Biological Factors:

Research has shown that several biological factors can contribute to suicidal behavior. Neuroimaging studies have identified differences in the brains of individuals who die by suicide, including altered activity in regions associated with emotion regulation and decision-making. Genetic factors may also play a role, as studies have identified a heritability component to suicidal behavior. Additionally, disruptions in the levels of certain neurotransmitters, such as serotonin, have been linked to increased suicide risk.

Psychological Factors:

Psychological factors, such as mental illness, can significantly increase the risk of suicidal behavior. Mental health conditions such as depression, anxiety, bipolar disorder, and schizophrenia are commonly associated with suicide risk. Trauma, including childhood abuse or neglect, can also increase the risk of suicidal behavior. Psychological factors may interact with biological factors to further increase the risk of suicide.

Environmental Factors:

Environmental factors, such as social and economic stressors, can contribute to suicidal behavior. Individuals who experience social isolation, financial hardship, or relationship problems may be more likely to consider suicide. Exposure to suicide, either through personal experience or media coverage, may also increase suicide risk. Access to lethal means, such as firearms, can further increase the risk of suicide.

As stated in the beginning, suicidal behavior is an extremely complex phenomenon that arises from the interplay of biological, psychological, and environmental factors. While each individual’s experience with suicidal behavior is unique, understanding the underlying causes of suicide risk is essential to developing effective prevention and intervention strategies. By addressing biological, psychological, and environmental factors, we can work towards reducing the incidence of suicidal behavior and supporting individuals who are at risk.

If you or anyone you know is suffering from suicidal tendencies, suicidal behavior, chronic mental illness like depression, anxiety, delusional episodes, etc., neurological diseases like Alzheimer’s disease, alcohol addiction, brain trauma, cognitive deficiency, or undergoing treatments for neurodegenerative diseases, please contact Specialized Therapy Associates at 201-488-6678 or The Functional Medicine Center for Personalized Care, LLC (www.FxMedCenters.com) at 201-880-8247 for our Integrative Mind-Body Health services which can greatly help you with holistic mind-body healing.

References:

Jollant F, Lawrence NS, Giampietro V, et al. Orbitofrontal cortex response to angry faces in men with histories of suicide attempts. Am J Psychiatry. 2008;165(6):740-748.

McGuffin P, Marusic A, Farmer A. What can psychiatric genetics offer suicidology? Crisis. 2001;22(2):61-64.Mann JJ. Neurobiology of suicidal behaviour. Nat Rev Neurosci. 2003;4(10):819-828.

Hawton K, Saunders KE, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379(9834):2373-2382.

Glenn CR, Kleiman EM, Cha CB, et al. Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review. Depress Anxiety. 2018;35(1):65-88.

Hjelmeland H, Dieserud G, Dyregrov K, et al. Psychological autopsy studies as diagnostic tools: Are they methodologically flawed? Death Stud. 2012;36(7):605-626.

Stack S. Media impacts on suicide: A quantitative review of 293 findings. Soc Sci Q. 2005;86(2):452-474.

The post Understanding the Complex Causes of Suicidal Behavior first appeared on Specialized Therapy.

The post Understanding the Complex Causes of Suicidal Behavior appeared first on Specialized Therapy.

The Hippocampal Pathway:

One of the most well-studied pathways of neurogenesis occurs in the hippocampus, a brain region associated with learning and memory. In this pathway, neural stem cells located in the hippocampus differentiate into new neurons that integrate into existing neural circuits. The process is regulated by a variety of factors, including growth factors, neurotransmitters, and environmental stimuli.

The Sub-ventricular Zone Pathway:

Another pathway of neurogenesis occurs in the sub-ventricular zone, a region located in the walls of the lateral ventricles of the brain. In this pathway, neural stem cells differentiate into new neurons that migrate to the olfactory bulb, where they integrate into the neural circuits involved in smell perception. The process is regulated by a similar set of factors as the hippocampal pathway, including growth factors, neurotransmitters, and environmental stimuli.

Regulation of Neurogenesis:

The pathways of neurogenesis are tightly regulated by a variety of factors. Growth factors, such as brain-derived neurotrophic factor (BDNF), play a critical role in promoting the survival and differentiation of new neurons. Neurotransmitters, including dopamine and serotonin, can also influence the generation and migration of new neurons. Additionally, environmental factors, such as physical exercise and enriched environments, have been shown to enhance neurogenesis.

Implications for Brain Health:

The discovery of adult neurogenesis has opened up new possibilities for treating brain injury and neurodegenerative disorders. For example, researchers are exploring ways to enhance neurogenesis in the hippocampus to improve learning and memory in aging populations. Additionally, neurogenesis may play a role in recovery from brain injury and stroke, as new neurons can help to replace damaged or lost neural circuits.

Neurogenesis is a complex process that occurs throughout an individual’s lifespan and is regulated by a variety of factors. The hippocampal and subventricular zone pathways are two well-studied routes of neurogenesis, and both are influenced by growth factors, neurotransmitters, and environmental factors. Understanding the pathways of neurogenesis and their regulation is critical to developing new treatments for brain injury and neurodegenerative disorders.

If you or anyone you know is suffering from sleeping disorders, chronic mental illness like depression, anxiety, delusional episodes, etc., neurological diseases like Alzheimer’s disease, alcohol addiction, brain trauma, cognitive deficiency, or undergoing treatments for neurodegenerative diseases, please contact Specialized Therapy Associates at 201-488-6678 or The Functional Medicine Center for Personalized Care, LLC (www.FxMedCenters.com) at 201-880-8247 for our Integrative Mind-Body Health services which can greatly help you with holistic mind-body healing.

References:

Ming GL, Song H. Adult neurogenesis in the mammalian brain: significant answers and significant questions. Neuron. 2011;70(4):687-702.

Doetsch F. A niche for adult neural stem cells. Curr Opin Genet Dev. 2003;13(5):543-550.

Park H, Poo MM. Neurotrophin regulation of neural circuit development and function. Nat Rev Neurosci. 2013;14(1):7-23.

Zhao M, Momma S, Delfani K, et al. Electrical signaling in control of adult neurogenesis. Prog Neurobiol. 2008;84(5):348-359.

Van Praag H, Kempermann G, Gage FH. Neural consequences of environmental enrichment. Nat Rev Neurosci. 2000;1(3):191-198.

The post The Pathways of Neurogenesis: A Scientific Exploration of Brain Cell Regeneration first appeared on Specialized Therapy.

The post The Pathways of Neurogenesis: A Scientific Exploration of Brain Cell Regeneration appeared first on Specialized Therapy.

The workplace can be a source of stress for many employees. Deadlines, performance evaluations, conflicts with colleagues, and other work-related stressors can take a toll on mental health. The American Psychological Association reports that workplace stress costs the U.S. economy billions of dollars annually in lost productivity and healthcare costs.

Therefore, it’s important for employers to recognize the impact of workplace stress on their employees’ mental health and take steps to reduce stressors. This can include offering mental health resources, such as an employee assistance program (EAP) or access to mental health professionals. It can also mean creating a workplace culture that prioritizes mental health, such as offering flexible work arrangements, promoting work-life balance, and encouraging employees to take breaks and prioritize self-care.

Strategies for Improving Mental Well-being in the Workplace

Both employers and employees can take steps to improve mental well-being in the workplace. Here are some strategies to consider:

Promote open communication: Encourage open communication between employees and management. Employees should feel comfortable talking to their supervisors about any mental health concerns they have, without fear of negative consequences. Employers can create a safe and supportive environment for employees to discuss mental health concerns by providing resources and training on mental health issues.

Encourage self-care: Encourage employees to prioritize self-care, such as taking breaks, getting enough sleep, and engaging in activities they enjoy outside of work. Employers can provide resources and support for employees to practice self-care, such as offering mental health days or wellness programs.

Create a positive work environment: A positive work environment can go a long way in improving mental well-being. Employers can create a positive work environment by fostering a sense of community and teamwork, recognizing employee achievements, and providing opportunities for growth and development.

Provide mental health resources: Employers can offer mental health resources, such as an employee assistance program (EAP) or access to mental health professionals. This can provide employees with the support they need to manage work-related stressors and other mental health concerns.

Encourage work-life balance: Encourage employees to maintain a healthy work-life balance by offering flexible work arrangements, such as remote work or flexible hours. This can help employees manage their workload and prioritize their mental health.

Reduce stigma: Reduce stigma surrounding mental health by educating employees about mental health issues and encouraging open communication. Employers can provide training on mental health issues and promote mental health awareness campaigns.

Mental health is a critical component of overall health and well-being, and it’s important for employers and employees to prioritize mental health in the workplace. Employers can take steps to reduce workplace stressors, promote mental health resources, and create a positive work environment. Employees can prioritize self-care, communicate openly with their supervisors, and seek out mental health resources when needed. By working together, employers and employees can improve mental well-being in the workplace and create a healthier, more productive workforce.

The post The Importance of Mental Health in the Workplace first appeared on Specialized Therapy.

The post The Importance of Mental Health in the Workplace appeared first on Specialized Therapy.

What are Psychoactive Hallucinogens?

Psychoactive compounds or psychedelics are known to induce hyper-realistic hallucinations. The “trip” however, is more than just a random high. Research suggests that hallucinogens like Psilocybin, the psychoactive compound in magic mushrooms, DMT, and LSD can rearrange and rewire neural pathways. Brain mapping images of individuals on psychedelics clearly show the brain light up like never seen before. Distinct regions of the brain which do not necessarily work together, are seen to operate in coordination with one another under the influence of psychedelics. In fact, psychoactive compounds are experiencing somewhat of a renaissance today, and more and more people in the field of science are asking: could it be possible to treat mental illness with these compounds?

To answer that question, we need to define psychedelics first. Psychedelic substances are defined as “classic serotonergic hallucinogens” as they directly interact with the 5-HT system, primarily acting as 5-HT2A receptor agonists. However, the mechanism of action is way more complex than previously thought, and they also bind to 5HT1A, 5HT2B, 5HT2C, 5HT6, and 5HT7 receptors with variegated neurological, physiological, and psychological implications.

What effect do these psychoactive compounds have on the brain?

5-HT receptors are associated with the release of neurotransmitters like Serotonin, Dopamine, Acetylcholine, etc., that tremendously affect mood, behavior, libido, sleep patterns, and sensory modulations. Consequently, functional imaging studies show that psychedelics massively increase the processing of sensory information and induce altered integration of sensory perceptions. This creates a novel experience for the user. However, psychedelics alter information processing systems within the cortico-striato-thalamo-cortical feedback loops. LSD and psilocybin enhance overall interaction between sensory and somatomotor brain networks while decreasing communication among associative brain regions, including large-scale brain networks (such as the Default Mode Network). In fact, LSD, Psilocybin, and DMT vastly increase functional connectivity between the thalamus and sensory-somatomotor cortical regions.

One of the signature features of psychedelics is an alteration in visual perception. These have repeatedly been associated with a reduction in α oscillations, particularly over posterior parieto-occipital brain areas. This suggests that psychoactive compounds greatly enhance the excitability of the visual pathway. However, the most fascinating fact about psychedelics is that they are capable of permanently changing/rewiring neural connectivity and creating novel neural connections which can massively affect/alter behavior permanently. Could this somehow help people with mental illness?

Treating mental illness with psychoactive hallucinogens

Data from double-blinded clinical studies suggest that Psilocybin, commonly found in magic mushrooms, greatly reduces cluster headaches, anxiety, anorexia, Obsessive Compulsive Disorder (OCD), and substance abuse. However, people with chronic mental illness almost often tend to suffer from neurological or psychological loops they fail to break away from. Since psychedelics are capable of creating novel connections between neurons in the brain and can rewire the neural network, the patients could break away from ruminating and destructive thought processes.

Psychedelics like DMT, Psilocybin, MDMA, and LSD can enhance associative learning, a cognitive function that is greatly impaired by neuropsychiatric disorders like Major Depressive Disorder (MDD). Studies suggest that psychedelics like LSD, DMT, and Psilocybin can greatly assuage symptoms in patients with bipolar disorder, PTSD, major depression, suicidal behavior, chronic anxiety, panic attacks, schizophrenia, and chronic insomnia. Some studies suggest that Psilocybin could even help patients with Alzheimer’s and Parkinson’s disease regain brain function. Lisuride, a non-hallucinogenic structural analog of LSD, exhibits antidepressant properties in several clinical studies. MDMA has been shown to have a significantly positive effect on PTSD patients. Overall, the pattern among numerous clinical studies is quite obvious. They all report that psychedelics in general can massively decrease the symptoms associated with mental health problems in the participating population.

In 2023, we are getting closer every day to when psychedelics could soon be approved by the FDA. Oregon has already approved the use of psilocybin starting January 1st, 2023. It is only a matter of time before the general population can legally explore the healing potentials of psychoactive compounds. However, the secret to success is micro-dosing.

Meanwhile, if you or anyone you know is suffering from mental illness, neurological diseases like Alzheimer’s disease, alcohol addiction, brain trauma, cognitive deficiency, or undergoing treatments for neurodegenerative diseases, please contact Specialized Therapy Associates at 201-488-6678 or The Functional Medicine Center for Personalized Care, LLC (www.FxMedCenters.com) at 201-880-8247 for our Integrative Mind-Body Health services which can greatly help you with holistic mind-body healing.

Reference:

Carhart-Harris RL, Goodwin GM. The Therapeutic Potential of Psychedelic Drugs: Past, Present, and Future. Neuropsychopharmacology. 2017 Oct;42(11):2105-2113. doi: 10.1038/npp.2017.84. Epub 2017 Apr 26. PMID: 28443617; PMCID: PMC5603818.

De Gregorio D, Aguilar-Valles A, Preller KH, Heifets BD, Hibicke M, Mitchell J, Gobbi G. Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine. J Neurosci. 2021 Feb 3;41(5):891-900. doi: 10.1523/JNEUROSCI.1659-20.2020. Epub 2020 Nov 30. PMID: 33257322; PMCID: PMC7880300.

Fuentes JJ, Fonseca F, Elices M, Farré M, Torrens M. Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials. Front Psychiatry. 2020 Jan 21;10:943. doi: 10.3389/fpsyt.2019.00943. PMID: 32038315; PMCID: PMC6985449.

Vargas MV, Meyer R, Avanes AA, Rus M, Olson DE. Psychedelics and Other Psychoplastogens for Treating Mental Illness. Front Psychiatry. 2021 Oct 4;12:727117. doi: 10.3389/fpsyt.2021.727117. PMID: 34671279; PMCID: PMC8520991.

The post Are psychoactive hallucinogens and synthetic psychoactive compounds the future for treating mental illness? first appeared on Specialized Therapy.

The post Are psychoactive hallucinogens and synthetic psychoactive compounds the future for treating mental illness? appeared first on Specialized Therapy.

Although Ketamine’s antidepressant mechanism of action is still being thoroughly studied, it is an antagonist of the glutamate receptor subtype that is widely expressed in the central nervous system. (CNS). In addition, it also serves as the mTORC1 pathway activator. N-methyl-d-aspartate receptor or NMDAR is a G-protein coupled receptor, and it plays crucial roles in synaptic plasticity and memory formation within the brain. mTORC1 pathway is responsible for translational processes that regulate cell growth and proliferation.

Ketamine has recently shown promising research in the treatment of certain psychiatric conditions such as bipolar disorder, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and substance abuse disorder. Due to its euphoric, dissociative, and hallucinogenic properties, ketamine abuse has led to its strict regulation and availability. However, in several clinical trials, Ketamine is largely effective in patients with treatment-resistant depression. In fact, Ketamine seems to work within 40 minutes of administration, and sub-anesthetic dosage can slowly help patients in therapy recover from severe symptoms of Major Depressive Disorder (MDD) or Treatment-Resistant Depression (TRD). Most studies agree that Ketamine has curative anti-depressive properties when administered in sub-anesthetic doses.

Although Ketamine could induce manic episodes in patients with bipolar disorder, case studies and open-label trials suggest that Ketamine when administered non-intravenously can be safe and effective for treating bipolar disorder. Additionally, studies also found that Ketamine treatment has a massive impact on suicidal ideation. Patients with suicidal thoughts were administered sub-anesthetic doses, and effects were observed within 4 hours of treatment. The single dose of Ketamine largely decreased suicidal ideation among the patients while also reducing suicidal tendencies for up to a week. However, long-term efficacy is yet to be determined. Overall, Ketamine has been shown to generate anti-suicidal thought processes irrespective of its anti-depressive properties, which itself is a significant breakthrough!

Besides having a significant curative impact on depression, suicidal behavior, and bipolar disorder; Ketamine was also studied for its impact on social anxiety disorder and general anxiety disorder. Six studies that used Ketamine on their patients found that Ketamine when administered at certain doses greatly reduced general anxiety and social anxiety among the participating patients. Surprisingly, patients who initially responded to Ketamine treatment continued to be in remission even after three months of the initial treatment with some help from maintenance treatment. However, the treatment also found that higher doses (1mg/kg) of Ketamine had the most anxiolytic effect although this could induce drug dependency.

A few studies conducted among USA military personnel and other PTSD patients also show promising results. Ketamine largely exhibited relief from PTSD episodes and physical symptoms in a majority of the participants. Additionally, sub-anesthetic doses were also seen to have a promising impact on people with OCD.

While psychedelics have already made a comeback in 2023, it is only a matter of time before FDA-approved treatment approaches with Ketamine and other psychoactive substances become a reality. When it comes to Ketamine, under sub-anesthetic doses, the drug undeniably has curative effects on several mental health disorders.

if you or anyone you know is suffering from mental illness, neurological diseases like Alzheimer’s disease, alcohol addiction, brain trauma, cognitive deficiency, or undergoing treatments for neurodegenerative diseases, please contact Specialized Therapy Associates at 201-488-6678 or The Functional Medicine Center for Personalized Care, LLC (www.FxMedCenters.com) at 201-880-8247 for our Integrative Mind-Body Health services which can greatly help you with holistic mind-body healing.

References:

De Gregorio D, Aguilar-Valles A, Preller KH, Heifets BD, Hibicke M, Mitchell J, Gobbi G. Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and K. J Neurosci. 2021 Feb 3;41(5):891-900. doi: 10.1523/JNEUROSCI.1659-20.2020. Epub 2020 Nov 30. PMID: 33257322; PMCID: PMC7880300.

Mandal S, Sinha VK, Goyal N. Efficacy of therapy in the treatment of depression. Indian J Psychiatry. 2019 Sep-Oct;61(5):480-485. doi: 10.4103/psychiatry.IndianJPsychiatry_484_18. PMID: 31579184; PMCID: PMC6767816.

Walsh Z, Mollaahmetoglu OM, Rootman J, Golsof S, Keeler J, Marsh B, Nutt DJ, Morgan CJA. K for the treatment of mental health and substance use disorders: comprehensive systematic review. BJPsych Open. 2021 Dec 23;8(1):e19. doi: 10.1192/bjo.2021.1061. Erratum in: BJPsych Open. 2022 Jan 18;8(1):e29. PMID: 35048815; PMCID: PMC8715255.

The post Ketamine: therapeutic implications against mental health disorders first appeared on Specialized Therapy.

The post Ketamine: therapeutic implications against mental health disorders appeared first on Specialized Therapy.

Both anxiety and stress affect the sympathetic nervous system. Upon activation, the sympathetic nervous system releases cortisol and adrenaline. Since adrenaline and cortisol coordinate stress responses, the evolutionary instinct of “fight or flight” kicks in. Many evolutionary biologists believe that anxiety and other emotional disorders could be a direct consequence of evolutionary mismatch.

An evolutionary mismatch occurs when a particular trait that was beneficial to an organism that originally evolved in a particular environment long ago, becomes redundant in a differing environment. For instance, our ancestors were hunters and gatherers whose survival depended on being watchful in the wild. We have changed our lifestyle, diet, and occupations over millions of years and have become more sedentary. Hence, the intense watchful stress response is no longer a necessity that tends to creep up even when one might be far from actual danger. Evidently, studies have shown that anxiety is more common in people with a sedentary lifestyle.

Regardless, if you are suffering from anxiety, certain medications, diet and lifestyle changes, and cognitive-behavioral interventions could benefit you enormously. Here are some breathing tips that would certainly help you calm your nerves:

Diaphragmatic Breathing and 4-7-8 breathing: Placing a hand on your chest and another on your stomach, inhale slowly through your nose and count to 3. Now, keep the air in your lungs and mentally make a count to 3 again. After this, exhale very slowly as you make a count to 5. Take your time with the process. Familiarize yourself with your surrounding and your sensory organs, and make sure you exhale for a longer period contrary to the inhale. Repeat 4-5 times.

The above breathing exercise is a slight variation of the original 4-7-8 breathing technique by Dr. Andrew Weil. According to the 4-7-8 technique, you should first exhale and empty your lungs of any resting air. Now, breathe in through your nose for 4 seconds. Next, hold your breath for 7 seconds and then exhale vigorously for 8 seconds until all the air is out of your lungs. You should repeat this 4-5 times each session and consider two-three sessions a day. Since diaphragmatic breathing and the 4-7-8 technique are incredibly effective, you should start feeling better immediately.

Yogic Breathing (Pranayama) and Guided Meditation: The ancient practice of Yoga is the perfect tool to ensure absolute mind-body health. Yoga strengthens the core, improves stamina, fortifies the cardiovascular system, and helps in weight loss by improving the rate of metabolism (BMR). As a result, Yoga enhances focus, attention, and awareness, reduces stress/anxiety, and brings mental calm and clarity to those who practice regularly. Pranayama, an ancient yogic breathing technique often fashioned as a lengthened exhale, equal breathing, and alternate nostril breathing can relieve stress and anxiety if practiced regularly. Much like the 4-7-8 and diaphragmatic breathing techniques, Pranayama has three distinct stages: inhalation, retention, and exhalation.

Someone who meditates regularly, often has to match the breathing rate to one’s heartbeat. During guided meditation, one learns to be aware of their surroundings, sensory organs, and inhale long, deep breaths while following progressive exhalation strategies. Guided meditation definitely helps with reducing the symptoms of acute stress and anxiety.

If you or anyone you know have been troubled by constant stress and anxiety, please reach out to us. Contact The Functional Medicine Center for Personalized Care, LLC (www.FxMedCenters.com) at 201-880-8247 or Specialized Therapy Associates at 201-488-6678.

Ishtiak Ahmed Chowdhury

References:

Bystritsky A, Khalsa SS, Cameron ME, Schiffman J. Current diagnosis and treatment of anxiety disorders. P T. 2013 Jan;38(1):30-57. PMID: 23599668; PMCID: PMC3628173.

Islam, M. R., & Chowdhury, I. A. (2017). Identification and Characterization of the Epidemiological risk factors of Type-2 Diabetes Mellitus. Asian Journal of Applied Science and Engineering, 6(3), 135-142. Available at: https://journals.abc.us.org/index.php/ajase/article/view/1105

Jiang L, Cao Y, Ni S, Chen X, Shen M, Lv H, Hu J. Association of Sedentary Behavior With Anxiety, Depression, and Suicide Ideation in College Students. Front Psychiatry. 2020 Dec 11;11:566098. doi: 10.3389/fpsyt.2020.566098. PMID: 33424653; PMCID: PMC7793895.

Price JS. Evolutionary aspects of anxiety disorders. Dialogues Clin Neurosci. 2003 Sep;5(3):223-36. doi: 10.31887/DCNS.2003.5.3/jprice. PMID: 22033473; PMCID: PMC3181631.

Website: https://www.medicalnewstoday.com/articles/324417#how-to-do-it

The post Anxiety and Stress: What they really are and how to calm your nerves first appeared on Specialized Therapy.

The post Anxiety and Stress: What they really are and how to calm your nerves appeared first on Specialized Therapy.

For example, while the spontaneity of someone with ADHD may be attractive to a potential partner, the ADHD person’s focus on the present and consequent lack of follow-through may become unwelcome to the non-ADHD spouse as time passes. A person with ADHD experiences the world in terms of now and not now. Being spontaneous is living in the now. Memory is about the past and planning is about the future, both not now. People with ADHD often excel at enjoying the present but have difficulty when it comes to taking care of things later on.

Each of the difficulties mentioned above for the ADHD person can contribute to problems in a marriage. What tends to happen it that the problematic behavior of the person with ADHD generates a response in the non-ADHD spouse that itself becomes a problem in the relationship. The person with ADHD promises their spouse to take care of a task later on, which is in the not now. When they make the promise, they do intend to carry it out later on. However, later on they are in a new present moment. When they made the promise is now in the past, the not now. They forget to do the task. Forgetting is something that happens to us all occasionally. But for the person with ADHD, the forgetting happens over and over.

The non-ADHD spouse gets tired of the forgotten promises and the undone tasks. They often tell themselves that if they don’t do it, it won’t get done. So, they often wind up doing more and more of the household tasks and wind up resenting it more and more. One thing we all do is generate attributions, or explanations, to ourselves for why things happen, particularly things that happen to us. The non-ADHD spouse winds up thinking negative things about their partner.  “They’re lazy, they don’t care, they think of me as their servant.” They can begin relating to their ADHD spouse as another child in the family who has to be taken care of.

In the meantime, the person with ADHD, who tries for a while to improve their behavior after being criticized by their non-ADHD spouse, eventually comes to believe that whatever they do is not good enough and they begin to think that their efforts won’t ever be recognized. The ADHD spouse often loses their motivation to keep trying. A vicious cycle of criticism and avoidance develops between the two spouses that can ruin the marriage if unrecognized and left untreated.

Melissa Orlov went down this spiral, but rather than let her marriage be destroyed, decided to change her responses to her ADHD husband and so she saved her marriage. She used what she learned the hard way and wrote two books to help couples, one or both of whom have ADHD, to save their marriage. The book titles are The ADHD Effect on Marriage and The Couple’s Guide to Thriving with ADHD. She also has a website, www.adhdmarriage.com, devoted to providing up-to-date information to couples struggling with ADHD in their marriage.

She states that the spouse with ADHD first needs to recognize that they have ADHD and then needs to seek treatment for it. The treatment is often medication but not always so. Then both partners need to change their incorrect attributions about the others’ behavior and trade their destructive responses to each other for positive methods to identify day-to-day problems and develop strategies to solve these problems. She acknowledges that this process is not easy but, based on the imperfect but happy marriage she now says she has, she encourages her readers to make the efforts to save their marriages too.

If you are the spouse with ADHD or the spouse without ADHD and you want to save your marriage, then you can start with checking out Melissa Orlov’s website, read one or both of her books or get personal help from one of the therapists at STA who specializes in helping people with ADHD. Call us at 201-488-6678 if you want help to make the changes that are likely to improve your marriage.

The post ADHD and Marriage: How to Manage the Two first appeared on Specialized Therapy.

The post ADHD and Marriage: How to Manage the Two appeared first on Specialized Therapy.

In their book, Burnout: The Secret to Unlocking the Stress Cycle, Emily Nagoski, Ph.D. and Amelia Nagoski, DMA (2019) write about what they call the “Something Larger”, or the source of meaning in our lives. Sources of meaning can be the pursuit and achievement of certain goals, service to a spiritual calling, connection with others, etc. The “Something Larger” gives one the thought “my life has a positive impact”.

Making Meaning When Terrible Things Happen- How to Deal With a Turbulent Life:

According to Nagoski and Nagoski (2019), sometimes life is stable and flowing, and we are regularly engaged in Something Larger, and the world just makes sense. Other times, life gets turbulent, and we clutch onto that meaning for dear life because it gets us through the storm, it helps us tolerate the despair. And sometimes those rocky times last too long and you feel numb, stuck, and hopeless. Little by little, you start to rebuild, with kindness, compassion, and approaching tasks in small steps (and with help from others!). Eventually, we go from coping to thriving again and can even come out of it with a greater sense of meaning in our life.

The Origin Story

Rewriting the narrative of your experience, focusing on the lessons and strengths you gained through adversity is a way for you to turn terrible into an opportunity to explore your sense of meaning in life.

Answer the following questions:

What parts of the adversity were uncontrollable to you? (the weather, other people, your life circumstances at the time, etc.) (Nagoski and Nagoski, 2019, pp. 69-70)

What did you do to survive the adversity at the moment? (Nagoski and Nagoski, 2019, pp. 69-70)

What resources did you leverage, to continue surviving after the adversity had passed? Be specific. (Money, information, friends, ability to research and seek, accepting help, persistence, coping skills, hope, etc.) (Nagoski and Nagoski, 2019, pp. 69-70)

Think about how the experience empowered you, think about what you learned, what insight you gained. (write it down)

Write a summary:

Even though I couldn’t control____________ (adversity), I managed to_______________(survival tactic), and then I used____________________ (resource) to grow stronger. After that, I could_______________(skill/win/insight) (Nagoski and Nagoski, 2019, pp. 69-70)

Meaning enhances well-being when you’re doing well, and it can save your life when you’re struggling (Nagoski and Nagoski, 2019).

If you would like personalized support and guidance on Making Meaning When Terrible Things Happen, please call Specialized Therapy Associates at 201-488-6678 to schedule your complimentary consultation.

Reference:

Nagoski PhD, Emily and Nagoski DMA, Amelia (2019). Burnout: The Secret to Unlocking the Stress Cycle. Ballantine Books.

The post Making Meaning When Terrible Things Happen first appeared on Specialized Therapy.

The post Making Meaning When Terrible Things Happen appeared first on Specialized Therapy.

Nutritional Deficiency is subtle and can appear in many forms. Have you ever noticed little nuances in your body? These might be things that have just popped up over time, such as little marks on your nails or some bumps on the back of your arms or legs. In most cases, people attribute these things to be meaningless or feel silly for bringing them up to a health professional. They do, however, have a meaning! The body is always trying to tell us what’s going on inside by giving us visual cues on the outside. Let’s dive into some of the most common external cues of nutritional deficiency and what they might mean.

Nails are commonly affected by nutritional deficiency. This includes both the strength and integrity of the nail in addition to the appearance. Brittle nails that split or break easily might indicate that someone is not getting enough biotin in their diet. Biotin is a B vitamin, also known as B7, and plays an integral role in the strength of nails. It aids in the formation as well as the binding together of keratin. Keratin is a protein that is needed for strong nails and hair. 

Marks or ridges on the nails can be another indication of a nutritional deficiency. White marks, ridges (often referred to as Beau’s lines), and horizontal rigging may be an indication that someone might be deficient in zinc, B6, or protein. These are especially important to monitor in those following vegan or vegetarian diets. The physical shape of the nail can also be affected. In those with chronic iron deficiency, the nails can become spooned shaped where they curve like a spoon. 

The skin is one of the main forms of communication when it comes to knowing what is going on inside by what’s going on outside. As the largest organ in the human body, the skin is composed of layers of tissues. It is used for detoxification as well as absorption. Some common skin conditions that are evidence of an internal imbalance are acne, keratosis pilaris or ‘chicken skin’, psoriasis, and general rashes. 

Acne can be evidence of an imbalance of zinc within the body as well as poor glycemic control. Both of these can be mediated by eating a diet rich in whole foods such as whole grains, beans and legumes, fruits, vegetables, nuts, seeds, and lean proteins. Diets rich in fiber are excellent for glycemic control. Aim for 8-10 grams of fiber per meal totaling 24-30 grams per day. Men can benefit additionally by reaching higher intakes of fiber, specifically from grains, fruits, and whole grain-based cereals when it comes to the risk reduction for colorectal cancer and adenomas. 

Another factor influencing the presence of acne is dairy in the diet. Dairy is inflammatory in nature for most people and the inflammation often manifests as skin issues such as acne. Acne around the mouth and chin can indicate hormonal issues, some of which can also be attributed to the hormones given to dairy cows and the natural hormones in dairy meant for calves to ingest and mature into adult cows. This increases growth hormones that have a positive effect on the presence of acne due to increasing the production of sebum, the oily secretion that can clog pores. Opting for dairy alternatives is a great option for most people.

Follicular keratosis, commonly referred to as ‘chicken skin’ or ‘strawberry skin’ manifests as tiny bumps on the back of the arms and or legs. These bumps are the result of the hyperkeratinization of pores, and the formation of a keratin ‘plug’ over the hair follicle. This might be caused by an essential fatty acid deficiency or a vitamin A deficiency. Eating a diet rich in colorful fruits and vegetables will provide natural vitamin A, specifically those that are red, yellow, and orange. Essential fatty acids can be consumed by adding some freshly ground flaxseed on top of meals or into smoothies. Chia seeds are another great option as they boast good amounts of fiber and protein as well. Using extra virgin olive oil in salad dressings is a great option as well. It’s important to note that consuming fried foods and foods containing hydrogenated or partially hydrogenated oils can lead to an essential fatty acid deficiency, even if you are consuming those good fats. The hydrogenated fats clog up the enzymes needed to metabolize the good fats, therefore the body is taking them in, but is unable to use them. 

Dry skin is a common issue and can often be solved with adequate hydration and the consumption of adequate essential fatty acids as well. If a condition such as psoriasis is present, this can be an indication of a variety of imbalances within the body. Psoriasis is characterized as the buildup of skin cells on the surface causing red scaly patches that are often itchy and uncomfortable. This commonly affects the knees, elbows, and scalp, although it can spread anywhere in the body. It has been observed to have a strong genetic link, but diet, lifestyle, and environmental factors can play into this also. Impaired digestion has been seen to influence psoriasis, specifically the poor digestion of proteins. Optimizing digestion is vital for maintaining a healthy body both inside and out. 

General and unexplained rashes are typically indicative of leaky gut or intestinal permeability. This means that food particles are getting past the lining of the gastrointestinal lining and into the bloodstream, eliciting an immune reaction by the body that can manifest as a rash. This can also manifest as brain fog, headaches, inflammation in the joints, and more. It is important to remember that not everyone is affected in the same way even if the root cause is the same. 

Hair growth and strength is another way for health practitioners to tune into whether or not someone might be experiencing nutritional deficiencies. Iron deficiency is one of the most common nutritional issues when it comes to hair loss. Those who follow vegan and vegetarian diets are at an increased risk for this and should consult a healthcare provider when determining the need for supplementation. Those with malabsorption issues such as celiac disease or those on medications for acid reflux are also at risk for poor absorption due to the change in the acidity of stomach acid. 

Another factor in hair health and growth is zinc. Zinc is an essential mineral needed for hundreds of metabolic processes within the human body. It is involved in the transcription and gene expression and the process of hair follicle generation. Zinc is found in many foods, but the ability to absorb and use it is higher in meat than vegetables. Beans and whole grains contain phytates that bind to zinc and make it harder to absorb. This combination puts vegans and vegetarians at an increased risk for zinc deficiency as well. Prolonged high dosing of zinc can deplete another important mineral, selenium. Always consult a healthcare professional before beginning any supplement regimen. 

Last but not least, we come to one of the most popular hair, skin, and nail supplements on the market: biotin. Biotin, also known as B7 or Vitamin H to some, has been widely marketed for its effect on growing hair. All B vitamins work in a complex and for most should be taken as such. Think of B vitamins as a family. When one member of the family is absent or lacking, the whole family cannot function as well as if all members were present and contributing. Biotin is important for many functions in the body including the breakdown of proteins and amino acids as well as the proper function of enzymes needed for fatty acid metabolism. Fatty acids are important for the hair, skin, and nails. Biotin deficiency is uncommon and is typically only seen in those with absorption issues such as IBD, those who chronically use antibiotics, those who consume large amounts of raw eggs, and those who consume excess alcohol. 

If you are experiencing any of these physical signs of imbalance, we recommend consulting with one of our functional medicine specialists. Not sure what vitamins and minerals you might be deficient in? Contact us to run a full micronutrient panel and see where you might need a  supplement of vitamins to get you back to feeling your best! Fight Nutritional Deficiency with us at Specialized Therapy Associates and Fx Med Centers. 

References

Baldwin, H., & Tan, J. (2021). Effects of Diet on Acne and Its Response to Treatment. American Journal of Clinical Dermatology, 22(1), 55–65. https://doi.org/10.1007/s40257-020-00542-y

Basavaraj, K. H., Seemanthini, C., & Rashmi, R. (2010). Diet in Dermatology: Present Perspectives. Indian journal of dermatology, 55(3), 205–210. https://doi.org/10.4103/0019-5154.70662

Lipski, E. (2020). Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion. McGraw-Hill.

Maxfield L, Crane JS. Zinc Deficiency.

The post Nutritional Deficiency and The Cues from Your Body first appeared on Specialized Therapy.

The post Nutritional Deficiency and The Cues from Your Body appeared first on Specialized Therapy.

Clinician Guidelines to Culturally Competent Care

Attention-Deficit/Hyperactivity Disorder is a highly prevalent and pervasive neurodevelopmental disorder. ADHD typically occurs in early development, prior to a child’s school enrollment and is characterized by persistent inattention and/or hyperactivity/impulsivity that affects an individual’s functioning and/or development. Individuals with ADHD can present with symptoms of inattention, hyperactivity/impulsivity, or a combination of both.

Inattention manifests behaviorally as failing to attend to details or making careless mistakes, wandering off task, lacking persistence, difficulty sustaining focus, and being disorganized. Individuals with inattentive features tend to reduce their engagement in tasks or activities that require sustained cognitive effort and may appear forgetful or distracted. Hyperactivity and impulsivity manifest behaviorally as excessive motor activity, restlessness or an inability to sit still when appropriate, appearing as if “driven by a motor”, difficulties waiting for one’s turn in social settings, social intrusiveness, and engagement in actions without recognition of the potential for harm or aversive consequences.

For a diagnosis of ADHD to be met, individuals must exhibit six or more symptoms of inattention or hyperactivity/impulsivity or a combination of both. Symptoms must be present for at least six months, are inconsistent with developmental norms, and directly interfere with an individual’s functioning. Symptoms must be present in at least two settings, such as at home, school, with peers/family, or during leisure activities.

ADHD is highly prevalent among youth and adult populations, with 11% of youth and 8.1% of adults affected during their lifetime. Recent research by London & Landes (2021) has demonstrated a significant increase in estimates of ADHD in adult populations by 24.6% in individuals aged 18-64 and a decrease in gender differences with respect to ADHD prevalence.

While estimates have shown higher rates of ADHD among men and boys, greater diagnostic clarity, symptom recognition, and systematic changes in health care have increased the assessment and recognition of ADHD symptoms in women and girls. However, disparities continue to exist for ADHD prevalence cross-culturally. These disparities in prevalence among diverse cultures may be due to cultural biases inherent in diagnostic assessment and clinical screening tools. Cultural prevalence rates may also differ, due to differences in the ways ADHD manifests in diverse cultures, interpretation of diverse youth behavior by clinicians or caregivers, and bias in rating and screening.

Despite research that demonstrates ADHD occurs in virtually all cultures and countries, the majority of the research on ADHD focuses on Caucasian Americans. However, race, culture, and ethnicity are critical to the assessment, diagnosis, and treatment of ADHD. While, searches for articles that include “ADHD” and “Race” have increased from 1990-2000, as well as reductions in bias in clinical care through diversity training that aim to reduce implicit bias, cultural biases in ADHD diagnosis continue. Furthermore, factors such as racism, stereotyping, trauma, and social disadvantage contribute to the maintenance or exacerbation of ADHD symptoms. These factors can also affect how an individual’s symptoms manifest, the likelihood an individual receives a diagnosis and treatment, and the rate of ADHD detection. Thus, recognizing how ADHD can present across various cultures is significant for clinicians and our communities.

For example, people of Hispanic heritage may be at risk for over-diagnosis, due to expectations within their culture to attend to and perform a variety of tasks during one period of time. This is in contrast to European American cultures who organize tasks and activities in a linear fashion, attending to a singular task or activity, prior to initiating another. Additionally, Hispanic culture deemphasizes structure, routine, and punctuality, whereas European Americans place a higher value on these factors. Therefore, Hispanic children may be at a higher risk of being perceived as impulsive and inattentive, symptomatic of ADHD, rather than behaving in accordance with their culture.

Because ADHD occurs during early, critical periods of an individual’s development, assessment and treatment of ADHD in all cultural groups is critical for the attainment of important skills required for a successful transition into adolescence and adulthood.

Tips for Clinicians in Providing Culturally Competent Care:

1. Identify your own cultural biases and reduce them, through:
   1. Intellectual Engagement (learning about cultural groups through articles, videos, journals)
   2. Emotional Engagement (engaging in personal reflection with own biases, attitudes, and experiences with diverse groups)
   3. Relational Engagement (developing positive relationships with people from different cultural groups)
2. Reflect on your life experiences with people of diverse cultural backgrounds
3. Consider your own experiences of discrimination. Ask yourself: “Are there aspects of your identity that impact the way you perceive others?”
4. Understand and assess key historical events, sociopolitical issues, basic values and beliefs, and cultural practices of your client.
5. Consider cultural explanations in the diagnosis and conceptualization of mental health issues.
6. Assess mental health through the use of a Cultural Formulation Interview*

Cultural Formulation Interviews in the diagnosis of mental disorders aims to identify and clarify key aspects of the presenting problem from the point of the individual and family members within the client’s social world.

A Cultural Formulation Interview:

1. Elicits the individual’s view of core problems and key concerns
2. Focuses on the individual’s way of understanding the problem
3. Uses client language in the description of the problem
4. Asks how the individual talks about their difficulties or symptoms with family and friends
5. Focuses on the aspects of the problem that are most salient to the individual
6. Obtains cultural perceptions of the cause of the problem, as well as factors that contribute to resiliency or the worsening of symptoms.
7. Identifies the role of culture as a protective or promotive factor in healing and wellness.

While little research has been conducted on ADHD in diverse cultures, and racial/ethnic minorities are less likely to be assessed, diagnosed, and treated for ADHD, clinicians can mitigate these disparities in mental health care by utilizing a culturally informed approach to care with all clients.

Specialized Therapy Associates includes staff that is highly skilled in the assessment and treatment of a wide range of mental health issues.  For a free consultation with our intake coordinator who will match you to the best provider and service to fit your needs and goals, call 201-488-6678 or visit https://www.specializedtherapy.com/make-an-appointment/ to schedule an appointment.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Centers for Disease Control (2020, November 16). Attention-Deficit/Hyperactivity Disorder  (ADHD). Data and Statistics About ADHD. https://www.cdc.gov/ncbddd/adhd/data.html

Conrad, P., & Potter, D. (2000). From hyperactive children to ADHD adults: Observations on the expansion of medical categories. Social Problems, 47(4), 559-582. https://doi.org/10.2307/3097135

Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, J. (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. Null, 47(2), 199 212.         https://doi.org/10.1080/15374416.2017.1417860

Fletcher, J. M. (2014). The effects of childhood ADHD on adult lab market outcomes. Health

Economics, 23(2), 159-181. https://doi.org/https://doi.org/10.1002/hec.2907

Fletcher, J., & Wolfe, B. (2009). Long-term consequences of childhood ADHD on criminal activities. The journal of mental health policy and economics, 12(3), 119–138.

Evans, S. W., Owens, J. S., Wymbs, B. T., & Ray, A. R. (2018). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Null, 47(2), 157-198. https://doi.org/10.1080/15374416.2017.1390757

Hook, J.N., Davis, D., Owen, J., & DeBlaere, C. (2017). Cultural Humility: Engaging Diverse Identities in Therapy. Washington, D.C., USA: American Psychological Association. ISBN 1-4338-2779-4 (Digital, undefined format) or ISBN 978-1-4338-2779-2 (Digital, undefined format)

Iwamasa, G.Y. & Hays, P.A. (2019). Culturally Responsive Cognitive Behavior Therapy: Practice and Supervision (2^nd edition). Washington, D.C., USA: American Psychological Association. ISBN 1-59147-360-8 (Hardcover)

Lensing, M. B., Zeiner, P., Sandvik, L., & Opjordsmoen, S. (2015). Psychopharmacological treatment of ADHD in adults aged 50+: An empirical study. Journal of attention disorders, 19(5), 380–389. https://doi.org/10.1177/1087054714527342

London, A. S. & Landes, S. D. (2021). Cohort change in the prevalence of ADHD among U.S.  adults: Evidence of a gender-specific historical period effect. Journal of attention disorders, 25(6), 771-781. https://doi.org/10.117/1087054719855689

Richards, P. S & Bergin, A. E. (Ed.). (2014). Handbook of Psychotherapy and Religious

Diversity (2^nd edition). Washington, DC, US: American Psychological Association.

ISBN 1-4338-1736-5 (PDF) or ISBN 978-1-4338-1736-6 (PDF)

The post Assessing ADHD in Diverse Cultures first appeared on Specialized Therapy.

The post Assessing ADHD in Diverse Cultures appeared first on Specialized Therapy.