Archive for September, 2007

September 29, 2007: adminclinical depression

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Addictive behaviors to me have often meant drug abuse or violence. However the more I investigated it I realized it covers a wide range of behaviors that can be regarded as addictive. It can relate to the person who keeps winding up in the same unhappy sort of relationships. Or the person who keeps reacting in the same unproductive ways when confronted with similar situations. So it doesnt need to be that heavy stuff but more behaviors, that when you analyze them, keep occurring.

Humans are creatures of habits and we like things to be largely predictable, even if its simple everyday things. Id hate to wake in the morning and know that the kitchen was going to be in a different place each day! Or that my place of work had moved and nobody told me! Or that when I got home the house wasnt there anymore! Crazy stuff but it does demonstrate we like a certain amount of predictability in our lives.

It would seem that way with relationships also. If in my role of therapist someone came to me and told me their life story (with a little probing from me) and it seemed that there were regular patterns being set up in the events they were talking about, I would pick up on these. Often the person telling the story is not aware of the similarities in their stories. It could be something like this from Sally (a fictitious character):

I never have enough time for myself. The kids need lots of attention, they have just started riding lessons that take up a few days of the week. My husband has just started a new job. Its great because hes earning so much more money but hes also working longer hours, poor thing. My own work is so demanding. Ive just been asked to take on more responsibility at work which is great because it means Im finally being recognized but there arent enough hours in the day. Weve also just bought another property for investment purposes and were renovating that madly. My husband expects me to do all the household chores which is fair enough because he is very busy at work and works long hours. My father has recently become ill and my other two sisters cant care for him because they live in the country so thats taxing on me ..

Get the drift? Here is someone who never has time for herself and its totally justified despite the fact that she is always tired and has started to become very anxious and snappy. Thats the cognitive dissonance (conflicting thoughts) part of the equation where we justify what is happening to us so that it seems in perspective. She knows something is not quite right but cant seem to connect the pieces of the story together because it seems quite normal her kids; her husband; her father; not enough time; life is busy

To help Sally I might help her start to see the links in her story that paint a picture of someone who needs to be busy; needs to be caring for others; needs to feel anxious and cant have quality time for herself. Now telling someone this is not easy because we can get quite defensive it clashes with that cognitive dissonance. It can leave us vulnerable, asking such questions as where would I go from here?

Looking into peoples past is often a good indication of where these behaviors have been learnt. With Sally her behaviors were needs to be busy; needs to be caring for others; needs to feel anxious and cant have quality time for herself. If I probed Sally and asked her about the relationships in her family when she was growing up there may well be some links there. She might say something like:

Well mum was often quite anxious. I remember once she had to have some time in hospital because she was so run down. But life was normal. I dont really think it was that stressful. Mum and dad split up when I was 12 and they argued a fair bit. I really felt sorry for mum and tried to help her out as much as possible. I was the oldest of 4 sisters so I used to be responsible for making sure they were ready for school and all that sort of thing.

Again Sally is telling us a perfectly normal story that happens to many of us in our daily lives. The thing for Sally though is that it has become a problem. She has become anxious (a predisposition she has inherited from her mother) and she has set up a lifestyle that for most of her life she has been quite used to. There was a period in her life when she was single where life was cruisy. She seemed to have more fun and more time to enjoy herself. However now she was in a family environment with her own husband and children she has borrowed from her memories and behaviors as a child. This has led to her largely replicating a lot of things that happened to her when she was growing up living in a household that really was quite stressful and frantic, even though she didnt see it that way at the time or in fact did not see it that way up until recently.

As Sally is in a place where she wants help, change can occur more quickly. One cant force change on another. If this process seems foreign to someone then it will not work. But, if like Sally and no doubt you, because you are ready for change and ready to do something then the awareness is easier to view and comprehend. It must be stressed though that our minds, because of that cognitive dissonance, will be resistant to change. It will come up with a hundred and one ways why it cant change. I cant do it this week because my husband is off interstate on a business trip so Im going to be far busier than usual. Sounds reasonable enough but you can bet your bottom dollar that in two months time if this person really isnt ready to change yet, there will be other equally valid reasons (or excuses?!) as to why change cannot occur now.

I have also had people in similar situations to Sally, pat themselves on the back and said they have been able to free up time and theyve done that by cutting down on their counseling appointments and not going to the gym anymore two things that were actually benefiting them! Wheres that whip and lets beat each other one more time! We humans are complex beings.

Where do we go from here? I’m putting in place the notion that depression just might be a reward that we have dysfunctionally learnt. Reward sounds a funny term but ultimately we are setting ourselves up for a dysfunctional reward that is predictable and keeps us in our you guessed it COMFORT zone!

So what can be some of these underlying messages that we have gained from a lifetime of being us? See if you can relate to any from the list below:

Im not worthy…. I dont deserve good things….. Its better if I think of others……
Ive always been told Im useless….. My self-esteem is too low anyway…..
Im ugly…… They deserve it more than me…… Im ok going without……

What underlying prevalent message do you have about yourself? Acknowledging vulnerability and being prepared for change is so incredibly powerful! Write down a short statement (similar to those above) that you believe may run through a lot of the decisions you make in life.

When I think of the common themes that run through my life these thoughts seem to dominate about myself :

Where do you go from here? If you have been able to identify behaviors that keep you stuck in a particular belief system, well first of all CONGRATULATIONS! That is a tremendous step forward that cannot be underestimated in its ability to move you forward and change your life.

The art now is to focus on your awareness of when these thoughts and behaviors are happening. See if you can catch yourself out. If you always need to be in hurry, theres never enough time in the day to finish things and here you are speeding along in your car, impatient at the slow coach in front of you, recall what you wrote down in the section above. Was it the need to always please others so youll be letting others down if you dont get there in record time? Was it that you have to work really hard to get anywhere and that was the message you got when you were a child? Well if you dont work quite as hard or move as frantically (including speeding) will the ground open up and swallow you? Will you be letting others down? Will you lose your job? If you find yourself resistant in your responses (that is you are tempted to say yes I will be letting others down!; yes I could well lose my job!) then ask yourself DO YOU KNOW THIS TO BE ABSOLUTELY TRUE? If you answer yes ask yourself again! Keep asking yourself until you get your mind to a place where it acknowledges that you dont know it to be absolutely true. How can you? I dont have a crystal ball and neither do you. But still if you want to insist that it is true then take a good look at why you have set this up in your life so these outcomes do become reality. This could be a tough one. It could mean you may have to be ready to make some MAJOR changes in your life if you want to rid yourself of these addictive behaviors. Either that or your body may well give way. It can only take so much. Then comes the heart problems, digestive problems, some people even attribute cancer or arthritis to the stuckness of not changing negative behaviors and thoughts.

Relationship problems fall into the same category. You can change a bad relationship, not by changing the other person (though we are often so tempted to after all arent they the reason for all this pain?? NO they are not!), you change the relationship by changing yourself. Look again at your list above on those programmed thoughts that have guided your life. Tell yourself you deserve a great relationship; you dont have to settle for second best; you are deserving of love; you are a beautiful person. You are! You just need to convince yourself. Change those thoughts and your relationship will change. Now I cant promise that ultimately you will stay with that person if you make the necessary changes to improve your life based on your real needs (but not at the expense or hurt of the other person of course!). But you may just find it is time to move on and discover what you truly deserve. This particularly applies for those people stuck in abusive relationships where the rewards of doing so have outweighed moving on. Abusive relationships are not good for anyone and you may find that if you are willing to change but your partner persists with their share of the abuse it may be better for you to get out.

Summary of this article:

Make a list of your issues like Sally did above. She explained in great detail why she is stressed with so little time whats your story? With one or more of your issues try and put it into the Cycle of Addictive Behaviors diagram. You can find this diagram at my web site at http://www.depression-treatment.com.au/CycleOfAddictiveBehaviorsLargerPic.htm Remember you are looking for a reward (the top part of the diagram) such as the need to feel stressed etc. Think of something that is going to happen soon that will repeat this thinking, maybe a really busy day is coming up that will make you flustered and stressed; maybe your partner is returning home from a business trip and you just know he or she is going to be grumpy; maybe a promotion is coming up at work and you know you wont get it because you are not deserving.

Once youve got the story, try and give it a different ending. One that breaks the cycle of thinking that has reinforced your thought patterns. Give it an ending that honors YOU, but not at the hurt or expense of someone else. Here I mean do not deliberately attack the other as though it is their fault. But just focus on you and what is right for you. If they take offense then that is an issue for them to deal with.

Good luck with your journey!

Mark Lockyer is a qualified Social Worker and Teacher with extensive experience in the mental health field. He is also the creator of the web site http://www.depression-treatment.com.au/

The study, published in the Aug. 29 issue of BMC Public Health , contradicts previous research suggesting that ethnic minorities are less likely to volunteer for clinical research, possibly due to infamous breaches of medical ethics such as the Tuskegee Syphilis Study.Ethnic minorities may be more willing than was previously thought to take part in clinical research (News-Medical-Net)

Enhanced and systematic efforts to identify and treat depression in the workplace significantly improves employee health and productivity, likely leading to lower costs overall for the employer, according to a study published in the Journal of the American Medical Association. The study was funded by the National Institutes of Health’s National Institute of Mental Health (NIMH). [click link for …Screening For Depression In The Workplace (Medical News Today)

Neurokinin-1 receptor antagonists as novel antidepressants: trials
British Journal of Psychiatry (subscription), UK - 12 hours ago
Subsequently, however, more extensive clinical trials did not reveal evidence of efficacy in depression. The development of novel antidepressants will

Neurokinin-1 receptor antagonists as novel antidepressants: trials … - British Journal of Psychiatry (subscription)

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: adminclinical depression

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As rated by American doctors, the most frequent medical problem is depression. It seems patients make appointments because of other symptoms (stomach trouble, sleep problems, allergies), and then the reason for the symptoms turns out to be depression. Typically, doctors then will prescribe anti-depressants even though the patients come in about other symptoms and after a few weeks, the symptoms fade and the patient feels more or less okay. Because the doctor is usually a General practice or Internal Medicine physician, he or she will have neither time nor training for much else. As a consequence, drugs are by far the most frequent method for dealing with depression.

What’s fascinating is that, while more drugs are now available (at greater costs) the quality of medical treatment hasn’t improved in more than fifty years. That’s the conclusion of a 1999 US government study on depression. Further, they concluded that typical psychotherapy, drugs (including SSRIs such as Prozac and Paxil), and no treatment at all seemed to provide similar results after about six months.

What does seem to work is changing one’s thinking. Thats great advice, but left unaddressed is the question, How do I do that?” In studies, one psychotherapy model stands as being more useful for depression, Cognitive Behavioral Therapy (CBT). Using CBT the therapist works with the client to change negative, destructive thought patterns.

In fact, changing old habits of thinking (and feeling and beliefs and reactions) is an easily learned skill, but if you are already depressed, you will have to go to the trouble of learning. The good news is that you can do it with a very few hours of work.

Elements of Cognitive Behavioral Therapy are in the recipe for NeuroLinguistic Programming and other, newer, alternative therapies that have all shown great success with depression. And, of course, the only side effects from managing your thinking is that you feel better, which cannot be said for any of the currently used drugs.

Its probably true that some forms of depression of some patients may be best helped with drugs. But for most of us who are just beat up by grief, loss, or the pace and intensity of modern living, there are, fortunately, some wonderfully effective new ways of dealing with the most common medical problem in our country. Try finding practitioners who do NeuroLinguistic Reprogramming, (NLP), Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT) or the rather newer Energy Therapies which have exploded into the world in the last few years. The clear leader in this last group is Emotional Freedom Techniques (EFT), which is being used with perhaps unprecedented success in a huge number of problems.

Perhaps the toughest part of depression is admitting that it might be what is going on in ones own life. Somehow, it carries an unwarranted stigma. But the stigma is unwarranted and there are many new resources that can help. If you think you or a loved one even might be depressed, it would be worth the small investment of time it takes to find out more about these new approaches. Because medical (drug) treatment of depression hasnt improved in more than fifty years, and you don’t have to settle for feeling bad.

Malcolm Campbell has been an alternative therapist and teacher for more than twenty years. He is a Master Practitioner and Trainer of NeuroLinguistic Programming, an ordained minister, and is trained in several other energy therapies. He is the developer of Yoga of the Mind (http://www.yogaofthemind.net) and is a past Director of Counseling for the Stress Management Center of Marin (California).

The Psychiatric Interview in Clinical Practice (2nd edn)
British Journal of Psychiatry (subscription), UK - 12 hours ago
The parts on the management of the interview are the most rewarding to read, particularly the section on discussion of suicide with patients with depression

The Psychiatric Interview in Clinical Practice (2nd edn) - British Journal of Psychiatry (subscription)

Understanding depression: Darker days bring darker moods
Schriever Air Force Base, CO - 17 hours ago
Editor’s Note: Dr. Smith is acting deputy assistant secretary of defense for clinical and program policy and acting chief medical officer for the TriCare
Study: Offering Treatment for Depression to Employees is in Associated Content
all 2 news articles

Understanding depression: Darker days bring darker moods - Schriever Air Force Base

Systematically identifying and treating employees depression symptoms is likely to result in higher job retention, fewer sickness-related absences and increased worker productivity, a study has found.Depression intervention aids productivity: Study (Business Insurance)

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