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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.
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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. There’s no question that the past year has been unlike anything we have ever experienced before. We had to learn how to adapt quickly and do our individual parts to slow the spread of COVID-19 in an effort to protect those at risk as well as our loved ones and ourselves. Think back to March 2020 when suddenly, we had to wear masks in public and wait in line to get into the grocery store while keeping our fingers crossed that there would still be some toilet paper on the shelves when it was our turn to go inside. The sparse availability of frozen vegetables, canned foods, and disinfecting products—let alone the dearth of critical supplies desperately needed for healthcare workers—gave all of us a front-row seat to the growing national emergency we were facing. On top of this, social distancing requirements, stay-at-home orders, the closing of schools, daycare centers, restaurants, lodging, health clubs, and non-urgent doctor visits reshaped our world as we knew it. Many people believed that within a few months, life would be back to normal, but as the spread of COVID-19 accelerated across the U.S. and around the world, things got worse instead of better. People were becoming more stressed and mental health problems were increasing. At times, life became too much for some and research showed the risk of suicide climbed.

Adjusting to the Next “New Normal”

Although each of us has had our own individual experience of the past year, to a large degree, we were all in this together, muddling our way through the frequently shifting changes that were required of us. It was not easy—that is for sure. But have you noticed that as time went on, not only did you adjust your behaviors to reflect the needs of the common good, but you have also actually gotten used to them? And now, with what looks to finally be a light at the end of the tunnel, that collective sigh of relief so many people have been waiting for is getting closer. But… does this make you feel happy and energized? Or does it give you anxiety and make you feel stressed? With what looks to be a light at the end of the tunnel, that collective sigh of relief so many people have been waiting for is getting closer. Some people are happy and energized about it, others are feeling anxious and stressed.
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Are You Stressed About Returning to Regular Life?

Just as we struggled to adjust to the restrictions of the pandemic, it’s likely that many people will not find it so easy to jump right back into the way things used to be. A few reasons for this are:
  1. While those who have been fully vaccinated might be embracing that extra layer of protection, there are many who either haven’t had the opportunity or don’t plan to get the vaccine. Since the contagious virus continues to spread and there are plenty of people who are at risk of getting it, they may still feel unsafe going to restaurants, social events, and other public gatherings—even while wearing a mask. Thus, feeling any pressure to do so will likely increase their concerns and anxiety.
So, if this applies to you, be sure you are eating a healthy, low-inflammatory diet, taking your supplements, and getting regular exercise to help manage your worries and keep your immune system strong.
  1. Working from home has been a bit of a curse for some, but a blessing for others. As staff is required to return to their offices in the coming months, some folks can’t wait for workplace camaraderie to resume—but not everyone is happy about it. The flexibility of working from home along with avoiding a commute has been very helpful for many individuals and families. Having to give that up is a big cause of stress for some people.
In addition, offices are well-known for spreading germs like colds and the flu. COVID-19 germs are of even greater concern right now. If you do have to go back to your office, it’s ok to wear a mask, even if others don’t. Washing your hands regularly and avoiding the all-too-common temptation to touch your face, can help lower your chances of getting sick.
  1. Mental health problems, such as anxiety, depression, substance abuse, and eating disorders have increased during the past year. Social distancing and staying at home allowed some people who are dealing with these conditions to keep them private. With restrictions being lifted and social distancing protocols changing, they may be feeling vulnerable and experiencing increased levels of shame or despair.
If you are struggling right now, it’s okay—and courageous—to reach out and get the help you need to work through and overcome your mental health issues.

Coming Out of Hibernation

While we have weathered the pandemic together, it’s important to recognize that people will come out of it in different ways and in their own time. Some are ready to be free of wearing a mask inside, but others are terrified of that idea. Likewise, some folks are looking forward to hugging, high-fiving, and shaking hands again, but some people are not. Your preference is okay—as is that of your family, friends, and neighbors—so being respectful of what others want and need is necessary to ease into the transition that is ahead of us. Humans are remarkably resilient, and we will eventually get to whatever the post-pandemic normal is going to be. Even though some things might be different than before, it is likely the challenges of the past year have made us all a little stronger. Anxiety, depression, substance abuse, and other mental health problems are treatable and shouldn’t wait. 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. Most people equate chronic illnesses with the elderly, but a recent Harris Poll study reveals that 44% of millennials born between 1981-1988 have been diagnosed with at least one chronic health condition. What’s really alarming is that 4 of the top 5 chronic health conditions (and 6 of the top 10) among millennials fall into the mental or behavioral health category, according to a study from Blue Cross Blue Shield. And the rates for these conditions are rising dramatically. That’s not even counting the increases so many people have experienced due to the pandemic. It begs the question: What’s wrong with millennials? What’s really alarming is that 4 of the top 5 chronic health conditions (and 6 of the top 10) among millennials fall into the mental or behavioral health category, according to a study from Blue Cross Blue Shield.
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Top 10 Conditions Among Older Millennials

Millennials include those born between the years 1981-1996, but the BCBS study focused on older millennials (ages 34-36 in 2017). The findings are disturbing and show that adults in the age range are struggling. Here are the top 10 chronic conditions among older millennials with the mental and behavioral issues highlighted in bold.
  1. Major depression
  2. Substance use disorder
  3. Alcohol use disorder
  4. Hypertension
  5. Hyperactivity
  6. Psychotic conditions*
  7. Crohn’s disease/ulcerative colitis
  8. High cholesterol
  9. Tobacco use disorder
  10. Type II diabetes
*Note that psychotic conditions included a wide variety of disorders, including schizoid, delusional, paranoid, dissociative, personality, hysteria, tics, sexual, gender, identity, food-related, somatoform, affective, childhood disintegrative, pervasive developmental, and more. What were the two conditions that saw the biggest increases in prevalence from 2014 to 2017? Major depression (31% increase) and hyperactivity (29% increase). In a newer BCBS study from 2019 that tracked statistics from 2017-2018, the biggest spikes were seen in major depression (12% increase) and alcohol use disorder (7% increase). What’s even more alarming is that millennials are experiencing all of these conditions at a higher rate compared to Gen Xers when they were the same age (34-36).

Millennials, Pandemic Bad Habits, and the Brain

According to the 2019 study by Blue Cross Blue Shield, millennials—all millennials, not just the older ones—are also some of the hardest hit by the pandemic, with 92% saying COVID-19 had a negative impact on their mental health. Among millennials, the pandemic contributed to major increases in unhealthy behaviors, including: At Amen Clinics and in Dr. Daniel Amen’s book, Your Brain Is Always Listening, these are referred to as “Bad Habit Dragons.” These inner dragons breathe fire on your emotional brain and fuel habits that don’t serve you. Inside your brain, there is a constant dance between your prefrontal cortex (involved in focus, judgment, and impulse control), your amygdala (the part of your emotional brain that responds to threats), and your basal ganglia (where habits are shaped and stored). When the PFC is healthy and strong, it can help direct and supervise the addition of healthy habits. When it is weak, you are more easily influenced by untamed dragons, and your impulses can take over, causing many bad habits to form. Once formed, good or bad habits take the same amount of energy. The rampant stress and anxiety of the pandemic weakened peoples’ PFCs and led to an increase in bad habits. This helps explain the rise in drinking, smoking, vaping, and recreational drug use during the pandemic.

The Link Between Mental Health and Physical Health

Millennials who have behavioral health conditions are also at greater risk of having chronic health conditions. They are 2.7 times more likely to have coronary artery disease, 2.1 times more likely to have diabetes, 1.9 times more likely to have Crohn’s disease/ulcerative colitis or hypertension, and 1.7 times more likely of having high cholesterol. The mental health/physical health connection goes both ways. At Amen Clinics, we have found that your physical health greatly impacts your mental well-being. Problems with blood flow (such as hypertension), inflammation, head trauma, exposure to toxins, infections (such as Lyme disease or COVID-19), autoimmune diseases, hormonal imbalances, and diabesity (obesity and diabetes) all contribute to psychiatric problems. Learning to improve these areas of your life can enhance your mental health. Depression, anxiety, aggression, suicidal thoughts, 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. 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.
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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. 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.
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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. “It has been said, ‘time heals all wounds.’ I do not agree. The wounds remain. In time, the mind, protecting its sanity, covers them with scar tissue and the pain lessens. But it is never gone.” —Rose Fitzgerald Kennedy Everyone comes face to face with grief at some point in their lifetime. Grief and loss can be overwhelming, leaving you with a range of emotions—sorrow, loneliness, helplessness, anger, guilt, numbness, emptiness, or all of the above. Suffering a loss can also cause physical symptoms, such as nausea or digestive issues, sleeplessness, headaches, fatigue, muscle tension, and chest pain. It’s also associated with anxiety, depression, and memory loss. In most cases after a loss, feelings of grief eventually subside, but for some people, they linger and make it difficult to get on with your life. Mental health professionals call this “complicated grief” or “prolonged grief,” and it can prevent you from getting back to work, taking care of your home, or maintaining healthy relationships with family and friends. In most cases after a loss, feelings of grief eventually subside, but for some people they linger and make it difficult to get on with your life. Mental health professionals call this “complicated grief” or “prolonged grief.”
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In cases of complicated grief, you may be following everyday advice in an effort to cope with your feelings. What you may not realize is that many commonly held beliefs about the grieving process could actually be intensifying your pain and making it last longer than necessary. It can leave you wondering if the grieving will ever end.

IS THERE A GRIEF TIMELINE?

There are no hard and fast rules regarding a grief timeline, and everybody grieves at their own pace. Some people feel like they’re drowning in sorrow and pain for months, years, or even decades after a loss. Others cope more quickly. Anything that reminds you of the loss—a place, a song, a routine (making coffee in the morning)—can dredge up painful feelings. Special occasions, such as birthdays, Mother’s Day, or Father’s Day, can be especially trying. We asked Amen Clinics patients to describe what grief feels like and how long the process took. You may relate to what they said. I was married for 35 years and my wife died in a bicycle accident. Six months later, I was able to work and take care of the dogs, but the hole in my heart hurt the most when I went to bed alone at night. I would wake up crying in the mornings. One of my friends told me to ‘just move on.’ (This is an example of one of the worst things to say to a grieving person.) I lost my teenage daughter almost 20 years ago, and the grief is still palpable. At first, it felt like a tsunami that would smother me, but as the years went by, it became more like a rhythmic wave. Every once in a while, though, a rogue wave comes out of nowhere, and I’m completely overwhelmed again. My dad died 5 years ago, and I keep thinking it’s supposed to get easier as time goes by. But that’s not the case. As my two young sons grow up, I miss him even more because I wish he were here as a role model for my boys. I thought I was coping pretty well after losing my best friend (we had been friends since we were in junior high) to cancer a year ago. But I heard a song she loved the other day on the radio, and the wounds opened up and felt raw again. I had to pull the car over and cry on the side of the road. I was a wreck the rest of the day. I feel embarrassed to tell people this, but I’m still grieving the loss of my dog. I had to put him down 2 years ago, and my heart is still shattered. He was my constant companion, and he provided unconditional love. I was so bonded to my furbaby. When I try to explain it to people, they say, “Oh, you can just get another dog.” No, I can’t just replace him. He was special to me. My wife died by suicide, and I have been wracked by guilt ever since, thinking there must have been something I could have done to prevent it. 

7 COMMON MYTHS THAT PROLONG GRIEF

In working with our patients at Amen Clinics, we have found that there are several commonly held beliefs about grief that actually prolong the process and make it more painful.

1. Wait to start the healing process.

People often say you should wait to heal from grief, but this prolongs the process. If you fell and broke your arm, when would you want to start healing? Immediately! This doesn’t mean healing will be quick—it rarely is—but it’s important to start the process.

2. Accepting the loss is the final stage of grief.

Dr. Elizabeth Kübler-Ross wrote about the 5 stages of grief: denial, anger, bargaining, depression, and acceptance. Waiting to go through these stages to arrive at acceptance will extend your grief. It is better to turn the 5 stages upside down—admit your loss, find peace, stop bargaining for something that will not change, reengage with others to avoid depression, and refuse to accept prolonged pain as a given.

3. It’s normal that you can’t sleep, so don’t try to fix it.

Grief often steals sleep. Insomnia decreases blood flow to the prefrontal cortex (PFC) in the front part of the brain. The PFC sends signals to quiet or calm your emotional brain; when it is weak, your emotions can get the best of you, and it is harder to make good decisions throughout the day. A healthier approach is to try a combination of melatonin (1 mg), vitamin B6 (10 mg), magnesium (100 mg), GABA (300 mg), 5-HTP (50 mg), and theanine (100 mg) to help promote grief-related sleep.

4. Avoid thinking about what happened.

In one study, bereaved people who had lost someone to accidental death or homicide wrote for 15 minutes a day for 4 days. One group wrote about the loss; the other was asked to write about something trivial. Afterward, those who had written about the loss reported less anxiety and depression and greater grief recovery than those who had written about trivialities. Spend 15 minutes a day for 4 days getting the story out, making sure to list both the positives (“He is no longer suffering”) and the negatives (“I miss him so much it hurts”) of the situation to promote healthy grieving.

5. Focus only on the good things.

Too often, when people had a complicated relationship with someone who passes, they try to remember only the good times and completely ignore the bad ones. Remembering an unbalanced situation prolongs grief. Instead, remember the positive and make peace with the rest.

6. Keep your chin up and stifle your tears.

Holding back from crying in an effort to appear resilient isn’t helpful. When we bottle our feelings and refuse to cry, our emotional brain becomes inflamed. After someone has died, it is healthy to let the tears flow freely.

7. Expect to get over the loss quickly.

If you believe the grieving process should be quick and painless, you’ll be setting yourself up for disappointment, frustration, and unresolved issues. Be patient. Grief is a journey, not a destination. Be patient with yourself as you work through the hard times and be patient with others too. Prolonged or complicated grief, 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. 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.
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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. In March 2021, the independent nonprofit organization, FAIR Health, released a report about the staggering mental health challenges children and teens have experienced during the COVID-19 pandemic. Depression, anxiety, adjustment disorder, drug overdoses, obsessive compulsive disorder (OCD), and eating disorders have all been on the rise. The report also found a 334% increase in the rate of intentional self-harm for 13- to 18-year-olds in one section of the U.S. The term self-harm refers to the intentional act of causing physical harm to oneself through a destructive means, but without the goal of suicide. In some cases, it can be an extreme measure such as crashing a car, but more often, self-harm involves burning, head-banging, hitting, severe scratching, skin picking, and hair-pulling, as well as cutting or carving the skin with a sharp object such as a razor blade, knife, or even a paperclip. Cutting is the most common form of intentional self-harm and represents up to 80% of cases. In the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V), it falls under the category of non-suicidal self-injury  (NSSI). Even in a “normal” year, approximately 15% of teens engage in cutting, with a greater percentage found in college students, although some adults and children also cut. Females tend to self-injure somewhat more than males, and the highest rates appear to be in those who are bisexual, but the reasons for this are still not completely understood.

The Motivation for Cutting

While there are many reasons a young person might intentionally cut themselves, this behavior is largely a maladaptive coping mechanism for kids and teens who are not able—or don’t know how—to express their emotions in a safe and healthy way. Those who cut are often seeking a type of symbolic relief from bad feelings they have or that are difficult for them to manage. Cutting is a maladaptive coping mechanism for people, especially kids and teens, who aren’t able—or don’t know how—to express their emotions in a safe and healthy way.
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For example, someone who dissociates or feels emotionally numb may cut to “feel alive,” while depressed teens may cut to “release” some of their sadness. Among other causes, cutting may also come from feelings related to:

Who’s at Risk?

Self-injury is usually linked to underlying mental health conditions. In particular, it is strongly associated with a history of childhood abuse, especially sexual abuse. Self-injury is also seen in those with posttraumatic stress disorder (PTSD), anxiety, OCD, depression, bipolar disorder, schizophrenia, eating disorders, and addictions, as well as in borderline personality disorder (BPD)—a condition for which emotional regulation is very difficult. Research from the medical journal Encephale indicates that 50-80% of those with BPD engage in some form of self-mutilation, including cutting.

Cutting Can Become Addictive

Because cutting provides a temporary sense of relief to the person doing it, it can become a form of self-medication. The actual pain from the cut induces a release of endorphins—the body’s natural pain killers—which can boost mood or feelings of calmness. However, by repeatedly engaging the brain’s opioid system in this way, tolerance to the pain can build up, thus leading to increased cutting to get the same level of relief from the endorphin response.

Clues to Look For

While cutting can be done anywhere on the body, the most frequently targeted areas are the thighs, wrists, hands, and stomach. It is likely that a young person will try to hide the evidence of this behavior, so if you are concerned about your child or teen cutting, be aware of these clues:

Mental Health Treatment for Cutting

If you discover that your child has been cutting, it can be shocking—even frightening, but it’s important to understand that this behavior is treatable. Letting your child know that you care and want to help her or him find healthier ways to cope with their feelings is a great first step. In addition to possible medication for certain patients, some of the treatment modalities include: Whether it’s in an outpatient or inpatient setting, finding a mental health practitioner who is experienced with treatment for self-harming clients and their underlying mental health issues can pave the way for a healthier future for the young person in your life. Self-harm 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. Recently, Dr. Daniel Amen was invited to consult on a tragic case that was presented on the Dr. Phil Show. Two years ago, at age 35, Josh was intoxicated on drugs when he stole his mother’s car and credit card. She called the police and had him arrested. In the bathroom at the jail, Josh used the laces of his shoes to hang himself. Josh physically survived his suicide attempt, but his brain was severely damaged from anoxia—a prolonged deprivation of oxygen.

The Devastation of Anoxic Brain Injuries

The brain is the most oxygen-hungry organ in the body. It uses 20% of the body’s total oxygen and it takes only a few minutes for a complete lack of oxygen to do horrible damage to the brain. Hanging and strangulation are not the only causes of anoxic brain injuries—they can also be caused by: The length of time that the brain goes without oxygen plays an important role in the prognosis of recovery. However, with a massive brain injury like the one Josh sustained, most people become completely incapacitated with a very limited ability for any type of recovery.
Anoxic Brain Injuries
SPECT surface scan that represents a case of anoxia. Notable decreases in blood flow throughout.
  Josh’s case is very sad indeed. For the past 2 years, he has been in a nursing home in a persistent vegetative state, kept alive by a feeding tube. He does not move, except through the brain stem reflexes of breathing, blinking, and coughing. His nervous system is deteriorating causing an increase in seizures, his hands are tightly balled, and his arms and legs are bent but rigid. After reviewing the medical records and learning more about the history of this terrible situation, Dr. Amen weighed in with his thoughts, based on his decades of medical practice using brain SPECT imaging. He explained that when the brain loses oxygen, brain cells quickly begin to die. Of the 170,000 SPECT scans done at Amen Clinics, the patients with anoxic injuries who have been scanned have the most severe brain damage he has seen. Dr. Amen also pointed out that with anoxia, the earlier interventions are done, such as hyperbaric oxygen treatment, infrared light therapy, or certain nutrients, the better the chance of reversing some of the injuries. However, in Josh’s case, Dr. Amen thinks the chance for any kind of recovery at this point is less than 1%, and that even if his brain could improve a little, Josh will never be Josh again. He would likely have a very, very low I.Q. because his brain is essentially dead. What complicates this awful situation, even more, is that Josh’s wife, Meagan, and his mother, Kelly, disagree on how to proceed after 2 years of seeing Josh in this condition. Meagan wants to bring him home, remove the feeding tube and let him pass away. Kelly, on the other hand, refuses to allow this and holds out hope that there will be some miraculous treatment that can improve his brain function. Even though he is still alive, Josh’s family has been grieving him in a way for nearly 2 years now. Without any resolution of the situation, they all are living with the chronic stress of unresolved grief.

Grief and Loss Dragons

In his new book, Your Brain is Always Listening, Dr. Amen writes about the inner dragons that breathe fire on our emotional brain (the amygdala). There are 13 different “Dragons from the Past” that evolve from the personal stories we tell ourselves based on our earlier experiences in life. We all have at least a few dragons, and most people have Grief and Loss Dragons. These show up as a normal reaction to losing someone we love, something important, or an attachment to ideas of what could have been. Like all dragons, they can be tamed with the right strategies, and it starts with accepting the reality of the loss and going through the healing process. For Josh’s family, the Grief and Loss Dragons are definitely breathing fire on everyone’s emotional brain. And sadly, these dragons can’t be tamed while he’s still alive. This drawn-out process will likely spawn Hopeless and Helpless Dragons as well as the Angry Dragons until this family can come to an agreement about what is best for Josh and for themselves. If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Your Brain Is Always Listening is written by psychiatrist, neuroscientist, and New York Times bestselling author Daniel G. Amen, MD. In this book, Dr. Amen equips you with powerful weapons to battle the inner dragons that are breathing fire on your brain, driving unhealthy behaviors, and robbing you of your joy and contentment. Order your copy here. If you want to join the tens of thousands of Amen Clinics patients who have already tamed their dragons and overcome their symptoms of addiction, anxiety, depression, trauma, and more, speak to a specialist today at 888-609-4318 or visit our contact page here.