to determine the prevalence of drug abuse among the elderly population. The seniors may require different substance abuse treatment then the youth. There has not been enough research done to prove that the generic substance abuse treatment is effective for all age groups.

It is probable that a 70-year-old male will require different substance abuse rehabilitation treatment than an 18-year-old female. A 70-year-old female suffering from depression and drug use will require different treatment from a 75-year-old male who has PTSD and an alcohol problem.

Treatment is unique for each individual and this is especially true for individuals with a dual diagnosis. Treatment for depression is different than treatment for substance abuse, and a person who has a dual diagnosis will require a different, combined treatment which is available at Apex Behavioral Health.

It is important that the elderly get treated for depression. While the elderly population accounts for 13% of the US population, they account for over 18% of all suicides.

Some people believe that depression is a normal component of aging, but that is not true. Physical ailments and medications can cause depression.

The following diseases or physical problems may result in depression. 

  • thyroid disorders  
  • diabetes  
  • Parkinson’s disease  
  • multiple sclerosis  
  • strokes  
  • tumors  
  • some viral infections 

The following medications may cause symptoms of depression: 

  • blood pressure medication  
  • arthritis medication  
  • hormones  
  • steroids

Many elderly people will hide their depression or substance abuse so it is important to notice subtle hints. Untreated depression is the number one cause of suicide.

Suicide warning signs include:

  • Appearing depressed or sad most of the time.
  • Talking or writing about death or suicide.
  • Withdrawing from family and friends.
  • Feeling hopeless.
  • Feeling helpless.
  • Feeling strong anger or rage.
  • Feeling trapped — like there is no way out of a situation.
  • Experiencing dramatic mood changes.
  • Abusing drugs or alcohol.
  • Exhibiting a change in personality.
  • Acting impulsively.
  • Losing interest in most activities.
  • Experiencing a change in sleeping habits.
  • Experiencing a change in eating habits.
  • Losing interest in most activities.
  • Performing poorly at work or in school.
  • Giving away prized possessions.
  • Writing a will.
  • Feeling excessive guilt or shame.
  • Acting recklessly.

    • A dual diagnosis can be treated effectively with the proper treatment for a person of any age. Please call Apex Behavioral Health if you or someone you know needs treatment.

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