Author: Dawn_2ol6

Adverse Childhood Experiences

One of the hopeful pieces about depression today is the recognition that there are many, many theories about what may lead to it.  And, while in some ways it makes the story more complicated, in other ways it gives us more information as to how we might treat or prevent depression in the future.  One of the theories is that depression can result from trauma, which is another huge topic.  However, today I want to discuss a subset of trauma that is known as adverse childhood experiences, or ACEs.

According to SAMHSA (Substance Abuse and Mental Health Services Administration), adverse childhood experiences, or ACEs, are stressful or traumatic events.  According to their website page, (https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences), ACEs can include a wide array of experiences, including physical, sexual, or emotional abuse, physical or emotional neglect, intimate partner violence or abuse, substance use in the household, mental illness in the household, a household member in jail, and parental separation or divorce.  These events can lead to an increase in depressive episodes and suicide attempts later in life.  In general, ACEs can also lead to an increase in other issues with substance abuse and issues with physical and mental health.  Sadly, ACEs are very common and touch many of our lives.

Despite the unpleasant reality of ACEs, there is hope.  Recognition of ACEs is growing, and more and more people are beginning to understand the possible relationships between ACEs and future health implications.  Work is also being done to figure out how we might better prevent ACEs from occurring in the first place.  Clearly, there is a long way to go, but I am so glad we are starting to look at a bigger picture of what health and wellness truly means for all of us.  Every little piece matters and can make a difference when our overall health is on the line.

Transcranial Magnetic Stimulation

Today I want to touch on another therapy that people may not have heard much about – transcranial magnetic stimulation, also known as TMS.

According to the Mayo Clinic’s webpage on the topic (https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625), TMS is a noninvasive procedure that involves magnetic fields to stimulate nerve cells in the brain.  This in turn can help improve symptoms of depression.  TMS involves repetitive magnetic pulses, and during a session an electromagnetic coil is placed on your scalp near your forehead.  The idea is that the pulses can help to activate regions of the brain that have decreased activity in depression.

TMS has shown promise for depression, and has some advantages over ECT (electroconvulsive therapy, also known as “shock” therapy).  ECT involves anesthesia, whereas TMS does not.  ECT also causes seizures as a part of treatment, but this is not intended in TMS (although seizures are an uncommon possible side effect of TMS).  Common side effects with TMS include headaches, scalp discomfort at the site of stimulation, lightheadedness, and tingling, twitching, or spasms of facial muscles, so TMS is not completely free of possible issues.  However, for many with depression TMS appears to be a better alternative to ECT.

Unfortunately, TMS is not available everywhere, and there are also potential issues with cost.  And, while some insurance covers TMS, others have been slow to cover it.  But, my hope is that these access and cost issues will start to be addressed more efficiently in the future.

What do you think?  Does TMS sound like a promising therapy for depression?  So far, the data appears to be positive, but TMS is fairly new, and more information is being researched.  Regardless, for depression patients TMS can be yet another tool that can help patients enter recovery.  My hope is that this treatment continues to expand and help more people affected by depression.

Cognitive Enhancement Therapy

In my last post, I talked about cognitive behavioral therapy (CBT) and how it can be used in depression.  A lot of people have heard about or experienced CBT, so it may be a topic that people are very familiar with.  Today, I want to touch on a different type of therapy that I had never heard about until a few weeks ago, and I would like to introduce it to you today.

Instead of CBT, this therapy is CET, which stands for cognitive enhancement therapy.  According to the website, http://www.cognitiveenhancementtherapy.com/, CET is a performance based, comprehensive, and developmental approach to the rehabilitation of social cognitive and neurocognitive deficits.  CET is designed as a recovery phase intervention for persons with schizophrenia or schizoaffective disorder who are symptomatically stable, but who nonetheless remain socially and vocationally disabled.  Participants work at recovery through structured group and computer exercises.   Overall, CET attempts to increase mental stamina, active information processing, and the spontaneous negotiation of unrehearsed social challenges.  It does so with a focus on enhancing perspective taking, social context appraisal, and other components of social cognition.  CET is evidence based, and can also be a cost effective strategy involved in treating schizophrenia or schizoaffective disorder.

Needless to say, I do not know much about CET, but since it is evidence based, that can lend more credit to the effectiveness of this therapy.  And, while I spend most of my time focusing on depression, I think this therapy is definitely something to consider in the area of schizophrenia.  My goal for this post was to at least make everyone aware that there is CET and that it can help.

How about you?  Have you ever heard of cognitive enhancement therapy?  Is this a topic you want to learn more about?  Are you touched by schizophrenia in any way and could see a benefit in trying this therapy? 

Cognitive Behavioral Therapy

Perhaps you have heard of cognitive behavioral therapy, also known as CBT.  Maybe you have not heard about it, but you have experienced it without it being called CBT.  Today I want to touch on what CBT is and how it is used.

According to the Mayo Clinic website (https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610), CBT is a common type of talk therapy.  You work with a mental health counselor in a structured way, attending a certain number of sessions.  CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.  CBT can be a very helpful tool in treating depression, post-traumatic stress disorder (PTSD), or an eating disorder.  But not everyone who benefits from CBT has a mental health condition.  It can be an effective tool to help anyone learn how to better manage stressful life situations.

Also, according to the Mayo Clinic website CBT is often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges.  CBT is a useful tool to address emotional challenges.  For example, it may help you: manage a mental illness, prevent a mental illness relapse, learn coping techniques, identify and manage emotions, cope with grief, resolve relationship issues, and overcome emotional trauma.

As you can see, CBT can have many benefits and can be very helpful for depression.  Does this sound like anything you have ever experienced before?  Was it helpful or beneficial in any way?  What did you learn from receiving CBT?  If it doesn’t sound familiar, I would encourage anyone touched by depression to look into this as a part of the treatment plan for depression.  It may not cause every depression symptom to go away, but CBT can be very useful when combined with other treatments for depression.

Emotional Labor

Today I want to talk about another topic that I have heard about only recently.  I am guessing that most of us have heard about physical labor, but are you familiar with the term “emotional labor”?  Although you may not have heard the term before, my guess is that you will be familiar with the concept.

So, what is emotional labor?  As usual, the term can have different definitions, but I take a very broad approach to it.  Emotional labor can be done anywhere and anytime, and it can involve regulating emotions and performing mental activities related to nurturing and caring.  Here are some examples: making appointments for yourself or others, buying and sending gifts or cards, delegating tasks to others, planning outings and trips, arranging care for children or other dependents, and working around the emotions of others.  Some examples of jobs that include a lot of emotional labor are flight attendants, hotel desk clerks, secretaries, and child care workers, who are typically expected to put on a smile every day and make sure everyone around them is happy and comfortable.

When it comes to depression and mental illness, you can imagine there is a lot of emotional labor that happens in these settings.  Mental illness can disrupt a person’s typical emotions, and caregivers also face a range of emotions.  And, while emotional labor has some plusses and can play an important role in caregiving, it is also important to note that just like any other types of labor, it can take a toll on those who perform it.  In my mind, a good first step is that no matter the setting, we recognize what emotional labor is and who is doing it.  Then we can begin to see how and when this labor can be redistributed or improved for everyone.

Screening

Today I want to touch on a topic that I think could be very helpful in the future of mental illness prevention.  It is fairly straightforward, and on paper seems like a fairly simple thing to do.  I am talking about mental health screening for children.

When I think about screenings, I remember some of what I experienced as a child.  I know we had vision screenings and hearing screenings at school, and I think we had some screenings and vaccines done in different health care settings.  The primary goal was to prevent or catch a problem early on and do something about it before it became a bigger problem, and I assume these still happen today.  But, all of the screenings that I have mentioned had to do with physical health – what if there were screenings for mental health?

As it turns out, mental health screening for children is possible.  I do not know if and where it is currently available, but in the state I live in they are recommending universal mental health screenings from birth to at least age 18.  Not all of the details have been worked out yet, but overall the intent is to screen all children.  To be honest, until I heard about this I had never thought about universal mental health screening for children, but now I am a big fan of this idea.  Why not screen all children and possibly prevent or catch problems early on?  I think it sounds like a great idea.

What do you think?  Should all children be screened for mental illness?  How do you think it should be done?  My hope is that this will one day become standard for all children all over the world, and I look forward to seeing this become a part of the care that all children deserve.

Survivor Day

As I write this entry, we are getting close to Thanksgiving, and with that comes another day related to suicide.  The Saturday before the United States of America’s Thanksgiving is International Survivors of Suicide Loss Day.  This day is meant to unite survivors of suicide loss around the world, and many countries and communities have events to remember loved ones and offer support for suicide loss survivors. The AFSP (American Foundation for Suicide Prevention) is a big sponsor of this day, and their website (afsp.org), is also a great resource for education and information related to suicide.

In the past I have attended events on International Survivors of Suicide Loss day.  In fact, where I live there is an event held every year. But, after going for a couple of years I did not feel that I needed to keep attending the events.  I think that this decision is personal for everyone. You may want to go only once, or you may want to go every year.  Or, you may not ever want to go.  However, that is the beauty of these events – they are there if you need them and want to gather with others who have experienced a suicide loss.

What are your thoughts on International Survivors of Suicide Loss Day?  Do you feel that having a day for suicide loss survivors is a good idea?  Do you think it is important?  Do you think it is helpful for suicide loss survivors to come together and support others who have had similar experiences?  While I don’t always attend an event, I think it is helpful to have a day recognize the (sadly) ever growing group of us who have experienced a suicide loss.  It is not a group anyone wants to be a part of, but there is comfort in knowing that we are not alone in our grief.

Visualization

Today I want to touch on the topic of visualization.  As usual, there are probably lots of definitions out there, but to me visualization is closing your eyes and picturing something in your mind.  You can visualize many things – your future self, a wonderful place you want to be, running through a particular situation – it would seem that the possibilities would be endless.  And, as I am referring to it here, visualizations are thought of as helpful or beneficial.  Of course people can visualize negative or disturbing things, but when I talk about visualizations my hope is that they are positive and valuable to a person.

Can visualization be used in depression or for caregivers?  I think so.  Visualizations can be pretty straightforward and easy to access, and they can be done whenever and however you want.  People can do visualization on their own or with others, and there are also resources available online and in books.  Of course, with depression, it may be hard to initiate visualization, but it also may be helpful to try. 

What should you visualize? That is up to you as well.  For depression or caregiving, can you think about what recovery would look like?  Can you think about what things you might want to do again?  What about new things you would do?  Is there a place you can visualize that makes you feel safe?  A place that makes you feel cared for?  A place of healing and hope?  I am sure there are many other ideas out there as well.

Overall, what do you think about the idea of visualization?  Does it seem worth a try?  Honestly, I have not had a lot of experience with it, but when I have used it I feel that is has been beneficial, and many people have found it useful.  My hope is that you consider giving visualization a try.

Voting for Mental Health

As I write this entry, today is Election Day in the United States of America.  Up until today everyone has been bombarded with mailings, phone calls, texts, TV ads, and social media posts telling us who we should vote for and why.  Then, as the day has unfolded I have seen a lot of people letting others know that they had voted.  I am grateful to live in a country with free elections, and I am proud to participate in the process.

Of course, when I vote, I think about issues that are important to me, and mental health is one of them.  Honestly, I think that mental health is related to every other issue out there, but I tend to focus mostly on prevention, education, support, treatment, advocacy, and recovery.  I look for candidates who seem to support mental health and treat it like the serious matter that it is.  The good news is that I think most politicians support mental health – it seems like an easy stance that caring about mental health means caring for other humans.  However, if you go below the surface, you find that there are lots of differences on what services are available and how they are paid for.  Unfortunately, money is always a concern, and different politicians aren’t willing to spend as much on mental health as others.  Of course, there are other priorities that also need funding, so it isn’t always easy to make these decisions.  But, when I vote, I look for candidates that I think are truly willing to go the extra mile for mental health.

Luckily, in the internet age, there are many resources available that can help you research the candidates and give you an idea of where they stand on major issues.  My hope is that when you vote, you think about supporting mental health as well.