ARCHIVE

Many people think of mental health disorders as isolated conditions. When we hear someone say, “I have depression,” or “My husband has anxiety” it leads us to think that there’s a specific solution for each of these problems that would help people feel better. But it’s not quite that simple. For instance, if someone had only depression, you might think antidepressants would be the simple solution to reduce symptoms and boost their mood and energy. But more than half of depressed patients don’t get the relief they want from taking antidepressants, according to a large study. Similarly, if someone has ADD/ADHD, you might think that prescription stimulants are the easy answer to their issues. But they often aren’t. Why are the standard treatment models ineffective for so many people? Increasingly, physicians and other clinicians recognize that most patients with psychiatric conditions have complex conditions that don’t fit into the tidy categorical boxes described in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM)—and for a good reason. Many people with mental health issues have an array of symptoms that can occur in a variety of disorders and confound the diagnostic process. Here’s an example of the same symptoms which can be seen in different mental health issues:
Depression Anxiety ADHD Bipolar Disorder TBI
Irritability x x x x
Insomnia x x x x
Poor concentration x x x x x
Impulsivity x x x
Restlessness x x x x x
Behavioral problems x x x

 

Having More Than One Psychiatric Diagnosis is Common

While there are other symptoms that cross diagnostic categories too, recognizing that most mental health problems are not single or simple disorders is helpful in understanding why so many people struggle to get adequate relief of their symptoms. A 2019 research study published in the journal, JAMA Psychiatry, reviewed the mental health history data of more than 5 million people and found that having one mental health disorder increased the risk of having another. This means that comorbidity (having two or more conditions) may actually be more common than having just one. Comorbidity (having two or more mental health conditions) may actually be more common than having just one.
Click to tweet
This means it’s common for people to have multiple conditions at the same time, such as depression and anxiety, ADD/ADHD and depression, panic disorder and bipolar disorder, addiction and anxiety or depression, obsessive compulsive disorder (OCD), and an eating disorder, and so on. Having multiple psychiatric disorders is referred to as dual diagnosis, co-occurring conditions, or co-existing disorders. Treating only one of the conditions will never be adequate. All of the issues need to be treated in order to get well. While it is still not yet known why mental health problems are more complex than originally believed, there are likely some genetic influences and environmental experiences that make some people more vulnerable to them.

Mental Health Disorders Have Multiple Causes

However, what we do know, is that a person’s mental health is directly linked to what’s going on in their brain. During the past 30 years, many people have sought treatment at Amen Clinics after they’ve had several failed attempts to feel better elsewhere. This is largely because of traditional psychiatry’s reliance on the limited DSM symptom-cluster approach to diagnosing their patients. Plus, most psychiatrists don’t use advanced imaging technology, such as SPECT (single-photon-emission-computed-tomography) to actually look at their patients’ brains to assess for the biological underpinnings of their symptoms. Consequently, many people are misdiagnosed and/or inadequately treated because underlying brain problems are missed altogether. Using the example of depression again, to accurately treat a patient, it’s necessary to identify what could be driving a person’s symptoms, since there are several potential causes, including these: Because of this, what works well for one person isn’t necessarily going to work for someone else. There is not a one-size-fits-all treatment for depression—nor for any other psychiatric disorder—because of the complexities that come with each condition as well as the uniqueness of each person’s brain.

A Game-Changing Discovery

Another discovery that helps to explain the problems with treatment response also comes from the extensive brain SPECT imaging work done at Amen Clinics, which now has a database of more than 183,000 patient scans. One of the most important findings is that some of the more common mental health conditions have several identifiable subtypes, which are based on specific brain patterns. The doctors and researchers at Amen Clinics have identified: What makes this work so important is that each of the disorders and their subtypes has different characteristics, which require individualized treatment plans that take into consideration a patient’s symptoms as well as their brain biology and clinical history. Without having SPECT scans as an adjunct tool, it would be much more difficult to accurately diagnose and treat patients. As Dr. Daniel Amen, founder of Amen Clinics, has said, “How do you know unless you look?” By having incorporated such a comprehensive evaluation process for each patient—including the valuable information from the scans—the doctors at Amen Clinics have successfully helped tens of thousands of people finally find relief from symptoms of multiple conditions, so they can live more fulfilling and healthy lives. Complex mental health problems can’t wait. During this ongoing time of uncertainty, your mental well-being is more important than ever. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Living with anxiety can be tough. It’s bad enough with the frightening thoughts swirling in your head, the endless worrying, and the panic you feel for seemingly no reason. It’s even worse that anxiety disorders also come with a host of symptoms that are not only uncomfortable but also can make you feel embarassed. If you’re among the 40 million people in the U.S. who typically have some form of anxiety each year, you can probably relate. Whether you have a generalized anxiety disorder, a phobia, panic disorder, or social anxiety—among other diagnoses—you may struggle with symptoms that are noticeable to others. This occurs because your body is reacting to the worrisome thoughts running consciously or unconsciously through your mind. And at times, these outward signs can be hard to control, especially since anxiousness can be unpredictable and crop up suddenly. When these outward anxiety symptoms manifest in the presence of others, they can make you feel worse. When embarrassing anxiety symptoms manifest in the presence of others, they can make you feel worse.
Click to tweet

5 Uncomfortable Yet Common Symptoms of Anxiety

Know that if you’ve ever experienced any of the following bothersome issues, you are definitely not alone!

1. Sweating

While it’s normal to sweat as the temperature goes up, when you’re exercising, or even giving a presentation, people with anxiety can break into a serious sweat when they get triggered. You can thank your stress response system for this. When it is activated, your heart rate goes up which raises your body temperature, and sweating is nature’s way to help cool you down. Nonetheless, it can be very uncomfortable for your face, head, or armpits to show obvious signs of profuse sweating for no apparent reason—especially while everyone else looks cool and collected. The self-consciousness you may experience when this happens can make your anxiety feel even worse.

2. Shaking and Trembling

The brain is wired for survival and responds immediately and unconsciously to any perceived danger. However, since people with anxiety are more predisposed to having fearful thoughts, they tend to have an elevated sensitivity to perceived threats (even if they aren’t real). The brain, however, responds to real and imagined threats the same way. When the fight-or-flight mode kicks in, stress hormones speed up your heart rate and respiration, while preparing your muscles to respond. This leads to varying degrees of uncontrollable shaking or trembling, which often can affect your hands, voice, legs, or your whole body—and even cause your teeth to chatter.

3. Gastrointestinal Distress

Your fight-or-flight system is also responsible for anxiety-related nausea, vomiting, diarrhea, gas, and other G.I distress. When it is activated, some of the neurotransmitters and hormones released get into your digestive tract and disrupt the balance of micro-organisms that live in your microbiome. This can lead to the sudden onset of G.I. symptoms. In turn, this can elevate your fear about having to get to a bathroom quickly, especially when you’re out in public or with friends, which of course can make you worry even more or cause you to repeatedly make up excuses for staying home.

4. Stuttering

While stuttering is a different disorder than anxiety, it isn’t unusual for someone who’s really anxious to stutter when talking. This can be caused by difficulty slowing down and organizing your thoughts or overthinking them which basically makes you trip over your words as you try to express yourself. Interestingly, a 2014 study in the Journal of Fluency Disorders has found that many people who stutter also have social anxiety disorder.

5. Raggedy nails

It’s not uncommon for someone who struggles with anxiety to bite their nails. The act of chewing on your nails can relieve stress—it’s a habit that usually starts in childhood or adolescence. However, those who continue to bite their nails and fingers when nervous can cause damage to the tissues of their fingers and nails which can be hard to hide and is another source of embarrassment. Also, chronically biting your nails can progress to a more severe condition called onychophagia which goes beyond nervous nail chewing to a category of disorders known as body-focused repetitive behaviors that are related to obsessive compulsive disorder. Many of the patients who have come to Amen Clinics to get help for their anxiety, undergo a SPECT scan as part of their evaluation. They often learn that one of the biological underpinnings for their anxiety is overactivity in the basal ganglia, which is a part of the brain that is involved in setting the body’s idle. Armed with this important information, the doctors can develop comprehensive treatment plans to reduce anxiety, so these patients can get be free from their symptoms, including those unpredictable ones that can make you feel even worse about yourself. Anxiety disorders and other mental health problems can’t wait. and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. YouTube star and vlog squad member Jeff Wittek suffered a horrific injury resulting from a filmed stunt gone wrong. The accident caused severe facial injuries and nearly cost him his eye. Since then, he’s endured several painful surgeries. From the scars on his face, his millions of followers could tell he’d suffered from something terrible, but what people couldn’t see was that he was also suffering on the inside. His mental health began to deteriorate, and he was experiencing a different kind of pain he had never felt before in his entire life—depression, anxiety, and serious emotional stress. From the scars on his face, YouTuber Jeff Wittek’s millions of followers could tell he’d suffered from something terrible, but what people couldn’t see was that he was also suffering on the inside as his mental health deteriorated.
Click to tweet

A YouTube Stunt Gone Terribly Wrong

“I’m obsessed with my profession,” Jeff said to Daniel G. Amen, MD, when he met with the psychiatrist, neuroscientist, and founder of Amen Clinics. “I just want everything to be perfect. and just be the best I can be when I put out these videos.” During the pandemic, Jeff turned 30 and had gotten to a point in his professional life where he wanted to create something bigger. “I can’t just be making these silly, stupid videos anymore,” he said. He agreed to do a stunt for a friend’s video that was going to be monumental. It involved an excavator, a massive piece of machinery used in construction that spins. In the middle of a lake, Jeff was going to be dangling on a wakeboard attached to the end of a rope on the excavator’s arm as it spun as fast as possible. It sounded like a lot of fun—at least for a YouTuber like Jeff who is used to doing crazy stuff most people would never do—until he spun wildly out of control and went flying face-first into the excavator itself. Jeff broke his hip, had 9 fractures in his skull and face, and had a full orbital blowout fracture. He couldn’t see out of one of his eyes. “Everybody thought I was gonna die,” he recalls. “I was pale white, and I lost a lot of blood.” His YouTube colleagues and friends put him into a car and rushed him to the hospital. along the way, Jeff tried to pull down the car’s visor, but his friends stopped him. They told him not to look at his face, and that’s when the influencer knew it was bad, really bad. And the 30-year-old had no idea that things were about to get worse.

When the Invisible Struggle Is Worse

As Jeff went through the process to heal from the head trauma and many fractures, he began to notice another side effect of the accident. He started feeling anxious and had a persistent blue mood. “I never thought that depression or anxiety or anything like that was even a real thing,” he admitted. “When I heard people talk about having it, I thought it would just be like, ‘Okay, you’re just a little nervous or something or you’re overreacting.’” He still has a hard time believing that it could be happening to him. “It’s just something I never expected I would go through,” he said. “I was in jail and I didn’t go through it.” As the weeks and months passed, things got worse, not better. “It got dark,” he recalled. “A couple months after the accident it was some of the darkest days of my life.” With all the changes in his mental health, he began to suspect his brain was also affected. That’s when he decided to visit Dr. Amen at Amen Clinics for a brain scan.

What Jeff’s Brain SPECT Scans Reveal

On a scale of 1-10, how bad was Jeff’s brain after the accident? When Dr. Amen told Jeff that his brain was currently a 4 out of 10, it hit hard. “I didn’t think it was that bad,” says Jeff. But the YouTuber’s brain SPECT scans showed why. SPECT is a brain imaging tool that measures blood flow and activity in the brain and it shows 3 things:   Jeff’s scan showed abnormal activity in several areas, including the following: Prefrontal cortex: This part of the brain located behind the forehead, which is where Jeff’s head rammed into the excavator, is involved with planning, impulse control, judgment, organization, learning from the mistakes you make, and more. Jeff’s scan showed low blood flow to this critical brain region, which is considered the part of the brain that makes us human. Dr. Amen explained to Jeff that when you have decreased blood flow here, “You can do things and say things you shouldn’t do.” Limbic system: The limbic system is involved in setting a person’s emotional tone. On Jeff’s scan, it shows overactivity in this region, which is associated with heightened anxiety and low moods. “Bumpy” appearance: In healthy SPECT surface scans, there is a smooth, even appearance to the brain. On Jeff’s surface scan, it looks more “bumpy,” which is sometimes a sign of exposure to toxins. Jeff admits that he used to have a problem with booze (he says he stopped drinking 3 years ago), which is commonly associated with “bumpiness” on brain scans. As Dr. Amen explained to him, “Your brain is older than you are.” Other neurocognitive tests Jeff took at Amen Clinics showed high scores for stress, anxiety, and depression, as well as conscious negativity. This means a negative outlook on life in general.

How Head Trauma Impacts Your Life

Traumatic brain injuries (TBIs), as well as the surgeries to treat injuries associated with head trauma, can have serious consequences in many areas of your life.

Healing an Injured Brain

On the bright side, it is possible to heal after head trauma. Although Jeff expressed concern about how bad his brain looked, Dr. Amen assured him that his brain wasn’t permanently damaged. And he said that if Jeff followed the recommendations he gave him, he could dramatically improve the health of his brain and decrease his symptoms. Head injuries, depression, anxiety, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. How many times have you predicted the way you will feel about something in the future and been right? For example, think about something you really want to get. If you’re a fashionista, perhaps it’s buying a new pair of the trendiest shoes. If you’re really into music, maybe it’s buying tickets to a concert you’ve been wanting to see. As you anticipate such things to come, you may feel really pumped up about them, believing they will make you feel just as happy when you get them as you do right now by simply thinking about them. This type of projection is called affective forecasting. The term affect refers to emotions. People commonly predict how they will feel when they acquire, achieve, do, or otherwise enhance their life. This makes sense in many ways and motivates us to be driven toward whatever the thing is that we want. What’s interesting though is that once you get what you wanted you aren’t going to feel quite as happy as you thought you would. The opposite is also true. A future event that you are not looking forward to because you’re sure it’s going to make you feel terrible, ends up being only moderately unpleasant.

We Unintentionally Exaggerate

The big problem with predicting how you’ll feel in the future is that you are projecting emotions based on how you feel in the present. Quite often those emotions are exaggerated, and most of the time they end up being off the mark. Since our lives are multi-faceted and influenced by many things at once, it’s very difficult to know exactly how you will feel down the road. Not to say that desiring things is necessarily bad, rather it is the emotional power we mistakenly assign to the feelings about them that is misleading and can subsequently diminish our satisfaction quotient. We’re usually pretty good at being able to predict in advance whether an event or situation is likely to be good or unpleasant. However, we’re not very skilled at accurately predicting what the intensity of our emotions will be nor how long they will last. This is due to impact bias which is our tendency to overestimate how good or bad something in the future will make us feel. One of the contributing factors for this kind of bias is the knack we have for focusing on a singular positive aspect of what it is to come while underestimating the concurrent demands of other things like responsibilities at home or work. For example, you and a group of friends plan a long weekend getaway. The excitement and joy you have about the fun you’ll have together overrides your thoughts about any negative implications, such as the cost of the trip or returning home on a red-eye flight.

It’s Not as Bad—or as Good—as You Predict

Aside from very stressful situations such as the death of a loved one or divorce, when we think about something bad happening in the future—like not getting a highly coveted job offer—we tend to overestimate how awful we will feel. This is because we accommodate rather quickly to changes in our circumstances. Through processes like reasoning, positive beliefs, and attribution to external forces, our psychological immune system helps us to recover from disappointing or otherwise negative events. In unconscious ways it helps us to adapt, so we’re likely to justify the loss by convincing ourselves that: So, what we initially predicted to be feeling really horrible, isn’t quite so terrible after all. We make similar unconscious accommodations with positive events too. For instance, today you might be projecting a sense of happiness for when you acquire or achieve something you really want. However, once it actually happens, it becomes integrated into your life, and though it’s still positive, the intensity of those predicted positive emotions starts to diminish and wear off surprisingly quickly. So, while the outcome is still a good one, your degree of happiness or satisfaction did not increase as much as you had anticipated it would.

Are You a Debbie-Downer?

Of note, if you’re almost always projecting feelings about the future with a glass-half-empty perspective, you might be what’s known as a negative forecaster. This mindset is consistent with certain mental health issues such as depression, which can cause people to lose their joy, interest in things, and hope for the future. Negative forecasting is also common in people with anxiety, who tend to be more fearful and predict the worst outcome for situations. Conversely, the tendency to believe you are going to feel good in the future is called positive forecasting and research has found it to be associated with a greater sense of well-being and resilience from stress. Seeing the future with a glass-half-empty perspective is called negative forecasting and is found in people with depression and anxiety. Conversely, positive forecasting is associated with a greater sense of well-being and resilience.
Click to tweet

3 Ways to Be More Realistic About Your Future Feelings

Although it can be challenging, it’s important to practice being more accurate in predicting how you will feel in the future because it can have a significant bearing on important decisions you make. If you’re considering a relocation, career change, getting married, or any life-changing event, be aware of the natural human tendency to be incorrect about how you will ultimately feel. To help guide you, here are 3 things you can do:
  1. Be sure you consider the pros and cons of things you desire so you can be more realistic about the emotional impact of your choices.
  2. To help temper miscalculations, talking to others and getting objective perspectives about how the things you want—or what you want to avoid—will likely make you feel when the future arrives.
  3. Don’t rush important decisions. Write down your thoughts in a journal over a period of time to help you stay in a more cognitive frame of mind, rather than letting your emotions dictate your decisions because emotions naturally fluctuate.
If you’re suffering with symptoms of anxiety, depression, or other mental health problems, at Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. By Neha Kansara, MD The month of May is marked by Mother’s Day, a time when we collectively celebrate the joys of motherhood. But for many women, being a mom or becoming one is fraught with emotional upheaval. As a specialist in women’s health and perinatal/reproductive psychiatry, I have seen that women can struggle at every phase of the process—fertility, pregnancy, and postpartum. Here are some strategies I use with my patients to help them achieve better emotional balance in their motherhood journey.

Coping with the Stress and Anxiety of Fertility Issues

As I say to my patients who are feeling overly stressed or anxious about fertility problems, “It comes easy and very naturally to many, but you may not be one of those many.” I typically remind these women that even though becoming pregnant may not be as easy and natural as it is for others, believing in the power of being a woman and having the confidence that their body can create a human being should keep them going. My recommendation to these women is to avoid letting the stress of infertility take over their life. Focusing on the stress creates even more stress and leads to feelings of anguish, frustration, and a sense of being a failure. This leads to grief and a sense of loss. One of my favorite sayings is: “Always remember that difficult roads lead to beautiful destinations!” When a woman has faith and believes in the process, it enhances the ability to create the magic and have a miracle baby.

Dealing with the Emotional Ups and Downs of Pregnancy

Some women hit the pregnancy jackpot and feel like a million bucks from the day of conception until the time they deliver. They’re the lucky ones. However, there are so many others who are bedridden due to complications, such as first trimester morning sickness, spotting that leads to fears of losing a baby, second trimester gestational diabetes, third trimester fatigue or pre-eclampsia, and so on. When pregnancies don’t go smoothly, it can give birth to mood instability, anxiety, anticipated apprehension, and catastrophic thinking. When I see patients like this, I suggest that they create an open line of communication with their obstetrician, so they feel assured that both they and their unborn fetus are in good hands. Secondly, I recommend practicing positive affirmations, breathing exercises, prenatal yoga, and meditation because they are useful tools that help calm pregnancy-related fears and anxiety. Last but not least, mothers-to-be do not need to go it alone in this journey. It’s important for pregnant women to seek support from close friends and family and to ask for professional help if needed.

Perinatal Mood and Anxiety Disorders

The first 3 months postpartum are the most difficult phase and time in a mother’s life. It’s so challenging, it has earned the term “the fourth trimester.” For some women, this stage may last much longer than a trimester, lingering on for 2 years or even more. During this phase when they are caring for a newborn, moms are trying to be the best version of themselves while also attempting to be attentive to everyone else’s needs the way they used to—all while dealing with sleep deprivation. This is also a phase that can be particularly challenging for maternal mental health. Postpartum symptoms, also known as PMADs (perinatal mood and anxiety disorders), can include a constellation of symptoms that are negatively influenced by hormonal imbalances, sleep deprivation, pre-morbid conditions, lack of support, difficulties in breastfeeding, and much more. For some women, a sense of pressure to be the BEST IDEAL MOM adds even more stress and contributes to postpartum depression, anxiety, trauma, and more. I always ask new moms to pose this question to themselves: “Will I be able to create the same balance I had achieved before, and if not, what’s the worst that can happen?” Helping women walk themselves through this process to unburden themselves of the pursuit of perfection and to believe in themselves helps them succeed in feeling more joy in motherhood.

Dr. Kansara’s 7 Healing Solutions for Perinatal Mental Health Issues

Here are 7 solutions I recommend to nearly all of my patients who are experiencing emotional challenges related to motherhood.
  1. The golden rule to always keep in mind: DO NOT SUFFER IN SILENCE AS YOU ARE NOT ALONE!
  2. Take time out for yourself even if it is just 10-15 minutes a day. You need to breathe deeply and heal yourself first. Self-healing is extremely important in this journey.
  3. Try to incorporate a healthy diet, adequate hydration, meditation, and exercise.
  4. Take daily walks whenever possible.
  5. Practice daily post-natal yoga.
  6. Ask for help and remember that there is no shame in that. People will support you when you ask.
  7. If your mental health is suffering and interfering with your daily life or your ability to bond with or care for your baby, you may benefit from professional help. Check the Postpartum Support International for resources and support or for more personalized treatment for perinatal mental health issues, contact Amen Clinics for the best quality of care.

About the Author: Neha Kansara, MD, Amen Clinics Dallas

Dr. Neha Kansara is a double board-certified psychiatrist at Amen Clinics specializing in women’s health and perinatal/reproductive psychiatry. She also serves on the panel of Postpartum Support International. To make an appointment with Dr. Kansara or to make a referral, contact us at 888-288-9834 or on our website here. As scientists and researchers continue their ongoing work into the impact of the COVID-19 crisis, it has become blatantly clear that mental health problems are rising in the United States and around the world. This increase is not only in people with pre-existing mental illness or some of those who already survived the virus, but the psychological distress has also impacted a number of people who had never before been diagnosed with a psychiatric condition. This news is almost enough to make anyone anxious or depressed! Since the start of the pandemic, The National Center for Health Statistics is one of the institutions that has been tracking this information using the Household Pulse Survey. As of April 2021, results from their data collection show that 35% of U.S. adults have reported having symptoms of anxiety or depression every day or nearly half the days. From a comparison perspective, from January to June 2019 only 11% of people reported having the same symptoms. Another survey, a poll from the Kaiser Family Foundation, reported that as of March 2021, 47% of people continue to have adverse mental health problems from pandemic-related stress and anxiety. These distressing statistics may have you wondering if this is simply the new normal and if you should just resign yourself to a life filled with angst. The answer is a resounding NO!

Pandemic Causes of Psychological Distress

Just when it seemed like we were starting to get ahead, certain states have cases surging again as more contagious variants proliferate. This, of course, may extend some of the struggles many people have been trying to manage for the past year, such as: It appears that younger adults, particularly women—and especially those with children at home—are struggling more with worry and stress during the pandemic. Aside from the concerns listed above, their normally higher need for social interactions with peers may be making them more vulnerable, because our time spent with others can often help buffer mental health symptoms. Getting together with friends, going to a gym, attending religious services, and community events have all been curbed to some extent in most places. With these normal outlets unavailable to many people right now, it is no wonder that rates of mental illness have been growing. Are you concerned about yourself or a loved one?

Symptoms of Anxiety and Depression

While everyone has a bad day on occasion, when the following symptoms occur regularly, it could be an indication that anxiety or depressive disorder has developed. Common Symptoms of Anxiety Common Symptoms of Depression Not everyone will have all the symptoms for either anxiety and/or depression, but even having a few of them can be a red flag that should not be overlooked. Reaching out to get professional help for treatment is an important first step to take so you can start feeling better. Even having a few symptoms of anxiety and/or depression can be a red flag that should not be overlooked. Reaching out to get professional help for treatment is an important first step to take so you can start feeling better.
Click to tweet

3 Lifestyle Strategies to Manage Stress, Worries, and Depressed Mood

To further support your mental health, the following 3 lifestyle strategies can help improve your symptoms and bring more balance into your brain and body even in the wake of a pandemic:
  1. Pay attention to your automatic negative thoughts (ANTs) because they are likely adding to your distress. Notice if you tend to think in terms of always or never, or if you predict the worst outcome for everything. You can learn to manage these ANTs by doing some reality testing using a simple technique borrowed from Byron Katie:
Start by identifying what the negative or stressful thought is, then ask yourself the following questions about it: Then turn around your thought to its opposite and see if it isn’t actually truer than your original thought. Use a journal to write down each ANT and your answers to the questions. By practicing this, you can reduce the control they have over how you feel each day.
  1. Choose more nutritious foods and eat at regular intervals. This helps to stabilize your blood sugar and properly fuel your brain and body, which in turn can support your mental health.
Include foods like these: And stay away from these:
  1. Exercise regularly in any way you can. Whether it’s walking—even just around the block, hiking, jogging, swimming, biking, yoga, or lifting weights at the gym, exercise is a natural antidepressant and anti-anxiety treatment. It boosts chemicals in the brain that reduce pain and stress and lift your mood.
We must continue navigating the persistent challenges brought about by the COVID-19 pandemic—at least for the foreseeable future. Therefore, by reaching out for help when you need it and incorporating healthy lifestyle strategies like these, you can start to reduce your symptoms and build more resilience as you move forward during these unpredictable times. It’s up to you to create your own version of the new normal. Anxiety, depression, and other mental health problems can’t wait. During this time of uncertainty, your mental well-being is more important than ever. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Are your days filled with Zoom meetings for work, video chats with family and friends, web appointments with doctors, online conferences with your kids’ teachers, and more? All that video conferencing is leaving people stressed, anxious, depressed, and exhausted. This new phenomenon has become so prevalent, it’s earned the nickname “Zoom fatigue,” and you’re probably one of the millions of Americans suffering from it.

5 REASONS WHY YOUR BRAIN HATES ZOOM

In a 2021 study involving 10,591 people, researchers from Sweden and Stanford University confirmed what we’ve all felt—video conferencing is draining. The team of scientists reveals that Zoom fatigue is more pronounced in women than men, and they point to 5 specific brain-related reasons why video calls are so exhausting.

1. Mirror anxiety

Anyone who has used Zoom has come face-to-face (or rather, face-to-screen) with their own image—either in one of those little boxes or full-screen—and it can cause something referred to as “mirror anxiety.” Scientific evidence shows that self-focused attention can heighten vulnerability to negative affect and has been associated with increased anxiety and depression.

2. Feeling physically trapped

When you’re in an in-person meeting, you’re free to move about—lean in, stand up, stretch, and more. On Zoom, however, you’re basically locked into one position, so your head and shoulders fit within the eye of your webcam. Physical restriction diminishes creative thinking and cognitive performance. For some people, this may feel like a virtual form of claustrophobia.

3. Hyper gaze

In the 2021 study, the researchers suggest that hyper gaze—having all those virtual eyeballs constantly staring at you—is anxiety-provoking. During in-person meetings, people may glance at you from time to time, but in video conferencing the direct eye gaze never stops. And when it’s a one-on-one meeting, the person’s head can take up the whole screen as if they’re standing less than 2 feet away. In real life, getting up close like this might seem confrontational or too intimate. Either way, it’s a stress inducer.

4. Cognitive load of interpreting nonverbal cues

When all you’re seeing on screen are people’s heads and shoulders, you miss out on critical nonverbal cues that your brain typically processes. In a real-life meeting setting, you would notice people’s body language, such as emphasizing a point with hand gestures, crossing their arms, tapping their toes nervously, and so on. Without these clues, your brain has to work overtime to grasp the underlying intent and meaning of what is being said.

5. Cognitive load of producing nonverbal cues

On the flip side, you may feel the need to overemphasize your own nonverbal cues in response to others or while you’re speaking. You may consciously think about making exaggerated hand gestures so others can see them. This places a greater demand on brainpower. As anyone who has been on Zoom knows, these aren’t the only reasons why video conferencing can be so exhausting. Add in tech glitches, having to deal with distracting background noise, and getting no feedback or delayed feedback while talking, and it’s easy to see why it’s so stressful.

6 WAYS TO REDUCE ZOOM STRESS AND ANXIETY

In the wake of the pandemic and the shift to remote working, it looks like Zoom and other video conferencing platforms are here to stay. Understanding the possibility of Zoom fatigue and making a few adjustments in your daily usage could be helpful for you.

1. Hide self-view.

If you have trouble with mirror anxiety, some video conferencing platforms offer an option to hide yourself, which allows others to see but prevents you from seeing yourself. If you’re really struggling with anxiety about video conferencing, it may be time to seek professional help.

2. Go wireless.

To minimize the size of your own face on the screen, use a wireless keyboard, which allows you to sit farther away from your webcam. This may help reduce self-consciousness.

3. Take mini-breaks.

Looking away from your computer screen for several seconds or briefly opening a document or your calendar to block all those faces for a brief moment can give your brain a short respite.

4. Get up…or down.

Consider a standing desk that you could move up or down during calls so you can have some ability to alternate from sitting to standing to alleviate feelings of being trapped.

5. Change your view.

If all those eyeballs staring back at you creeps you out, try “speaker view” instead of “gallery view.” By contrast, if seeing one person’s face full-screen in speaker view is alarming to you, switch to the gallery view. Or you may find that switching back and forth from speaker to gallery view may give your brain a break.

6. Create a routine.

To reduce the stress and anxiety associated with video conferencing, stretch or practice deep breathing before and after video conference calls. This can help calm your mind and body. Feelings of stress and anxiety can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Are you feeling a sense of emotional overwhelm like you just can’t cope with the tsunami of challenges you’re facing? A lot of people eagerly anticipated a return to normalcy at the end of 2020, but that didn’t happen. All the changes, accommodations, limitations, and demands that we have had to deal with due to the pandemic have really added up and are taking a toll on many people. A recent report from the American Psychological Association found that 84%—that’s more than 4 out of 5—of the people surveyed have been experiencing elevated levels of stress. In addition, almost half of them reported having symptoms of anxiety and/or depression, as well as weight changes and problems with sleep—conditions that often accompany emotional overwhelm. There are a number of practical factors that can be contributing to how people are feeling, including circumstances such as: Having to manage multiple stressors like these, while knowing we must continue to push through for an undetermined length of time, is exhausting and can stretch the capacity to cope. Bearing this in mind, it’s important to understand that overwhelm is actually a natural response to all that people must deal with right now. It can also be very unsettling to know that even though there has been progress with getting the pandemic under control, we still must live with a lot of uncertainty. Managing multiple stressors, while having to keep pushing through for an undetermined length of time, is exhausting and can stretch the capacity to cope. Overwhelm is a natural response to all that people must deal with right now.
Click to tweet
What can make overwhelm even worse, is the absence of many things we might normally do to try and feel better. For example, some people aren’t yet able to spend time with friends, loved ones, or in community settings in a way that satisfies their human need for fulfilling connection. And with all the demands on their time, many folks are missing out on the activities that normally would give them joy and help with stress relief. Of course, some people are simply worn too thin to add one more thing to their plate. Despite all of this, please remind yourself that in the face of great difficulty, you persevered and made it this far.

3 Ways to Ease Emotional Overwhelm

To help you keep going, here are 3 simple things you can incorporate into your life that don’t cost anything and are not demanding of your time. Plus, they can improve your well-being while strengthening your ability to cope as you work your way toward the pandemic’s finish line.

1. Notice the micro-moments that lift your spirits each day.

When under duress, it’s easy to stay focused on the problems at hand. However, there likely are some small everyday things that help you feel momentarily better, such as: Paying more attention to the little uplifting things throughout your day can provide a nice counterbalance to those feelings of overwhelm.

2. Manage your automatic negative thoughts (ANTs).

It’s easy to get caught up in a cycle of unhelpful thinking patterns when life is stressful. These ANTs, as Dr. Daniel Amen calls them, fester in your mind and make you miserable, plus they release chemicals in the brain that make you feel emotionally and physically worse—and that’s not something you need more of right now! Using a technique borrowed from Byron Katie, here is a simple way you can challenge the negative thoughts that are making you feel even more overwhelmed: Start by identifying what the negative or stressful thought is, then ask yourself the following questions about it: Now, turn that original thought around and see if its opposite is actually truer because it just might be. By challenging your negative thoughts, you’ll learn to see through them more quickly, so they don’t keep dragging you down.

3. Reach out and connect with others.

Talk to someone else about how you feel instead of keeping it bottled up inside. Being overwhelmed right now is nothing to be embarrassed about. By connecting with others, whether it’s a trusted friend, family member, church community, or psychotherapist, you will discover that you aren’t alone. Having someone to lean on when the going gets tough can make all the difference in the world. Give yourself a pat on the back for hanging in there. This unprecedented and difficult time has shown how strong you can be. By incorporating the strategies above, you can boost your resolve to get through it while increasing your resilience for the future. Chronic stress, anxiety, depression and other mental health problems can’t wait. During these uncertain times, your mental well-being—and that of your loved ones— is more important than ever. Waiting until life gets back to “normal” is likely to worsen symptoms over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. A wildly popular docuseries on Netflix explores the mysterious disappearance of Elisa Lam, a Canadian tourist who arrived in Los Angeles in 2013 only to vanish days later while staying at a rundown hotel in downtown Los Angeles. Crime Scene: The Vanishing at the Cecil Hotel airs the last known footage of the 21-year-old—a grainy video of her acting strangely in one of the hotel’s elevators. In the video, Elisa looks scared, frantically presses multiple buttons, appears to be trying to hide from someone, and makes some bizarre hand gestures. When the police released the video days after her disappearance, it quickly went viral, garnering millions of views and dozens of conspiracy theories. When Elisa’s lifeless body was found in one of the water tanks on the roof of the hotel, the mystery and theories grew exponentially. Was she murdered? Was she on drugs? Was it suicide?

DID MENTAL ILLNESS CONTRIBUTE TO ELISA LAM’S DEATH?

In the end (spoiler alert!), officials ruled it an accidental death and indicated that bipolar disorder was a contributing factor. Elisa had been diagnosed with bipolar spectrum disorder, which affects nearly 6 million Americans and is a severe mood disorder in which people cycle between depressive episodes and mania. On her Tumblr account, Elisa had written openly about having bipolar disorder and depression. Despite this, an army of Internet sleuths who emerged in the wake of her disappearance gravitated to more macabre theories about her death. Like too many people in our society, they overlooked the very real and negative impacts mental illness can have on a person’s behavior and life. The Netflix docuseries touches on Elisa Lam’s mental health struggles, but there is so much more you need to know about bipolar disorder. The Netflix docuseries touches on Elisa Lam’s mental health struggles, but there is so much more you need to know about bipolar disorder.
Click to tweet

7 SURPRISING FACTS ABOUT BIPOLAR DISORDER

1. People with bipolar disorder often stop taking their medication.

In the Elisa Lam docuseries, the coroner’s report revealed only traces of the medications prescribed to treat bipolar disorder, including antidepressants, a mood stabilizer, and an antipsychotic. Curiously, the amounts detected in her system were less than what had been prescribed, meaning Elisa was either skipping doses or taking less than recommended. In the docuseries, a psychiatrist suggests, “I think Elisa stopped taking her medications. And once she stops taking her meds, the risk for a mood episode goes way up.” It is not unusual for people with bipolar disorder to stop taking their medications. Bipolar disorder is typically very responsive to treatment. In fact, people with this condition often feel so much better after starting a prescription, they believe they no longer have an underlying issue and stop taking their meds. A 2016 review of existing research shows that as many as 70% of bipolar patients don’t adhere to prescription recommendations. Noncompliance results in worsening symptoms, increased hospitalizations, and a rise in suicidal behavior.

2. Some bipolar people experience psychosis.

Experts interviewed in the docuseries suggest that Elisa’s strange behavior in the elevator may indicate that she was experiencing a psychotic episode related to mania in bipolar disorder. Psychosis is associated with a disconnect from reality and can involve hallucinations, delusions, disjointed thinking, confusion, and a lack of self-awareness. In some people, it can lead to risky or dangerous behaviors.

3. Bipolar disorder increases the risk of suicide.

As many as 60% of bipolar patients attempt suicide at least once in their lifetime, according to a 2019 review in Medicina. In untreated bipolar disorder, an alarming 1 in 5 complete suicide. Does this mean Elisa Lam was intentionally trying to harm herself? We will never know the truth about what exactly was happening in Elisa’s mind as she climbed inside the water tank on the roof of the Cecil Hotel. But sadly, far too many individuals with this condition take their own lives.

4. Teens are vulnerable to bipolar disorder.

In the docuseries, it is revealed that by age 21, Elisa Lam had already been diagnosed with bipolar disorder. This isn’t unusual, and in fact, it is most common for the onset of this mental health condition to occur in a person’s late teens to mid-20s. Elisa had also been diagnosed with depression, which research shows may be an early symptom of bipolar disorder. In fact, 1 in 5 adolescents who experience the onset of major depressive disorder will develop bipolar disorder—within 5 years!

5. Having bipolar disorder is stigmatizing.

The Netflix series reveals that Elisa wrote about her mental health issues on her Tumblr account, exposing how painful and isolating it can be. Among her posts, Elisa wrote: “Apparently, I’m bipolar. A few good days followed by a week of sleeping. That is the pattern.” “Depression sucks.” “I had a relapse.” “Fellow bipolars, you may be the only ones who understand what this is like.” “It’s a vicious cycle, isn’t it? I’m just so tired. So very tired.” “I don’t want to live like this.” “According to some people, I have a chemical imbalance. Can I just inhabit someone else’s brain?” Feeling stigmatized, misunderstood, and alone is common among people with bipolar disorder, depression, anxiety, and other psychiatric conditions. Finding others to talk to and share your feelings—whether it’s a mental health professional or a support group—can be helpful.

6. Bipolar disorder is a brain disorder.

Brain SPECT imaging shows that bipolar disorder is associated with abnormal brain activity. In bipolar patients at Amen Clinics, we see increased activity in the limbic system (emotional center), amygdala (fear center), hippocampus (mood and memory center), and cingulate gyrus (the brain’s gear shifter). Elisa Lam Docuseries and Bipolar Disorder

7. Many people are misdiagnosed with bipolar disorder.

Many people are misdiagnosed with bipolar disorder after they have had a significant concussion that affects their prefrontal cortex and temporal lobes. When someone is misdiagnosed and given treatment for the wrong condition, it can make symptoms worse. Anyone struggling with symptoms of bipolar disorder should seek a diagnosis that includes brain imaging to rule out other factors and to help identify any co-existing conditions. Bipolar disorder, depression, mania, psychosis, and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever, and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

By Dr. Elissa Mendenhall N.D.

Meet my patient Ronnie. A retired sea captain in his sixties, he’s a cheerful and optimistic man. On first impression, you would never guess that he had been experiencing multiple panic attacks each day since before he was 16 years old. By the time he arrived in my office, he had been suffering with daily panic attacks for some 50 years.

Although he led a productive and active life and career, his panic disorder very much impacted his quality of life. In the past, he had tried a variety of anti-anxiety medications, such as escitalopram and fluoxetine, but he found no relief from them.

Ronnie also had an inflammatory bowel disease, collagenous colitis, which was symptomatic to some degree most days of the month. When it was very active, he would sometimes have 30 bowel movements a day. There were a number of foods and nutritional supplements that he couldn’t tolerate because they triggered diarrhea or painful cramping. In addition to the panic attacks, Ronnie had been having episodes of depression for days to weeks at a time without a known cause.

What Was Causing Ronnie’s Issues?

I postulated that Ronnie’s bowel disorder was increasing brain inflammation. In addition, the medication he was taking for the bowel disease—budesonide—was helpful at relieving his symptoms, but I was aware that it is in the glucocorticoid family of medications, known to trigger depression and other psychiatric issues.

I told him that it was possible this medication could be causing depression. That’s when we started tracking the times when he took the medication. Our sleuthing revealed that the times he was depressed did, in fact, correlate with the times he was using that medication.

Finding a Path to Healing

Pinpointing the medication as a contributor to Ronnie’s depressive episodes was only the first step. We also tested for hidden food allergies and changed his diet, which cooled down the inflammation in his brain and his digestive tract. After he changed what he was eating, not only did his bowel disease go into full remission for several months, but his panic attacks also became far less frequent. With his dedication and my guidance, he was able to reduce and eventually almost eliminate the use of budesonide, which resolved his depression.

The next step involved pharmacogenetic testing and found that he was incompatible with SSRI antidepressants and several other classic antidepressant medications. In fact, he had a genetic marker that is common in people with bipolar disorder. Even though he did not meet the diagnostic criteria for bipolar disorder, his psychiatric prescriber saw the results of the panel I’d ordered and suggested he try a mood stabilizer medication (lamotrigine). With this, Ronnie’s panic attacks stopped altogether.

I had the privilege of working with Ronnie over the course of the next several years. During this time, he remained stable with only a few flares of mild anxiety and gut issues. Finally, after five decades of struggling, he was able to focus on the retirement and life he had envisioned. Freed from the grips of anxiety and disease, the sea captain ventured out to new horizons and began traveling the world with his wife. 

About the Author: Elissa Mendenhall, ND, Amen Clinics San Francisco Bay Area

Dr. Elissa Mendenhall, ND practices at Amen Clinics, which offers in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Dr. Mendenhall is a naturopathic doctor who can prescribe both natural and prescription medications.