Tag:

anxiety

Happy, Crappy Holidays!

{Photo with my sister in Fairfield, CA}

While skimming research articles for scholarly information to include in a blog post on Seasonal Affective Disorder (SAD), I put the information aside for a bit in order to write about my own observations and experience dealing with seasonal mood changes.

Long story short…basically, A LOT of people get depressed during the holidays, fall, and winter seasons. But not everyone meets enough criteria to be formally diagnosed and treated for SAD . Yet, a lot of people feel BAD (no acronym…just “bad”) and guilty that they’re not as happy as expected to be during the joyous holiday season. Several of my patients say they feel down, need to force themselves out of bed, and lack motivation. Many also attribute feeling depressed due to missing family members and loved ones, especially since holiday celebrations tend to make their absence even more apparent.

I read quotes that spread throughout social media with phrases along the lines of “December is the last month of 2014…get off your butt and make it count!” Honestly, I myself would be content if I made it through December 2014 by accomplishing the bare minimum of my daily tasks.

And don’t get me wrong — the holiday seasons are a joyful time for many, and I love when people go all out with their decor, gift-giving, and traditions. But I want to acknowledge that there’s a range of how people feel this time of year and that it’s okay if you don’t feel peppy, super motivated, holiday cheery, and overjoyed because there are a lot of people who feel the same way. With my patients, I try to normalize and validate their feelings, focus on the general progress they’re making, and if their mood declines this season, we try to to work on ways to get through this difficult time of year and hopefully move forward once the holidays are over.

Now, here are some bullet points on SAD:

to meet criteria for SAD, one must experience at least 2 yearly consecutive episodes of depression (with a seasonal pattern), which causes significant impairment in daily functioning (for example: calling in sick for work, negatively impacting relationships, feeling suicidal, etc). For more details, please click here for a good summary on the NAMI website.
About 5% of the U.S. population experiences SAD, with symptoms lasting approximately 40% of the year
Cause may be due to a combination of factors, both biological and psychological which may include the following:
- One of the chief biological causes found in the literature is due to changes in our sleep/wake cycle (circadian rhythm) which tend to occur with seasonal changes (Anyone else struggle with winter daylight savings time? I definitely do). For more details, check out this research article by Dr. Alfred Lewy.
- more vulnerabilities to stress this time of year (as I mentioned above)
There are treatments that have been researched to help: light therapy, psychiatric medications, psychotherapy (specifically cognitive behavioral therapy)

If you are struggling with symptoms, you shouldn’t have to go through this alone. Please seek help by reaching out to your doctor, who can discuss possible treatments or even refer you to a psychiatrist or therapist.

And if you know someone who might be struggling with symptoms, you can help by showing them your support and encouraging them to seek help.

References:

Seasonal Affective Disorder

Rohan KJ, Roecklein KA, Haaga DA. Biological and psychological mechanisms of seasonal affective disorder:
a review and integration. Curr Psychiatry Rev. 2009;5(1):37-47.

December 8, 2014 8 comments

Psychiatry

You Are Not Alone

written by freudandfashion

{OCD Awareness Week}

As a kid, I guess I had strange habits: tip toeing on floors to avoid picking up germs, blinking each eye a certain number of times on each side, tapping my fingers as if I was playing an imaginary piano, and the list goes on. I never thought my habits were a problem until kindergarten when my mom was called to pick me up at school. Apparently, it was wrong for me to pee in my pants because I thought the bathroom in my classroom wasn’t clean enough to use. Fortunately, I outgrew most of these habits (yes, I no longer pee in my pants), but some of my symptoms still persist to some degree. Though I do NOT have OCD (Obsessive Compulsive Disorder), I have several patients who suffer from the disorder and feel tormented by their debilitating symptoms.

In support of OCD Awareness Week (October 13-19, 2014), I want to share some knowledge and facts about OCD.

In the United States, OCD is the 4th most common psychiatric diagnosis
- this means that 1 out of every 40 people in this country may suffer from OCD
Internationally, 1 in 100 adults, and up to 1 in 200 children likely have OCD

Therefore, if you have OCD YOU ARE NOT ALONE.

OCD is more detailed to discuss in one post, but the explanation I give my patients includes some of the following points:

Everyone experiences anxiety to some degree. Some may cope with the anxiety by cleaning, organizing, and checking behaviors (such as checking doors to make sure they are locked), but those with OCD repeat these behaviors to the point that their symptoms cause impairment in their day to day lives. Their symptoms can be quite distressing, time-consuming, and debilitating to the point that relationships, school, and work are negatively impacted.
One misconception is that people with OCD are perfectionists, rigid, controlling, domineering, and have a “my way or the highway” mentality. This is not necessarily true because most people with OCD recognize that their symptoms are excessive and problematic, and more often feel embarrassed, ashamed, and far from perfect.

Now, if you’re wondering about my mismatched socks outfit — I’m wearing them to show even more support for OCD Awareness Week. Though the week is almost over, you still have time to show your support and participate in promoting the discussion of OCD by wearing mismatched socks and posting a picture through social media (use hashtags #sockittoocd, #ocdweek).

For more details on OCD and its symptoms, please visit the International OCD Foundation website.

October 16, 2014 4 comments

Psychiatry

Go Green!

written by freudandfashion

I spent this Sunday partaking in what practically 50% of Americans are fans of: watching pro football. I looked in awe at the stylishly bright, slick, and sporty pink athletic gear that each team member wore in support of Breast Cancer Awareness Month. I wished that Mental Illness Awareness Week (October 5-11, 2014) received just as much media and support.

For me, Mental Illness Awareness Week means promoting empathy rather than sympathy. With empathy comes understanding and lessening of stigma. Even as a psychiatrist, there are times when I feel awkward asking friends about depression, so I can imagine how difficult it might be for anyone to openly discuss and start a conversation about mental illness. But keep in mind that mental illness is far more prevalent than you may think:

– 1 in 4 U.S. adults suffer from mental illness

– 1 in 10 Americans take antidepressants

– Almost 50% of children ages 8-15 with a mental illness received NO treatment last year

Yet, despite how prevalent it is, suffering from mental illness is often lonely and isolating and nobody should have to feel that way.

So what can YOU do?

– Go Green! Wear lime green this week to serve as a reminder and trigger discussion among others about raising awareness and destigmatizing mental illness

– check out the Nami website to learn more facts about mental illness, treatment, and resources

– try to lend support rather than avoid. If you sense that someone you know is struggling, please check in on them. It sounds so simple, but you can make a difference and potentially save someone’s life

THOUGHT OF THE DAY: Share one thing you did this week to show your support (post in comments below)!

October 7, 2014 4 comments

therapy

Thankful Thursdays

written by freudandfashion

My aunt’s guide dog, Walnut

Meet Walnut, a wise, reactive, and protective guide dog by day; warm, playful, and attention-craving yellow lab by night. For Thankful Thursdays I’m proud to list Walnut, for I am thankful for the service and unconditional love she has provided my aunt since 2004. Walnut retires this month from her duties as a seeing eye dog so that she can enjoy her life as a playful pet with less stress (pretty much what we hope to achieve as humans when we retire!).

I also wrote a previous post on our family dog, Sanka, a career-change dog who grew up with Walnut and was also trained as a guide dog for the blind.

FYI Service dogs may be certified as Psychiatric Service Dogs and are individually trained to perform tasks to mitigate the psychiatric disabilities of their partners.

How about you? Would love to hear what you are thankful for this week!

(For more info on the background of my Thankful Thursdays series, click here).

October 2, 2014 6 comments

Psychiatry therapy

Stay or Leave?

written by freudandfashion

Office Balcony Sunset

I recently made a difficult decision regarding my job, which triggered feelings of uncertainty, fear, and self-doubt. In the process of contemplating my decision, I recalled one of my patients, a college student who struggled with depression. Despite going to a prestigious university, his overwhelming fear of not getting accepted into law school further exacerbated his depressive symptoms. I responded with seemingly consoling statements such as “you’re still young…you’ll get there…you have a lot going for you…I went through the same situation and it worked out okay.” However, my attempts to reassure really weren’t reassuring at all (it’s well known in psychiatry that reassurance generally doesn’t reassure mostly because the statements fail to validate the patient’s current experience). Reflecting back, I realized that in the moment I didn’t want to relive my own pain, uncertainty, and fears that I experienced in my process of applying to medical school. I recalled the discouragement I felt with each rejection letter I received. And I was still feeling discouraged at my current job. Since I gained insight from connecting his experience with my own, I looked forward to validating his feelings at his next appointment. Unfortunately, he cancelled his appointment and never returned.

I realize that contemplating decisions regarding a career path, relationships, love, and pretty much anything pertaining to life in general, makes us vulnerable and uncomfortable. The idea of change can trigger fear and act as a barrier towards future ventures. After a year long process, I finally decided to resign. My anxiety peaked even more because I felt uncertain of the next step to take. Where do I go from here? Will I feel happier? Will I regret my decision?

Seeking motivation to push forward and take risks, I read quotes by famous writers, all with similar themes to never give up, choose the “road less traveled,” try new things, and learn from your mistakes.

The dangers of life are infinite, and among them are safety. ~ Goethe

Yet, it took being on a plane last night watching The Amazing Spiderman 2 hearing Gwen Stacy (played by Emma Stone) give her valedictorian speech to make me realize how mainstream and pervasive this dilemma is:

“…I say it today of all days to remind us that time is luck. So don’t waste it living someone else’s life, make yours count for something. Fight for what matters to you, no matter what. Because even if you fall short, what better way is there to live?”

As mentioned above, my decision involved resigning from my highly-desired, well-paid job in order to take control of my life, practice, and career. Since my last day, I have mixed emotions of feeling liberated, hopeful, excited, yet completely scared at the same time.

I made the right decision.

“…you can fail at what you don’t want, so you might as well take a chance on doing what you love.”

~Jim Carrey

Putting in work at my new office in West Hollywood

Photos courtesy of Marlon Santos (Diamond Reel Media)

September 10, 2014 24 comments

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