A Political Prescription for Donald Trump’s Brain

In January, a few thousand mental health professionals, led by John Gartner, organized a Facebook petition warning that Donald Trump is psychologically incapable of competently discharging the duties of President of the United States. By April, the group, Duty to Warn, at a conference at Yale, agreed that the issue no longer was whether Trump is mentally ill but whether he’s dangerous. This week, Duty to Warn, now 63,000 signatories strong, not only broadcast that message in a wildly successful book—The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, edited by Bandy X. Lee, M.D., debuted near the top of The New York Times best-seller list—but became a political action committee (PAC).

The first is to “get the nuclear gun out of Trump’s hands,” by backing H.R. 669, sponsored by Representative Ted Lieu of California, which would prohibit a nuclear strike against an enemy unless Congress first declared war.

The second is to find and win over the 19 Republicans needed for passage of the bill. That, Gartner adds, will enable his group to perfect a program for flipping the 24 seats needed to end Republican control of Congress in 2018 so that Trump can either be reined in or impeached.

The majority of the country now knows that Donald Trump is unfit and they’re terrified,” says Gartner. “We have to drive them to the polls.” He envisions mobilizing campaigns of letter-writing to legislators by constituents and—borrowing the view put forth by political psychologist Drew Westen that targeting the limbic system drives people to the polls—airing videos that “fear monger with the truth.” “Instead of scaring people about killer immigrants or sex rings in pizza parlors,” he aims to create videos for candidates that explain the peril posed by Trump’s mental state and “talk about ‘I’m going to keep your children alive.’”

Systematic Treatment Enhancement Program for Bipolar Disorder – STEP-BD

The NIMH-funded Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) is a long-term outpatient study designed to find out which treatments, or combinations of treatments, are most effective for treating episodes of depression and mania and for preventing recurrent episodes in people with bipolar disorder.

1. Q. What was the goal of the STEP-BD depression psychosocial treatment trial and how did it fit into STEP-BD?

The study reported in the April 2007 issue of the Archives of General Psychiatry describes the results of a clinical trial examining the effectiveness of four psychosocial interventions for people with bipolar disorder who are experiencing a depressive episode. The clinical trial was part of the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) research program, the largest, federally funded treatment trial ever conducted for bipolar disorder. STEP-BD enabled researchers to explore a range of treatment options related to bipolar disorder, including mood-stabilizing medications, antidepressants, atypical antipsychotic medications, and psychosocial interventions (talk therapies).

Once enrolled in the STEP-BD program, participants aged 15 or older received individualized care from their STEP-BD treatment provider that included the best available treatment options. This approach was called the Best Practice Pathway. Participants in the Best Practice Pathway who were age 18 or older and whose depression did not improve or who experienced a new depressive episode, could enter the randomized clinical trial that examined the effectiveness of different combinations of medication and psychosocial therapy for the depressive phase of bipolar disorder.

In this one-year randomized clinical trial, the goal of the psychosocial study was to determine if receiving intensive (and long-term) treatment with any one of the three psychosocial therapies offered in STEP-BD was more effective in relieving bipolar depression than receiving treatment with a brief, short-term talk therapy intervention.

2. Q. Why is the psychosocial treatment trial important?

Although various treatments currently are available for treating bipolar disorder, including medications and talk therapies, it is not known if psychosocial interventions, when received alongside medication, can help relieve bipolar-related depression and keep patients well in typical, real-world clinical settings. In addition, most previous clinical trials were conducted in single academic centers and included carefully selected groups of research participants who may be different from the people seeking care in everyday practice settings.

In this regard, the psychosocial treatment study in STEP-BD is unique because it included “real world” patients experiencing the early phases of a depressive episode, who were already receiving care for their bipolar disorder as part of STEP-BD. The therapists who delivered care in the psychosocial treatment study received STEP-BD training in the different psychosocial therapies by experts in the field. The training and ongoing supervision was of low intensity, consistent with what is typically available in clinical practice.

3. Q. How were participants selected for inclusion in the psychosocial treatment trial?

While enrolled in the STEP-BD Best Practice Pathway, participants were evaluated for depression at every follow-up visit. These clinic visits recorded and tracked participants’ treatment and assessed their symptoms and clinical status for the duration of participation in the study. If the study participants experienced a depressive episode, they could choose to leave the Best Practice Pathway and enter the randomized portion of STEP-BD; 366 participants did so.

The randomized acute depression study lasted 26 weeks and addressed the question of whether adding an antidepressant medication (buproprion or paroxetine) to an existing mood stabilizing medication is more effective for treating acute bipolar-related depression than adding a placebo pill. All participants in this portion were required to be on a mood stabilizing medication, such as lithium, valproate, carbamazepine or other mood stabilizer approved by the U.S. Food and Drug Administration.

These 366 participants also had the option of participating in the randomized psychosocial treatment study in which they would receive psychosocial treatment in addition to their medication treatment. Of the 366 participants who entered the randomized depression trial, 236 chose to enter the psychosocial portion. In addition, 57 STEP-BD participants who were enrolled in the Best Practice Pathway, but who were not part of the medication portion of the randomized depression trial, chose to enter the psychosocial study as well. Altogether, 293 participants took part in the psychosocial treatment study. Many of those who chose not to participate in the psychosocial portion of the study were already receiving psychotherapy on their own.

4. Q. What psychosocial interventions did participants receive?

Researchers randomly assigned participants to receive either a short-term collaborative care intervention or one of three longer-term intensive therapies that have been shown to help stabilize bipolar symptoms—cognitive-behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), or family-focused treatment (FFT). Collaborative care was considered the “control” intervention, meaning that the outcomes of this therapy were used as a baseline by which to compare the other three intensive therapies. All of these therapies focused on education about the illness, relapse prevention planning, and bipolar illness management interventions, and all but collaborative care consisted of up to 30, 50-minute sessions that took place over nine months.

Collaborative care, which consisted of three, 50-minute sessions over six weeks, provided participants with a workbook, an educational videotape and other information that aimed to help them understand and manage the illness, maintain adherence to medications, and develop a treatment contract geared toward preventing bipolar episodes.

In the CBT intervention group, participants received education about the illness. They learned to challenge negative thoughts or beliefs about bipolar disorder or its associated stressful life circumstances, developed schedules to stay active, and developed strategies to detect and cope with mood swings.

The focus of IPSRT was on attaining and maintaining regular social rhythms (daily routines and sleep/wake cycles) and the relationship of daily activities to mood and levels of social stimulation. IPSRT therapists encouraged participants to keep track of their daily routines (e.g., when they went to sleep, when they woke up, etc.) while working toward establishing stable social rhythms. Patients also worked to resolve key interpersonal problems related to grief, role transitions, interpersonal disputes, or interpersonal skill deficits.

In FFT, participants and their relatives (e.g., spouses and parents) were taught an understanding of bipolar illness, its course, treatment and management. Family members were taught how to recognize early warning signs that might predict an oncoming depressive or manic episode in the person with bipolar illness, and strategies to intervene when these warning signs occurred. Treatment included enhancing communication between the participants and their family members to improve the quality of family interactions, and problem-solving to manage conflicts related to the illness.

5. Q. What do the results from the STEP-BD psychosocial treatment trial tell us about the treatment of bipolar disorder?

The outcome measures that were used to evaluate success of the treatments were “time to recovery” (e.g., how quickly did people get well) and the total amount of time during the study year that participants remained “well” (measured by the probability of being well during any given month). To be considered “well” in the study, participants had to have no more than two symptoms of mild or moderate mania or depression.

Of the 293 STEP-BD participants in the psychosocial treatment study, 59 percent recovered from their depression; 41 percent either did not recover or left the study early.

Over the course of the study year, participants in the intensive psychotherapies (FFT, IPSRT, CBT) had a more successful recovery rate (64 percent) compared to the individuals in the collaborative care group (52 percent). Also, participants in the intensive psychotherapies who recovered did so faster (on average, after about 113 days) than those in the collaborative care group (after about 146 days). Furthermore, the participants in the intensive psychotherapies were one and a half times more likely to remain well during any given month of the study year than those in the collaborative care group.

The study also showed that in each of the four psychosocial treatment groups, participants who were also enrolled in the randomized medication portion of the trial got well faster than those who were not, even though all patients were receiving some type of medication. In addition, recovery time was faster in all four groups for those participants who had family supports available.

Differences among the three intensive psychosocial interventions were not statistically significant, but they are worth noting. Over the yearlong study, 77 percent of participants in the FFT recovered, compared to 65 percent of participants in IPSRT and 60 percent in CBT.

6. Q. What do the results mean for people with bipolar depression and the doctors who provide care for them?

This one-year study showed that, in conjunction with adequate mood stabilizing medications, intensive psychotherapy is more effective in helping people recover from a depressive episode, and stay well over a one-year period, than a brief collaborative care treatment. All three types of intensive psychosocial treatments had comparable benefits.

Overall, psychotherapy appears to be a vital part of the effort to stabilize episodes of depression in bipolar illness. These findings should help clinicians plan treatments for individuals recovering from an episode of bipolar depression.

Understanding Paternal Postpartum Depression

Postpartum Depression is an illness usually associated with women, but it may come as a surprise to learn that it can also affect men. Studies have shown that one in ten new fathers will experience some of the symptoms of Paternal postpartum depression within three to six months of their baby being born, but their struggles are more likely to go unrecognised than those of their partner.

As with female Postpartum Depression, there is no single cause for why some men develop Paternal Postpartum Depression and not others, although there are groups of men who have been shown to be more likely to suffer from it. research by the UK’s National Childbirth Trust showed that men who had a strained relationship with their partner throughout the pregnancy had an increased risk, along with younger fathers and men who were struggling financially. Men were also more likely to develop it if their partner had Postpartum Depression too.

The symptoms of Paternal Postpartum Depression are very similar to those experienced by women and include:

Feeling very low and despairing
Feeling guilty, irritable or angry
Being unable to sleep, waking early or having nightmares
Having difficulty concentrating or making decisions
Worrying excessively about the baby’s health and wellbeing
Feeling like a failure or feeling inadequate
Comfort eating or not eating at all
Physical symptoms such as headaches
Having thoughts about harming yourself or the baby
However there are symptoms which appear specific to men and include:

A sense of being excluded from the relationship between the mother and baby
Conflict between how you think you should be and how you actually are
Suffering panic attacks or extreme anxiety
Socialising less and avoiding friends
Lack of interest in sex
Not doing well at work
Acting impulsively
Becoming violent
It can be difficult for men to recognise that they are suffering from Paternal Postpartum Depression as there isn’t the same focus and attention given to male postpartum mental health, also it can be hard to identify it as being more than the usual stress, upheaval and challenge a new baby brings. Research has shown that men often don’t acknowledge feelings of sadness, hopelessness or despair, so depression can often be missed by trained mental health professionals. We live in a society that adheres to the cultural myth that men should be stoic and tough and it can be difficult to change a lifetime of conditioning. Women are more likely to talk about their Postpartum Depression, but men are more likely to employ negative coping mechanisms such as drinking excessive amounts of alcohol and working too much, withdrawing into themselves and reacting with anger.

Getting Help for Paternal Postpartum Depression
If you are a man who thinks you may be suffering from Paternal Postpartum Depression it’s important not to ignore it, as left untreated it could get worse or damage your marriage, career or relationship with the baby. There is so much help available and lots of different treatments you could try and the first step is to talk to someone about how you are feeling. It can be difficult to open up, but it’s important to remember that mental health issues are just the same as physical health problems and there is no shame in asking for help. It doesn’t make you less of a man or father to admit your difficulties and Paternal Postpartum Depression is an illness, not a personal weakness. It can help to think of it as being the same as a broken leg; you wouldn’t walk around on it without seeking treatment and mental health is no different.

The first stage is to be honest with yourself about how you feel. There is a short online assessment you could take if you think you may have Paternal Postpartum Depression here although this is to be used as a general guideline and isn’t a substitute for a medical diagnosis. Your doctor is the best person to talk to initially as they can recommend various types of treatment. The options available include:

Counselling
Medication such as anti-depressants
peer support groups
Cognitive Behavioural Therapy (CBT)
It’s important to also reach out to friends, family and co-workers for support too and don’t try to deal with the feelings alone. You could also see if there are any local Dad’s groups or family support agencies who could offer advice. Self-help options can be used alongside any medical treatments such as exercise and making time for interests and hobbies, even if it is only for an hour here and there. There is also a vast amount of support online if it is easier to remain anonymous such as support forums where you can chat with other Dads, plus there are numerous websites offering advice and coping skills. You could also try telephone helplines if it is easier to access support over the phone. If your partner is also suffering from Postpartum Depression you may both need to seek treatment and support at the same time or you could try family therapy.

5 Tips for Parents of Troubled Teens

The teen years already come with a variety of challenges, including seeing many unexpected changes in your teen’s behavior. Although teens can appear to be unpredictable at times, much of their behavior is entirely normal for adolescence. However, some teens may struggle with emotional, psychological, and behavioral concerns, and they may exhibit behavior that is troubling or concerning. For instance, troubled teens might:

  • abuse drugs and alcohol
    engage in risky sexual activity (unprotected sex, promiscuity, etc.)
    harm themselves through cutting or other forms of self-harm
    talk about suicide
    exhibit extreme signs of defiance (frequently skipping school, many fights at home)
    act aggressively toward friends and family
    display a sudden change in peers that also accompanies getting into trouble with the law or at school
    experience rapid mood swings or intense moods such as depression or mania
    parents of troubled teens

It’s important to recognize that all teens are going to display behavior that is different than what you’re used to seeing in them. For instance, you might have always known your child to be talkative, engaging, and helpful around the house. Now your teen barely says a word, spends all of their time in their room, and refuses to help out with chores. Your words of wise guidance is received with a shrug of the shoulders or a roll of the eyes. You’re not sure exactly who your teen is anymore.

Despite these changes, this is normal behavior for adolescence. A troubled teen is often going to exhibit extreme forms of behavior, such as those listed above.

How to Help Troubled Teens
If you’re having a hard time with your teen consider the following ways you can help:

Focus on strengthening the relationship with your teen.

You might know the saying about troubled teens and youth: the ones that are the hardest to love are the ones that need it the most. If you can, spend quality time with your teen every day, even if it’s for 15 minutes. The point is that you want to boost the connection you have with your teen, or create one if there’s not one already there. Teens who feel connected to, accepted, and loved by their parents often display less troubling behavior. To strengthen your relationship with your teen:

  • Tell your teen you love them.
  • Spend some one-on-one time together. Find something you both enjoy doing.
  • Praise your teen whenever possible.
    Express empathy whenever you see your teen struggling with emotions.
  • Show interest in your teen’s life.

Encourage your teen to follow healthy lifestyle habits. It might not solve all the problems, but getting enough sleep, eating well, and exercising can have a great impact on a teen’s emotional stability. Each of these healthy habits affect both the mind and the body, leading to mental clarity and well-being. Talk to your teen about developing a routine for getting good sleep, exercising, and eating well.
Create more structure for your teen.

Along the lines of developing a routine for healthy lifestyle habits, you may need to create more structure in general. Although your teen might at first fight against it, structure often helps troubled teens to feel safe and secure by your parenting. This too can support the parent-child relationship. Structure may include being more firm about your house rules and enforcing them, having clear expectations of your teen and communicating them, as well as having clear rules around drug/alcohol use, curfews, and other boundaries that support your teen’s safety.
Listen to your teen openly and honestly.

One of the primary needs for teens is to be loved and accepted by their parents. Acting out behavior may stem from not feeling heard or understood. Or worse, feeling rejected by their parents. If you are working on strengthening the relationship with your teen, do your best to hear what your teen has to say. Step into your teen’s shoes and empathize with their feelings and thoughts. This is another way to find connection. And it’s through genuine connection that help relationships grow and develop.
Educate yourself on teen development.

It’s important to know that adolescence is a stage onto itself – it is unlike childhood and adulthood. The needs of a teen are unique. Teens want their independence but require the same security that children do. Meanwhile, teens do their best to walk this tightrope toward adulthood. This is a challenging stage of life, and it demands certain types of parenting. Furthermore, the teen brain is still developing, which can cause teens to be more emotional and impulsive versus logical and rational. A fuller understanding of adolescence can support you in responding to the needs of your teen.
Help Your Teen Manage Their Anger
Many troubled teens exhibit anger and often find themselves in trouble because of it. Because of the consequences that come with expressing anger inappropriately, you can help your teen learn how to manage their anger, in addition to the suggestions provided above. Unfortunately, the consequences to not being able to control anger can include damaging relationships at home, school, and work. In extreme cases, failing to appropriately manage anger can lead to violence, legal problems, suspension/expulsion from school, and other problems. It’s important for parents or caregivers to teach their teens how to manage their anger and use coping tools for facing intense emotions in a healthy way. This is particularly true for parents of troubled teens, who may struggle with anger and may have a hard time expressing this emotion appropriately.

Teens who struggle with anger:

often simply lack the tools to appropriately express their anger.
can learn how to acknowledge anger but not respond to it
can learn how to express their anger in a healthy way
can learn to redirect their anger towards a positive cause
If you are a parent of a troubled teen who often displays anger or aggression, you might teach your teen to:

Develop effective coping skills. Talk to your teen about specific choices they can make in the moment. You might come up with a list together so that your teen has options to choose from. These might include breathing, walking away, thinking of the consequences, or talking to someone.
Develop control over angry responses. You can let your teen know that this will take practice. Anger is a very quick emotion and can come on suddenly. It takes time to learn to have control over anger. However, letting your teen know that it’s possible can be a first step.
Increase frustration tolerance. Sometimes anger or frustration doesn’t need to be followed up by an action. In other words, slowly your teen can learn to tolerate the anger inside (by learning to express it in a healthy way) versus exploding with an angry response.
Improve problem-solving strategies. To help avoid triggers, you can teach your teen to strategies that help solve problems. This in turn can help your teen feel empowered. (Often, feeling disempowered is the root cause of anger.)
Replace aggressive behavior with assertive behavior. Talk to your teen about the differences between passive, aggressive, and assertive behavior. This can also give your teen more choices in terms of how they respond to an anger-provoking moment.
These are suggestions for helping troubled teens with anger, emotional ups-and-downs, and defiance. However, if any of the above suggestions are not entirely effective, it is best to seek the support of a mental health professional.

6 Things to Avoid When Speaking to Someone with Depression

he Centers for Disease Control in Atlanta reported in 2016 that one in 20 Americans 12 years of age and older suffer from depression. With as prevalent as this disease is in society today, one would assume that most people would know how to behave toward another individual who suffers from depression.

In fact, you may not know how to speak with someone with this illness or behave in a manner that does not aggravate his or her depression symptoms. You can help a depressed loved one by avoiding these nine behaviors when you speak with or visit this individual.

1. Mocking or Making Light of the Illness
People who do not understand what depression really is may be tempted to make light of it or even mock someone who suffers from it. Depression as a chronic illness is far more than just temporary moodiness or a brief period of feeling blue. It is a serious and devastating disease that can negatively impact every aspect of a sufferer’s life.

As such, it is critical that you do not make fun of the person or simply dismiss him or her as a drama queen or attention seeker. Your loved one suffers from a genuine medical condition that can be treated and managed with proper therapeutic intervention.

2. Saying the Depression Will Go Away
It is also important that you do not tell the person that his or her symptoms will eventually go away. Some people with depression experience intermittent relief and periods of happiness and even euphoria.

However, without proper depression treatment the symptoms eventually come back and are often more intense. Unlike illnesses like the common cold or hay fever, depression is not an illness that will simply go away on its own.

3. Saying It is God’s Plan
You should avoid telling your depressed loved one that his or her depression is part of God’s plan. Regardless of your religious affiliation or spiritual beliefs, it is vital that you recognize that depression is a genuine and serious medical condition that must be treated with therapy and antidepressants if necessary. You may aggravate and further depress your loved one by telling him or her that God wants this person to suffer.

4. Offering Drugs and Alcohol
People who suffer from depression are at an increased risk already of abusing drugs and alcohol. They do not need anyone to offer them a drink or drugs to help mask or numb their emotional and mental turmoil.

As much as you may hate to see your loved one suffer, you should avoid offering drugs and alcohol to this person. Instead, you should offer to help your loved one find a medical provider who can offer the right treatment for the disease.

5. Bragging about Your Own Good Life
People who are chronically depressed are already sensitive to what other people think of them or how they perceive other people to live. Even if everything in your life is going perfectly, it is important that you avoid bragging about your good fortune to the depressed loved one. You should save your good news about your life to share when your friend or relative is undergoing proper treatment for his or her depression.

6. Agreeing with the Person’s Depressed Beliefs and Emotions
Your friend or loved one may believe that everything in life is terrible and that there is no hope for the future. When depressed people believe that there is no hope, they put themselves at an increased risk of suicide or self-harm.

As such, you should not agree with the person that his or her life is awful and that the future is just as bleak. Agreeing with his or her depressed perception on life could encourage this individual to commit suicide. If this person says that he or she wants to die or is thinking about committing suicide, you should call 911 immediately.

7. Avoiding the Depressed Loved One Entirely
You may find speaking with your depressed loved one to be a trying if not troublesome experience. As much as it might distress you to be around this person, you should still make an effort to check in with him or her every few days.

You do not have to spend hours conversing with this individual. Still, the time that you do spend talking with him or her should be centered on encouraging this person to get professional help and to make an appointment with a licensed and qualified mental health provider.

8. Comparing the Person to Another Person with Depression
Depression affects each sufferer differently. The symptoms that your loved one feels may be entirely different to those symptoms that another person experiences.

With that, you should avoid comparing your depressed loved one to someone else you know with the same illness. Your friend or family member may not want to hear that this other person has the same illness or even that he or she is recovering well. Your loved one needs individualized attention and empathy to be guided toward professional treatment.

9. Saying that Your Loved One Does Not Need Help
Finally, you should avoid telling your loved one that he or she does not need professional help. As mentioned, depression is not an illness that will simply go away on its own.

Like a lingering infection in your blood, it might lessen and even recede briefly. However, it will often come back with a vengeance and cause as much if not more pain to the sufferer.

Your loved one’s best option to find relief from depression lies in getting immediate and professional mental health services. You should encourage him or her to call the local mental health provider today to start receiving treatment for his or her depression.

Depression is a serious illness for which prompt and professional medical and therapeutic services are warranted. You can help a friend or relative who suffers from this illness by encouraging him or her to seek proper help and by avoiding these nine behaviors.

6 Ways Social Media Affects Our Mental Health

Health experts love to say that sitting is the new smoking. Given the number of diseases to which sitting is linked, and the number of people it apparently kills every year, sitting is one of the worst things we can do for health. But possibly as concerning is the mental health habit that’s almost ubiquitous these days: Mindlessly scrolling through our social media feeds when we have a few spare minutes (or for some, hours). And as we probably know intuitively, and as the research is confirming, it’s not the best habit when it comes to our collective psychology.

The American Academy of Pediatrics has warned about the potential for negative effects of social media in young kids and teens, including cyber-bullying and “Facebook depression.” But the same risks may be true for adults, across generations. Here’s a quick run-down of the studies that have shown that social media isn’t very good for mental well-being, and in some ways, it can be pretty bad.

It’s addictive

Experts have not been in total agreement on whether internet addiction is a real thing, let alone social media addiction, but there’s some good evidence that both may exist. A review study from Nottingham Trent University looked back over earlier research on the psychological characteristics, personality and social media use. The authors conclude that “it may be plausible to speak specifically of ‘Facebook Addiction Disorder’…because addiction criteria, such as neglect of personal life, mental preoccupation, escapism, mood modifying experiences, tolerance and concealing the addictive behavior, appear to be present in some people who use [social networks] excessively.” (They also found that the motivation for people’s excessive use of social networks differs depending on certain traits—introverts and extroverts use it for different reasons, as do people with narcissistic traits. But that deserves a piece of its own.)

And studies have confirmed that people tend to undergo a kind of withdrawal: A study a few years ago from Swansea University found that people experienced the psychological symptoms of withdrawal when they stopped using (this went for all internet use, not just social media). Their recent follow-up study found that when people stop using, they also undergo small but measurable physiological effects. Study author Phil Reed said, “We have known for some time that people who are over-dependent on digital devices report feelings of anxiety when they are stopped from using them, but now we can see that these psychological effects are accompanied by actual physiological changes.” Whether this is true of social media per se is unclear right now, but anecdotal evidence suggests it may be.

It triggers more sadness, less well-being

The more we use social media, the less happy we seem to be. One study a few years ago found that Facebook use was linked to both less moment-to-moment happiness and less life satisfaction—the more people used Facebook in a day, the more these two variables dropped off. The authors suggest this may have to do with the fact that Facebook conjures up a perception of social isolation, in a way that other solitary activities don’t. “On the surface,” the authors write, “Facebook provides an invaluable resource for fulfilling such needs by allowing people to instantly connect. Rather than enhancing well-being, as frequent interactions with supportive ‘offline’ social networks powerfully do, the current findings demonstrate that interacting with Facebook may predict the opposite result for young adults—it may undermine it.”

In fact, another study found that social media use is linked to greater feelings of social isolation. The team looked at how much people used 11 social media sites, including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat and Reddit, and correlated this with their “perceived social isolation.” Not surprisingly, it turned out that the more time people spent on these sites, the more socially isolated they perceived themselves to be. And perceived social isolation is one of the worst things for us, mentally and physically.

Comparing our lives with others is mentally unhealthy

Part of the reason Facebook makes people feel socially isolated (even though they may not actually be) is the comparison factor. We fall into the trap of comparing ourselves to others as we scroll through our feeds, and make judgements about how we measure up. One study looked at how we make comparisons to others posts, in “upward” or “downward” directions—that is, feeling that we’re either better or worse off than our friends. It turned out that both types of comparisons made people feel worse, which is surprising, since in real life, only upward comparisons (feeling another person has it better than you) makes people feel bad. But in the social network world, it seems that any kind of comparison is linked to depressive symptoms.

It can lead to jealousy—and a vicious cycle

It’s no secret that the comparison factor in social media leads to jealousy—most people will admit that seeing other people’s tropical vacations and perfectly behaved kids is envy-inducing. Studies have certainly shown that social media use triggers feelings of jealousy. The authors of one study, looking at jealousy and other negative feelings while using Facebook, wrote that “This magnitude of envy incidents taking place on FB alone is astounding, providing evidence that FB offers a breeding ground for invidious feelings.” They add that it can become a vicious cycle: feeling jealous can make a person want to make his or her own life look better, and post jealousy-inducing posts of their own, in an endless circle of one-upping and feeling jealous.

Another study looked at the connection between envy and depression in Facebook use and, interestingly, discovered that envy mediates the Facebook-depression link. That is, when envy is controlled for, Facebook isn’t so depressing. So it may be the envy that’s largely to blame in the depression-Facebook connection.

We get caught in the delusion of thinking it will help

Part of the unhealthy cycle is that we keep coming back to social media, even though it doesn’t make us feel very good. This is probably because of what’s known as a forecasting error: Like a drug, we think getting a fix will help, but it actually makes us feel worse, which comes down to an error in our ability to predict our own response. One study looked at how people feel after using Facebook and how they think they’ll feel going in. Like other studies suggested, the participants in this one almost always felt worse after using it, compared to people engaging in other activities. But a follow-up experiment showed that people generally believed that they’d feel better after using, not worse. Which of course turns out not to be the case at all, and sounds a lot like the pattern in other types of addiction.

More friends on social doesn’t mean you’re more social

A couple of years ago, a study found that more friends on social media doesn’t necessarily mean you have a better social life—there seems to be a cap on the number of friends a person’s brain can handle, and it takes actual social interaction (not virtual) to keep up these friendships. So feeling like you’re being social by being on Facebook doesn’t work. Since loneliness is linked to myriad health and mental health problems (including early death), getting real social support is important. Virtual friend time doesn’t have the therapeutic effect as time with real friends.

All of this is not to say that there’s no benefit to social media—obviously it keeps us connected across great distances, and helps us find people we’d lost touch with years ago. But getting on social when you have some time to kill, or, worse, need an emotional lift, is very likely a bad idea. And studies have found that taking a break from Facebook helps boost psychological well-being. If you’re feeling brave, try taking a little break, and see how it goes. And if you’re going to keep “using,” then at least try to use in moderation.

How To Know When You Need A Mental Health Day

Madalyn Parker, a web developer in Ann Arbor, Michigan, emailed her colleagues to say she’d be using two sick days to focus on her mental health. The company’s CEO, Ben Congleton, responded by thanking her for helping “cut through the stigma of mental health.”

Parker shared his positive response on Twitter, and the story has gone viral. The tweet has sparked discussions across major media about workplace mental health.

Treat Mental Health Like Physical Health

If you had a cold, you might decide to power through your workday. But if you had the flu, you’d likely need to stay home and rest.

And no one would call you weak for getting the flu. In fact, your co-workers would likely thank you for not coming into the office when you’re sick.

Mental health rarely gets the same respect. Instead, people are told to “get over it” when they’re struggling with anxiety, depression or other mental health issues.

But mental health is part of your overall health. If you don’t proactively address your mental health, you won’t be able to perform at your best.

When To Take A Mental Health Day

As a psychotherapist, I’ve helped many people determine whether they were mentally healthy enough to do their job. And much of it depends on the mental health issue you’re grappling with and what kind of work you do.

I once worked with a bus driver who was battling depression. She fought to maintain her concentration but would sometimes grow forgetful. It was clearly a safety concern, requiring more than one mental health day. She needed a leave of absence to work on herself.

Fortunately, most people in need of a mental health day aren’t in such a dire condition. Instead, they’re struggling to handle stress, regulate their thoughts, or manage their emotions. And a day or two away from the office might give them an opportunity to administer the self-care they need to get back on track.

Here are a few times when you might decide you need a mental health day:

• When you’re distracted by something you need to address. If you’re behind on your bills and taking a day off to tackle your budget could help you feel as though you’re back in control, it may make sense to take a day to address it so you can reduce your anxiety.

• When you’ve been neglecting yourself. Just like electronic devices need recharging, it’s important to take time to charge your own batteries. A little alone time or an opportunity to practice some self-care can help you perform better.

• When you need to attend appointments to care for your mental health. Whether you need to see your doctor to get your medication adjusted or to schedule an appointment with your therapist, taking a day off to address your mental health needs is instrumental in helping you be your best.

Why Leaders Should Care About Employees’ Mental Health

It would be wonderful if all employers supported employees’ efforts to take care of their mental health in the same way Congleton did. But clearly, the tweet went viral because most employers wouldn’t have had the same reaction.

That’s unfortunate because workplace mental health is important not to just to individuals, but to the entire workforce.

The U.S. Department of Health and Human Services estimates that only 17% of the U.S. population is functioning at optimal mental health. And 1 in 5 people experience a diagnosable mental health condition at any given time.

The Center for Prevention and Health estimates mental illness and substance abuse issues cost employers up to $105 billion annually. Reduced productivity, absenteeism and increased healthcare costs are just a few of the ways mental health issues cost employers money.

Fortunately, conversations like the one sparked by this tweet can be key to reducing the stigma that surrounds mental health. Clearly, people aren’t either mentally healthy or mentally ill.

Mental health is a continuum, and likely, we all have room for improvement. Taking a mental health day every once in a while could help you build mental strength and improve your mental health.

Complex Post Traumatic Stress Disorder (C-PTSD)

According to research, the traumatic events like car accident, disasters are time limited. If some of the people experience chronic trauma, the behaviour and coping mechanism of such cases becomes severely impaired. The existing diagnosis of PTSD does not include the severe psychological which happens due to repeated or chronic prolonged trauma. Thee are many additional symptoms such as the way people adapt to stressful events changes permanently.

According to the research professors from Harvard University, there is a need to create new diagnosis for Complex PTSD to understand the real effects of long term and repeated trauma. The Complex PTSD symptoms got another name called Disorders of Extreme Stress Not Otherwise Specified (DESNOS). Developmental Trauma Disorder (DTD) are also present in some of the cases specially children who experience chronic trauma.

What is Complex post-traumatic stress disorder?

The complex trauma which is often used as a separate term for CPTSD, is a result of repetitive and prolonged trauma such as child abuse, intimate partner violence, caregiver abandonment, etc. Few other examples are prisoners of war, concentration camp survivors, captivity or entrapment situations can lead to C-PTSD-like symptoms, It includes long feeling of helplessness and deformation of sense of self.

Although there has been some research done and argues by research community, this illness has not been included in American Psychiatric Association’s DSM 5 as well as in World Health Organization’s ICD 10. There has been a proposition to put it in ICD 18 in the year 2018.

The major differences between PTSD and C-PTSD includes captivity, psychological fragmentation, sense of safety, trust, and self-worth are lost, higher tendency to be revictimized. The most important difference is the loss of coherent sense of self.

What additional symptoms in Complex PTSD?

Following are some of the additional symptoms on top of PTSD which patients of C-PTSD may experience:
1. Emotional Regulation – like persistent sadness, suicidal thoughts, explosive anger, inhibited anger, etc.
2. Consciousness – They tend to forget traumatic events, reliving traumatic events, etc.
3. Self-Perception – This is the top differentiator. It will involve person feeling helpless, guilt, stigma, and a sense of being completely different.
4. Relations with Others is suffered – isolation, distrust, etc.
5. Loss of faith
6. Continued sense of hopelessness and despair

Treatment for Complex PTSD

The Standard evidence-based treatments is very effective for PTSD. For treating Complex PTSD the interpersonal difficulties and specific symptoms are required to be addresses. Recovery from CPTSD requires restoration of control and power for the traumatized person. Here the survivors needs to be empowered by healing relationships. They need strong feeling of safety, remembrance, mourning and everyday life.

Self-esteem: How to Help Boys

Adolescence and Teenage years are hard on kids – whether they are boys or girls. It happens equally as well and there is no winner when it comes to low self esteem.

According to latest research in the field of self esteem in kids, the difference in scores on tests of self-esteem among teenage boys and girls is very small. The girls do have self-esteem issues during adolescence. But so do the boys. Adolescence years are equally hard on kids – whether they are boys or girls.

Do Good to Feel Good

If one wants to feel good about self, then he/she has to do something good to feel good about. Doing real and worthwhile things make a person have a positive self esteem and makes him always look upon himself positively. You need to start developing a helpfulness culture in the family where all members help in doing things of one another or may be for people outside home. If you are staying near an elderly neighbor, start with shovelling their walk or mowing their lawn. Get involved in different charitable activities as a family. Raising money for a for a good generic cause also makes a family feel good about themselves. This goes a long way in establishing positive sense of feeling for boys and makes them know that they have earned their positivity.

You should be ready to welcome your son’s friends anytime for doing something fun. Open up your home for the boys to have good time. He will start having confidence on his mother and himself.

Top tips on the boys self-esteem

1. Always set Boundaries and Rules to Follow

Teenagers also needs rules and boundaries just like younger children. Set rules, set expectations that fits your family values and explain them the importance of following them. Make them understood that you expect the rules to be followed regularly and what will follow if it isn’t followed. This makes the boys know that they are values and brings a self-esteem boost for them.

2 Do not Praise too much – be generous

Praising and acknowledging the acts and deeds of children always go as a sure way of building self confidence in children. Tell positive things to your your teens say specific praise. Do not forget to praise them for their efforts since this is what matters and not the results. Let your son know how much you are pleased looking at how hard he has been trying. Always be sincere with your praise since teens after some time will know whether the praises are genuine or not – defeating the whole purpose of praising and pumping them up.

3. Be Supportive During a Conflict

Boys sometimes end up being in middle of a conflict at either school or among friends or team members. Always listen to them and their story before being judgemental about them. The conflicts which they face seems silly to us, but they are very serious for them. Because of teenage years and hormonal changes happening in them. Create a habit and support your child in good and bad equally. Do not budge from taking stand for your child if needed. If they starting feeling that they have a parent to lean on who loves and accepts them is a great confidence booster for them.

How to Deal with a Critical Mom?

There are many ways to look at the mother daughter relation. I is different than mother son relation and father son relation. Mothers are protective, sensitive and critical about the way they treat and love their daughters. So why the relation is so fraught as compared to the one between mothers and sons? The real reason is that boys tend to demand and strive for more separation to find their own identities as compared to girls which gives boys and mother’s relations a sense of separation, whereas the girls tend to come closer and becomes more like their mothers as they grow up – increasing the competition and hidden conflicts. Girls strive to develop a sense of self like their mother rather than against their mothers which causes all the difference of being so critical. It can make the communication with mom more and more frustrating since competition creeps in.

Mom’s are not mean when you find them awake all night or believe so that they are awake. The mothers do not pester their daughters unnecessarily. They are expressing their love and concern, but the way is what it is. You need to train yourself to see what is inside as compared to what is coming outside – nit-picking, criticism, and all those things you don’t like.

How to handle Critical and Meddling Moms

There are many examples where a highly critical mom has been driving crazy people till their own old years. Like one of the person in her 70’s said that her mom criticise her for her skinny legs, non-feminine appearance, body hairs, etc. such that it is haunting her till today everyday. Her mom still in her 90’s tell her daughter to become more sexy and appealing by becoming feminine rather that doing the things like she is doing. Quite a pain, if you put yourself in the daughters shoes who has been suffering due to ever critical mom since last 7 decades.

Here are some of the things which you can do to handle the situation:

1. Focus on things you can change rather than on what you can’t change like your mom and her behaviour. You cannot just have any control on your mother and her emotional blabber. Just accept and think you are responsible for your happiness.
2. Do try to understand that the parents criticism is not about you but about some of their inner feelings which lost during the course of years. The problem of why they are criticizing lies in you parent’s own self-contempt. They should first learn to accept and love themselves and here you go – they will become better and less criticizing.
3. They think you are their extension and do the same self check with you as well. They do not consider you as a separate person rather a part of themselves hence so critical.
4. Parent cannot always be right. They have their own say, but since you are an adult, you can also think and decide on your own. Parents still jhave the same perception about you since you are the same kids for them forever. So relax and take fun in their opinion rather than slogging and sweating out due to their viewpoint.
5. Be assertive with your parent. You are not required to be defensive and make excuses. Be polite and say “I don’t appreciate this”. This can channelize the inner content and the anger outburst is not expelled on to other non-deserving relations like your child or spouse.
6. The more time you spend with people who bring positive energy in you the more are the chances that the critical comments from your mother will fade away. Just balance the time you spend with positive people and negative people. You will be fine. This balance will bring you peace and joy.