MANAGING STRESS IN OUR LIVES

Monday
Feb272017

NO NEWS IS GOOD NEWS?

I thought about this old saying recently in light of recent events that have caused a lot of people to feel anxious when watching or listening to the news.  I try to help people who come to me to let go of their worries about things that they hear on the news and often will suggest that they not watch or listen to news, especially news on TV.  I have previously blogged about this and freely confess that I am biased when it comes to this as I have not watched TV news since three-forths of the way through the Vietnam War [about 1970].  I stopped watching because I had friends who had been drafted and were fighting in the war and I did not want to see news about their being wounded or killed.  I had a deferment because of medical school and yet I felt guilty that my friends had to fight in the war or leave the country [I had a friend make this choice].

After the war, I decided to continue not watching the TV news as it was frequently focused on violence and negative things that were stressful to watch and listen to and I did not think I gained anything from watching and listening to it.  It did not seem to directly motivate me to do something about what I was witnessing on the news and would instead lead me to feel stressed and then be less able to do something to counteract what appeared to be happening.  It was not as if the negative news was balanced with positive news.  Even if it were, I believe that the negative news would have more influence over me than the positive. I have joked with people that I don't know what country I live in or which state, etc. Of course that is not true. I get my news from radio [unless it is a negative focus or is describing violence] and print sources that includes reading news on the internet.  However, I avoid looking at photos depicting violence, etc.

Avoiding TV news and references to violence would be difficult for a lot of people. Since watching the TV news makes a lot of people anxious and feel stressed and pessimistic about the future, why do they watch it?  I had several people who watched the air planes flying into the Twin Towers in New York City thousands of times. They couldn 't stop themselves.  It seemed to represent a hope that the next time they watched it they would find out it wasn't real after all.  Maybe the same desire keeps many people watching TV news in hopes that it will also turn out to not be real. Well, that puts control over stress in our lives directly in the hands of those who control the news that is shown.  

I encourage people to take back control of their lives and the stressful events that they espose themselves to. To me this means no TV news and no violent shows and no overwhelmingly painful commercials about dogs and cats being mistreated or children suffering from cancer.  It is vey hard to erase those sad faces from our brains and yet having them there does not help those animals or those children.  It can keep us from being more active helping those in need as we are preoccupied coping with the stress of remembering these events and the hopelessness that often comes with it.

So, no news is good news!

Monday
Jan092017

YOUR BRAIN IS ON YOUR SIDE OR THANK GOODNESS OUR BRAIN'S ARE ORGANS THAT MAINTAIN PATTERNS

Many of us [all of us?] have experienced a time when we want to change what we are doing but don't seem to be able to change our behaviors or thoughts. It can feel like our brain's are working against us...therefore the question of "whose side our brain's are on."  So what is up with our brains? William James stated that: " In most of us, by the age of  thirty, the character has set like plaster, and will never soften again." [from The Principles of Psychology, 1890, by James]. A summary of years of research regarding personality [How Much Can You Really Change After You Turn 30? by Melissa Dahl from the New York Magazine; 2014/11] indicates that by 30-35 years of age it is set and not likely to change much after that. This seems to mean that behavior patterns are stable and more resistant to change as well.  Paul Costa, Jr scientist emeritus at the laboratory of behavioral science at the National Institutes of Health is reported to have indicated that changes in personality come much more slowly in the 30s, 40s, and 50s. Now Brian Little, a lecturer in Psychology at the University of Cambridge [England] indicates that even though up to 50% of our personality is genetically derrived, we can still choose how we behave even if it is at odds with our core personality traits. However, Little believes that we will feel anxiety if we deviate from our core personality traits and will feel depleted and need to return to our "real selves" to let go of the anxiety.  

So, does any of this apply to patterns of behavior that are caused by traumatic events and become part of our daily coping with life?  It does seem that the patterns that we establish as children at harder to modify compared to later ones. These patterns related to traumatic events don't seem to be part of our core personality traits although those core traits must influence how we cope and what patterns that we establish. This may be why some people who are traumatized develop obsessive coping patterns while others are irritable and others over think and others are people pleasers, etc.  

So, does this mean that traumatic experiences can cause us to cope and develop stable coping patterns that are difficult to change but are not part of our core personalities and not really who we are? And why does our brain resist changing patterns?  Well, some of those patterns are essential for sustaining our lives in the next few minutes like body temperature, respirations, heart functioning, etc. Maybe this is why our brains are cautious about changing patterns.  In addition, when we are traumatized and learn to cope to reduce the liklihood of being traumatized again, our brains are going to want to be sure that it is ok to change this coping and that we will not be overwhelmed like before. 

Therefore, it is a good thing that our brains maintain patterns and our brains really are on our side.

 

Friday
Jan062017

PSYCHOTIC SYMPTOMS AND TRAUMATIC EXPERIENCES

There is research evidence [Kelleher et.al; American Journal of Psychiatry Vol 70: Issue 7: Pages. 734-741]that adolescents who are assaulted or bullied are significantly more likely to experience psychotic symptoms. They also noted that adolescents with psychotic symptoms were significantly more likely to be assaulted and more likely to be bullied.  So, they found a bidirectional relationship between psychotic symptoms and trauma for adolescents.  If you have psychotic symptoms you are significantly more likely to be traumatized and if you are traumatized you are significantly more likely to have psychotic symptoms. Also of significance is the finding that the more an adolescent is traumatized the more likely to have psychotic symptoms.  Importantly, they also found that if trauma was reduced the psychotic symptoms were also reduced. 

The above highlights the severe stress that adolescents experience when they are traumatized including leading to psychotic symptoms that are directly related to the traumas and will be reduced [go away completely?] when traumas are reduced.  Also, it is important to realize that adolescents with psychotic symptoms are more likely to be traumatized and hopefully can be protected from this happening. 

I have seen psychotic symptoms in traumatized adolescents and adults that can be successfully treated by stopping the trauma and reducing or eliminating flashback experiences related to the traumas.

Monday
Dec192016

"I DON'T CARE AND I DON'T CARE THAT I DON'T CARE."

Recently one of my patients came in and announced that "I don't care and I don't care that I don't care."  She said that she realized this just the day before.  She reflected on this and indicated that it was a relief not to care.  She feels less stressed and yet still feels responsible for others and realizes that she takes care of others better than she takes care of herself.  She believes that "not caring" is helping her to feel less stress and take better care of herself.  

So, what is this "not caring?"  I am treating this person for severe PTSD symptoms that include paranoid thinking, frequent flashbacks and dissociative symptoms.  One of the treatment goals has been to not feel a need to react to the past and also to no longer fear past traumatic experiences, recognizing that they have no power anymore. The growing success not reacting to the past seems to have led to being able to "not care" about things from the past, and "not care" about things that are happening now or that might happen in the future.  It is like a weight has been lifted as worries about the past and fears about the future have lessoned. There is a calm more of the time now and it is easier to be around people. A feeling of responsibility for others is still a problem but is also more contained than before. It is also easier to focus on self care.

My wish for the universe is that all living things can learn to "not care" what happens, so that they can experience the joys of living, without being distracted by "caring."

Confusing? Imagine that you don't care and don't care that you don't care, and see what happens.  

Sunday
Sep112016

SUICIDE AND GUNS

From the Harvard Public Health magazine of the Harvard T.H. Chan School of Public Health report on "Guns and Suicide...the hidden toll" by Madeline Drexler, Editor of Harvard Public Health magazine. Ms. Drexler summarizes data on the association of suicide and gun ownership.  She reports that many more people kill themselves with guns [19,392 in 2010] then are murdered with guns [11078 also from 2010]. Also from 2010, 38,364 people killed themselves and over half used guns. Thus, suicide by gun was more than all other methods combined.  About 85% of suicide attempts with guns end in death while only 3% of poisoining end in death.  There are a number of reasons that someone would become suicidal and yet the outcome of these thoughts are directly linked to the method used.  A 2008 study by Davis and Hemenway [New England Journal of Medicine 2008; 359:672-3] found that suicide using guns was 3.7 times more likely for men and 7.9 times more likely for women in states with highest rates of gun ownership. Estimates now are that one in three households have at least one gun. Davis and Hemenway also found that while the populations [from 2001-2005 data] were almost even between states with the highest gun ownership [47% of households had guns] compared to states with the lowest gun ownership [15% of households had guns] there were 16,577 suicides by firearms in high gun ownership states and 4,257 suicides by firearms in lower gun ownership states, while suicides by other means were virtually equal [9,172 compared to 9,279].  So of course more suicides occurred in states with more guns but what also seems significant is that there was no difference in rates mental illness, divorces, money stress, etc that might have been a reason for more suicides by firearms in high gun ownership states compared to low gun ownership states.  Also, a 2001 study from Houston, Texas [reported by Davis and Hemenway] looked at the time between someone first deciding to kill themselves and their suicide attempt.  They found that 24% said it was less than 5 minutes; 48% said less than 20 minutes; 70% less than one hour; and 86% less than 8 hours. This highlights the increased risk for suicide when there is access to guns as the decision is made within 20 minutes almost half the time.  This suggests that suicidal berhavior may frequently be impulsive and leads to death if guns are available.  This would explain why more people kill themselves in areas with more guns as the impulse to kill oneself may be more frequent than we think it is. Also of importance is that 9 out of 10 times there are no more suicide attempts after the first one.  Thus if they survive the attempt they are not likely to try again.  Put this with the fact that nearly 90% of suicide attempts with guns end up in death and it is clear how important it is to keep guns out of the hands of suicidal people. 

All of the above highlights the danger of access to guns as this significantly increases the number of suicides.  People who disagree with these findings or feel that access to guns is not the issue point to the fact that there are a number of other countries that have strict gun control laws and yet have significantly higher rates of suicide.  My response would be that that does not change the reality that access to guns dramatically increases the number of people who committ suicide in the United States.  This would suggest that if access to guns in these other countries were increased that their rates of suicide would increase as well.

So what is the solution?  One person suggested always storing guns without bullets and store them outside the home.  Others suggest that fewer guns is more likely to lead to fewer suicides because it is less likely that people will change their behavior patterns and store guns outside of their homes.  This is especially true if people feel a need to have their guns close at hand to protect themselves.  This then points to a need to help people feel that they do not need to protect themselves by having quick access to guns.  This suggest to me that we would have to lower the stress level in people and help them to feel part of the larger community of humans as isolation inceases stress and fearfulness.

So, how do people lower their stress level?  I have written a number of blogs about that. To lower our stress levels it seems to require that we let go of our judging and stereotyping others and begin to see that we are more alike than not and that we need each other in order to be happy and feel fulfilled in our lives.