Depression

     Clinical depression is one of the most common, serious mental health disorders. In the United States, about one in five people will experience, at some time in their life, a persistent, disabling depression with intense emotions of anxiety, hopelessness, negativity, self-absorption and helplessness that does not let go easily, even when circumstances and relationships improve. It does not respond to simple reassurance or a change of attitude.
     Depressive illness can vary from just interfering with usual activities and relationships to being very debilitating. Severe depression can make it hard or even impossible for sufferers to relate to and communicate with others, or to manage simple day to day tasks.
     There are a number of causes of depression. It can be due to a chemical imbalance in the brain (endogenous depression); it can be part of an illness such as bipolar disorder; or a reaction to an event such as the death of a spouse or loss of a job (reactive depression).
     Often people do not seek help for their depression. They may feel embarrassed, or see it as a sign of weakness or be fearful of stigma. Getting help is important and there is substantial evidence to show that most people who seek help will recover fully, especially if they take action early.

Types of Depression

• Major depression is a depressed mood that lasts for at least two weeks.​
• Psychotic depression is a depressed mood that involves seeing or hearing things that are not there (hallucinations), feeling everyone is against you (paranoia) and having delusions.
• Dysthymia is a less severe depressed mood that lasts for several years.
• Bipolar disorder (or manic depressive illness) involves periods of feeling low (depressed) and high (manic).
• Mixed depression and anxiety is a combination of symptoms of depression and anxiety.

Treatment

​     Treatment can do much to reduce or eliminate the symptoms of depression, and usually includes a combination of the following:

• Learning new coping strategies;
• Lifestyle changes such as increasing exercise and physical fitness;
• Not using alcohol and other drugs;
• Taking medication; and Individual therapy (psychological therapy), support and sometimes electroconvulsive therapy (ECT)

Bipolar Depression

     Bipolar Disorder involves the individual alternating between episodes of depression and mania. During depressive episodes symptoms can be severe with intense feelings of low mood, worthlessness and guilt. During manic episodes the individual may feel overactive, intensely high or elated. This elevated mood is out of proportion to the circumstances the individual currently finds themselves in.
     Manic and depressive episodes may vary in length and severity from days, to weeks to months. Manic episodes may end abruptly with the onset of depression, and people may even experience periods of stability between mood swings.
     Bipolar disorder is considered to have a strong biological cause, though causes are not fully understood. Genetic predisposition to develop the illness has been established. However, like all mental health problems, psychological and social stresses contribute to the development of this condition. Stress, physical illness or emotional crises can trigger mood swings in people who are vulnerable.
     Bipolar disorder occurs in approximately 2% of the population. It is typically diagnosed when people are in their early to late twenties, and affects men and women equally. Most will experience an episode that will probably require hospital care.
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Symptoms

• Intense feelings of low mood, worthlessness or hopelessness and despair;
• Poor concentration;
• Lack of energy; and
• Loss of interest in things previously enjoyed.

Treatment

     Treatment can do much to reduce and even eliminate symptoms of bipolar disorder. Medication is generally considered an essential component to treatment. However, a combination of medication, psychological intervention, sometimes electroconvulsive therapy (ECT) and community support programs usually result in the best outcomes. Treatment can be provided in a variety of settings including both inpatient and outpatient facilities.

ADHD in Children

We offer Transcultural therapy. This therapy makes sure that we use other forms of therapy from all around the world before we prescribe medication.

Anxiety Disorder

     Anxiety is a normal part of life. However, for many people anxiety becomes a real problem because it occurs too frequently, is out of proportion to the circumstances, or interferes with their work, family and social life. A person with an anxiety disorder may experience intense, persistent worries or fears about everyday situations.

     Anxiety disorder affects 18.1 percent of adults in the United States (approximately 40 million adults between the ages of 18 to 54) – (NIMH)

     Anxiety is a complex process and is not just about feeling nervous, worried or stressed. Anxiety is fundamentally a response to danger and often referred to as the fight or flight response. Anxiety can hold you back from doing things you want or need to do, and affect your physical health. It can be hard to break this cycle, but you can learn to feel less fearful and to cope with your fear so it doesn't stop you enjoying life.
Treatment helps the patient become aware of unhelpful thinking; enable you to separate yourself from the anxiety by using logical analysis and self-questioning strategies; and to be active and get on track to living a valued life.

We don't know exactly what causes anxiety disorders, other than a combination of factors like family history of mental health problems, stressful life events, long-term physical illness and personality traits.

Elements

1. Physical symptoms that occur are the result of stress hormones and other body chemicals that cause racing heartbeat, dry mouth, rapid breathing, dizziness, nausea and light headedness.
2. Behavioral part of anxiety is where you may avoid certain situations that make you fearful, even though they are not necessarily dangerous. These can be public speaking, social engagements, crowded shopping centers, air travel and eventually even going to work or leaving the house.
3. Psychological part is that we don't feel anxious unless we think there is a danger. This is when anxiety becomes a problem when our thinking about a situation is not realistic, because we overestimate the danger we face. People with excessive anxiety also have a tendency to underestimate their ability to cope with adversity, which compounds the problem.

Treatment

     There are two main types of treatment: psychological therapy and medication. Cognitive Behavior Therapy is the most commonly used treatment in mental health disorders and is very effective for anxiety and depression. Treatment is available in the form of group therapy day program, or individual therapy as an outpatient.

Schizophrenia

​     Schizophrenia is commonly diagnosed in late teens and early twenties and the causes are not fully understood. They are likely to be a combination of hereditary and other factors. It is probable that some people are born with a predisposition to develop this illness, and that stress or use of certain drugs, such as marijuana or amphetamines, can be a trigger.
     Schizophrenia is an illness that affects the normal functioning of the brain. It interferes with a person's ability to think, feel and act. During onset, the person often withdraws from others, becomes depressed or anxious and develops unusual ideas or extreme fears. Early detection is vital to the person's well being.

Symptoms

• Confused thinking: Thoughts become confused and jumbled. It can be hard to think clearly enough to talk logically. It can be difficult for a person to concentrate during a conversation or to remember what is being said. Thinking can be much faster than usual or slowed down.
• Hallucinations: People experiencing a psychotic illness may see, hear, feel, smell, or taste something that is not actually there. They might hear voices no one else can hear, see things that aren't there or feel something moving on their skin. They might feel cut off from the world around them, or that everything is unreal.

• Delusions: Some people experiencing a psychotic illness may hold false beliefs known as delusions, i.e. that someone is trying to hurt them or control their thinking. A person may be convinced their delusion is real even if those around them challenge it, and they find evidence supporting the fact that their delusion seems illogical to others.​
• Changed feelings: How a person feels may change for no apparent reason. Some people may experience moods that swing from one extreme to another very quickly. For example, swinging between being very happy and feeling very heavily depressed. Some people's feelings may seem dampened or flat and they may show less emotion than other people.
• Changed behavior: People experiencing a psychotic illness may behave in ways that they did not behave before they became unwell. For example, they may become angry seemingly without cause, be very active, have no energy, have trouble sleeping or eating, have trouble socializing, or be fearful. These behaviors relate to their hallucinations, delusions and disordered thinking.

Treatment

     Treatment can do much to reduce and even eliminate the symptoms. Anti-psychotic medication helps correct the chemical imbalance in the brain while lifestyle changes such as reducing alcohol and other drugs helps to improve physical health as well. Individual counseling; family support and counseling; and involvement in a recovery program that focuses on reducing social isolation and building personal relationships are essential.

Drug & Alcohol Dependence

​     The word addiction is often used to refer to any behavior that is out of control in some way. People often describe themselves as being addicted to a television show or to clothes shopping. The word is also used to explain the experience of withdrawal when a substance or behavior is stopped (e.g. “I must be addicted to coffee: I get a headache when I don't have my cup in the morning”).
     However, experiencing enjoyment or withdrawal doesn't necessarily imply addiction. Because the term “addiction” is commonly used in such a vague way, there have been many attempts to define it more clearly
A simple way of describing addiction is the presence of the four Cs:

• Craving
• Loss of Control of amount or frequency of use
• Compulsion to use
• Use despite Consequences.

     Consider a person who finds alcohol so pleasurable that he regularly goes to the bar after work (Craving). His drinking escalates to overcome tolerance, and he experiences withdrawal when he abstains. He tries and repeatedly fails to cut down (loss of Control). He begins to reorganize his life in order to maximize drinking opportunities, neglecting his work and family (Compulsion). Eventually his spouse leaves and he loses his job (Consequences).
     Addictive behaviors  can  be hard to change. One thing that makes change so difficult is that the immediate effects of addictive substances tend to be positive. People may feel good, have more confidence and forget about problems. In contrast, the problems from use might not be obvious for some time.

Why do People Keep Using? (Abuse)

     People may come to rely on the effects of addictive substances to bring short-term relief from difficult or painful feelings. The effects of addictive substances can make problems seem less important, or make it seem easier to talk and to be with others. People may come to believe that they cannot function or make it through the day without addictive substances. When people use addictive substances to escape or change the way they feel, using can become a habit, which can be hard to break.
     Continued addictive substances use, especially heavy use, can cause changes in the body and brain. If people develop physical dependence and then stop using, they may experience distressing symptoms of withdrawal. Changes to the brain may be lasting. These changes may be why people continue to crave addictive substances and slip back into substance use long after they have stopped using. When people who are addicted stop their substance use, they often compare the experience to leaving an important relationship.

Treatment

​     It is recommended that a qualified health professional assesses individuals displaying addictive behaviors. An assessment offers the opportunity to diagnose, treat and develop a treatment plan in collaboration with the person. Once an individual receives the correct treatment they begin their road to recovery. When patients receive a diagnosis they often feel relief in knowing they are not alone and are provided with an explanation to their behaviors. Treatment beyond the medical detoxification stage includes assessment for any concurrent mental health problems, appropriate medications which may, for example, help diminish alcohol craving, and introduction to self-help groups to maintain recovery. An important part of treatment is planning an individualized post hospitalization support program, to facilitate ongoing recovery.

POST TRAUMATIC STRESS DISORDER (PTSD)

     PTSD is a psychological condition that develops following an extremely stressful event or series of events that cause intense fear. Those with PTSD are much more likely than others to have major depression, problems with substance abuse, or panic disorder sometime in their lives.
     In PTSD, factors associated with the original event elicit the same stressful feelings later on, so the affected person often tries to avoid these ‘triggers'.
     Feelings of stress in response to a trauma are normal; PTSD is characterized by the intensity of the feelings, how long they last, how one behaves in response to these feelings, and the presence of particular symptoms.

Combat Related PTSD

     Military veterans are more likely than most to experience a number of traumatic incidents in their lives. The additional stress of military service and multiple deployments can also affect how some members of the military react to potentially traumatic events.

Treatment

     Most people who experience trauma will experience some kind of psychological reaction – this is part of a normal human reaction to an overwhelming experience. PTSD can affect people of any age, culture or gender.
     Psychological treatments focus on a number of key areas:

• Relaxation training and anger management training
• Exposure therapy
• Mood control training
• Skills training for managing addictions
• Communication and relationship skills training

     Treatment includes inpatient, or day patient programs. Family groups are very helpful in assisting partners and children to understand what is happening to their partner/parent.

Symptoms

Re-experiencing Symptoms
These involve reliving the traumatic event in some way:

• Intrusive and vivid memories of the trauma;
• Flashback in which we may feel as though the trauma is happening all over again;
• Nightmares about the trauma; and
• Trigger responses – aspects of our environment remind us of the trauma.

Avoidance of ‘triggers'
People with PTSD often avoid things in their environment which may trigger distressing memories of the trauma. They may include particular places, people, situation, topics of discussion etc.

They also try to avoid having these thoughts or feelings about the trauma and use drugs, alcohol, work, gambling or self-harm to block them out.
‘Physical tension'

People with PTSD usually feel very tense, wired, on edge, ‘ready for action' and experience:

• Disturbed sleep;
• Problems with memory and concentration;
• Are easily startled;
• Have anxiety and panic attacks; and
• Feel irritable and on edge.

Other problems commonly experienced include guilt, sadness, depression, mood swings, anger control problems, addictions and impulse control problems.

POSTPARTUM DEPRESSION​

     Many new mothers experience what is commonly referred to as the 'baby blues' a few days after giving birth. These feelings of anxiety and lack of confidence can be very distressing but in most cases last only a week or two. Postpartum depression develops anytime in the first 12 months after birth. It can develop gradually or suddenly, leaving the new mother feeling completely overwhelmed, inadequate and unable to cope. They may have problems sleeping, panic attacks or an intense fear of dying.
     Postpartum depression can develop if the mother has a history of depression and/or anxiety or a family history of mental health problems. Or it may be due to a prolonged labor and/or delivery complications; or problems with the baby's health and care.

Treatment

     As with depression and anxiety disorders, Cognitive Behavior Therapy (CBT) is very effective. This treatment helps by changing negative thoughts and feelings; encourages involvement in activities; and with increased awareness helps to prevent depression from becoming serious again.
     Only a few women will need inpatient treatment in which case admission should be to a mother and baby unit.

​It affects 10 to 20 percent of new mothers.

Our Other Programs Include

References

1. ADHD in Children
2. Adjustment Reactions
3. Alzheimer's
4. Anxiety
5. Bipolar Disorder
6. Dementia
7. Depression
8. Life Transitions and Adjustments
9. Psychotic Symptoms
10. Mood Disorders
11. Schizophrenia
12. Substance Use & Abuse
13. Trauma & PTSD
14. Women's Mental Health Issues
15. Minority and Immigrant Mental Health
16. Works with Multi-Cultural Populations

NIMH » Mental Health Information