Several new diagnoses will appear in the soon to-be-released Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V).  In fact, quite a bit of controversy surrounds the inclusion of several of these new “disorders” in what is considered to be the mental health world’s diagnostic “bible,” as many question their validity and appropriateness for inclusion.

Among the new DSM-V disorders is Excoriation (Skin Picking) Disorder, classified within the Obsessive Compulsive and Related Disorders.  It is understandable that the initial public reaction to this release of information has been skeptical (at best). News outlets have begun to question the validity of the diagnosis. Readers have begun to leave comments such as, “Great, now we’re all mentally ill.”

Yes, everyone picks at his or her skin at some point; however, Excoriation Disorder far exceeds “normal” grooming behavior. Think of grooming behavior as occurring on a continuum, with normal, washing and exfoliating on one end of the continuum, extending to picking, scraping, or gouging that results in scarring or disfigurement on the other end.

There’s no greater skill to easing anxiety and physical tension, than learning to relax.  It sounds silly, perhaps, to think of relaxing as a skill, but think about how many times you’ve said or heard someone else say, “relax,” “calm down,” “settle down,” or “chill out.”  And, if you’re on the receiving end of that comment, it’s not as easy as it seems.

Improving the Diagnosis of Bipolar Disorder in Children

Approximately 1.5% of the population, worldwide, bipolar disorder is not uncommon. However, bipolar disorder in children presents differently than it does in adults, an important difference which is not addressed in our current diagnostic manual (DSM-IV-TR). As a result, it is frequently misdiagnosed.

Let’s look at the facts:

Approximately 6 million individuals experience panic disorder each year. Panic disorder is characterized by recurrent, intense periods of anxiety/panic, which are often unprovoked, or, “out-of-the blue,” and are accompanied by anticipatory anxiety regarding the possibility of future attacks. Panic disorder can be quite debilitating, sometimes accompanied by agoraphobia, or avoidance of pubic places due to fear of being in a setting or situation from which escape or finding help may be difficult.

Before we get to what DOES NOT work, let’s discuss what DOES work. Evidence for effective treatment of panic disorder is very well documented. The data show with great robust that cognitive behavioral therapy (CBT) is effective and is superior to a number of other treatment strategies.

Cognitive behavioral therapy for panic disorder often includes:

One of the most difficult parenting moments we may experience is seeing our child in distress and feeling powerless in our ability to help him or her feel better. There will be a time in the life of every parent in which his or her child is struggling and the path to understanding and overcoming this struggle is unclear.

In order to help a child overcome distress, it is first important to identify the problem. Anxiety disorders are among the most common psychological difficulties in children and adolescents, affecting approximately 13% of youth in the United States.

Anxiety disorders in childhood are the greatest predictors of anxiety, mood, and substance abuse difficulties in adulthood; thus, it is important to identify and treat anxiety difficulties as early as is feasible.

Early identification and intervention is associated with positive long-term outcome.

A Parent’s Guide to Anxiety Disorders

Anxiety is a healthy, normal, and adaptive response to stress. It is our body’s way of alerting us to danger. It can be motivating and helpful to us in meeting our goals. However, in excess, it can cause us to feel overwhelmed and leave us unable to carry out our daily activities.

There are a number of anxiety disorders common to children of which parents should be aware:

I am very excited to welcome Dr. Donna Marino to Therapy That Works as a guest blogger. I find her area of expertise, Positive Psychology, to be an exciting, evidence-based approach to wellness, as I’m sure you will as well.

Dr. Marino:

While Positive Psychology is not exactly new (it’s been around for almost 15 years now, started by Martin Seligman, in 1998, during his APA presidency), it is still considered new to the field of psychology.  It is a new perspective on mental health that research is demonstrating, can lead to “a new you.”

Now, will you wake up singing like Beyoncé or swimming like Michael Phelps?  Well, no, but research shows that it will make you happier.  In fact, Positive Psychology has been referred to as the “Science of Happiness.”  The key difference between Positive Psychology and Self-help or Pop Psychology is its grounding in research. It is considered an evidence-based treatment.

So, what is Positive Psychology?

Below, is a nice summary regarding this exciting avenue of treatment by principal investigator and Trichotillomania Learning Center (TLC)  Scientific Advisory Board member, Dr. Jon Grant:

N-Acetyl Cysteine (NAC), a dietary supplement and amino acid that affects glutamate levels in the brain, has been studied in the treatment of a number of conditions across medicine and psychiatry. In recent years, NAC has been thought to have the potential to improve symptoms of Trichotillomania (hair pulling).  As no medication or other substance to date has shown effectiveness in the treatment of  TTM, this finding is one of promise and one that warrants consideration and further investigation.

Words cannot express the sorrow of a nation that grieves the loss of innocent youth and those who gave their lives to protect them.  Emotions run deep; from confusion and sadness to anxiety and anger. In the wake of such trauma, it is our natural response to traumatic events, to try to make sense of what we experienced.  We search for meaning. Why would such a horrific event happen? What can we do to ensure the safety of our loved ones?

And, yet, we are likely to never understand why on December 14, 2012, a 20 year-old, heavily armed man opened fire in Sandy Hook Elementary School, killing twenty children between the ages of 6 and 8 and six staff members, before turning a gun on himself.

The compulsion to hoard belongings has been likened to addiction; yet there are some important differences between the two. In a previous post,  some of those differences were discussed.  Most importantly, however, are the differences in treatment approach. I am frequently asked by loved ones, “Can’t I just go in and clean the house?” It can be difficult to understand why this is not in the best interest of the individual struggling with hoarding difficulties.  Herein lies the reason:

The topic of compulsive hoarding has garnered much attention in recent years in the mainstream media.  Compulsive hoarding has been likened to addiction in some discussions of the problem, yet they are very different constructs.  Let’s take a look at the what we know about the similarities and differences in order to answer the burning question of why can’t someone clean a hoarder’s home for him/her. For brevity’s sake, let’s look at the two behaviors in simplistic terms (although they are both quite complex):