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Anxiety

Hoarding: Compulsion or Addiction?

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):


Anxiety

Buried in Stuff: Understanding Compulsive Hoarding

WHAT IS COMPULSIVE HOARDING? Compulsive hoarding is a disorder that involves the accumulation of belongings to such an extent that the resulting clutter renders parts of the living space unusable. WHAT ARE THE SIGNS/SYMPTOMS OF COMPULSIVE HOARDING? The acquisition and failure to discard a large number of items/possession that are considered by most to be of little or no value These possessions clutter the living space, rendering the space unable to be used in the manner in which it was intended The hoarding behavior causes marked distress or interferes with one’s daily functioning NOT JUST MESSY Clutter is a symptom, not the problem. People who hoard form powerful attachments to objects.


Cognitive Behavioral Therapy

Effective Mental Healthcare for All: Improving Mental Health Disparities

With the growing diversity of the U.S. population, it is imperative that we, as mental health treatment providers, are culturally aware and competent in providing the best possible evidence-based healthcare. This post is Part 2 of 2 in which Dr. Chapman discusses healthcare’s responsibility to our changing community. Part 1 can be found at: What are Mental Health Disparities? I am pleased to welcome back Clinical Psychologist, Dr. L. Kevin Chapman, who serves as Associate Professor, and Director of the Center for Mental Health Disparities at the University of Louisville. Dr. Chapman is an expert in evidence-based psychotherapy practice and focuses his academic endeavors on efforts to eliminate mental health disparities.


Cognitive Behavioral Therapy

What are Mental Health Disparities?

With the growing diversity of the U.S. population, it is imperative that we, as mental health treatment providers, are culturally aware and competent in providing the best possible evidence-based healthcare. I am pleased to welcome Clinical Psychologist, Dr. L. Kevin Chapman, who serves as Associate Professor, and Director of the Center for Mental Health Disparities at the University of Louisville. Dr. Chapman is an expert in evidence-based psychotherapy practice and focuses his academic endeavors on efforts to eliminate mental health disparities. This post is Part 1 of 2 in which Dr. Chapman discusses healthcare's responsibility to our changing community.


Anxiety

Managing Stress in a Tough Economy

80% of Americans on the East Coast identify money as a significant source of stress in their lives, according to the 2011 American Psychological Association, Stress in America Survey. And, while the economy, housing market, and job markets remain significant concerns for many, personal finances remain the most common concern for Americans.To a large extent, our lives revolve around money; it determines our housing, our schools, our clothing, our meals, our self-care, anour entertainment. It is closely connected to our education, our employment, and, to some extent, our identity. It is no wonder so many Americans report financial concerns.Financial stress is often overlooked and dismissed as an insignificant, common experience; however, worries about money can have very significant effects on our lives, including our daily functioning, interpersonal relationships, physical health, and emotional well-being.


Cognitive Behavioral Therapy

Case Files: Sara and her Hair Pulling (Trichotillomania)

Sara pulls the woven, green hat from her head to show her nearly bald scalp, with only a few tufts of long, thin hair surrounding her crown. Sara has trichotillomania. She pulls her own hair out. This is not the first time I met with Sara. In fact, we’d been working together for months, but this is the first time she felt comfortable enough to show me what she’s done to herself.“This is where I pull from, Dr. Deibler,” she explains. I nod and say nothing, not because it’s unimportant, but because it’s important to react as if this discussion is like any other discussion, even though she has never before revealed her trichotillomania to anyone.It hadn’t always been this way for Sara. She began pulling her eyelashes and eyebrows at age 7. Now, at age 14, she’s pulled nearly all of the hair from her head and wears a cap so that no one can see. It’s not that she’s never sought help. She’d been to therapist after therapist, each one helping her cope with her parents’ divorce and family problems, but none of whom knew how to help Sara with her hair.


Emotional Health

Case Files: Max and his Strep-Induced Psychiatric Illness

I had never seen anyone quite like "Max."  The plunge from what appeared to be a normal 8 year-old boy to a scared, paranoid, fragile child who was grasping to hold on to reality was striking.  Max knew what many of his doctors had yet to discover, he had a raging strep infection. And, this infection, like many times in the past, would run rampant  in his body, largely undetected, causing him to experience a host of symptoms of serious mental illness. In 1998, Dr. Susan Swedo, a researcher at the National Institute of Mental Health (NIMH), first described in the scientific literature a subtype of OCD in which children demonstrated an abrupt onset of neuropsychiatric  symptoms (OCD, tics, ADHD-like symptoms, anxiety) preceded by streptococcal infection. This syndrome was termed PANDAS, Pediatric  Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.  In PANDAS, the body’s immune system is over-reactive to  strep bacteria, leading to psychiatric and neurological symptoms. The greatest challenge for Max was the professional community's debate over the very existence of PANDAS/PANS.


Emotional Health

When Infection Triggers OCD

In 1998, Dr. Susan Swedo, a researcher at NIMH, first described in the scientific literature a subtype of OCD in which children demonstrated an abrupt onset of neuropsychiatric symptoms (OCD, tics, ADHD-like symptoms, anxiety) with a “saw-toothed” course, preceded by streptococcal infection.  This syndrome was termed PANDAS, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.  In PANDAS, the body’s immune system is over-reactive to strep bacteria, leading to psychiatric and neurological symptoms.  Dr. Swedo continued to study this subgroup and investigated potential therapies, including intravenous immunoglobulin (IVIG), plasmapheresis, and antibiotic prophylaxis to prevent symptom exacerbations. PANDAS remained a little known and debated diagnosis. Dr. Swedo, and more recently, other researchers as well, have dedicated themselves to understanding this phenomenon.


Emotional Health

Sensationalism at its Best: Psychiatric Illness on TV

Let's face it; people are drawn to television programming that evokes emotion.  Whether it's a love story, action film, comedy, or a heart-wrenching drama, we are drawn to watching the emotional experiences of others. Sometimes, watching these illustrations of life serve as a means of fantasizing, sometimes escape and wonder, sometimes amusement; and always an experience of emotion in response to what we see.  We naturally attempt to relate or empathize with the characters on the screen.  So, how do we react when relating to the character is something we are not able to do? What if we cannot understand their emotional experiences, their thoughts, or their choices?