Former professional football player Lewis Howes, who hosts the wildly popular podcast The School of Greatness, seems to have it all. But in a candid session with Dr. Daniel Amen, Howes shares that he didn’t always feel like a success. In fact, the bestselling author and entrepreneur says, “I felt like I was dumb pretty much my whole life.”
Howes struggled in school, where he says he was always at the bottom of his class. He had a tutor and attended special needs classes during recess and after school, but no matter how hard he studied he still got Cs and Ds. When he entered eighth grade, he tested at a second-grade reading level, and administrators wanted to hold him back a grade. It was a real blow to his self-esteem.
“[Learning] was always stressful. It was always exhausting,” says Howes. Eventually, he thought, “What’s the point of trying?” As a result of constantly trailing behind his peers academically, he struggled with confidence, insecurity, and anxiety that lasted into his 20s.
With the help of psychotherapy, workshops, and other therapeutic experiences, Howes has managed to overcome it, but not everybody does. In fact, having any form of learning disability is linked to a greater risk of lasting mental health problems.
Having any form of learning disability is linked to a greater risk of lasting mental health problems.
Learning disabilities encompass a range of issues that negatively impact academic performance. Common learning disorders include:
Specific learning disabilities are the most common form of learning disorders, accounting for 33% of the 7 million students in U.S. public schools receiving special education services, according to the National Center for Educational Statistics. A specific learning disability (SLD) is a type of neurodevelopmental disorder that causes problems with reading, writing, spelling, thinking, speaking, or doing math. SLDs include dyslexia, dyscalculia, and dysgraphia.
Irlen syndrome is a visual processing problem in which certain colors irritate the brain. Although it is not widely known, Irlen syndrome affects nearly half of individuals with reading or learning problems. Being unaware of this underlying condition can lead to a lifetime of frustration.
Autism spectrum disorder is a brain-based disorder that is characterized by developmental delays, difficulty with social skills, communication problems, and more. Approximately 1 in 59 children are affected by autism, but some people with high-functioning ASD may not get diagnosed. Instead, these individuals may spend a lifetime feeling like they don’t fit in.
Behavioral problems that involve ongoing aggression, defiance, or temper control problems can interfere with the ability to learn.
ADD/ADHD is a brain disorder that causes symptoms—such as short attention span, difficulty with focus, distractibility, and procrastination—that impair learning. ADD/ADHD affects over 6 million children ages 3-17 and an estimated 4.4% of adults.
Traumatic brain injuries are not considered a learning disorder, however, they can have lasting negative impacts on learning. Brain SPECT imaging shows that mild head injuries are associated with trouble concentrating, memory problems, brain fog, and other issues that disrupt the learning process.
THE LINK BETWEEN LEARNING DISORDERS AND MENTAL HEALTH ISSUES
Anything that interferes with the learning process and impairs academic performance can increase the likelihood of emotional problems and mental health issues, including:
Anxiety
Close to 24% of youngsters with a specific learning disorder experience severe anxiety, according to research in the Journal of the Canadian Academy of Child and Adolescent Psychiatry. Worries about taking tests or being nervous about looking unintelligent in front of classmates can become overwhelming. These feelings can last into adulthood where you may continue to get anxious at work or when going for a job interview. This type of anxiousness can hold you back from reaching your potential and achieving what you want in life.
Depression
A 2016 study reveals that over 14% of children and adolescents with specific learning disorders suffer from severe depression. Not being able to get good grades despite studying hard can make you feel like a failure. And when extra help doesn’t improve the situation, it can leave you feeling hopeless and helpless. On top of that, making friends can be more challenging, and people with learning disabilities may withdraw voluntarily from social activities or be left out. Either way, social isolation combined with feelings of being unworthy are a recipe for depression.
Chronic Stress
For people who grow up with learning disorders, stress can be a constant companion. Research in the Journal of the Canadian Academy of Child and Adolescent Psychiatry found that nearly 17% of youngsters with specific learning disorders suffer from severe stress and 75% have low levels of resilience. Relentless stress exacerbates learning problems as it impairs the ability to focus and can disrupt the memory formation process.
Substance Abuse
Having learning disabilities puts you at increased risk of substance abuse. It’s easy to understand why this might happen. Living with a sense of inadequacy or struggling with anxiety or depression related to learning problems may prompt some individuals to use drugs or alcohol to cope with these emotions. Such behavior makes learning even more challenging. If substance abuse begins at an early age, it can have a negative impact on brain development, which further complicates issues in adulthood. Researchers writing in the Indian Journal of Psychological Medicine suggest that “children with dyslexia and other learning disabilities should be screened for substance abuse.”
Suicidal Thoughts and Behaviors
For individuals with learning disorders, depression and low self-esteem can spiral into suicidal ideation. A 2017 Canadian study found that adults with a learning disability were 46% more likely to attempt suicide compared with people without learning disorders.
Because learning disorders can cause a lifetime of mental health struggles in addition to suicidal behaviors, it is critical to screen children early. And as an adult, if you suspect that a learning disability may be an underlying cause that is holding you back from reaching your goals and living the life you want, it’s time to see a mental health professional. Considering how often undetected head injuries are involved in these issues, looking at how your brain functions with SPECT imaging can also help provide the answers you want.
Learning disorders and the mental health issues that come with them 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 888-288-9834or visit our contact page here.If I get through the day and don’t take my life then that is a victory. If I don’t go buy that gun, if I don’t use that knife, if I don’t jerk that steering wheel into oncoming traffic, if I don’t hang myself, if I don’t put that hose in my car’s tailpipe, if I don’t go into the garage and start the car, if I don’t jump off that cliff or overpass, if I don’t swallow all those pills, then that is a victory.
These are the words of Zane, a social worker and a counseling patient who managed to survive decades of suicidal ideation. In The Suicide Solution, released Sept. 14, 2021, during National Suicide Prevention Month, authors Daniel Emina, MD, (Amen Clinics psychiatrist) and Rick Lawrence (award-winning author and minister) chronicle Zane’s—and many other people’s—journey out of the valley of the shadow of death. In this excerpt from the book, the authors delve into what makes some people more vulnerable to suicidal thoughts and behaviors.
Down through history, that cascading number includes many well-known cultural influencers, from Marc Antony (Roman general and politician) to Anthony Bourdain (host of Parts Unknown) to Fidel Castro Diaz-Balart (son of Fidel Castro) to Kurt Cobain (lead singer/songwriter for Nirvana) to George Eastman (inventor and philanthropist) to Margot Kidder (actress, Lois Lane in Superman) to Richard Manuel (lead singer of The Band) to Freddie Prinze (actor and star of Chico and the Man) to Anne Sexton (poet) to Kate Spade (fashion designer) to Alan Turing (mathematician and World War II codebreaker) to Vincent van Gogh (artist) to Robin Williams (actor and stand-up comedian).
It’s an endless, heartbreaking funeral procession.
So, why do some of us remain stuck [in patterns of destructive thinking] while others seem to bounce through the potholes and keep on going in life? What makes some people more vulnerable to the pull of suicide than others? In the famous first line of his classic novel Anna Karenina, Leo Tolstoy writes: “Happy families are all alike; every unhappy family is unhappy in its own way.” Translated into this context, every healthy brain is alike in its “wholeness,” but every stuck brain is stuck in its own way.
4 Factors That Increase Suicide Risk
These are the factors that catalyze a descent into the darkness:
1. The brain’s “self-preservation” mechanisms experience a breakdown.
Our brains are hard-wired to help us survive. When internal and external stressors overwhelm these “fail-safe” mechanisms, our natural protections stop working properly. The anxiety we experience in the course of everyday life is deeply linked to our fundamental determination to preserve ourselves. Anxiety is a normal emotion—it’s the brain’s alarm system, letting us know when something is wrong so we can start the process of fixing the problem. But when our response to the alarm is dysfunctional, or our alarm system itself doesn’t work the way it’s designed to work, our self-preservation safeguards fail us.
2. Bugs in the brain’s software (or our psychology) create “cognitive distortions” that lead to hopelessness, negative self-evaluations, and dire predictions for the future.
These cognitive distortions undermine our social behavioral skills
tempting us to avoid solving problems in the first place,
keeping us stuck in existing ways of thinking (“cognitive rigidity”), and
limiting our “menu” of healthy coping mechanisms.
3. Bugs in the brain’s hardware (or biology) create “broken links” in the areas tasked with managing our emotions and impulse regulation.
A team of psychiatrists set out to identify “brain alterations that contribute to suicidal thoughts and behaviors,” poring over the data from more than a hundred imaging studies over the course of two decades. They published their findings in the journal Molecular Psychiatry. They discovered a pattern of broken links in the brains of suicidal patients—a “dysregulation” of the specific brain regions and circuits that are supposed to maintain a stable emotional response to stressors.
4. Individual and environmental variables can increase the risk of suicide, especially when they’re mixed into a “cocktail” of circumstances.
When both personal and circumstantial variables pile on top of each other, it can create a “perfect storm” that overwhelms a person’s normal defenses.
In spite of these factors, it is still possible to find a way out of the darkness and into the light.
If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
The Suicide Solution by Daniel Emina, MD, and Rick Lawrence offers hope and a practical toolbox for people who are struggling to find their way out of a cave of anxiety, depression, and suicidal thoughts—and for anyone who cares for someone who’s been lost in that cave. Informed by the clinical realities of anxiety, depression, and suicide, the authors draw from the transformational relational strategies of Jesus to chart a path into life and freedom. It’s very common—and normal—to get a case of the jitters before taking a test, giving a presentation, or going on a first date with someone. In most cases, your brain will calm down once you get distracted by the task at hand.
Unfortunately for some people, it is very difficult to settle their minds. They can get keyed up for hours or even days in advance, with mounting tension that eventually starts to feel overwhelming. They may describe their experience as having an anxiety attack or a panic attack—terms that are often used interchangeably. However, in a clinical sense, these two types of “attacks” differ in numerous ways.
What Happens in an Anxiety Attack?
Anxiety is one of the most common mental health conditions. According to the National Institute of Mental Health, approximately 31% of adults in the U.S. will have an anxiety disorder at some point in their life. To some degree, anxiety is a normal response to a threat—whether real or imagined—and is part of our human condition. However, people who have persistent anxiety go beyond the norm. They tend to be chronic worriers, and consequently carry bigger burdens of stress.
Unfortunately, there are times when that stress and worry can lead to what feels like an “attack” because of symptoms like these:
Increased heart rate and muscle tension
Hypervigilance, such as being easily startled or feeling jumpy
Panic attacks are also disruptive to daily functioning, but because they are less predictable and the symptoms are more intense, they can cause significant amounts of distress for those who suffer from them.
How Panic Attacks Differ from Anxiety Attacks
Aside from being more acute, a panic attack is different from an anxiety attack in a few ways. Whereas anxiety symptoms gradually build up, panic attacks can come on suddenly. They may seem to come out of the blue, or the onset of one may be in response to a known trigger, such as:
Having a phobia, like to snakes, and seeing one nearby in the grass
Fear of traveling through tunnels or over long bridges
Getting into an airplane or an elevator
Whether they are expected or not, the symptoms can come on rapidly and with an intensity that can be momentarily impairing. These include:
Chest pain and a pounding or racing heart, causing someone to think they are having a heart attack
Hyperventilation and shortness of breath can lead to feeling lightheaded and dizzy
Shaking, sweating, hot flashes, or chills
Nausea or stomach pain
A sense of being choked or smothered
Feeling detached from their body or surroundings
Because these symptoms often strike unexpectedly, a person suffering through them may feel like they’re losing control, going crazy, or even that they’re about to die.
Fortunately, panic attacks usually only last about 10 minutes, although it is possible for a person to have multiple ones in a row making symptoms endure for longer. Nonetheless, because of the distress they cause, a person who has had one or multiple panic attacks in public may begin to feel unsafe leaving their home for fear of having another and subsequently feeling embarrassed or helpless if it happens.
5 Steps to Break a Panic Attack
One of the challenges with a panic attack is that because people tend to have shallow breathing, the brain can sense of decrease in oxygen making the out-of-control symptoms even worse. However, the good news is that there are things you can do to help offset them.
Dr. Daniel Amen, neuropsychiatrist and founder of Amen Clinics, teaches his patients these 5 steps to break a panic attack:
1. Stop and take 3 slow, deep breaths.
When you breathe quickly from your upper chest it triggers an adrenaline response which makes you feel more panicked. Instead, use your diaphragm/belly to inhale for a count of 3, hold 2 seconds, and exhale to the count of 3, and repeat this pattern a few times.
2. Do not leave the area unless you are in real danger.
To break your panic attack, you should stay and overcome your initial adrenaline reaction, showing yourself there is no reason to “fight or flight.”
3. Break your tunnel vision.
When your fear sets in, you will quickly have tunnel vision, and this will cause you to feel trapped. By looking slowly from side to side, you become aware of your surroundings and can begin reasoning that there is no danger.
4. Focus on something outside of yourself or warm your hands.
Once your brain knows you’re safe, it’s helpful to focus on any object in front of you, noticing its color, texture, and size. This can distract you from your symptoms and help you feel calmer. Also, running your hands under warm water offers an immediate relaxation response.
5. Speak out loud in complete sentences.
This will prevent you from hyperventilating, and initially, you will speak with short, blunt words, but as you gain control, you will also be able to express your emotions accurately.
Manage your Anxious Thoughts with This Easy Technique
If you struggle with anxiety or a panic disorder, it’s easy to get caught up in fearful and stressful thoughts that can trigger you. Dr. Amen knows this is a pervasive problem for many people. He refers to these automatic negative thoughts as ANTs and he teaches his patients how to recognize and challenge them, so their thoughts can become more realistic.
Using a technique borrowed from Byron Katie, when you recognize a negative and anxiety-provoking thought running through your mind, ask yourself these 4 questions:
Is this thought true?
Do I absolutely (100%) know it’s true?
How would I feel if I didn’t have this thought?
Who would I be without the thought?
Then turn your original thought around to its opposite and see if that is actually truer. Chances are, it is. By practicing this regularly, you’ll begin to have more accurate thinking, rather than believing the thoughts that make you feel anxious.
By incorporating these simple strategies when panic or anxiety starts to set in, you can help to minimize the distress caused by the symptoms and develop a greater sense of control over what can otherwise feel very overwhelming.
Anxiety disorders, panic disorders, and other mental health problems can’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. “I almost don’t feel comfortable being relaxed.” That’s what “Pretty Little Liars” actress Tammin Sursok recently told Dr. Daniel Amen in an episode of Scan My Brain, a video series featuring high-profile individuals who share their brain SPECT scans and open up about their mental health. In the past, a previous doctor suggested that Sursok try Xanax. “I tried a half of one and it felt so foreign to me, that feeling of being relaxed, that I did not feel comfortable,” the actress said. “If I feel too relaxed, I get more anxiety.”
Sursok’s reaction is more common than you might imagine. Perhaps you can relate. When you have a free hour in your day, are you able to kick your feet up and read a great book for pleasure, listen to music that makes you happy, or just let your mind wander? Or do you feel antsy about “wasting time” and throw some clothes in the washing machine, grab a book that you should read for work, or feel guilty about not being productive?
Why is it so hard for some people to relax? A host of common issues inside the brain might be to blame for keeping your mind spinning.
Why is it so hard for some people to relax? A host of common issues inside the brain might be to blame for keeping your mind spinning.
Some people with low levels of the neurotransmitter dopamine, which is commonly seen in people with ADD/ADHD, tend to be excitement-seeking and conflict-driven. For these people, relaxing is just another word for boring. Big thrills—whether they come from bungee jumping, taking a spontaneous road trip, or even having an argument—boost dopamine in the brain. Sursok, whose brain SPECT scans showed activity patterns typically seen in those with ADD/ADHD, says she sometimes finds herself searching for that dopamine rush by creating conflict in her close relationships. “Things will be going really well, and I’ll be having a great day with my husband and then something will trigger me, and I will go straight to getting that feeling up, getting my heart to palpitate.”
Relaxation Rx: Boost dopamine in healthier ways to reduce the need to seek excitement or conflict. You can increase the neurotransmitter naturally by eating a higher-protein, lower-carbohydrate diet and taking nutritional supplements like green tea, rhodiola, and ginseng.
2. Your emotional brain is overactive.
When the brain’s emotional centers and fear centers are overactive, it can be associated with depression and anxiety. If you have this common brain pattern, you may stay busy as a way to distract yourself from your anxious thoughts and feelings of hopelessness. When the world calms down around you, it’s like those worries and depressed moods come into sharper focus.
Relaxation Rx: Practice mental hygiene by challenging the automatic negative thoughts (ANTs) that creep into your mind and prevent relaxation. Supplements that calm the emotional and fear centers of the brain include saffron, omega-3 fatty acids, and GABA. Bright light therapy and the scent of lavender may also help.
3. Your sympathetic nervous system is stuck in overdrive.
Our sympathetic nervous system (SNS) is the fight-or-flight response that makes us feel anxious and afraid. Our parasympathetic nervous system (PNS) is the relaxation response that counterbalances the SNS and helps us calm down after a heart-pounding incident. When the nervous system is healthy, they work in concert to help us manage stress. Chronic stress or prolonged trauma, however, can interfere with the body’s relaxation mechanism. When trauma is severe or prolonged or it leads to post-traumatic stress disorder (PTSD), the SNS can get stuck on, making you feel restless, anxious, panicky, hyperaroused, hypervigilant, or sleepless. If this is the case, even when you try to relax, you aren’t able to shake off those feelings.
Relaxation Rx: If the SNS is stuck on, calm it with meditation, prayer, hypnosis, guided imagery, diaphragmatic breathing, and calming supplements, such as GABA, magnesium, or theanine. For PTSD, therapeutic interventions such as EMDR may be helpful.
4. You stress about relaxation.
When relaxation is just another task on your to-do list, it can be counterproductive. And if you approach it with a perfectionist attitude, it could backfire. For example, checking your heart rate monitor every few seconds as you engage in deep breathing or meditation to see if your level is going down may actually increase feelings of anxiousness.
Relaxation Rx: If this sounds like you, don’t make relaxation a chore. Rid yourself of expectations and just breathe, take a walk, or meditate without any goals. And remember, self-care isn’t one size fits all. Try a variety of activities and hobbies to see what works for you.
5. You fuel your brain with distressing news.
If you’re hooked on watching or reading the news, you’re basically feeding your brain a steady diet of disturbing deaths, disasters, and divisive politics. You’re flooding your mind with toxic thoughts that activate the brain’s fear circuits, making you feel chronically anxious and afraid. It’s hard to relax when you’re constantly on edge and your brain is seeking out the next impending disaster around the corner.
Relaxation Rx: Limit your media consumption and subscribe to news outlets, such as the Good News Network, which specializes in highlighting the positive things that are happening in our world. Anxiety, depression, PTSD, 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 888-288-9834or visit our contact page here. When someone is experiencing a psychotic episode—seeing people who aren’t there or hearing voices that no one else can—it feels just as concrete as rational thoughts do. A person suffering in this way has lost touch with reality and cannot distinguish what is real from what is not.
The term “psychosis” is actually a multifaceted symptom, not a disorder unto itself. It can be part of a lifelong or a temporary psychiatric illness or be a once-in-a-lifetime occurrence. Approximately 3% of the U.S. population will experience a psychotic episode at some point in their lives, and each year about 100,000 young adults or teens will have their first such episode. New research shows these numbers could be increasing due to COVID-19.
Approx. 3% of the US population will experience a psychotic episode at some point in their lives, and each year about 100,000 young adults or teens will have their first such episode. These numbers could be increasing due to COVID-19.
One theory about why this could happen involves the body’s own defense system. In order to fight off COVID-19, the immune system goes into overdrive by releasing a flood of immune cells in what is called a “cytokine storm” to attack the invading virus. Unfortunately, one of the consequences of this natural process is significantly increased inflammation which can adversely affect the body and brain.
A research study published in the journal, The Lancet, analyzed the medical records of more than 236,379 patients who had COVID-19. They found that 1.4%—or 3,309— of them suffered from some form of psychosis within 6 months of their recovery from the virus.
Although most people who get it will not have any unusual symptoms, cases of COVID-related psychosis have been increasingly observed. Another report about 42 cases of psychosis in people stricken with the virus was published in Neuroscience Letters. The doctors who authored the report noted that in many cases, it is difficult to know if their psychotic symptoms were the result of inflammation in the brain, if a person was predisposed to developing a psychotic disorder, or if their symptoms stemmed from other contributing factors such as isolation and stress during the pandemic.
Nonetheless, the relatively quick onset of new psychotic symptoms can be very concerning and confusing to the patient and their loved ones.
Symptoms of Psychosis
Psychotic symptoms occur on a spectrum that ranges from mild to severe levels of impairment. These symptoms are often very distressing and can interfere with major domains of functioning, such as interpersonal relationships, work or school, and self-care. They include:
Delusions: Tightly held beliefs that are neither grounded in nor supported by objective evidence, such as a person believing the FBI planted microchips in their teeth.
Visual or auditory hallucinations: Seeing or hearing things that aren’t there or having unusual bodily sensations.
Disorganized thinking: Having tangential and/or loose associations with thought processes, as well as something called “word salad” which is incoherent speech that randomly mixes up words and syntax.
Abnormal or disorganized movements: Agitation, rigid or bizarre postures, mutism, unusual facial expressions, and catatonia during which there is an absence of physical movement or verbal communication.
Diminished emotional expression: Monotone speech and reduced eye contact and facial and hand movements while talking.
“Negative symptoms”: A lack of self-directed initiation to engage in activities (avolition); diminished interest in speaking (alogia); decreased ability to experience pleasure (anhedonia); and disinterest in social interactions (asociality).
6 Types of Psychotic Disorders
There are several psychiatric conditions that are characterized by psychotic symptoms and these manifest in varying degrees of severity and impairment as well as lengths of time.
This is the most common and debilitating psychotic disorder. It is a chronic psychiatric condition that is marked by recurrent episodes of delusions, hallucinations, disorganized speech and behavior, and negative psychotic symptoms. Approximately 0.3% to 0.7% of people in the U.S. are diagnosed with this disorder.
2. Schizophreniform Disorder
This condition is like schizophrenia, except the course of symptoms lasts between 1 and 6 months.
3. Schizoaffective Disorder
Someone with this condition will have the same symptoms of schizophrenia and concurrently have a sustained episode of major depression or bipolar.
4. Delusional Disorder
A person with this condition will have delusions that last longer than one month, and there are numerous subtypes that include:
Erotomanic type believes someone is in love with her/him despite not being romantically connected.
Grandiose type is convinced they have a wonderful—but unrecognized—talent, insight, or contribution.
Jealous type is certain their spouse/significant other is being unfaithful.
Persecutory type believes that others are after them in some way through spying, harassment, following, trying to poison, etc.
Somatic type has delusions around sensations and/or functions in their body.
5. Brief Psychotic Disorder
A person with this condition has psychotic symptoms that last one month or less. Although the onset can be anytime in life, first episodes are more common during the mid-30s. If a person has one brief psychotic episode, it’s very possible they’ll have more during their lifetime.
6. Substance-Induced Psychotic Disorder
As the name implies, this is diagnosed when a person has delusions and hallucinations that occur during or after intoxication from a drug (i.e. alcohol, marijuana, opiates, benzodiazepines, cocaine, LSD, and amphetamines) or during withdrawal from the substance(s).
Because of the recurrent thought disturbances and breaks from reality, psychotic disorders are among the most challenging mental health conditions to have. Fortunately, treatment with antipsychotic medications (and other meds), along with the support of psychotherapy and case management, is possible for someone who suffers from one of these conditions to keep their symptoms in check.
Psychotic symptoms 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, 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. Peer pressure is nothing new, especially among teens and adolescents. The influence peers wield on their social circle has long been associated with driving behavior—both good habits and bad habits. For example, seeing a friend drink, smoke, use drugs, bully others, or binge eat increases the likelihood of engaging in that behavior oneself. Experts call this “social contagion.” Sadly, it also applies to self-harm.
This is especially alarming in light of the dramatic increase in self-injury among teens since the pandemic began. According to an analysis of healthcare claims by FAIR Health, claims for intentional self-harm as a percentage of all medical claims for adolescents aged 13-18 skyrocketed by 99.8% in April 2020 compared to April 2019. Experts suggest the number of teens engaging in nonsuicidal self-injury could continue to increase.
Seeing a friend drink, smoke, use drugs, bully others or binge eat increases the likelihood of engaging in that behavior oneself. Experts call this “social contagion.” Sadly, it also applies to self-harm.
Nonsuicidal self-injury (NSSI) is the act of purposely harming oneself without the intention of taking one’s own life. People who hurt themselves often have a history of adverse childhood experiences, such as abuse, being bullied, childhood neglect, or sexual assault. They may turn to cutting, skin-picking, burning, or other forms of self-mutilation as a way to numb their emotional pain.
NSSI is most frequently seen in adolescents and young adults. Research in Child and Adolescent Psychiatry and Mental Health indicates that 17% of adolescents report at least one incident of self-harm. That’s higher than the 15% of college students who say they have engaged in self-injury at least once, according to a 2011 study in the Journal of College Health. And it’s more than 3 times higher than 5% of adults reporting self-harm. Approximately 65% of those who engage in NSSI are female, but experts suggest the behavior is likely underreported in males.
STUDY FINDS SELF-HARM IS SOCIALLY CONTAGIOUS
Long-standing research shows that among adolescents, exposure to a peer’s suicidal behaviors raises the chances of dangerous copycat actions. Newer findings in a 2020 Canadian study in Acta Psychiatrica Scandanavica indicate that having knowledge of a friend’s nonsuicidal self-injury is significantly associated with an adolescent’s own involvement with self-harm, suicidal thoughts, and suicide attempts.
In this study, researchers administered the following 3 questions about NSSI and suicidal behavior to 1,483 Canadian adolescents ages 14-17.
In the past 12 months, did any of your friends deliberately harm themselves but not mean to take their life?
Sometimes people deliberately harm themselves but they do not mean to take their life. In the past 12 months, did you ever deliberately harm yourself but not mean to take your life?
In the past 12 months, did you ever seriously consider taking your own life or killing yourself?
Based on the responses, females indicated awareness of a friend’s self-harm at a rate of nearly 3-to-1 compared to males. Compared to boys, girls also reported higher rates of their own engagement in NSSI (girls 11.4%, boys 3.4%), suicidal thoughts (girls 8.5%, boys 4.3%), and suicide attempts (girls 4.8%, boys 2.3%).
SELF-HARM AND MENTAL HEALTH
A wealth of scientific evidence shows that NSSI is associated with other mental health conditions. Among people who engage in self-harm may also struggle with issues such as anxiety, depression, post-traumatic stress disorder (PTSD), borderline personality disorder, substance abuse, eating disorders, dissociative disorders, or obsessive compulsive disorder.
The team of Canadian researchers also analyzed mental health status and its effect on NSSI, assessing any diagnoses for major depressive disorder, anxiety disorders, ADHD, oppositional disorder, or conduct disorder. They found that adolescents who met the criteria for an anxiety disorder or depression were more likely to say they knew a friend who had been involved in self-harming behaviors. Those with some form of anxiety—including certain phobias—ranked highest with 28.6% reporting knowing a friend who engaged in self-injury. Among teens with depression, 20.4% said they knew peers who tried to hurt themselves.
Engaging in NSSI as an adolescent also has detrimental effects on mental health in adulthood, according to findings in a 2020 study in European Child & Adolescent Psychiatry. In this study, researchers followed students in grades 7-8 for 10 years. Compared to youngsters who did not engage in NSSI, those who repeatedly injured themselves as adolescents exhibited significantly higher rates of anxiety, stress, NSSI, and problems with emotional regulation a decade later.
HELPING TEENS PREVENT OR HEAL FROM SELF-INJURY
Preventing and healing from self-harm is possible. Recognizing that NSSI is socially contagious is an important step in identifying an adolescent’s risk for self-injurious behaviors. Providing teens with strategies to handle peer pressure—for example, saying no like they mean it, disagreeing respectfully, or asking questions—can be beneficial in the prevention of this increasingly common problem. It is equally critical for parents to know the warning signs of self-harm, including scars, frequent cuts or bruises, far-fetched tales about how an injury occurred, wearing long sleeves even in summer, carrying sharp objects, declining academic performance, and social withdrawal.
In addition, addressing any co-occurring mental health issues should be part of an NSSI treatment plan. Investigating brain health with functional brain imaging may also be beneficial as it can reveal underlying abnormal activity. A 2019 brain imaging study found decreased brain function in regions of the brain that play a role in emotional regulation. Finding solutions that enhance overall brain health and emotional well-being is key to overcoming nonsuicidal self-harm.
Self-harm, suicidal thoughts and behaviors, 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 888-288-9834or visit our contact page here.
July is BIPOC (Black, Indigenous, Persons of Color) Mental Health Awareness Month.
For BIPOC communities, racial trauma, or race-based traumatic stress (RBTS) is a common, yet often overlooked, factor that can complicate the clinical presentation. Symptoms can look very similar to post-traumatic stress disorder (PTSD) and can include depressed mood, hypervigilance, low self-esteem, and/or somatic symptoms such as headaches, GI distress, and insomnia. It is important to note that according to research from the American Psychological Association, unlike PTSD, RBTS is not a mental health disorder but rather a mental and emotional injury that can occur as the result of living within a racist system or experiencing events of racism.
As mental health professionals, it is imperative to be aware of the unique emotional health challenges that your BIPOC patients may bring into the treatment room.
Thinking in 3’s can help you become better equipped to address racial trauma in your clinical practice. These 3 factors are Context, Clarity, and Action:
Factor 1: Context
One of the best ways to help your patients is by educating yourself about the social, cultural, and systemic factors that influence wellness. This is not an instant fix, but a long-term commitment to self-study. Note that I said SELF-study. Although it may be tempting to ask your BIOPC patients to educate you about aspects of their culture that you are not familiar with, this really creates an added burden of emotional labor for individuals who are already in emotional pain. Your patients are coming to you for guidance in their most vulnerable moments—one of the best ways to honor them is by doing your own work.
Where to start: A great place to turn is Harvard University’s Resources and Reading on Racial Justice, Racial Equity, and Anti-Racism published by the Institutional Anti-Racism and Accountability Project (IARA) at the Shorenstein Center. The US Dept of Health and Human Services also has a host of resources available.
Factor 2: Clarity
Continuously engaging in critical self-reflection is essential to understanding your own personal blind spots and how those blind spots may be impacting how you engage with clients from communities that have historically been denied equal access to power and opportunity. This self-reflection can be difficult at times because our brains are wired to seek consistency in thoughts, beliefs, and actions. Any conflict results in discomfort. Leon Festinger, an American social psychologist termed this tendency “cognitive dissonance.
Where to start: Rather than avoiding discomfort, try altering your beliefs toward the discomfort by asking yourself the following questions:
Are my thoughts or beliefs about this topic productive?
Is there any way that this thought can cause harm?
Are my thoughts or beliefs about this topic factual?
Are my thoughts or beliefs about this topic as important as I’ve made them out to be?
What aspect of my identity is being threatened if I were to embrace a new belief or point of view?
If hearing words like “white supremacy,” “structural racism,” or “privilege” triggers feelings of anger or extreme discomfort, ask yourself why and be willing to understand the source of the dissonance.
Factor 3: Action
Become an agent of change. One key aspect of critical self-reflection is really getting clear about your values. Once you are clear, the next question to ask is “Am I moving through the world in a way that is in alignment with those values?” If you notice tension, that’s generally a pretty good indication that some bit of dissonance is present.
Where to start: Rather than running away from the discomfort, examine it, challenge it, and when it’s necessary, have the courage to change.
Dr. Reba Peoples is a functional psychiatrist at Amen Clinics who delights in appreciating those unique traits and qualities that make each of us who we are. She is board-certified in psychiatry and functional medicine and specializes in creating personalized treatment plans that are aimed at optimizing emotional health and well-being. Find out more about our services at AmenClinics.com. When you have lived through a traumatic situation, your brain has a natural way of preserving the experience in an effort to protect you from future occurrences that could be dangerous. All of us have this built-in survival system. It stems back to our cave-dwelling ancestors in prehistoric times who always needed to be on the alert to avoid becoming the dinner for a large creature, such as a saber-toothed cat.
When we are faced with a threat, this fight-or-flight system automatically kicks in and releases cortisol and other stress hormones into our brain and body. This causes our heart rate to go up and our muscles become primed to run away from whatever could hurt us. All of this is designed to increase our chances of surviving. Once the event passes, the fight-or-flight mechanisms naturally turn off.
What Happens in the Brain During a Traumatic Experience?
While this protective mechanism in our brain is largely a blessing, it can be troublesome for anyone who suffers from post-traumatic stress disorder (PTSD), because it doesn’t know when to turn itself off. It’s as though your brain stays attuned to any sense of danger—whether real or imagined. During trauma, parts of your brain go offline in order for you to focus on escape and survival, and because of this, some of the memories about the traumatic experience can get stored in the non-cognitive areas of the brain, like the sensory system (i.e., certain smells, textures, and sights) or in your body.
Do you struggle with any of these unwanted symptoms of PTSD?
1. You panic during thunderstorms or when winds are high.
People who have survived natural disasters, sometimes by the skin of their teeth, have endured very traumatic and life-threatening situations. For example, imagine a family who stayed at home when a big hurricane hit and had to huddle together in the hallway of the house as all the windows blew out while the wind howled for several hours. After surviving a very threatening situation like that, the sounds of uncontrollable weather can understandably be a big trigger, even when there is no actual hurricane (or tornado or other threat) looming.
2. You need to sit near an exit or facing an entrance.
Because of the traumatic experience you had, such as being abused, assaulted, or stalked, you may feel too vulnerable when you cannot see everyone who is in the room. Therefore, you prefer sitting at a table where you can have your back to the wall, or right next to the entrance or exit to accommodate any urge you may get to leave immediately if you feel threatened.
3. You feel a sudden need to use the restroom when a traumatic memory gets triggered.
One of the reasons this could happen is because some of the stress hormones that are secreted by your fight-or-flight system affect your G.I. tract. Going back to prehistoric times again, it’s believed that this function caused our ancestors to expel their bowels to be lighter and increase their chances of escaping from a predator. Unfortunately, this automatic function now can make you feel like you don’t have control over your physical body.
4. You mentally check out in the middle of a conversation.
You’re physically present but feel removed from your mind and/or body and may not have any sense of what the other person is saying. This is known as dissociation and occurs when you get triggered by something that evokes a painful traumatic memory. It’s a coping mechanism that allows you to escape from something that is too difficult to think about. Dissociation is often momentary, but sometimes these episodes can last for a while.
5. You startle easily.
This kind of hypervigilance is common for people who have PTSD. It’s as though an alarm goes off in your head from unanticipated loud noises or movements—even when there’s no actual threat to your safety. Again, this is the result of a fight-or-flight system that has difficulty shutting down.
These symptoms and reactions can be very stressful. When cortisol and other stress hormones are constantly being released into your brain and body, they can lead people to rely on unhealthy coping mechanisms, such as overeating or using alcohol and recreational drugs to feel calmer. Unfortunately, that relief is only short-lived and makes your problems worse.
PTSD Treatment Can Make a Positive Difference
A much more enduring way to get PTSD symptoms under control is by reaching out for professional help. The idea of working through your trauma may feel uncomfortable because it is something you don’t like to talk about. However, there are certain therapies that have been found to be quite successful for trauma survivors and typically involve less talking. Eye movement desensitization and reprocessing—also known as EMDR—is one such modality.
By using eye movements or small hand-held devices that alternately stimulate the two hemispheres of your brain, EMDR helps to get the memories “unstuck,” so you can process them from the present, rather than being pulled back into the overwhelming traumatic moments of the past.
With the right treatment, it’s possible to heal from the symptoms of PTSD and work through your trauma so the distressing memories of your past don’t continue to limit and control your future.
PTSD 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 couplesFind out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.By Rishi Sood, M.D.
Although there is a growing amount of research on and increased awareness about post-traumatic stress disorder, many misconceptions about PTSD persist.
PTSD and its effects on military veterans have been well documented, but other types of trauma are also known to cause the condition. For example, childhood abuse in the form of physical and sexual trauma is known to lead to PTSD. Children exposed to such trauma often struggle with mood regulation and have increased rates of self-destructive and suicidal behavior. PTSD can also occur later in life as a result of medical illnesses—such as myocardial infarctions, obstructive sleep apnea, or stroke—or due to stays in the intensive care unit, which many people have unfortunately experienced because of COVID-19.
Myth #2. PTSD develops immediately after suffering a trauma.
Symptoms of PTSD can occur 3 months after a traumatic experience, but it often occurs much later. Delayed-onset PTSD describes a situation where an individual does not develop symptoms until 6 months after the inciting event. In some cases, individuals experience PTSD years later. In a study of World War II veterans, many reported experiencing such symptoms later in life. This was thought to be brought on by major life changes such as losing a spouse. Just because someone is not affected by a traumatic event soon after does not mean that the individual is immune from being significantly affected many years down the road.
Myth #3. PTSD makes people violent.
Many individuals who experience PTSD do not display violent tendencies. In fact, many individuals with PTSD shut down and avoid situations that pose any perceived threat. This puts significant strain on personal relationships and the ability to effectively function at work. In the dissociative subtype of PTSD depersonalization and derealization are seen. Individuals who experience depersonalization feel disconnected from their body while individuals who experience derealization feel the world around them is not real.
Myth #4. PTSD is just one thing.
Individuals with PTSD can vary significantly in their presentations. As a result of trauma, some individuals can develop externalizing symptoms, which are characterized by symptoms of aggression and impulsivity. To cope, many will turn to substances such as alcohol and marijuana to calm the brain. Unfortunately, this can lead to brain injury and can worsen focus and mood. Others may develop internalizing symptoms, which are characterized by somatic symptoms, anxiety, and depression. Individuals who were once extroverted and had a secure sense of self can become more isolated and distant.
Myth #5. PTSD isn’t treatable.
Although PTSD can have devastating effects, the great news is that effective treatment is available. Psychotherapy can be an effective tool and there are different modalities utilized. Cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and other trauma-focused therapies can be helpful. In some cases, medications such as SSRIs or SNRIs can provide significant relief. MDMA-assisted therapy in a controlled clinical environment and in the presence of a trained therapy team is also being studied and appears promising.
Dr. Rishi Soodpractices 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. Sood is board certified in Adult Psychiatry and Child and Adolescent Psychiatry. In addition to his background in psychiatry, he is a board-certified pediatrician. Find out more about our services at AmenClinics.com. 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.
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:
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.
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.
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.
