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Psychiatry Blog

Discussing topics like how to find a psychiatrist, psychiatrist vs. counselor, what is psychotherapy, and much more.


​Our blog is meant to provide information and answers to common questions in psychiatry, cognitive behavioral therapy, mental illness, mental health professionals, talk therapy, psychologists, substance abuse, and anything else that would be helpful to those seeking mental health information. Knowing how to find a good psychiatrist, and what a licensed psychiatrist is will help you in your search.

Mental Health Awareness

3/30/2021

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Mental health issues effect each one of us, every day.  Simple anxiety can escalate and systemic problems like schizophrenia are real illnesses just like a broken bone or cancer. 
 
By becoming aware of mental health issues you can develop a knowledge of the various factors involved in taking care of one's mental health.  Unfortunately there is still a significant stigma attached to mental health issues and diseases.  Awareness campaigns focus on productive discussions and acceptance of the reality of mental illnesses and how we can raise awareness and support those suffering from them.
 
There are a number of ways to get involved in mental health awareness:
  • Discuss mental health openly-  Sharing information on social media or through conversations is important. Just be sure the information you are sharing is based on real medical evidence and not common myths or stereotypes. 
  • Tools – There are other online blogs, screening tools, and telehealth services that offer anonymity and help others recognize symptoms as needing treatment.  Speaking about it at other wellness-oriented facilities like gyms could provide someone the impetus needed to get help.  Libraries or other public forums offer information about how to access resources in the community.
  • Support Advocacy – MHA and NAMI offer help lines and support for mental health issues. Through financial and volunteer efforts you can support these and other programs.  Encourage others to do the same.  Use social media like Facebook and LinkedIn to make others aware of the availability of help and to encourage mental health awareness.
  • Be a Friend – If possible, support any of your friends and acquaintances who you believe are having difficulty with mental health issues.  This includes those who are grieving, lonely or feeling lost.  Sometimes a friendly ear is all that is necessary.  Hearing others speak honestly about their problems can help them feel heard and respected.
  • Self Care – Take care of your own mental health.  Talk to your psychiatrist or counselor and read about new techniques and programs.  Practice wellness and participate in programs.  Take your mental health as seriously as you do your physical well being.
  • Legislative – In Congress there are pending changes to Medicaid and behavioral health funding.  Protecting funding and support for these issues is critical to continued services for many thousands of Americans.  Contact your legislative representatives and let them know how you feel about this problem and how their actions can help reduce the number of people suffering.
 
May is mental health month.  Celebrate it by spreading the word about the services available and how good mental health is important.  Don't restrict your work to a single month.  Continue the fight throughout the year to help others in need.
 
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What Are Benzodiazepine Withdrawal Symptoms?

3/26/2021

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Benzodiazepines, often referred to as benzos, is an anxiolytic made for treating anxiety, insomnia, and seizures. They are a commonly prescribed class of medications with brand names such as Klonopin, Valium, and Xanax.
 
While they help treat various conditions, benzodiazepines are potentially addictive, and some patients will develop a tolerance to them over time.  There are benzodiazepine withdrawal symptoms that occur if one were to suddenly stop taking the medication after being on them for an extensive period of time. Doctors do not recommend quitting such medications "cold turkey", as this can cause serious withdrawal symptoms, which varies in severity.
 
Usually, the withdrawal symptoms begin within 24 hours of quitting the medication, and it can last days to weeks.
 
Benzodiazepine Withdrawal Symptoms
As mentioned, benzodiazepines are part of a group of medications known as nervous system anxiolytics treating anxiety and sleep disorders. The common types include alprazolam, clonazepam, diazepam, and lorazepam.
 
They are potentially habit-forming easily which can result in physical dependence. If you are looking to quit taking a benzodiazepine medication, it should be under the guidance of your healthcare professional.  Your psychiatrist will help you wean off slowly and with proper coping strategies, among other tools for a comfortable withdrawal process.
 
There isn’t an exact guide to the symptoms, timeline, and the severity of withdrawal, as individuals have different experiences, depending on factors like:

  • Duration of taking the medication
  • The dosage
  • If the prescription were misused
  • The mental health condition
  • If there are other drugs taken simultaneously
  • Misusing alcohol or other drugs 
 
Common symptoms include:

  • Physical aches or pains that can be uncomfortable or severe
  • Abnormal sensations, like feeling there are bugs crawling on one’s skin
  • Hyperventilation
  • Muscle spasm
  • Sweating
  • Anorexia or weight loss
  • Anxiety or panic attacks
  • Hypersensitivity
  • Depression
  • Difficulty in concentration
  • Nausea and/or vomiting
  • Insomnia
  • Hallucinations, delusions, or the detachment from reality
  • Grand mal seizures
  • Cravings for benzos or other drugs for sedation, which may lead to relapse
 
While there isn’t a definitive guide for everyone, there are 3 possible phases for withdrawals, having only an estimated timeline. Again, those taking benzodiazepines need to do so under the guidance of their healthcare professional and should never stop them right away, especially when they do not consult a professional or develop a plan.
 
Here are the following withdrawal symptom phases:
 
Early or Immediate Withdrawal
The early withdrawal, also called rebound symptoms, shortly occur after one stops taking benzodiazepines. The symptoms depend on the drug's half-life. For instance, the symptoms of short-acting medications like Xanax would come quicker compared to long-acting medications like Valium.
 
During this stage, one may experience symptoms of the condition the medication was treating starting to come back, even worsening without benzodiazepines.
 
Acute Withdrawal
Acute withdrawal will happen after experiencing immediate withdrawal symptoms, usually within a few days. The symptoms can last multiple days, sometimes much longer.
 
Most symptoms will occur during this interval.  Generally people report this period being the most difficult.
 
Protracted Withdrawal
While most symptoms would subside after acute withdrawal, there may be lingering side effects.
 
The British Journal of Clinical Pharmacology found that about 10-25% of those who use benzodiazepines for extended periods would experience withdrawal symptoms that can last for over a year. The protracted withdrawal symptoms are also known as post-acute withdrawal symptoms, including the following:

  • Anxiety
  • Depression
  • Insomnia
  • Loss of sex drive
  • Mood swings
  • Poor concentration
 
All of these symptoms may effect one’s quality of life, appearing without any warning and causing distress. Therapy and counseling, or even other medications, can help manage such symptoms.
 
There are coping strategies and medications used for the withdrawal from benzodiazepines, under the guidance of your addiction physician to come up with a treatment plan. That way the symptoms are monitored and their severity will be managed and minimized.
 
If you or a loved one plans to quit their prescribed dosage of benzodiazepines, do speak with your healthcare provider to find out if this is the right choice and how to go about it. 
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Coping Mechanisms for Stress

3/17/2021

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Stress is all around us.  It is at work, at home, socially, and many other places.  Managing the stress is difficult but in order for you to continue to perform at your best, there are ways to cope.
 
Problem and Emotion
There are two primary coping skills, problem-based and emotion-based.  Problem-based is situational like when you need to end a relationship or change jobs or deal with household repairs.  Emotion-based is when you need to deal with your feelings.  A good example is the loss of a loved one.  You cannot change the situation, you need to find ways to process your own emotions.
 
Sometimes you need both skills.  If so, talk to your counselor about which may be best targeted first.  For example, if you are upset about a bad performance review, it would be best to not speak until you have had time to calm down and process the information.  If the review was accurate, how can you change your behavior or skills to improve.
 
Skills
Some coping techniques can include:
  • Asking for help from a friend or professional.  For a career-oriented stressor, there are employment counselors at community colleges or major universities.  For serious safety issues there are women's shelters.  Religious organizations offer volunteers to advise or suggest options.
  • List.  Create a list of tasks that can help.  Then review the list to see which are doable and prioritize your actions.  Then work the plan.
  • Boundaries.  If someone makes you feel inferior, limit your time with them.  See them in social situations where you can move around, if at all possible.
  • Time management.  Not every call or email requires an immediate response.  Group return calls to use your time more effectively.  For children, except for emergency situations, give them specific times twice a day (like 10 a.m. and 2 p.m.) when they can call and make it a coordinated call.  Each child will get a chance to speak and offer their side of the situation or make a request.
 
What to Avoid
There are a number of strategies that have gained popularity but may actually be detrimental to your health and should be avoided:
  • Alcohol and Drugs – Substances won't resolve your issues; they only mask the problems for a period of time.  In fact “self medicating” may actually create worse or larger problems.
  • Stress Eating – Over eating or too much unhealthy food can lead to disorders.  The same is true with restricting or failing to eat. 
  • Over Sleeping – This is another temporary escape if you sleep too much.  A solid 7 to 9 hours a night is appropriate.
  • Retail Therapy – Shopping is another gateway resolution that can backfire and leave you in a worse position.
 
Most of these suggestions are reactions.  You should also develop some proactive strategies.  An example with weight loss when you have an upcoming holiday is that you need to decide how you will avoid overeating.  The bottom line is to find what works for you.  A counselor or therapist can help significantly.
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How To Help Someone With PTSD?

3/10/2021

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how to help someone with ptsd
When someone you care for suffers from mental health issues like PTSD (post-traumatic stress disorder), it can become overwhelming for you as well. Thankfully there are effective treatment options available for PTSD.  You may be wondering how to help someone with PTSD? Your actions can definitely help your loved one overcome symptoms of PTSD and live a happy and healthy life. 
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​Provide Social Support

It is very common for patients with PTSD to withdraw from social life. They might feel ashamed and prefer to avoid being a burden on others.

It is important for you to respect the emotional and physical boundaries set by the effected individual. Your care and support can definitely help him/her overcome negative feelings of grief, helplessness, and despair but it is also important to not overwhelm them. 

You can encourage the person to pursue hobbies, seek out friends, and participate in activities that he/she likes such as singing, swimming, and rock climbing. This would enable the patient to forget the traumatic event by diverting his/her mind to pleasant activities
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​Be a Listener

Never push a patient with PTSD to talk. You should, instead, be ready to listen without judgments and expectations. 

Make it clear to your loved one that you care and are interested in listening to his/her experience.  It is the act of listening that would be helpful to your loved one. Don't be quick to offer advice.
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Rebuild Safety and Trust 

A traumatic event may alter the way your loved one sees the world. It might make the world seem like a frightening and dangerous place for that person. It may also damage his/her ability to trust others. 

Rebuilding trust can instill a sense of security, in such cases, and contribute to faster recovery.  You can express your commitment to your loved one to help him/her feel secure. Creating a predictable routine can also help to restore a sense of security and stability to patients with PTSD and help them regain their confidence.
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​Anticipate Triggers

Any trigger including a person, thing, place, or situation which reminds the patient of the trauma could set off the symptoms of PTSD.  Sometimes, the triggers are obvious. In some cases, it might take you time to identify the triggers.

Careful observation of the pattern of symptoms would help to identify the possible triggers. Identifying such triggers and avoiding them can help the patient prevent outbursts of negative emotions and support recovery. 

Common PTSD triggers include: 
  • People, locations, and things that recall the unpleasant memories
  • The sight, sound, or smell associated with the traumatic event
  • Significant times and dates, such as anniversaries 
  • Media coverage about the traumatic event 
Trying to remain calm and composed during an emotional outburst and communicating to the patient that he/she is “safe” would help the situation from escalating.

Conclusion
It takes time for a person with PTSD to overcome the difficult emotions brought about by the traumatic experience. However, continuous support and care by loved ones can help him or her get rid of the symptoms and live a happy and normal life. 
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Seeking appropriate treatment including medications and counseling, when necessary, are also critical when helping your loved one recover faster. 
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