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Coping with PTSD

Five ways to cope with PTSD

How can you cope with PTSD symptoms? We look at five possible strategies.

Post-traumatic stress disorder is caused by witnessing or being part of a frightening or shocking event, and it can affect day-to-day life and productivity. In this article, we discuss a few ways that you can keep its symptoms under control.

Post-traumatic stress disorder (PTSD) is best known as the condition that affects people who have served in the military, and who are therefore most likely to have witnessed a disturbing event on the battlefield.

Yet developing PTSD can be a natural response to any number of distressing experiences, such as sexual abuse, physical assault, accidents, or any type of violence.

Symptoms of PTSD include a heightened state of anxiety — especially accompanied by persistent flashbacks of the traumatic event — sleeplessness, moodiness, and avoidance of places or social situations that might trigger flashbacks.

According to the Anxiety and Depression Association of America (ADAA), 7.7 million adults in the United States live with PTSD, though women are twice as likely as men to develop this condition.

PTSD can last for years, and its symptoms can severely impact overall quality of life. That being the case, it can sometimes be tempting to apply negative coping strategies to deal with symptoms of PTSD.

Negative coping strategies may seem helpful on the spur of the moment, yet they can easily turn self-destructive in the long-term. These can include resorting to alcohol or recreational drugs to numb your feelings, decrease stress, or quieten your thoughts.

Alcohol and other substances may take the edge off to begin with but can cause addiction if used as a substitute for a proper treatment, such as cognitive behavioral therapy (CBT), which has been recognized as a “safe and effective intervention” for this disorder.

So what are some things you can do, in addition to CBT and any other treatments recommended by your doctor, in order to keep your PTSD symptoms under control? Here are a few approaches you may want to consider.

1. Mindfulness meditation

Increasingly, meditation and mindfulness-based relaxation techniques have been shown to help manage a range of disorders.

Mindfulness meditation-based treatments have been shown to reduce depressive moods and boost self-perception.

review of mindfulness-based treatments for PTSD points to a few therapies that have been found effective in reducing avoidance and self-blame in people diagnosed with the disorder. These are:

  • mindfulness-based stress reduction(MBSR), which is an intensive 8-week program focused on the practice of mindfulness meditation that aims to train people to focus their attention on their breath and learn to avoid getting carried away by intrusive thoughts
  • mindfulness-based cognitive therapy (MBCT), defined as “an adaptation of MBSR,” has a very similar structure but is designed to target depressive moods and negative thoughts, more specifically
  • mindfulness-based exposure therapy, which includes a 16-week non-trauma-focused programthat incorporates MBCT techniques and favors safe and controlled exposure to avoided stimuli, focusing on self-compassion training
  • meditation-relaxation, such as loving-kindness meditation, was also deemed effective in increasing self-compassion and reducing depressive symptoms related to PTSD
  • mantrum repetition practice, which refers to “the silent repeating of a sacred word or phrase,” appears to be effective in targeting anger, hyperarousal, or the state of being constantly on guard, and symptoms of anxiety and depression

2. Regain focus through physical activity

Many people who have been diagnosed with PTSD say that finding an enjoyable physical activity that they can perform regularly has helped them to reduce their levels of stress and cope with their symptoms.

Rebecca Thorne, who was diagnosed with PTSD following childhood trauma, explains how runninghas helped her to cope with the symptoms that were impacting her life.

“I am a runner – and I suffer from [PTSD],” she says. “One of the many things I think about while I’m running, and also when I’m not, is the relationship between the two.”

I embrace running in all weathers […], always with a considerable amount of ascent. As I fight my way up the climbs, I often imagine that the hill is my illness and I am going to slowly and steadily conquer it. Yet it never feels like suffering and, once at the top of the hill, I can reach out and touch the sky.”

Rebecca Thorne

Researchers from Anglia Ruskin University in Cambridge in the United Kingdom found that surfingcan be an effective coping strategy for war veterans diagnosed with PTSD.

According to the team, this sport helps veterans to attain a focused mind state known as “flow,” in which they are so absorbed in the activity they are performing that all other thoughts and emotions are pushed aside.

Dr. Nick Caddick, who was involved with the study, compares this with the effects of mindfulness meditation, just that it is more active. He calls it “a moving form of mindfulness.”

Medical News Today also reported on a study that suggested that Tai chi — a form of martial arts — can help war veterans to manage their PTSD symptoms.

Read full article here…

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Bipolar II Disorder

Know the Symptoms and Treatment for Bipolar II Disorder and how is it different from Bipolar Disorder

By Jenna Fletcher

Bipolar II disorder is a form of the psychiatric disorder known as bipolar disorder. All forms of bipolar disorder cause unusual mood swings and shifts in energy and activity levels.

Bipolar II disorder is a form of this disorder characterized by cycles of depressive episodes followed by hypomanic periods. Hypomania is a period of mood and behavior that is elevated above normal behavior. It is not as extreme as a manic period.

Contents of this article:

  1. How does bipolar II disorder differ from bipolar I disorder?
  2. Symptoms
  3. Diagnosis
  4. Treatment
  5. Outlook
Bipolar II disorder is characterized by hypomanic periods preceded by depressive episodes.

The main difference between bipolar I disorder and bipolar II disorder has to do with the intensity of the manic period.

Bipolar I disorder is characterized by at least one episode of mania before or after a hypomanic or major depressive episode. Sometimes, the manic episodes that occur in bipolar I disorder may trigger a psychotic episode where the person disassociates from reality.

People with bipolar II disorder do not experience true manic episodes, where their mood and energy levels are so high that it causes trouble with work and socializing and may cause psychosis. Some individuals with bipolar I disorder have to be hospitalized during periods of mania.

However, this does not make bipolar II disorder less severe than bipolar I disorder. In bipolar II disorder, the depressive episodes are similar to those in bipolar I disorder and cause significant disruption to the person’s daily life for an extended time.

Symptoms

Symptoms of bipolar II disorder include periods of hypomania followed by depressive episodes.

While it can be normal for people to experience periods of feeling upbeat followed by periods of sadness, in people with bipolar disorder, these swings are more extreme.

People experiencing hypomania may notice a combination of the following symptoms:

  • an increase in energy or feeling more agitated
  • feeling more upbeat or wired
  • increased self-confidence
  • decreased need or inability to sleep
  • racing thoughts
  • talking too fast or talking much more than normal
  • a tendency towards reckless behavior, such as spending too much, drinking or using drugs, or risk taking
  • impaired decision making

For these periods to be classified as true hypomanic episodes, they must last for at least 4 days and have at least three of the above symptoms.

People experiencing hypomania may feel very good during these periods, and may not know anything is wrong. However, loved ones watching a person with bipolar II disorder will notice abnormal changes in behavior during hypomanic episodes.

When people with bipolar II disorder are not in a hypomanic state, they may be in a major depressive state. Symptoms of major depressive episodes include the following:

An inability to sleep may be a symptom of a major depressive episode.
  • feelings of sadness, emptiness, or hopelessness
  • loss of interest in activities
  • inability to sleep or sleeping too much
  • decreased energy
  • feelings of worthlessness and guilt
  • trouble concentrating or focusing
  • weight gain or weight loss without dieting
  • suicidal thoughts or tendencies

Other signs and symptoms of bipolar II disorder may occur during both periods of hypomania and major depressive episodes. These may include the following:

  • anxiety
  • melancholy
  • rapid cycling between states

Risk factors

There are no known risk factors for bipolar II disorders, although some studies suggest there may be a genetic component.

Read full article here…

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All About Anxiety Disorder

Anxiety: Causes, Symptoms and Treatments

anxiety disorder imageAnxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying.

These disorders affect how we feel and behave, and they can manifest real physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can be extremely debilitating, having a serious impact on daily life.

People often experience a general state of worry or fear before confronting something challenging such as a test, examination, recital, or interview. These feelings are easily justified and considered normal. Anxiety is considered a problem when symptoms interfere with a person’s ability to sleep or otherwise function. Generally speaking, anxiety occurs when a reaction is out of proportion with what might be normally expected in a situation.

Anxiety disorders can be classified into several more specific types. The most common are briefly described below.

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is a chronic disorder characterized by excessive, long-lasting anxiety and worry about nonspecific life events, objects, and situations.

GAD sufferers often feel afraid and worry about health, money, family, work, or school, but they have trouble both identifying the specific fear and controlling the worries. Their fear is usually unrealistic or out of proportion with what may be expected in their situation. Sufferers expect failure and disaster to the point that it interferes with daily functions like work, school, social activities, and relationships.

In this short video from The Psych Network, Dr. Sylvia Gearing discusses Generalized Anxiety Disorder and how it affects sufferers.

Panic Disorder

Panic Disorder is a type of anxiety characterized by brief or sudden attacks of intense terror and apprehension that leads to shaking, confusion, dizziness, nausea, and difficulty breathing. Panic attacks tend to arise abruptly and peak after 10 minutes, but they then may last for hours. Panic disorders usually occur after frightening experiences or prolonged stress, but they can be spontaneous as well.

A panic attack may lead an individual to be acutely aware of any change in normal body function, interpreting it as a life threatening illness – hypervigiliance followed by hypochondriasis. In addition, panic attacks lead a sufferer to expect future attacks, which may cause drastic behavioral changes in order to avoid these attacks.

Phobias

A Phobia is an irrational fear and avoidance of an object or situation. Phobias are different from generalized anxiety disorders because a phobia has a fear response identified with a specific cause. The fear may be acknowledged as irrational or unnecessary, but the person is still unable to control the anxiety that results. Stimuli for phobia may be as varied as situations, animals, or everyday objects. For example, agoraphobia occurs when one avoids a place or situation to avoid an anxiety or panic attack. Agoraphobics will situate themselves so that escape will not be difficult or embarrassing, and they will change their behavior to reduce anxiety about being able to escape.

In this short video from HealthGuru, Dr. J. Clive Spiegel M.D. talks about the difference between fear and phobia.

Social Anxiety Disorder

Social Anxiety Disorder is a type of social phobia characterized by a fear of being negatively judged by others or a fear of public embarrassment due to impulsive actions. This includes feelings such as stage fright, a fear of intimacy, and a fear of humiliation. This disorder can cause people to avoid public situations and human contact to the point that normal life is rendered impossible.

Read full article here…

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Diabetes and mood swings: Effects on relationships

Diabetes and mood swings: Effects on relationships

Written by Rachel Nall, RN, BSN, CCRN

Diabetes is a condition that impacts the way a person’s body uses sugar for energy. However, diabetes affects much more than blood sugar. It can impact nearly every body system and have an effect on a person’s mood.

Stress associated with managing diabetes as well as concerns about potential side effects can all contribute to changes in mood. In addition, the actual highs and lows of blood sugar levels may also cause nervousness, anxiety, and confusion.

It is important for people to recognize their own individual symptoms of high or low blood sugar. They must also ensure they seek support for any concerning mental health symptoms they might experience.stress and mood swings

Watching these mood swings can often be difficult for friends and family to understand. However, learning why a person may experience mood changes related to diabetes and being supportive can help to promote a stronger, healthier relationship.

How do diabetes and mood swings go together?

Diabetes can have many effects on a person’s mood. For example, managing diabetes can be stressful. A person may be constantly worried about their blood sugar and whether it is too high or too low.

Adjustments to their diet and constantly checking their blood sugar can also add to a person’s stress and enjoyment of life. As a result, they are more likely to experience feelings of anxiety and depression.

Blood sugar swings can cause rapid changes in a person’s mood, such as making them sad and irritable. This is especially true during hypoglycemic episodes, where blood sugar levels dip lower than 70 milligrams per deciliter (mg/dL).

Hyperglycemic episodes where levels spike higher than 250 mg/dL may cause confusion in people with type 1 diabetes, but are much less likely to in those with type 2 diabetes.

When a person’s blood sugar returns to more normal ranges, these symptoms often go away. In fact, changes in mood and mental status can be one of the first signs that someone’s blood sugar levels are not where they should be.

According to Johns Hopkins Medicine, the mental symptoms associated with low blood sugar levels may include:

  • feeling confused
  • feeling anxious
  • having difficulty making decisions

Symptoms that indicate a person may have high blood sugar levels include:

  • difficulty thinking clearly and quickly
  • feeling nervous
  • feeling tired or having low energy

Having diabetes can also cause a mental health condition called diabetes distress. This condition shares some elements of depression, anxiety, and stress.

While a person may not have symptoms severe enough for a doctor to diagnose them with a more severe mental illness, these symptoms can affect the quality of life for a person with diabetes.

An estimated 33 to 50 percent of people with diabetes experience diabetes distress at some point during the course of their disease. The sources of distress can include the responsibilities of managing the condition to worrying about potential complications.

Effect of diabetes on mental health

People with type 1 or type 2 diabetes are at increased risk for experiencing depression.

Depression is a serious mental health condition that can cause a person to feel hopeless about life, have low bouts of energy, and lose interest in activities they once enjoyed. In very severe cases, depression can cause a person to feel as if life is not worth living and even contemplate suicide.

A diabetes diagnosis can also add to a person’s experience with depression. For example, a person who struggles with depression often lacks motivation and energy to engage in healthful behaviors. This could include healthful eating or exercising regularly.

Read full article here…

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Improve Mental Health

A leisurely walk can boost mood, psychological well-being

Written by

Regular exercise is considered key for improving and maintaining physical health. When it comes to psychological health, however, new research suggests that you do not need to hit the gym in order to reap the rewards.

Researchers from the University of Connecticut (UConn) in Mansfield found that simply going for a leisurely walk can improve mood and boost subjective well-being, particularly for adults who are normally sedentary.

Leisure walk for mental healthLead study author Gregory Panza, of the Department of Kinesiology at UConn, and colleagues recently reported their findings in the Journal of Health Psychology.

While a number of studies have shown that physical activity can benefit psychological health, Panza and team note that it remains unclear how the intensity of physical activity impacts subjective well-being, defined as a person’s own evaluation of their lives.

The researchers decided to investigate this association further with their new study, which included 419 healthy, middle-aged adults.

The physical activity of each adult was monitored over 4 days using accelerometers, which participants wore on their hips.

Additionally, subjects completed questionnaires detailing their daily exercise routines, psychological well-being, level of depression, whether they experienced pain and its severity, as well as the extent to which pain disrupted their day-to-day activities.

Light, moderate activity led to greatest improvements in well-being

The researchers found that adults who were sedentary had the lowest levels of subjective well-being and the highest levels of depression, which indicates that lack of physical activity is detrimental to psychological health.

Overall, the team found that people who engaged in physical activity demonstrated greater subjective well-being. However, the benefits of physical activity were found to vary by intensity.

Light-intensity activity, for example, was associated with greater psychological well-being and lower depression, while moderate-intensity activity was linked to higher psychological well-being and reduced pain severity.

Light-intensity activity was defined by the study as a leisurely walk that does not noticeably raise heart rate, breathing, or sweating. Moderate-intensity activity was defined as walking a mile in 15 to 20 minutes, with a slight increase in heart rate, breathing, and sweating.

Notably, the study results revealed that sedentary adults who increased their exercise levels to light or moderate activity demonstrated the greatest increases in subjective well-being.

However, vigorous-intensity activity – defined as jogging or briskly walking a mile in 13 minutes, with very noticeable increases in heart rate, breathing, and sweating – appeared to have no impact on subjective well-being. However, the researchers say that this is not necessarily a bad finding.

“Recent studies had suggested a slightly unsettling link between vigorous activity and subjective well-being,” says study co-author Beth Taylor, associate professor of kinesiology at UConn. “We did not find this in the current study, which is reassuring to individuals who enjoy vigorous activity and may be worried about negative effects.”

Read full article here…

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Impact of Childhood Bullying – New Research Finding

Childhood bullying may lead to increased chronic disease risk in adulthood

Being bullied during childhood might have lifelong health effects related to chronic stress exposure – including an increased risk for heart disease and diabetes in adulthood, according to a research review in the March/April issue of the Harvard Review of Psychiatry. The journal is published by Wolters Kluwer.

Childhood BullyingRecent advances in understanding of the negative health effects of chronic stress highlight a pressing need to clarify the longer-term health implications of childhood bullying, according to the review by Susannah J. Tye, PhD, of the Mayo Clinic and colleagues. “Bullying, as a form of chronic social stress, may have significant health consequences if not addressed early,” Dr. Tye comments. “We encourage child health professionals to assess both the mental and physical health effects of bullying.”

Health Impact of Bullying – What’s the Evidence?

“Once dismissed as an innocuous experience of childhood, bullying is now recognized as having significant psychological effects, particularly with chronic exposure,” Dr. Tye and co-authors write. Bullying has been linked to an increased risk of psychiatric disorders, although there are still questions about the direction of that association.

Bullied children also have increased rates of various physical symptoms – recurrent and unexplained symptoms may be a warning sign of bullying. Dr. Tye comments, “It is important that we appreciate the biological processes linking these psychological and physiological phenomena, including their potential to impact long-term health.”

Studies of other types of chronic stress exposure raise concerns that bullying – “a classic form of chronic social stress” – could have lasting effects on physical health. Any form of continued physical or mental stress can put a strain on the body, leading to increasing “wear and tear.” This process, called allostatic load, reflects the cumulative impact of biological responses to ongoing or repeated stress – for example, the “fight or flight” response.

“When an individual is exposed to brief periods of stress, the body can often effectively cope with the challenge and recover back to baseline,” Dr. Tye explains. “Yet, with chronic stress, this recovery process may not have ample opportunity to occur, and allostatic load can build to a point of overload. In such states of allostatic overload, physiological processes critical to health and well-being can be negatively impacted.”

With increasing allostatic load, chronic stress can lead to changes in inflammatory, hormonal, and metabolic responses. Over time, these physiological alterations can contribute to the development of diseases – including depression, diabetes, and heart disease – as well as progression of psychiatric disorders.

Read full article here…

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Anger Management

 

Anger Management

Natasha Smith, MA, LCPC – Online Counselor and Therapist

Anger?  When does it create a problem?

Anger is a very strong emotion.  We sometimes share anger to show what we are experiencing in the moment, how hurt we are, and the degree to which we are flustered by our experiences.  When we are open to examining our anger, we can begin to positively enter self-exploring and discovery.  However, anger becomes more a problem when we chose to create barriers that block us from open and genuine communication. 

Among a few of the internal defenses that might be used to express anger are: (1) Nagging, (2) Excessive accusations, (3) Gossiping, (4) Blaming, (5) Justifying and (6) Displaying a passive role to avoid accepting responsibility for the anger.

Anger can be expressed both directly or indirectly to intentionally hurt others.  Normally guilt, anxiety, hurt and insecurities can be accompanied by anger.  When experiencing these distinct range of emotions, we generally look at the intensity of the anger and thereby, react to the pressure.  A healthier way of adjusting to our anger may be to say “I am feeling overwhelmed or may be anxious” rather than acting out verbally or physically.

Anger-managementMany cognitive psychologists have suggested that anger can be accounted for by how we process events and reflect on them personally.  “I am angry because of the way I perceive or see things occurring” is one thought pattern that might explain what we are experiencing in a given situation.  The goal of cognitive therapy is to assist with tackling the faulty belief system we have, assumed interpretations reflecting the world around us, and how to ultimately reach a point of healthier reflective thinking.  In identifying anger, it is not only significant to analyze what we are going through, but the degree to which we are affecting others.  Sometimes a person does not experience issues from our vantage point and this needs to be better understood and sorted out so that we can reach a successful chain of interaction.

Professional counselors have suggested a few tactics to appropriately manage anger.  They may be as follow:

  1. Separating ourselves from situations that we are faced with
  2. Relaxing and taking deep breaths
  3. Taking silent pauses in speech, along with pauses that focus on the anxiety provoking situation
  4. Reflective thinking, and
  5. Visual imagery. 

In addition to these coping strategies, spiritual and emotional support are two critical attributes that contribute to the longevity of positive encounters. When anger is too harsh to unravel and “let go”, it is recommended for one to seek out guidance from a trained professional who can really hear the issue at hand and put them into perspective for you. 

Meet Natasha Smith, MA, LCPC here for further support

Positive Thinking

 

Positive Thinking

Natasha Smith, MA, LCPC – Online Counselor and Therapist

Positive thinking and taking action are two of the most important factors associated with better living, great health and achievement.  Focus more on creative planning, happiness and success and you will invite people who will enjoy being around you and genuinely want to assist you, because they are connecting with the energy that positive thinking creates deep within us.

The first step in understanding how to gain stronger outcomes from positive thinking is to examine our basic attitudes we have toward life.  In certain instances, do we find ourselves filling the “glass” only half up or full.  Positive thinking is something that we must internalize deep within ourselves and make a decision to reach success.

Positive thinking takes more than merely speaking the words, but to know them enough to put into action.  The power of buying into what we think and putting the foot work into making the necessary changes for healthy living goes a long way in terms of creating the most out of our relationships with both self and others.

Getting bigger and biggerInner work is required to reach a level of developing a mature and creative style of processing positive emotions and behaviors.  There are moments when it helps to visualize what we are experiencing in the moment- to examine our self-talk messages: “I feel angry and therefore, I react in anger” rather than realizing deeper layers of anger and how they hinder us from remaining focused on many of our successes.

Researchers have addressed the importance of offering  positive affirmation to encourage you towards great success.  Affirmations are positive self-statements that we give ourselves regarding the type of goals, plans we have.  What we continue to tell ourselves and reflect on psychologically or verbally becomes engraved on the subconscious mind.  This alters the way individuals see things, their habits, attitudes and behaviors.

The best thing about developing positive thoughts is that it can manifest into great things.  Affirmation is one way to get the ball rolling and gearing you in the right direction.

If you need additional assistance, feel free to talk more with a qualified therapist.  Many clients with deeper issues pertaining to poor lifestyle dynamics respond a great deal to negative self-talk or evaluation which only helps to reinforce negative responses to outside influences.  From clinical experiences, negative ideas and attitudes perpetuate not only escalating tension, however, continue fights between clients in group settings.  One’s social skills may be heavily impacted by how they see changes going on in their environment.  In order to establish success, you have to make a decision to be happy and process stronger resolutions.

Meet Natasha Smith, MA, LCPC here for further support

The Ventral Vagal

Janette Strokappe

 

The Ventral Vagal

Expert advice by veteran Family Therapist and Psychologist

Janette Strokappe – Online Counselor and Therapist

For many years, the autonomic nervous system was thought to be the sympathetic nervous system in balance with the parasympathetic nervous system. The sympathetic revved the body up and the parasympathetic calmed it down.

Dr. Stephen Porges’ Polyvagal Theory changed all that. As I am just summarizing the polyvagal theory, if you want more thorough information, just google Polyvagal theory.

Dr. Porges discovered that the parasympathetic system is composed of two branches of the vagus nerve which arise from different areas of the brain.

The unmyelinated branch is an ancient system found also in reptiles. Its action is below the diaphragm. Myelin is the outer coating of a nerve which allows it to transmit impulses more efficiently. This branch lacks myelin.

The ventral vagus which we are interested in is found only in mammals and it is myelinated. It arises from the brain very close to the area that stimulates the face muscles and voice box. Stimulation of the ventral vagal allows up to be more relational.

When we are threatened the responses come down the development chain starting with the most developed.

We try:

  1. Smile and try and act pleasant to defuse the situation.
  1. If that doesn’t work, we prepare for fight or flight.
  1. If that doesn’t work, the body may go into freeze mode. Freeze dulls pain if we are attacked and if the predator relaxes its grip it gives us a chance to escape.

This is all below the level of consciousness. We do not have voluntary control over these responses.

It is possible with chronic stress to get stuck in fight or flight or freeze. It is also possible to alternate between them.

The signs of hyper-arousal (fight or flight)

Exaggerated startle reaction Outbursts of anger
Extreme vigilance Irritability
Feelings of panic and anxiety Insomnia
Reduced tolerance for pain Fatigue
Difficulty concentrating Constantly being on guard.
Feelings of electricity going through your body especially the legs. (feelings of bugs under the skin Frequent urination
Headaches

The signs of hypo-arousal (freeze) are:

  •  Feelings of being hopeless and helpless
  • Dissociating into daydreaming, or into a book where you are startled if someone calls or touches you.
  • Just wanting to be in a dark room, lying in bed with the covers pulled over your head.
  • We can alternate between these two states.

Stimulating the Ventral Vagus.

The only way out of these states is to activate the ventral vagal (relational) nerve.

There is two-way traffic in this nerve. Many signals come from our internal organs and travel up the vagus to the brain. This is the “gut feelings” that we get.

Signals travel back down the ventral vagus to have a calming effect.

There are some experiments being done with electrical stimulation of the ventral vagus for depression and epilepsy.

While we can’t do that, there are things we can do for ourselves to stimulate the ventral vagus.

butterfly hug

What We Can do at Home to Stimulate the Ventral Vagus:

Remember, safety above all. If you do not feel safe, it is below the level of conscious response, and the ventral vagal will not activate.

  1. Values: Friends, family good health and generosity are essential.
  1. Being creative: Whether through writing, art, acting, singing or dancing.
  1. Prolonged exhale is the best way to stimulate the ventral vagus. If you haven’t seen the video I usually make available, then follow the instructions for conscious breathing which will follow.
  1. Conscious Breathing: The breath is one of the fastest ways to influence our nervous system. The vagus nerve is stimulated when the breath is slowed from our usual 10-14 breaths per minute to 5-7 breaths per minute. Breathe in through your nose and give a very prolonged exhale through the mouth. Like you are saying AAH!
  1. Valsalva Maneuver: This involves attempting to exhale against a closed airway. You can do this by keeping your mouth closed and pinching your nose while trying to breathe out. This increases the pressure inside of your chest cavity increasing vagal tone.
  1. Diving Reflex: Considered a first rate vagus nerve stimulating technique, splashing cold water on your face from your lips to your scalp line stimulates the diving reflex. You can also achieve the nervous system cooling effects by placing ice cubes in a ziplock bag and holding the ice against your face and briefly hold your breath. The diving reflex slows your heart rate, increases blood flow to your brain, reduces anger and relaxes your body. An additional technique that stimulates the diving response is to submerge your tongue in liquid. Drink and hold lukewarm water in your mouth sensing the water with your tongue.
  1. The Butterfly Hug: The butterfly hug is a soothing gesture you can do anytime. Wrap your arms around your body at the level of the shoulders. Alternating pat one shoulder and then the other until you feel calm.
  1. Connection and Feeling Safe: Reach out for relationship. Healthy connection to others can initiate regulation of our body and mind. Relationships can evoke the spirit of playfulness and creativity or can relax us into a trusting bond with one another. While it is most effective in person, connection can be made through the phone or texts or social media. Texting only becomes a problem when it is used to avoid person to person contact.

This is a very simplified version of Dr. Porges polyvagal theory.

 Contact Janette Strokappe for online counseling support

Biological and Neurological Causes of Addiction

Tracie Timme

 

Addiction – Biological and Neurological Causes

An academic paper by

Tracie L. Timme – Online Counselor and Therapist

This paper is about the biological and neurological causes of addiction, how it affects many people, and systems of the body that are affected.

The category that addiction best falls into is a behavioral syndrome, noted for compulsive drug use with relapse into more drug use.  Addiction can happen without being physically dependent, and physical dependency can happen without being addicted (Spanagel & Heilig, 2005).  For the past 20 years scientists have looked at positive drug reinforcement as what lies beneath addictions.  According to Spanagel & Heilig (2005), other neuronal systems must aid in addictive behavior, all systems work together.  This means that one system affects the other.  One of these systems, which detect influencing environmental stimuli, is the mesolimbic dopamine system, which affects the core brain reinforcement system.  The hypothesis for the neurobiology of addiction is that there are changes on the molecular and structural levels that are irreversible, caused by the dopaminergic reinforcement system having synaptic plasticity, due to constant drug use. (Spanagel & Heilig, 2005).  Scientists seem to think that there is some kind of modular switch that explains the irreversible transition from controlled drug use to compulsive drug use.  These scientists say “It has been claimed that transcription factors such as “AFosB” may constitute such a molecular switch” (Spanagel & Heilig, 2005, p. 2).  This transition factor builds up in the mesolimbic dopamine system with continuous drug use.  However a modulator of transcription factors is Per2 and that does remain in the brain for quite a few weeks after drug treatment.  Some change in the mesolimbic dopamine system that is irreversible that has been seen is the micro structural alterations on the dendrites of medium spiny neurons, which are the essential cell population inside the mesolimbic dopamine system.  However, that change is not seen past 3 months after drug treatment ends.  That contradicts the irreversible switch theory of moving from controlled drug use to compulsive drug use (Spanagel & Heilig, 2005).

Schepis, Adinoff, & Rao, state that adolescents are more persistently and acutely affected by addiction than are adults.  These differences possibly have to do with neuroplastic changes that aid entrenchment and accelerated use, which leads to more neurobiological liability and SUD (substance use disorder) being great factors as the outcome (Schepis et al., 2008).  This study also shows that adolescents with a family history of substance use are more likely to have neurobiological and neurobehavioral dysfunctions (Schepis et al., 2008).  Adolescence is the period when most neurons grow.  Neurocognitive functions such as decisions, monitoring oneself, controlling impulses, and gratification delay, are relative to the PFC (prefrontal cortex) and the anterior cingulate activity; these things seem to be affected by changes in pretty much all of the neurotransmitter systems.  The most important factors in becoming a SUD are alterations in the dopamine related systems.  Dopamine is a key factor in the mesolimbic neural pathways (Schepis et al., 2008).  According to Schepis et al., “This circuit originates in the ventral tegmental area (VTA) and projects to the nucleus accumbens (NAc) and various limbic structures” (p. 8).  A variety of environmental reinforcers trigger the mesostriatal to release dopamine (DA).  In order to assign value to these reinforcing stimuli, there needs to be an increase in striatal concentrations of DA (Schepis et al., 2008).

Big scary spiderIn an article about SUD by Taylor, he explains Gray’s behavioral inhibition system (BIS) and the behavioral activation system (BAS), which, may be seen in the physiological reactions and shown in the psychopathology.  Gray also says that the neural structure of the BIS incorporates information to the prefrontal cortex (PFC), and the neural structure of the BAS could be related to the dopaminergic reward circuit (Taylor, 2005).

Love passion, what some people consider an addiction, has neurobiological links with addiction.  In love passion, neurochemicals that play a part in wanting that feeling all the time are dopamine, ocytocin, and vasopressin.  Dopamine plays a major role in addictions.  Other neurotransmitter systems that are common between addiction and love passion are GABA and glutamate, noradrenaline and serotonin, opioid, and cannabinnoid.  These are implicated in the addiction process, as is the corticotrophin system that regulates the oxytocinergic and dopaminergic systems (Reynaud, Karila, Blecha, & Benyamina, 2010).  Even though love passion is not considered to have a recognized definition or diagnosis criteria, it is very similar to addiction.

Alcohol affects GABAA  receptors and a subtype of glutamate receptors called N-methyl-D-aspartate (NMDA).  These neurotransmitters control the excitatory tone and activity of the brain.  GABA is the inhibitory neurotransmitter and glutamate is the excitatory neurotransmitter (Devaud, Risinger, & Selvage, 2006).  Incoordination, reduced nervousness, anticonvulsant, and relaxation, the symptoms of intoxication, are partly controlled by coming across these neurotransmitter systems.  These actions show how the central nervous system (CNS) reacts to more GABAergic activity and less glutmatergic activity (Devaud, et al., 2006).  GABAA  and  NMDA receptors are part of a larger receptor family and each has their own protein make-up.  The different neurological responses are due to the combination of the different receptors.  Men and women have a different chemical make-up as far as systems go.  The difference between men and women when they drink is in the brain- and endocrine-mediated stress reactions.  Men take the flight or fight response, whereas women tend to try to nurture the other and avoid aggressiveness (Devaud et al., 2006).

Another test shows that substance use and most psychiatric disorders are common and complex and have multiple genes that play into the phenotype, which show no pattern of Mendelian transmissions.  There are two parallel mechanisms that influence this genetic complexity.  One is the explanation of polygenicity, which means many genes come together at the same time to ensure vulnerability.  In SUD, the genes that might be involved are genes related to drug-specific metabolism, neurobiological processes regulators similar to all abused drugs, and some that comorbidity-related that change environmental vulnerability.  The second parallel mechanism that influences genetic complexity is heterogeneity, which shows that it is only one genetic variation that could make up a single specific phenotype that could be needed for the initiation and possibly the upkeep of addictions (Schumann, 2007).

Different people have different chemical make-ups, so everyone, more than likely, will have different effects from addictions.  The many different receptors bind with different chemicals; if there is some disruption of that binding, many different affects could happen.  Some people simply do not to become addicted to things, where others become addicted very easily.  It is all in how chemicals bind together with the receptors, and apparently in the genetics.

Alcoholism is a terrible addiction that has been shown to be passed down from generation to generation.  People who have a history of alcohol abuse in their family, have a greater chance of using themselves.  According to previous studies Hanson, Medina, Nagel, Spadoni, Gorlick, and Tapert, (2010) hypothesis says that there is a difference in the size of the hippocampus of adolescents with a family history alcohol use problems and those adolescents who do not have a history of alcohol use issues.  When the hippocampi of non-drinking youth with a family history of alcohol use was compared with youth who did not have a history of alcohol use in the family, those who had the history had smaller hippocampi or asymmetry that was abnormal (Hanson et al., 2010).  The hippocampus is involved in making new memories.  There is ongoing myelination in teen years, so if there is a problem with family history of alcohol use, then there will no doubt be a neurodevelopmental lag that hinders the proper growth of the left and right hemispheres of the hippocampus (Hanson et al., 2010).  From their own preliminary findings, their hypothesis found not to be correct.  Hanson et al. (2010) found that the hippocampal asymmetry was the same for youth with and without a family history of alcohol use.

Slutske et al. (2002) looked at four different studies on alcohol expectancies.  Out of those four, three of them were done on twins.  All of the participants of these studies were experienced drinkers (Slutske et al., 2002).  What people expect of alcohol starts when they are young.  Children see adults drink all the time, whether it is on the television, the radio, in a restaurant, or, sadly enough, in their own homes.  From these experiences we can see how others are affected by alcohol.  They look like they are having a lot of fun. Whether they are laid back and relaxed, laughing hysterically, or not afraid of anything, almost superhero type, so we expect what we see to happen to us.  With that in mind we start to drink.  Those who have a family history may start sooner than others, because they were exposed to it much younger and on a regular basis.  In a recent study Slutske et al. (2002), examined how genetics, parents’ thoughts, and the same peer groups, affected thoughts of alcohol use, compared to thoughts of alcohol use with factors that are unrelated, peer groups that are not the same.  What they came up with from this study, was that genetics alone did not make a significant difference, but when added to the family environment, together they made a huge difference on how people thought of alcohol and its use (Slutske et al., 2002).  The thought here is that the social learning theory has more to do with alcohol use and dependence than does only genetics.

The ethanol in alcohol effects the predisposition of abuse and dependence.  The way neural pathways are activated or deactivated by alcohol.  With this in mind, research has turned to pharmacology, where medications affect cellular and physiological levels in the brain (Ray et al., 2010).  These endophenotypes affect the subjective responses of alcohol, therefore may work to help treat alcoholism.  The medication that is approved by the FDA has shown to lessen the good feelings of the alcohol, bring out more of the fatigue, stress, and confusion felt by alcohol use, therefore lowering the enjoyment (Ray et al., 2010).

Carlson (2010) explains that there are variations of genes that do play a big role in becoming addicted to substances.  Environment also has a lot to do with whether you become dependent or not.  He also goes on to explain that being prone to becoming an addict could be how your body metabolizes substances or by how the structures and biochemistries in your brain differ (Carlson, 2010).

A cause for alcoholism could be that the person is predisposed to the genetics of an alcoholic.  However, just because you may be predisposed to alcoholism does not mean you will automatically become an alcoholic yourself.  It may take outside factors to play a role in becoming an alcoholic.  Coming from a line of alcoholics and seeing it every day, may have great impact on how you see the disease.  Having friends that you spend most of your time with, could also have a great impact on whether or not you drink.  A trusted friend, colleague, boss, or family member may offer you a drink to calm down, and it works, you like it, therefore you use it to chase away the blues or your bad day.  You repeat these feelings of being alright enough that you now need it to get through your day.  You become addicted.

References

Carlson, N. R. (2010). Physiology of behavior (10th ed.). Boston, MA: Pearson Education.

Devaud, L. L., Risinger, F. O., & Selvage, D. (2006). Impact of the hormonal milieu on the neurobiology of alcohol dependence and withdrawal. Journal of General Psychology, 133(4), 337-356. doi:10.3200/GENP.133.4.337-356

Hanson, K. L., Medina, K., Nagel, B. J., Spadoni, A. D., Gorlick, A., & Tapert, S. F. (2010). Hippocampal volumes in adolescents with and without a family history of alcoholism. American Journal of Drug & Alcohol Abuse, 36(3), 161-167. Retrieved from EBSCOhost.

Ray, L. A., Mackillop, J., & Monti, P. M. (2010). Subjective responses to alcohol consumption as endophenotypes: Advancing behavioral genetics in etiological and treatment models of alcoholism. Substance Use & Misuse, 45(11), 1742-1765. Retrieved from EBSCOhost.

Reynaud, M., Karila, L., Blecha, L., & Benyamina, A. (2010). Is love passion an addictive disorder? The American Journal of Drug and Alcohol Abuse, 36(5), 261-267. doi:10.3109/00952990.2010.495183

Schepis, T. S., Adinoff, B., & Rao, U. (2008). Neurobiological processes in adolescent addictive disorders. The American Journal on Addictions, 17(1), 6-23. doi:10.1080/10550490701756146

Schumann, G. (2007). Okey lecture 2006: Identifying the neurobiological mechanisms of addictive behaviour. Addiction, 102(11), 1689-1695. doi:10.1111/j.1360-0443.2007.01942.x

Slutske, W. S., Cronk, N. J., Sher, K. J., Madden, P. F., Bucholz, K. K., & Heath, A. C. (2002). Genes, environment and individual differences in alcohol expectancies among female adolescents and young adults. Psychology of Addictive Behaviors, 16(4), 308-317. doi:10.1037/0893-164X.16.4.308

Spanagel, R., & Heilig, M. (2005). Addiction and its brain science. Addiction, 100(12), 1813-1822. doi:10.1111/j.1360-0443.2005.01260.x

Taylor, J. (2005). Substance use disorders and cluster B personality disorders: Physiological, cognitive, and environmental correlates in a college sample. American Journal of Drug & Alcohol Abuse, 31(3), 515-535.

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