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. Recently, Prince Harry has bravely been hitting the airwaves and opening up about mental health in a very personal and meaningful way. After stepping away from royal duties in 2020, Harry and his wife Meghan Markle, the Duke and Duchess of Sussex, have revealed intimate stories about their own psychological struggles. In the AppleTV+ television series “The Me You Can’t See” that he co-produced with Oprah Winfrey and in sit-down interviews with the media mogul and others, Harry has spoken from the heart about issues he’s faced.
In addition, he has shared the fact that he’s been going to therapy, and he’s discussed some powerful therapeutic techniques that he uses in his own life. Opening up about personal struggles in such a public way takes tremendous courage, and his efforts to bring mental health issues out of the shadows of our minds should be applauded.
In this new conversation about mental well-being, Amen Clinics would add one more element—the brain. Our brain imaging work—over 170,000 brain scans related to behavior—reveals that “mental health” is really “brain health.” SPECT, the brain imaging technology used at Amen Clinics, measures blood flow and activity in the brain and reveals 3 things: areas of the brain with healthy activity, too little activity, and too much activity. Abnormal activity in the brain is often associated with symptoms of mental health issues. The human brain is an organ just like your heart and all your other organs, and you can only be as mentally healthy as your brain is functionally healthy.
In light of the brain’s role in psychological, cognitive, and behavioral well-being, here are 5 takeaways from Harry’s recent revelations about mental health and how the brain is fundamentally involved in each of them.
5 Takeaways From Prince Harry’s Recent Revelations About Mental Health
1. Destigmatizing mental health
Harry has been championing the importance of talking about mental well-being for years since he and his brother, William, The Duke of Cambridge, and his sister-in-law Catherine, the Duchess of Cambridge, launched Heads Together. This initiative encourages people to stop feeling ashamed and start speaking up and asking for help when they are having issues related to emotional well-being. “Sharing your story in order to be able to save a life or help others is absolutely critical,” says Harry in the documentary series.
What’s happening in the brain: By labeling anxiousness, depression, and other issues as mental illness or psychiatric illness instead of brain health issues, people suffer in silence because of the shame they feel. No one is shamed for heart disease, cancer, or diabetes. No one should be shamed for anxiety, depression, or post-traumatic stress disorder (PTSD). Brain SPECT imaging helps destigmatize mental health issues. When people see a scan of their brain, it helps them view their problems as medical, not moral. This makes them more likely to talk openly about their struggles.
2. Addressing past trauma, grief, and loss
Harry shares that he was devastated by the death of his mother Princess Diana in 1997 in a car crash in Paris. Only 12 years old at the time, Harry recalls feeling “so angry with what happened to her.” But following his mother’s tragic demise, he wasn’t able to work through those feelings or discuss his grief with many people. He admits that in his 20s, he began drinking heavily and doing drugs as a Band-Aid to cover up the emotions that threatened to bubble up. “I would find myself drinking not because I was enjoying it but because I was trying to mask something,” he says, adding, “I was willing to try and do the things that made me feel less like I was feeling.”
What’s happening in the brain: When we bottle up our grief, our emotional brain becomes inflamed. In order to heal from trauma, grief, and loss, people need to work through the pain rather than numbing it with alcohol or drugs.
3. EMDR therapy
In the third episode of the series, Harry reveals that he’s benefited from a psychotherapeutic therapy called EMDR (eye movement desensitization and reprocessing). This technique can be a potent treatment for people who have experienced emotional trauma as well as those who have developed PTSD. During the episode, Harry allows viewers to watch him as he undergoes the treatment, which involves eye movements (or other alternate hemisphere stimulation) to dampen the emotional charges associated with distressing thoughts and upsetting memories about the trauma. Harry says, “For me, London is a trigger, unfortunately, because of what happened to my mom and because of what I experienced and what I saw.”
What’s happening in the brain: Research suggests that EMDR activates mechanisms in the brain that allow you to reprocess distressing memories and emotions in a healthier way. The human brain is naturally wired to overcome upsetting events. A number of brain regions—including the hippocampus (memory-making center), amygdala (fear center), and prefrontal cortex (behavior center)—communicate with each other to effectively process the memories associated with these events. For some people, trauma disrupts the healthy flow of communication between these brain regions and disturbing memories get stuck. EMDR restores the healthy neural communication process so you can get unstuck.
4. Havening to soothe anxiety
In one of the episodes, Harry demonstrates a self-soothing technique called havening that can be helpful when feeling nervous or experiencing a panic attack. Developed by Ronald Ruden, M.D., havening is surprisingly simple. You can slowly rub your hands together as if washing them, slide your hands down from your shoulders to your elbows as if hugging yourself, or run your fingers from your forehead to your chin as if washing your face.
What’s happening in the brain: From a neuroscience perspective, havening is a form of bilateral hemisphere stimulation, meaning it activates both sides of the brain while you mentally bring up a stressful thought or past trauma. This touch technique generates delta waves in the brain, the brainwaves that usually occur during sleep and that help calm anxious feelings. At the same time, special nerve endings in the areas of the body being touched sends signals to the amygdala (the brain’s fear center) that indicate safety and security.
5. Recognizing ancestral trauma
In an interview with Dax Shepard on the actor’s Armchair Expert podcast, Harry revealed that he faced trauma that was passed down to him. The Duke of Sussex assured that he wasn’t placing blame on his parents, but he says, “If I’ve experienced some form of pain and suffering because of the pain or suffering that my father or my parents had suffered, I’m going to make sure I break that cycle so that I don’t pass it on.”
What’s happening in the brain: Sometimes your mental health issues are not your own, but rather they have been passed down to you through the generations from your ancestors. These irrational fears, anxieties, and worries are “ancestral dragons” that breathes fire on the emotional centers of the brain. Recognizing these dragons and learning to tame them can calm the brain’s emotional centers.
Going Beyond Mental Health to Brain Health
Kudos to Prince Harry for tackling these important issues! What a magnificent ambassador for emotional health and well-being.
Here’s to delving even deeper to show people how the brain is the ultimate key to mental health. Reframing the discussion from mental health to brain health changes everything. It decreases shame and guilt and increases forgiveness and compassion from their families. Reframing the discussion to brain health is also more accurate and elevates hope, increases the desire to get help, and increases compliance to make the necessary lifestyle changes. Once people understand that the brain controls everything they think, feel, say, and do, they want a better brain so they can have a better life. In multiple studies, including one in BMC Psychology, improving the physical functioning of the brain improves the mind.
Get your brain right and your mind will follow.
Anxiety, depression, emotional trauma, 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 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. Although clinical cases of patients with alternate personalities were documented and treated by physicians and psychoanalysts in the early 1900s, dissociative identity disorder (DID) was not officially recognized as a distinct psychiatric condition until 1980. By that time, the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) was published and the impact of trauma on brain development and psychological functioning had become more widely recognized. Despite the skeptics who supported unsubstantiated myths about DID as a true diagnosis—including that it was a fad disorder, extremely uncommon, or caused by suggestion—we know today that it is a very real and often misunderstood mental health condition. In an effort to bring more awareness to this condition, actress AnnaLynne McCord chose to speak openly publicly about her own DID diagnosis and allowed her visit to Amen Clinics to be filmed.
DID used to be called multiple personality disorder and is found in approximately 1% of the population. While there are other possible contributing causes of DID, such as war and natural disasters, it is estimated that 90% of cases are brought on by extreme physical, emotional, or childhood sexual abuse.
Dissociative Identity Disorder Evolves as a Coping Mechanism
For example, a young child who is the target of repeated sexual abuse by a parent may project the experience onto someone else inside her mind as though it isn’t happening to her real self. Dissociating from the experience occurs unconsciously to help her get through the trauma while blocking out the horror of it. Her young brain cannot process nor accept what is happening, yet she must find a way to survive without being overwhelmed by the emotions and shame that threaten to engulf her. In an appropriately developmental way, her brain creates an alternate identity that gives her a way to cope.
Alternate Personalities
In cases of DID, a person will have a core personality and at least one “alter,” although it’s not unusual for someone to have several. The alters have specific personality traits and may be of different ages or genders and have attitudes, behaviors, capabilities, and mannerisms that differ from the core personality. Although there are varying reasons for switching from one personality to another, stress or reminders of the abuse and trauma are common triggers. Again, this is an unconscious process that serves the need to be protected from the past traumatic experiences a person was subjected to.
Common Symptoms of Dissociative Identity Disorder
Although symptoms often begin in childhood, research has found that it can take 6 to 12 years after seeking treatment for DID to be properly diagnosed. Aside from a practitioner’s potential lack of knowledge about the disorder, another reason for this is because people with DID—as with other trauma-based disorders—often have a number of co-occurring conditions, including:
The overt symptoms of these conditions may often be the focus of treatment, while other symptoms that are clinically consistent with the diagnosis of DID may be overlooked or not recognized. These include:
Dissociation and switching personalities
Gaps in memory about everyday events, including personal information
Memory lapses about the traumatic events
Feeling disconnected to reality and/or their body
Diagnosis and Treatment of Dissociative Identity Disorder
In cases where DID is suspected but not confirmed, a psychotherapist or psychiatrist can utilize reliable clinical assessment tools, such as the Structured Clinical Interview for Dissociative Disorders (SCID-D) or the Dissociative Disorders Interview Schedule (DDIS) to obtain additional diagnostic information.
Some people with DID may initially be reluctant to talk to their doctor or psychotherapist about their alternate personalities. While embarrassment or shame may inhibit them from disclosing this information, another reason may be that doing so gets too close to the traumatic memories, which by virtue of their alters, they have had some degree of protection. It’s understandable. A very common reaction in therapy for those who have endured trauma is a tendency to try and minimize or skirt around certain issues or feelings, because of the sense of overwhelm they engender.
Healing from Dissociative Identity Disorder is Possible
With an experienced practitioner, a person suffering from DID can begin the healing process, but it must be appropriately paced and not rushed. Helping the patient to develop greater emotional stability and a sense of psychological and physical safety is the first step. Once that has been attained, then the process of working through the painful traumatic experiences can begin. Over time, as those memories are assimilated and better managed, learning how to live and cope in the present—without dissociation and splitting—can be practiced and achieved.
Dissociative identity disorder, emotional trauma, and other mental health problems can be treated. 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. Before her thought processes and behavior changed, Chris was a loving wife, mother, and grandmother. Although she was always considered a bit on the eccentric side, she and her family members were very close.
As the days of the 2020 lockdown persisted during a year of political vitriol, Chris became obsessed with the TV news and spent countless hours each day watching it. She developed an increasing disdain and fear of the sitting president and began to believe he had brainwashed her daughter into supporting him. In Chris’s mind, there was no other plausible explanation for why her daughter would have changed from one political party to another.
Chris’s obsession led her to handwrite a “manifesto” for the incoming president regarding the brainwashing along with other delusional concerns and sent it to the news station. She felt certain her revelations would become a breaking story on the news. Of course, this did not happen.
Her odd and increasingly paranoid behavior along with the nonsensical ramblings in the “manifesto” were clear signs to her family that Chris had become psychiatrically impaired in some way, but they did not understand what was happening. Prior to this time, Chris had no reported mental health history and had been sober for 47 years.
Of note, BrPsy is not specific to the pandemic. It is included among the psychotic disorders listed in the Diagnostic and Statistical Manual of Psychiatric Disorders, 5th Edition(DSM-5).
Prevalence and Symptoms of Brief Psychotic Disorder
Approximately 9% of first-onset psychosis cases are diagnosed as BrPsy. This condition is twice as common in women as it is in men. It can occur almost anytime throughout a lifespan, although on average, first episodes are more common during the mid-30s. It is quite possible for someone who has had one such episode to have more during their life.
The diagnostic criteria for a brief psychotic episode include one or more of the following symptoms:
Delusions – Beliefs a person develops that are inconsistent with reality and are tightly held despite contrary evidence related to those beliefs
Hallucinations – Hearing (usually voices) or seeing things that others cannot, or having strange sensory perceptions
Incoherent, derailed, or disorganized speech
Severely disorganized or catatonic behavior
What separates BrPsy from other psychotic disorders is the course of the episode. Usually, there is a quick onset of symptoms that resolve within a month. Nonetheless, the symptoms are very intense and distressing and can cause significant impairment in functioning, as well as an increased risk for suicide. Often, patients will require treatment with antipsychotics and/or other medications to get their symptoms under control. Many may need to be hospitalized for a period of time until they become stable, but once the episode has fully resolved, they return to their normal level of functioning.
COVID-19 and Psychosis: A Growing Concern Around the World
As more case studies are published about the mental health impact of the COVID-19 pandemic, it is evident that Chris’s case is not an isolated one. Very stressful situations, such as traumatic experiences or loss, are known to be triggers for brief psychotic disorder. This is consistent with what many health care professionals believe is the underlying cause for many of the cases in the past 12 months—chronic emotional and psychological stressors related to the pandemic.
The medical journal, Schizophrenia Bulletin, described 6 cases of patients with a first psychotic episode that happened during the lockdown in Italy. Among them was an otherwise healthy 73-year-old man who became delusional and believed he had been infected with COVID-19 by his wife (although he hadn’t) and was the world’s sole survivor. He threatened to commit suicide by jumping out of a window. With appropriate treatment in the hospital, his symptoms were in remission after 25 days.
Vulnerability to Brief Psychotic Episodes
Certainly, most people who have been under a lot of duress since the start of the pandemic will not have a psychotic break; however, there are some who are more vulnerable, including those who have these disorders or traits:
Unusual perceptual experiences, such as feeling out-of-body at times
A tendency for odd or eccentric behavior
Suspiciousness and/or paranoia
Even though there have been adjustments made to the initial social distancing restrictions, it is more important than ever to maintain good practices of self-care, including stress and anxiety management. Be sure you are doing these 3 basic things to take care of yourself:
Eat a healthy, balanced diet that is low in sugar and processed food
Take time each day to get some exercise
Focus on the things you can control, instead of the things you can’t
Incorporating simple brain-healthy strategies like these to improve your daily habits can help reduce your risk of developing mental and physical health problems now and in the foreseeable future.
Psychotic disorders 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. Being sexually abused as a child is one of the most horrific experiences a human can be forced to endure. Yet this heinous act is far too common, and it often occurs in the home. Research in the Journal of Adolescent Health shows that among children under the age of 18, 1 in 9 girls and 1 in 53 boys will experience sexual abuse or sexual assault. And 75% of adolescents who have been sexually assaulted were victimized by someone they knew well, according to a 2003 National Institute of Justice report. Sadly, the emotional pain of childhood sexual trauma lasts long after the abuse has ended and can have a negative impact on mental health, brain health, and cognitive function.
Sadly, the emotional pain of childhood sexual trauma lasts long after the abuse has ended and can have a negative impact on mental health, brain health, and cognitive function.
Suffering from sexual abuse has a detrimental effect on a person’s mental health throughout their lifetime. According to findings in the Journal of Psychology, 20%-40% of people with psychiatric disorders have a history of childhood sexual trauma. Experiencing sexual abuse during childhood is associated with a wide range of mental health disorders in adulthood, including:
Not only does childhood sexual abuse take a toll on mental health, but it also impacts brain health and cognitive function. A 2017 study in Industrial Psychiatry Journal found that childhood sexual trauma is associated with negative changes in the structure and volume of brain regions, including the prefrontal cortex, superior temporal gyrus, corpus callosum, parietal lobes, hippocampus, and cerebellum. Two of these brain regions are particularly troubling:
Prefrontal cortex (PFC): This region of the brain is the last to reach full maturation and continues to develop throughout adolescence and young adulthood. This area is involved in planning, attention, executive function, organization, and impulse control. It also plays an important role in keeping other areas of the brain in check, such as the amygdala (fear centers) and limbic system (emotional centers). The changes in the PFC seen in sexual trauma survivors may open the gateway to hypervigilance, paranoia, attention problems, and poorer academic performance.
Hippocampus: Problems in the hippocampus, which is involved in mood and memory, can also have a major impact on quality of life. Issues with depression as well as memory problems can occur. Interestingly, brain imaging studies on childhood abuse survivors show more abnormalities in the hippocampus in adults compared with children. Research on the neurobiological toll of child abuse and neglect suggests that changes to the hippocampus due to childhood abuse may be gradual and don’t appear until adolescence or adulthood.
This same 2017 study mentioned earlier found decreases in cognitive function and memory in those who suffered childhood abuse. In addition, abnormalities in the functioning of neurotransmitters, such as serotonin (a feel-good neurochemical), as well as abnormal hormonal responses have been noted in abuse victims.
Early Intervention and Treatment Can Help
One of the most promising findings in the research is that intervention and therapies can help. Early reporting of sexual abuse and early intervention can be effective in warding off structural changes in the brain and psychological issues. But it’s critical to know that it is never too late to seek treatment for abuse that occurred during childhood.
At Amen Clinics, thousands of patients who were sexually assaulted have improved their brain health, cognitive function, and mental well-being with targeted treatment. Our brain imaging work shows that you can change your brain and change your life… for the better.
Depression, anxiety, memory problems, and other issues related to childhood sexual trauma 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.
“You’ll see me just show up with a black wig and a new personality. I was this tough little baddy, and then I’d be the Bohemian flower child.” That’s how actress AnnaLynne McCord, perhaps best known for her work on Nip/Tuck and 90210, described her history with multiple personality disorder in a session with Daniel Amen, MD, a psychiatrist, neuroscientist, and founder of Amen Clinics.
In an effort to destigmatize mental health problems, AnnaLynne agreed to let her session with Dr. Amen be filmed and talked candidly about having a split personality, which is currently referred to as dissociative identity disorder.
COMMON SYMPTOMS OF DISSOCIATIVE IDENTITY DISORDER (DID)
In her session with Dr. Amen, AnnaLynne openly talked about her experiences with multiple personalities, including gaps in her memory, which is one of the most common dissociative identity disorder symptoms.
In general, common symptoms of dissociative identity disorder include:
Gaps in autobiographical memory (everyday events and past traumatic events)
Inability to recall certain personal information
The existence of two or more distinct identities (know as “splits,” “alters,” or “personality states”)
Headaches
Loss of time
Trances
Out-of-body experiences
The distinct identities may have different names, temperaments, and self-image. These distressing symptoms tend to cause problems in other areas of life, including in relationships and at work or school.
AnnaLynne had been diagnosed with DID prior to her visit to Amen Clinics. She thinks that being an actress played a role in her ability to split. “All of my roles were splits, but I didn’t even realize I was doing it at all until I did a project 90210,” she says of the show she was on for 5 years. For that role, she played a popular high schooler.
During a hiatus from the series, she acted in an independent film call Excision, where she played a very different character. “I played a very cerebral, disturbed, strange little girl that was very close to who I feel I am on the inside. It was very exposing, very confronting, probably a bit retraumatizing without realizing it,” she says. “The crazy thing about it was that I wrapped that film at 2 AM on a Tuesday and had to be happy, crazy Beverly Hills blonde bombshell on Wednesday at noon. I couldn’t find her, she was not accessible. I was dark, I was very deep into this character Pauline and I couldn’t get [out].”
For many people who struggle with dissociative identity disorder, they remain unaware of their alters or splits. Not so for AnnaLynne. She recalls times when she was “co-conscious” of her true self and the split she was at age 13 that she calls “little Anna.” “She was a balls to the wall, middle fingers to the sky, anarchist from hell who will stab you with the spike ring that she wears, and you’ll like it. Then she’ll make you lick the blood from it,” she says. “She was a nasty little creature, but I have so much gratitude to her because she got me out of the hell that I was in.”
That hell was childhood sexual trauma.
AnnaLynne has said publicly that being raped at age 18 triggered memories of child sexual abuse. “I don’t have anything until around 5. Then from 5 to 11, I recount incidents throughout,” she says. “Then when I was 13, I have a singled-out memory that was one thing, but I don’t have the sense of anything else at that time.”
MULTIPLE PERSONALITIES AND THE BRAIN
According to Dr. Amen, the brain is the key to the development of dissociative identity disorder. Low blood flow to the front part of the brain, which AnnaLynne’s brain SPECT scan revealed, is involved. The frontal lobes are the brain’s brake. When activity is low in this region and you’ve had intense childhood sexual trauma, people may split as a way to manage it.
Head trauma can also be a contributing factor. AnnaLynne experienced a couple of car accidents that caused whiplash. As Dr. Amen has explained to tens of thousands of patients at Amen Clinics, head trauma is one of the primary causes of mental illness, but few people know it because traditional psychiatry doesn’t look at the brain. Functional brain SPECT imaging changes that.
AnnaLynne’s SPECT scan showed low activity in the back of her brain too, which is commonly seen in people who have experienced whiplash. Healing the brain with natural therapies, such as hyperbaric oxygen therapy (HBOT), nutraceuticals, and a brain healthy diet can help.
OVERCOMING STIGMA RELATED TO MULTIPLE PERSONALITY DISORDER
There are many myths about multiple personality disorders, which increase stigma and prevent people with this misunderstood mental health issue from seeking treatment. AnnaLynne is determined to change that.
“I am absolutely uninterested in shame,” she says. “There is nothing about my journey that I invite shame into anymore, and that’s how we get to the point where we can articulate the nature of these pervasive traumas and stuff, as horrible as they are.”
By sharing her session with Dr. Amen, she is hoping to increase awareness about dissociative disorder and childhood sexual trauma so other people don’t need to suffer in silence.
Dissociative identity disorder, childhood sexual trauma, 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. On July 24, 2018, pop superstar Demi Lovato woke up in a hospital after overdosing on heroin she says was likely laced with fentanyl. The near-death overdose caused three strokes, a heart attack, and damage to her brain that’s left her with visual problems. How could the singer’s life have derailed so dangerously after being sober for six years?
She reveals what drove her to overdose in her new 4-part docuseries, “Demi Lovato: Dancing With the Devil,” which premiered on YouTube on March 23, 2021. In the raw and wrenching series, she says she wanted to “set the record straight about what happened” when she OD’d. What unfolds is a heartbreaking story that sheds light on how crippling addiction can be.
Here are 5 insights you can learn about substance abuse and overdoses from this gripping docuseries.
1. Addiction is generational.
Lovato’s story is one the psychiatrists and brain imaging specialists at Amen Clinics hear far too often from patients—a parent’s addiction leads to a child experiencing feelings of abandonment and rejection and eventually falling into addiction themselves. It’s a generational cycle of addiction that is commonly seen in psychiatric circles. In the words of Daniel Amen, MD, the founder of Amen Clinics and author of Your Brain Is Always Listening, the children of alcoholics and drug abusers become filled with inner Dragons from the Past that breathe fire on the emotional centers of the brain and drive anxiety, depression, and addiction. It creates a cycle of addiction that is hard to break. At one point in Lovato’s life, she took a hard look at her behavior—drinking vodka at 9 AM from a Sprite bottle—and realized “I’m just like my Dad.”
2. Unresolved past traumas can fuel addictive behaviors.
In Dancing with the Devil, Lovato describes how she “never took the time to dig deep and work on the trauma” she had experienced in her life. She was estranged from her father, who was an alcoholic and abusive to Lovato’s mother. The young star cut him out of her life, but the emotional trauma she felt from that harmful relationship drove her to use alcohol and drugs to self-medicate.
3. Addicts are very skilled at hiding their behavior.
In Lovato’s docuseries, she says she admitted to friends that she was drinking alcohol and smoking weed again, but she hid the fact that she had started using hard drugs—cocaine, MDMA (ecstasy), methamphetamine, crack, oxycontin, and heroin. She says she was “very good at hiding the fact I was addicted to crack and heroin.” But there was a toll to keeping that secret. “Any time you suppress a part of yourself, at some point it’s gonna overflow. And that’s ultimately what happened to me,” she says.
4. The pressure to be perfect can contribute to relapse.
Lovato has emerged as an advocate for mental health and has openly talked about not only her addiction, but also her struggles with an eating disorder, a diagnosis of bipolar disorder (she now says she was misdiagnosed with bipolar disorder, which is common, and actually has ADHD), and other issues. “Mental health is something that we all need to talk about, and we need to take the stigma away from it,” she says. Her efforts are admirable but being put in a position as a role model created undue pressure for her to seek perfection. “I felt like I had to be this perfect role model,” says the singer, who thinks it played a role in her relapse.
5. Addiction and overdoses damage the brain.
In discussing what happened to Lovato after the overdose, one of her doctors says, “Time is brain.” Lovato’s oxygen levels were dangerously low, meaning her brain wasn’t getting the oxygen it needs to function. The longer a person goes with the brain being starved of the nutrients it needs, the greater the risk for lasting damage and a tougher recovery. Lovato’s brain suffered damage from three strokes, and she has residual issues in the vision centers in the back part of the brain. Lovato now suffers from blind spots and can no longer drive.
The brain SPECT imaging work at Amen Clinics shows how devasting addiction and strokes can be to the brain. They cause reduced blood flow to the brain, which has been associated with depression, ADD/ADHD, suicidal thoughts, bipolar disorder, schizophrenia, substance abuse, and more. It’s also the #1 brain imaging predictor that a person will develop Alzheimer’s disease.
Addictions, bipolar disorder, ADD/ADHD, 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. Traumatic experiences can be devastating to those who are exposed to them. They can lead to significant mental health problems and changes in how a person functions and copes—even long after the trauma has passed. Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are 2 types of diagnoses people may be given, based on symptoms that result from significant emotional and/or physical trauma.
Generally speaking, PTSD can develop after a single traumatic event that is life-threatening—or perceived to be—by the person who experiences it. Common examples of such situations include:
This condition may also be diagnosed in people who have survived other types of horrific situations, such as having been:
A prisoner of war
Subjected to torture
Kidnapped
Living in a war-torn area
A victim of human trafficking
Abused by a domestic partner over an extended period of time
Symptoms in PTSD and Complex PTSD
Right now, the most current version of the Diagnostic and Statistical Manual (DSM-V) does not separate PTSD from CPTSD in its classifications; however, the ICD-11 (International Classification of Diseases) identifies these as 2 separate conditions. While both PTSD and CPTSD share some of the same symptoms, there are specific characteristics in complex PTSD that are not seen in regular PTSD.
To be diagnosed with PTSD, a person must have significant problems in functioning due to the following core symptoms that last for at least several weeks:
Have nightmares or flashbacks during which the fear of the traumatic event is vividly re-experienced
Avoidance of activities, situations—or even thoughts and memories—of the traumatic event
Being in a state of hypervigilance or being easily startled because of an ongoing perceived sense of threat (even though the traumatic event has passed)
A person with PTSD can also have other symptoms, such as sleep problems, difficulty with, concentration and memory, anger issues, depressive symptoms, and even suicidal thoughts.
According to the ICD-11, a person with complex PTSD is likely to have the same core symptoms of PTSD listed above, but in addition, has the following symptoms that are persistent and severe in nature:
Problems controlling their emotions
Believe they are worthless or a failure and inferior to others
Have feelings of profound shame and guilt related to the traumatic event that distorts their perspective of themselves and the traumatic event(s)
Have difficulty getting close to others and sustaining relationships
People with CPTSD may also have periods of amnesia about what happened and periods of dissociation (feeling removed from themselves). The combination of all of these symptoms can lead to significant problems functioning in many aspects of their lives, including personally, with family, socially, and at school or work.
Interestingly, there may be some mitigating factors that can reduce the number and degree of symptoms a person develops from a chronic traumatic situation. For example, some research has found that there may be protective factors for certain people, such as a genetic predisposition for resilience and/or familial support that may help a person to develop PTSD, rather than extra challenges associated with complex PTSD.
Complex PTSD vs. Borderline Personality Disorder
From a clinical perspective, there are some similarities between complex PTSD and borderline personality disorder (BPD), particularly with regard to emotional stability, and so a person may get diagnosed with PTSD plus BPD. However, as explained in a 2020 article published in the British Journal of Psychiatry, people with BPD have a fluctuating (good/bad) perception of themselves, whereas, with CPTSD, self-perception is typically only negative. Also, those with CPTSD tend to avoid relationships or have a difficult time maintaining them, while those with borderline personality tend to jump into relationships quickly and create a lot of instability with their partners.
Treatment for Trauma Makes a Difference
People with complex PTSD often have difficulty trusting others. Given the horror of what they must have gone through at the hands of another person (or multiple people), it is understandable. Finding a mental health professional who is skilled in working with CPTSD is very important so that some level of trust and emotional comfort can develop. When that happens, additional therapeutic modalities can be included in a person’s healing journey, such as:
EMDR: Eye Movement Desensitization and Reprocessing (EMDR) has been one of the more successful treatments for PTSD. It involves less talking than other therapies and generally allows for traumatic memories to be addressed in a way that feels safer to the person working through them.
DBT: Dialectical Behavioral Therapy (DBT), which has a strong mindfulness component, can be helpful for learning to regulate emotions as well as managing stress and self-destructive behaviors, such as substance abuse or self-injury.
With the right kind of compassionate support and treatment, symptoms of complex PTSD and PTSD and really can get better over time.
PTSD 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. It’s hard to imagine why a man would pay women to abuse him, but that’s the dark world Brandon has been stuck in.
For years, he has solicited women to cause him physical pain by stepping on his face and neck, walking on him, kicking him in the groin and other abuse, while wearing expensive designer shoes. He even had someone run over his arm. And he pays money for them to do these things to him.
Pain helps to make Brandon feel alive.
Even though he has been with his girlfriend, Lindsay, for more than 2 years now, he continues to engage in this of kind behavior with other women to get his needs met outside of their relationship. While Brandon recognizes that his desire to have women demean and abuse him is abnormal, it feels good to him in the moment. In fact, the more he pushes his limits, the greater the thrill or reward he experiences.
At the same time, he feels shameful about it—not just the behavior—but the constant lying and hurt he causes Lindsay. The biggest problem for Brandon though, is his inability to stop. Like an addict who can’t stay away from drugs, Brandon can’t control his urges to seek out pain.
A Referral to Amen Clinics was Needed!
When Lindsay and Brandon were featured on the Dr. Phil show recently, Lindsay said she believes Brandon needs help; that she loves him but feels something is wrong with him, and maybe he could get better with the right help. Dr. Phil agreed and said he suspected Brandon’s history of traumatic brain injury was playing a big role in his significant behavior problems.
He referred Brandon to Amen Clinics for a full evaluation of his brain–STAT!
Dr. Phil explained to Brandon that seeing Dr. Daniel Amen was the first step in healing his brain because Amen Clinics does some of the finest work in the country in evaluating and rehabilitating brains. He also knew Dr. Amen would give Brandon a personalized treatment plan to address his brain and behavior issues.
The Power of Brain Scans
Dr. Amen, who uses brain SPECT imaging as part of the evaluations at Amen Clinics, met with Brandon to discuss what his brain scans revealed. There were some very telling clues about Brandon’s behavior issues.
To begin with, there was extensive injury to his brain as evidenced by several areas of low blood flow, particularly in his prefrontal cortex (PFC). This area is the brain’s CEO and is involved with:
Reasoning and decision-making
Planning and forethought
Insight
Empathy
Judgment
Impulse control
While many of these functions were compromised for him, the biggest issue for Brandon was his utter lack of impulse control. Even if he wants to stop himself, the odds are against him because thebrakes of his brain don’t work!
Another area of concern from his scans was the low blood flow in his temporal lobes. Damage to this part of the brain can cause problems with language, memory, anger, mood instability, and dark thoughts. And it was Brandon’s dark thoughts that were troublesome even to himself—that he had them and couldn’t control them.
As Dr. Amen says, “It’s easy to say a person is bad. It’s harder to ask why.” This is the reason he uses brain SPECT imaging to look at the brain and identify the underlying causes of symptoms and behavior problems.
It’s easy to say a person is bad. It’s harder to ask why. Using brain SPECT imaging to look at the brain helps us identify the underlying causes of symptoms and behavior problems.
While Brandon is fully responsible for his decisions and behavior—and recognizes this—it was very helpful for him to understand the problems with his brain. Using the brain scans to identify the problem areas, Dr. Amen was able to give Brandon a specific treatment plan so he can start healing and strengthening his brain while he works on changing his maladaptive behaviors.
Brain Trauma and Mental Illness
Unfortunately, many people with brain trauma don’t know they have it because most doctors don’t actually look at the function of a person’s brain. Without looking at the brain, how can you know what’s really going on?
Have you ever had a concussion or other type of head injury?
Did you know brain trauma is a major cause of mental illness and behavior problems? Left untreated, a brain injury can lead to:
The good news is that with the right diagnosis and treatment, your brain really can get better. Learning to avoid things that hurt your brain, engaging in brain-healthy habits, taking targeted nutraceuticals—or medications if necessary—and other therapies can help optimize your brain function, even if you’ve had a head injury.
You are not necessarily stuck with the brain you have today!
TBI and concussions 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.
