Monthly Archives: April 2021

Motor Abnormalities a Harbinger of Serious Mental Illness? – Medscape

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Motor problems in children may be a harbinger of serious mental illness, new research suggests.

Investigators found that motor abnormalities were twice as common among those who develop psychosis or depression compared to their counterparts in the general population, suggesting that these abnormalities may help predict vulnerability and provide an opportunity for early intervention.

“We have learned there are motor signs that are measurable in adolescence [that are] more prevalent in these disorders,” said lead investigator Katherine S. F. Damme, PhD, Adolescent Development and Preventive Treatment Program (ADAPT), Northwestern University, Chicago, IIllinois,

“This is just scratching the surface of motor signs, but they may have some transdiagnostic vulnerability across these psychopathologies” to which sensorimotor connectivity and motor behaviors “might provide additional insight,” Damme added.

The findings were presented at the virtual Congress of the Schizophrenia International Research Society (SIRS) 2021.

A Core Symptom

There has been a lot of interest in the pathophysiology of psychosis and in detecting it early, said Damme. “It has devastating effects, and early intervention is of great importance,” she added.

However, previous research has typically focused on effect or cognition, rather than on motor signs, despite the fact that motor signs are a “core symptom of both psychosis and depression.”

The prevalence and presentation of motor signs in adolescence, which is a “critical time for identifying these risk markers” because of their proximity to the onset of psychosis, has been understudied, Damme said.

For their study, the investigators gathered motor function data from the Adolescent Brain Cognitive Development Study (ABCD), which included 10,835 children aged 9 to 11 years with broad demographic diversity from 21 sites across the United States.

Overall, 27.6% of the children were reported to have at least one motor sign; approximately 3% were reported to have two or more motor signs.

The most common of these was dyscoordination, which was endorsed by 19.3% of participants. In addition, 8.8% were reported to have had experienced developmental motor delays, 1.5% had psychomotor agitation, and 0.3% had psychomotor retardation.

The investigators determined that 4.6% of participants met the criteria for depression, 2.6% for psychosis, and 1.8% for comorbid psychosis and depression.

Motor signs were much more common among children with depression, psychosis, or both than among those who did not have these conditions; 45.8% reported having at least one motor sign.

Developmental motor delays and dyscoordination occurred at about the same rate in both patients with depression and those with psychosis. Rates were higher among patients with both of these conditions than among those with either condition alone.

In contrast, psychomotor agitation was more common among patients with depression alone and among those with comorbid depression and psychosis than among patients with psychosis alone. The rate of psychomotor retardation was increased among patients with psychosis alone but was less common among patients with comorbidity than in the healthy control group.

Familial Vulnerability

The investigators also assessed participants who had not been diagnosed with a mental illness but who had a family history of depression only (28.9%), a relative with psychosis-like experiences (0.6%), or a family history of both depression and psychosis experiences (1.8%).

Although the effect size was smaller, there was a higher rate of motor signs among participants with a family history of these conditions, Damme said. “Again, we see that it’s elevated across developmental motor delays and at a similar rate in people who have depression and psychosis.”

In addition, psychomotor agitation was linked to depression with psychosis and depression without it.

Sensorimotor connectivity network data for the cohort indicated there was no main effect of diagnosis on corticostriatal connectivity.

However, more depressive symptoms were related to less connectivity (P = .024). There was a similar finding for psychotic-like experiences. The total number of such experiences related to lower connectivity (P < .001).

During the post-presentation discussion, Ian Kelleher, MD, PhD, honorary clinical lecturer in psychiatry at the Royal College of Surgeons, Ireland, Dublin, said he was “surprised” by the finding that the rate of psychomotor retardation was lower among participants with psychosis and depression.

Damme noted that some of the motor sign item ratings came by way of a child interview and that some of these item ratings came from the adults in the children’s lives.

She added that she was not entirely sure whether asking an 8- to 11-year-old in a clinical interview whether they are experiencing motor signs “might be the best way to get at motor slowing.”

Subtle Features

Commenting on the findings for Medscape Medical News, Peter F. Liddle, MD, PhD, professor of psychiatry, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom, noted that the “features we’re talking about are pretty subtle.

“What I’ve been wondering about for some time is whether we should be getting video recordings and using machine learning approaches to teach a computer to recognize normal movements vs abnormal movements and particularly facial expression,” said Liddle, who was not involved with the research.

He called the current study “interesting” but noted several factors that affect the potential utility of the findings in predicting outcomes.

First, they “may not be very good for distinguishing schizophrenia from mood disorders; but if the question is simply determining which young person might go on to develop a significant mental disorder, then it may be useful,” Liddle said.

He endorsed the investigators’ conclusion that motor abnormalities may be a transdiagnostic marker. Beyond that, they may be “more useful as a predictor of the likely long-term severity, but that’s my own hypothesis based on my work,” he added.

Another question concerns the sensitivity of motor abnormalities as a predictive marker. With the rate of the abnormalities identified in those who developed psychosis and depression about double the rate in the overall population, “it sounds like those assessors were fairly sensitive…but not all that specific,” said Liddle.

A third issue relates to treatment. “By the time people get sent to a psychiatrist for assessment for possible impending psychotic illness, they’ve often already had medication,” typically an antidepressant or antipsychotic.

“It’s very well established that dopamine-blocking antipsychotics produce hypokinesia and also dyskinesia,” which could then become a confounding factor, Liddle said.

The study was funded by grants from the National Institute of Mental Health. The study authors and Liddle have disclosed no relevant financial relationships.

Congress of the Schizophrenia International Research Society (SIRS) 2021: Abstract 3007091. Presented April 19, 2021.

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Adaptive vs. Maladaptive Perfectionism: Knowing the Difference

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Adaptive vs. Maladaptive Perfectionism

Recently I came across a few posts that highlighted how perfectionism can turn against the well-being of an individual. From being one of the habits that kill your motivation to being a predictor of depression among people, there is a lot that perfectionism is found to be linked with. Surprising, right?

Interestingly, not all perfectionists will be facing these issues! Wondering why? Well, there is a particular type of perfectionism that causes the problem. Yes, there are types of perfectionism that are adaptive and Maladaptive Perfectionism. The former is considered healthy and the later is the one that causes problems.

Let us understand the difference between the two and also identify our perfectionism style!

Adaptive vs. Maladaptive Perfectionism: The Meaning

Adaptive Perfectionism

It is the healthy form of perfectionism that supports an individual’s well-being. It is also referred to as Perfectionist Striving. People who practice adaptive perfectionism will strive and thrive to achieve the goals they have set but at the same time, they will understand if all things are not accomplished.

They appreciate and accept the fact that it is okay if not everything is achieved with the perfectionism that they have planned in their head.

Adaptive perfectionists will look for success in their life, complete their tasks, and have high standards. But instead of being stressed about the outcomes, they will be adaptive towards the final outputs.

One of my favorite features of practicing adaptive perfectionism is taking into account the strengths and limitations that allow an individual to set realistic goals. Plus, this strikes out the chances of overexerting oneself. So your mental peace and strength are stored.

According to Stoltz & Ashby 2007,

“Adaptive perfectionism is characterized as a normal, healthy type of perfectionism and is defined by deriving satisfaction from achievements made from the intense effort but tolerating the imperfections.”

Adaptive perfectionism

Maladaptive Perfectionism

It refers to the unhealthy form of perfectionism that ends up taking a toll on an individual’s well-being. Another name for this unhelpful form of perfectionism is Perfectionist Concerns.

Individuals who practice this form of perfectionism are found to set high standards for themselves and when fear of failure to reach ends up making them feel stressed.

When the failure is encountered (because of setting tasks beyond one’s strengths) it gives rise to self-doubts, which in turn brings various other issues along with it.

What becomes more concerning about maladaptive perfectionism is the fact that to avoid this loop of

Setting high standards—> Failure—> Self-doubts—>Other Issues

The individual starts to avoid the tasks another assuming they do not align with their strengths and interests.

But wait! What if a maladaptive perfectionist ends up achieving the high standards or the unachievable tasks they have set for themselves? They will end up telling themselves that they are not good enough or the outputs are not as good as desired, again stepping in the loop of self-doubt!

So basically no matter whether they achieve the high set benchmarks or not, they will let the fear of failure or dissatisfaction paint the picture for them. They will be overly critical of their efforts and achievements as they have a strong urge to be perfect in society which for them is defined in terms of being absolutely flawless.

According to Stoltz & Ashby 2007,

“Maladaptive perfectionists possess a need to control their environment and when events do not go as planned, they develop negative attitudes.”

Adaptive vs. Maladaptive Perfectionism: The Differences

Now that you have a clearer picture of what adaptive and maladaptive perfectionism looks like, let us analyze some differences between them.

Adaptive Perfectionism Maladaptive Perfectionism
Also known as Perfectionist Striving Also known as Perfectionist Concerns
Healthy practice; overall positive impact on an individual’s well-being Unhealthy practice; overall negative impact on an individual’s well-being
Strives and thrives for success Let the fear of failure control their ac
Sets achievable standards Sets unreasonable and unrealistically high standards
The central focus is to do things right The focus here is to avoid errors
Have a balanced thinking pattern Have all or nothing thinking style (it is either perfection or failure for them)
There is sync between their set standards and performance towards achieving it There exists a large gap between highly set standards and performance
Focuses on timely completion of the task Engaged in the habit of procrastination to avoid errors
Motivated to achieve positive feedback Motivated to avoid negative  consequences
Able to experience pleasure and satisfaction from their efforts Unable to experience pleasure and satisfaction from their efforts

Maladaptive Perfectionism: Why Is it the Problematic

Running after mirage is never helpful! Every time you think you are almost there, it will end up fading up as you step closer to it. The same is the case of maladaptive perfectionism. An individual can continue to run after it but just like a mirage, it will fade away because “absolutely flawless” is just a misconception.

This process of running after an unachievable sense of perfectionism and getting exhausted is found to be linked with various mental health conditions and other lifestyle problems. Several studies have been conducted in this direction and all of them have hinted at a negative correlation between maladaptive perfectionism and the overall well-being of a person. We are sharing some of the key findings with you.

Maladaptive Perfectionism

Are you Practicing Maladaptive Perfectionism?

To check whether you lie on the healthy or the unhealthy side of perfectionism we are sharing some signs of maladaptive perfectionism with you. If you can relate with four or more of these then you might be on the unhealthy side of perfectionism.

Note: These signs are not a measure of clinical testing.

  1. You are always looking for ways to please others.
  2. You are criticizing others’ behavior.
  3. When you are being criticized by others, you tend to get defensive.
  4. Your thinking pattern is either black or white (all or nothing).
  5. You procrastinate on important tasks.
  6. You feel guilty and ashamed of your failures.
  7. You close yourself off to others.
  8. You tend to take things personally.
  9. There is a constant need to control your emotions.
  10. You are very critical of your own efforts.

Brownie Content: TED Talk Guide To Practice Healthy Perfectionism

While doing my research on how to break the loop of maladaptive perfectionism and ways to practice perfectionism I came across this amazing TED Talk by Dr. Domar. The title of her TED Talk is “Is there any such thing as healthy perfectionism?

So which type of perfectionism are you following in your life, adaptive or maladaptive?

Share your response in the comments section below!

If you are a rooter for adaptive perfectionism then keep going you are on the right track to achieve great things in your life. However, if your pattern of perfectionism resembles maladaptive perfectionism you don’t have to worry. Just remember the three important mantras to break out of this loop:

  • You can always take steps to address your unhealthy perfectionism and your way out of it.
  • Start practicing self-compassion (it is identified as a great tool to combat maladaptive perfectionism).
  • It is okay to reach out for help. Connect with a mental health professional today because therapy is one of the most reliable ways to deal with maladaptive perfectionism.

Visit BetterHelp

You got this buddy!

Thank you for reading!

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Women don’t ‘feel heard’ during reproductive health appointments, study finds

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A new study found that 23% of women and people with gynae organs have felt ‘not listened to’ during medical appointments about their reproductive health. We explore why this is, and ask a GP for their advice on being heard

Many of us will understand the importance of taking our reproductive health seriously – and yet, research by the gyne cancer charity The Eve Appeal, has recently highlighted that nearly a quarter of women and people with gynae organs have felt ‘not listened to’ when seeking medical help from a healthcare professional.

Additionally, of the 72% of women who have had an appointment for their reproductive health, 23% felt they weren’t taken seriously and felt disappointed by how their healthcare concern was handled, and 20% felt like they were raising a ‘trivial issue’.

Coming just after endometriosis awareness month in March – sparking conversation about a condition which, on average, takes eight years to diagnose, despite affecting one in 10 women in the UK – as well as Channel 4’s The Black Maternity Scandal, which investigated the increase in the likelihood of death during pregnancy and after birth for Black women, the findings from The Eve Appeal study echo a similar sentiment.

“It’s always disappointing to hear that patients feel that they have not been heard by their doctor, or any health professional,” Dr Clara Russell, a GP with nearly 20 years of experience and founder of Noggin says as she reflects on the study. “Unfortunately, I’m not surprised that these are the findings.

“The reasons for this are complex. An issue for both patient and doctor is time – 10 minutes is often not enough to go through the wide range of symptoms that may be relating to reproductive health.

“Symptoms can be complex and masked as something else, such as pelvic pain that is disguised as abdominal in origin, or irregular periods and fatigue that may be linked to stress and mental health,” Dr Russell explains.

“From my experience of talking to patients about when they haven’t felt listened to, one of the recurrent concerns is that reproductive symptoms are attributed to a pre-existing condition instead of being initially investigated as something new. If patients have co-existing conditions and present with symptoms relating to reproductive health, these symptoms can sometimes all be tied together as one and this can leave patients feeling frustrated.

“Often, there are a lot of emotions attached to discussing these matters – fear, embarrassment, shame – and this can make it difficult for a patient to bring up and for a doctor to handle sensitively, especially in such a short space of time.”

doctor and patient

This sense of stigma that can come attached to issues of reproductive health is at the heart of The Eve Appeal’s Get Lippy campaign – which aims to break down taboos and shame around gynae health, to empower women to understand their bodies, and to get any worrying symptoms checked at the earliest opportunity. Partnering up with Tesco and lip care brand CARMEX, products sold during the campaign will donate 10% to The Eve Appeal’s work – continuing the conversation, and raising awareness of gynecological health and the importance of persevering with appointments.

“Women should never be made to feel like they aren’t being listened to when they raise issues relating to their body. It is vital we break down taboos that surround women’s health and address the problem of women feeling that their concerns are seen as trivial or unimportant,” says Nadine Dorries, Minister for Women’s Health. “It’s brilliant to see the Get Lippy campaign empowering people with tips for getting the most out of healthcare appointments and working with the health services to provide better gynae support.

“I am committed to creating a health and care system that works for all women by launching the first government-led Women’s Health Strategy. I urge all women to come forward and to share their experiences through our call for evidence, so we can put your voices at the center of your care.”

The campaign highlights the extent of this issue, and for those who are unsure how to approach appointments about reproductive health, Dr Russell has four tips for being heard:

1. Prepare

10 minutes goes quickly. Take a list of what you want to discuss and prioritise with your doctor what is the most important to get through.

2. Try to let go of embarrassment

Your doctor has seen and heard it all before, tell them if you are embarrassed and let them reassure you.

3. Keep a symptom diary

Pelvic pain, periods, erection worries, concerns about mood, and tiredness are often intermittent, so keeping some notes about when the symptoms have been an issue for you will help your doctor get a better idea of what might be useful to do next.

4. Reflect on your appointment

If you leave the room and feel you haven’t been listened to or you haven’t got what you needed, pause and reflect. What did you get from the appointment and what was missing? If you think you need more time, book another appointment, and don’t feel ‘bad’ about going back to cover your concerns again. If you really felt unhappy, try booking to see a different doctor in the practice.

Working through the stigma and taboo of reproductive health isn’t easy – it’s something many have lived with for a lifetime – but doing so is vital for the sake of our health. For more information and tips, and to learn more about the Get Lippy campaign, head to eveappeal.org.uk.

 

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Do I Have A Crippling Depression? How To Deal With It?

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Do I have crippling depression

Crippling depression is a form of clinical depression or a major depressive disorder that can make a person feel debilitating. This condition shows remarkably depressive episodes and the individual is not able to complete even the simplest tasks like working in the office, sleeping, eating or cooking.

This depression makes a person feel ‘crippling’ but that might not be the right way to address the condition as it feels hurtful or insulting to people facing physical disabilities. This is one of the biggest reasons that some of the experts prefer using severe depression or major depressive disorder.

However, it is to be noted that crippling depression is not an uncommon state, and approximately 7.1% of adults in the United States experience one major depressive disorder in their lives, as per the National Institute of Mental Health (NIMH).

What Is Crippling Depression & Its Symptoms?

Crippling depression is a severe form of depression that limits the basic functionality of a human being, including an inability to live a normal life. Some episodes extend from a few weeks to months and the person may show resistance to treatment. Life looks like a struggle and a number of sufferers explained that they feel like lying in bed all day rather than waking up and going through their life activities.

symptom of Depression

Now the question is if clinical depression is the same as major depressive disorder? Well, it is true that major depressive disorder and clinical depression share the same symptoms but the popular term ‘Clinical depression is an example of how symptoms are affecting their lifestyle in an easily explainable manner.

There is evidence that shows that crippling depression is significantly different from other types of depression according to the degree of severity. It is believed that the symptoms have crossed the threshold from a manageable condition to a disability.

Symptoms Of Crippling Depression 

Symptoms affecting physical health

  • Low energy in the body
  • Struggling to sleep or sleeping all the day
  • Restlessness
  • Weight fluctuations
  • Loss of appetite or overeating
  • Body pains
  • Digestive problems
  • Headaches

Symptoms affecting mood and thought process

If you have any of the above symptoms that are persistent and generating suicidal thoughts within, ask for support immediately. Call 1-800-273-8255 or 911 now or connect with suicide helpline numbers (India).

Cause For Severe Form Of Depression Or Crippling Depression

Those who are wondering why I have crippling depression, this section might help you! NIMH defined four categories that put a person at risk of the depressive state including:

  1. Genetic
  2. Biological
  3. Environmental
  4. Psychological

There has been an estimation that about 50% of cases of crippling depression are linked to genetic behavior. It can occur to those who have previously dealt with depression or have a family history of the same. If someone is facing serious medical disorders like cancer, chronic diabetes or have major life transitions then the risk accelerates.

Diagnosis Of Crippling Depression

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), if someone has the following symptoms for more than 2 weeks then the doctor may diagnose them with crippling depression. Although the physician will be asking you to go through physical exams and lab tests to rule out physical symptoms.

Other points considered:

  • Depressed mood
  • Loss of interest in activities that were loved earlier
  • Change in sleep patterns
  • Loss of memory and concentration
  • Appetite changes

Treatment Of Crippling Depression

There are a number of treatment options to help you overcome crippling depression and they are processed according to triggering events or genetic predisposition, as per every individual.

1. Psychotherapy

Psychotherapy for depression

Psychotherapy usually involves ‘talk therapy’ or where a person gets to talk with a mental health professional about their experiences in order to find solutions. Several therapy approaches include:

All the three methods above help in identifying the reasons for distorted thinking, patterns, behavior, and responses. Based on the talks, the therapist helps in finding goals and working towards them.

Psychotherapy is an effective treatment as the person becomes aware of the negative thoughts and unrealistic ideas and helps themselves in overcoming maladaptive behavior.

2. Medications

Antidepressants and other required medications are provided by the physician according to the condition of a person. However, it is most likely that you would be recommended medications along with psychotherapy.

3. Electroconvulsive Therapy

ECT is given only when the other therapies do not succeed as expected. The person will electrically stimulate the portion of the brain when you are under anesthesia.

Nowadays, ECT is a painless procedure and effective in providing relief from the long-term effects of crippling depression. Do not hesitate to discuss ECT with your doctor as treatment of crippling depression.

 Wrap-Up

We are hopeful that you are aware of what crippling depression is, what causes it and how it can be cured. It is advised to ask for help right now if you are dealing with crippling depression by emailing us at info@calmsage.com or learn about the 5 best depression support groups.

 

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How to deal with hayfever, and take care of your wellbeing

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Ecological medicine doctor Dr Jenny Goodman shares tips for coping with hayfever and explores why you might be suffering from hayfever now – even if you never have before

Hayfever is one of many modern epidemics, or what I call ‘21st-century plagues’ – it was rare or unknown before the Industrial Revolution. Its spread is to do with our environment, our nutrition, and the way we live. Like many other illnesses today, hayfever is potentially preventable.

The first description of it in the UK medical literature was in 1819, in a paper presented by Dr John Bostock (1772–1846) to the Medical and Chirugical (surgical) Society. In Japan, where the Industrial Revolution occurred about 100 years later than in Britain, hayfever also appeared about 100 years later. But in Japan people developed allergic reactions to the pollen of Japanese trees, in particular the cedar tree. In the UK, similarly, people become allergic to the pollen of their local grasses or trees, though different people get ill at different parts of the hayfever season, depending on when their particular ‘demon pollen’ is most plentiful in the air.

What’s happening here is that particles of air pollution, primarily from vehicle exhaust fumes, are somehow causing people to have violent allergic reactions to an essentially harmless biological material that has been part of our natural environment forever: plant pollen.

This is an example of the phenomenon that Dr Claudia Miller of the University of Texas has called ‘TILT’ – toxicant-induced loss of tolerance. In other words, inherently toxic substances (in this case car fumes) are causing the body to react to an inherently harmless substance (in this case pollen) as though it were dangerous. This phenomenon is a big contributor to the rise of allergies in general, not just hayfever.

So, what to do? While moving out of town to a less polluted area isn’t a practical or immediate solution for most of us, there are other things we can do.

1. Look at your gut health.

The lungs (and skin and immune system) are profoundly affected by the state of the gut, and the gut is often a good place to start with treating hay fever. Cut out sugar, cut out dairy products for the duration of the hayfever season, and generally follow the advice on ‘spring cleaning your gut not your house’ in the spring chapter of my book.

2. Supplements and herbal remedies

Quercetin is a very useful natural anti-histamine, a plant product. Vitamin C helps some people too, as does zinc. And of course, Vitamin D, if you have not been taking it throughout the winter. Many herbal remedies help with hayfever, and with allergic rhinitis in general (of which hayfever is just one particular example); chamomile, ginger, lime flower, and eyebright are but four.

3. Try local honey

Local honey makes a big difference to some sufferers, but it does have to be local, so the bees are feeding off the same plants whose pollen is affecting you.

4. Try to avoid air pollution

Staying-Alive-in-toxic-times

Avoidance of air pollution is the best solution, where possible, but it doesn’t work instantly. Remember, it is the exposure to pollutants that has over-sensitised you to pollen, and that over-sensitisation doesn’t vanish overnight. It may take two or three seasons away from traffic fumes (or mostly away from them) to make a difference.

Lastly, it’s important to understand that allergies such as hayfever may behave differently in different people, so resolving hay fever may require an individual approach too. It’s sometimes best to see an expert, such as a herbalist or a nutritional practitioner.

Dr Jenny Goodman is an ecological medicine doctor and author of ‘Staying Alive in Toxic Times: A Seasonal Guide To Life-long Health’ (Yellow Kite). Available in paperback from all good bookstores. Visit drjennygoodman.com

Connect with a nutritionist using nutritionist-resource.org.uk

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