Mind and Body - Page 59

November 27, 2015

Tiger and Elin and the Rest of Us

With the distraction of Tiger Woods' pathetic press conference apology, in which he sadly used the children served by his Foundation as chits to excuse his sexual behavior, we could easily lose a valuable moment of insight_ Marital infidelity need not spell the end of a marriage and can sometimes signal the beginning of greater intimacy.

November 27, 2015

The Professor Who Killed

On Friday, February 12, Professor Amy Bishop allegedly opened fire in a meeting of her colleagues at the University of Alabama, killing three of them.

November 27, 2015

Why Obama Hates Las Vegas

The President doesn't seem to like Las Vegas-not even a little bit. During a town hall meeting about a year ago, he advised corporations receiving bailout money to stop meeting there. Then, about a week ago, he advised American families to stop gambling away their tuition money at Vegas casinos. The President explained that he was just using Vegas as a metaphor for the less responsible ways Americans spend money in a tough economy, when their focus should be on tuition and mortgage payments. I just don't think that's the whole story. Over the weekend, while I was playing poker at home in Massachusetts with my 7-year-old son Cole, I came up with what may be the real reason Las Vegas bugs the President. There were distinct moments during our game when I realized my son had some independent decisions to make_ * He had to decide whether to take a risk and bet his "money" on the hand he had been dealt. I couldn't see his cards, so I couldn't decide for him.

November 27, 2015

Psychiatry and Spirituality

Over the last several decades, psychiatry has prided itself on becoming a true medical specialty. Hundreds of medications for anxiety and insomnia and depression were added to our therapeutic armamentarium. The Diagnostic and Statistical Manual of Mental Disordersswelled with conditions defined by increasingly specific lists of signs and symptoms. Technological innovations like Positron Emission Tomography offered the promise of meaningful testing to confirm or refute a psychiatrist's particular diagnosis. The excitement of making psychiatry conform to the medical model, just like internal medicine or surgery, led to turning out a generation of psychiatrists many of whom have never been in psychotherapy themselves and are mostly comfortable prescribing medicine and much less comfortable exploring the life stories and stresses and hopes and dreams of their patients. The idea that problems of meaning, problems of the soul, were the roots of our patients' suffering, not just problems of brain chemistry, seemed to fall out of fashion. However, it took more than a tide of technology to nearly sweep away the most powerful way psychiatrists can heal patients-namely by using human empathy to find and change their self-defeating patterns of thinking, feeling and behavior. I believe it took an underlying fear of the immeasurable power of the human spirit. The truth is that healing patients suffering with anxiety and depression and psychosis and attention deficit problems requires bringing oneself to the task of intuiting when in life their self-confidence or self-esteem or sense of safety was shaken. It requires listening with one's heart to find those moments in childhood or youth or young adulthood that disheartenedone's patients. It requires taking down the interpersonal walls that leave so many of us strangers to one another and becoming intimate with the conscious and unconsciousemotions of those who seek comfort and compassion and, yes, curative therapies from us. If none of that sounds like something that can be found on a CT scan, that's because it can't. No brain scan or blood test will ever show the way the human spirit, properly harnessed, can heal. No EEG will explain the power of a moment of epiphany to change the course of a person's life, nor the potential for a sustained increase in mood or decrease in anxiety or disappearance of psychosis brought about by one human being understanding another's suffering at the deepest level. The most powerful healing in psychiatry might be accepted as mystical and immeasurable were it not for a relatively recent historical prejudice in favor of tiny molecules rather than small miracles. I have no such prejudice left. From my perspective as a doctor, I worry not at all whether the medicines I sometimes prescribe or the moments of connection I always attempt to achieve with my patients are the more powerful remedy. I want only to wrestle their suffering to the ground and I welcome the help of every force I can bring to the battle-whether I can understand it as a scientist or not.

November 27, 2015

Good Jealousy

Jealousy has a bad reputation. After all, jealousy can end friendships. Jealousy can lead people to brood over feeling short-changed by life and distract them from precious gifts they should be enjoying. Intense jealousy can interfere with romance and marriage and destroy the very bond that sparks the jealousy to being with. Jealousy taken to psychotic levels is, of course, paranoia-a true psychiatric disorder.

November 27, 2015

Haiti and Human Resilience

The tragedy in Haiti has already shown us a great deal about the human spirit.

November 27, 2015

The Quiet Epidemic

A recent studyspearheaded by author and researcher Jean Twenge reveals that we have a Tsunami of psychiatric illness headed our way.

November 27, 2015

Autism and Anxiety

Autism is, as most everyone knows, a developmental disorder that begins by age 3 and includes major disturbances in a child's social skills and ability to communicate. It strikes 1 in 100 babies born in America. Recently, data emerged showing that a comprehensive program to identify autistic children as toddlers and deliver an integrated behavioral treatment plan including lots of play and human interaction improves the IQs of autistic children. This is good news and a very good reason to increase our efforts to identify autistic children as early as possible and provide them the care they need. As a psychiatrist who has worked with both adults and children with developmental disorders, I also believe that it is important to treat most or all autistic children very early for what I think are very clear symptoms of unwieldy anxiety. After all, autistic children can shun human interaction, stiffen at human touch, often gravitate toward repetitive and soothing movements, seem drawn to objects or machines that generate predictable rhythms (like fans) and can act out angrily when their routines are altered. All of these signs are also consistent with those of an anxiety disorder. It is possible that, in the end, autism will be understood as a severe anxiety disorder starting in early childhood. Remember, OCD (obsessive-compulsive disorder) is classified as an anxiety condition. Anxiety is the core driving force for the repetitive thoughts or actions that plague so many. Obviously, the desire of an autistic child to maintain a specific routine or repeat a specific behavior or watch a spinning plate seems very similar to the actions of those with obsessions and compulsions. For this reason, not only behavioral techniques, but also medicinal remedies have to be considered front line therapies to interrupt the progression of autism once it is identified. I advise parents of autistic children, therefore, to strongly consider judiciously using medications like serotonin reuptake inhibitors (Paxil, Zoloft, Lexapro and others) immediately when autism is diagnosed. The possibility should at least receive very vigorous consideration from the doctors involved in caring for these children. I also believe that the new treatment already approved for depression called rTMS or repetitive transcranial magnetic stimulation may have benefits for autistic children. It has almost no side effects and reduces anxiety very significantly. Bottom line_ The most vigorous treatment for autism as soon as possible is probably the best way to limit its long-term consequences. If my child were stricken with the disorder, I would include the early use of anti-anxiety medication as part of that strategy.

November 27, 2015

Be a "Holiday Healer" This Season

Holidays bring joy, but they often bring stress, too. Economic stress and stress related to travel make the Christmas list, but my patients tell me that the greatest stress that comes with Christmas and the New Year is relationship stress. Holidays bring us into closer contact with relatives and friends with whom we might otherwise choose to have very limited interactions. Unresolved conflicts with brothers and sisters can play in the background of handshakes and toasts. That constantly critical step-parent might be around you the whole day. A gift is unwrapped that reminds you again that a friend just "doesn't get you" or has never been nearly as generous as you are.

November 27, 2015

A Generation of Addicts

We are raising a generation of addicts, and we'd better do something about it, starting now. A new federal survey has found that more and more teens are smoking pot, abusing pain pills and using illicitly-obtained stimulants used to treat attention deficit disorder. 15.9 percent of tenth graders reported using marijuana in the last month. The percentage of eighth graders who considered using ecstasy once or twice a dangerous activity decreased from 42.5 percent in 2004 to 26 percent in 2009. It isn't just drugs our kids are addicted to. Kids now play what's called "the choking game" with greater frequency, too. This "game" (which it isn't) involves them choking one another or using improvised nooses to cut off oxygen to the brain and feel "high." Teens are also using food as a drug, with obesity rates soaring. It seems as though they are saying in large numbers that anything will do to get them away from reality. But I don't think marijuana or pain medication or stimulants or the choking game or fast food are the biggest "drugs" to which kids are addicted. They are using their iPods, DSIs, YouTube, reality TV and celebrity escapism in order to shut down their minds, avoid their feelings and substitute the "high" of technology and entertainment. The price of a generation of addicts is incalculable. We have to expect that teenagers using pot and Adderall and Percocet and choking and 21st century versions like Facebook will face an increased rate not only of substance dependence, but of depression and anxiety and their physiological brethren-from hypertension to cardiac disease to malignancy. We have to expect higher rates of sexually transmitted diseases, as young people turn to sex to feel better, too. We have to anticipate more violence, as young people evolve into adults with little experience managing their anger and a higher likelihood of turning to street drugs to try to contain that and every other uncomfortable feeling. More than one of my young patients tell me they participate regularly in "Live Action Role Play," in which a group of teenagers conspire to pretend to be people other than who they really are-nearly full-time. So a cashier at a grocery store can be treated by his friends like a rock star, complete with text messages asking where he's headed on tour. It isn't just teens, either. Kids are getting into the "act." Club Penguin gets them ready to treat animated creatures like real pets-as in, to not care about real life any more than bright images on a screen. Cell phones put instant messaging in the hands of 9-year-olds and remove them from face-to-face or even voice-to-voice communication. All of this activity can be reduced to one basic behavior: Getting high, as in, intoxicated. We may not see it that way today, but we surely will, looking back, from some very complicated and painful tomorrow. Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.