Drchristinavillarreal's Blog

Research studies have shown that children raised by a depressed parent are at increased risk for academic and behavioral problems, as well as developing major depression themselves. These risks emanate from both a child’s genetic predisposition for developing depression, as well as their stressful environmental upbringing, says Michelle Sherman, PhD, a clinical associate professor of psychology at the University of Oklahoma Health Sciences Center in Oklahoma City and the author of I’m Not Alone: A Teen’s Guide to Living with a Parent Who Has a Mental Illness. “Children often assume blame or responsibility for their parents when things go wrong, like in depression or divorce” adds Sherman.

Parents suffering from untreated major depression are typically pessimistic and uninterested in life and social activities; they also frequently have low energy, and irritability- all of which make even the basic tasks of parenthood overwhelming. When mothers are depressed, they tend to be less organized, less responsive, more likely to express negative emotions, and less likely to be engaged with their children compared to non-depressed mothers, says Kate Fogarty, assistant professor of youth development at the University of Florida. For many children, this experience forces them to learn to care for themselves prematurely, and may place them inappropriately in the role of parental caretaker. Other children are less capable, and develop dysfunctional patterns of behavior and emotional disturbance as a result of ongoing parental neglect.

A study of 244 formerly depressed adolescents revealed that those whose mothers had a history of major depression were more likely to experience a recurrence of depression between the ages of 19 and 24, and had more frequent and severe depressive episodes. Depressed mothers had more of an impact on the adolescents’ mental health than depressed fathers, according to this 2005 study by researchers at the Oregon Research Institute in Eugene, Ore., although the sons of depressed fathers were found to be more likely to consider and attempt suicide. The effects of having a father with depression has not been studied to the extent of depressed mothers, says Fogarty, but she suspects that the effect would be similar for any primary caretaker. “If this was the father and he was depressed, I would suspect there would be similar results. Researchers look at maternal depression mainly because mothers are traditionally the primary caretaker, but that’s changing” she adds.

How to support children with a depressed parent, and decrease their mental health risks.
“Depressed parents and their families should know that there is much one can do to reduce a child’s risk for becoming depressed. Just one adult who’s available and willing to help support the child can make a big difference in a child’s life when a parent is depressed,” says Sherman. Additional emotional support can come from relatives in the family, a child psychologist, school teachers, church members, or other role models in community groups. Spouses of depressed parents also need support, since parental duties often fall disproportionately upon them much of the time. Couples and family therapy are also great resources that teach healthy communication, as well as how to build coping resources and resiliency in all family members.

Grandparents can also be a great resource in mitigating the negative effects of parental depression upon a child. “Frequent contact between a child and his or her grandparents, especially if the relationship is warm and nurturing, lessens the likelihood the child will develop depression later in life” according to Fogarty. “It is important for children to have a strong adult who is consistent in his or her life” adds Fogarty.

Adults hoping to help should provide a structured environment whenever possible, most importantly, one that encourages a child to express their emotions. “That can be as simple as maintaining a dialogue with the children, keeping the lines of communication open. It can also be showing sensitivity to the child’s needs,” says Fogarty. Children with a depressed parent need adults who can detect their emotional state, since they often struggle to notice their own feelings and mood. As children, they’ve learned to focus on the emotional states of others, as a way to anticipate the shifting moods of their depressed parent. “If a child comes home after a bad day and is visibly upset, a depressed caregiver might not be available to help them through that process,” says Fogarty.

Is there hope for children raised by a depressed parent?

Some of these children show incredible resiliency, in spite of the challenges they’ve faced being raised by a depressed parent. These tend to be children with higher than average intelligence, who learn early on how to utilize an array of outside resources for guidance and support. They are often capable of socially complex problem solving, appearing ‘wise beyond their years.’ Further, they are usually comfortable with stressful situations, making them well suited to careers that require them to anticipate and read others’ emotions. They tend to be independent and self-sufficient, and are often ‘the workhorse’ and conflict facilitator in groups. As adults, they are usually sensitive and understanding of others with mental health issues. While children raised by a depressed parent remain vulnerable to depression themselves due to the aforementioned reasons, this experience does not mean they are doomed to repeating the life of their depressed parent. With sufficient support and early intervention, children raised by a depressed parent can go on to lead normal, healthy lives.

Many of us anticipate weight gain during the holidays because of the rich and varied foods associated with holiday celebrations. The American Council on Exercise (ACE) estimates that the average citizen consumes 4,500 calories and gains 3-7 pounds on Thanksgiving alone. Some of us will gain more than others, and some of us will struggle more to lose the added weight come January 1, 2011. Besides lamenting over this seemingly unfair fact, what can we learn about our genetic propensity for weight gain?

Healthy weight management is frequently a core goal amongst the patients I treat in my private practice in the Bay Area, CA. Most people aiming to improve their mental health recognize that a key component of emotional well-being is maintaining healthy diet and exercise habits. In my clinical experience, there is a good deal of variance in people’s willingness and ability to accomplish their healthy eating and exercise goals.

Family, twin, and adoption studies examining the genetic influence of weight gain suggest that at least 70% of our weight is genetically determined, and perhaps as heritable as our height. Some experts in the field believe weight is more heritable than other conditions, including heart disease, breast cancer, hypertension, or even mental illness. Claude Bouchard & colleagues conducted experiments on a metabolic unit in which different sets of identical twins were exposed to the same number of calories and same amount of exercise. The twin pairs each gained approximately the same amount of weight, however there were marked differences in weight gain amongst the different pairs of twins, despite exposure to the same amount of calories and exercise. Bouchard emphasizes that genetic variation “has much to do with the risk of becoming obese,” though clearly, there are environmental factors that play an important role in weight management.

It’s fairly common knowledge that our genes determine our body shape (take this quiz to determine if you are apple, pear, hourglass, petite or slim/athletic) and body type (take this quiz to determine if you are an endomorph, ectomorph or mesomorph), and our skill and motivation to exercise (it’s not uncommon for people to inherit their physical agility and coordination skills.) Researchers studying the Human Obesity Gene Map found that there are over 300 separate trait areas (loci) that may be involved in weight control.

So what does this mean for you this holiday season?

While our genes have an influence upon our weight and body type/shape, ultimately, our weight remains highly influenced by environmental factors, such as the diet and exercise regimen we choose. This holiday season, understand your genetic predisposition for weight gain, and make your choices accordingly.

Warden and Fisler suggest that the differences found in individual’s genetic profile could lead to greater flexibility in national recommendations such as the food pyramid for changes in lifestyle involving diet and exercise created to prevent obesity.

Researchers of the Substance Abuse and Mental Health Services Administration report that in 2009, Nearly 1 in 5 adult Americans, (45 million, or 20 percent) experienced some form of mental illness. The study defined mental illness as “a diagnosable mental, behavioral, or emotional disorder in the past year, regardless of their level of functional impairment.” This annual survey is the largest of its kind undertaken by the US government. This article examines the relationship between vitamin D deficiency and mental illness amongst Americans.

Which age group and gender is most affected by mental illness?

The 18-25 age group was reported as having the most mental illness, and more women than men were afflicted, stated Peter Delany, a doctor who heads behavioral research at the Substance Abuse and Mental Health Services Administration. He adds “about one in 20 individuals, or around 4.8 percent of the population, met the criteria for having a serious mental illness” which was defined by the study as ‘serious functional impairment, which substantially interferes with or limits one or more major life activities.’

In my own clinical practice in the Bay Area, CA, I am treating more and more individuals from this age group, as well as those in their 30′s- many of whom are struggling with work related stress, relationship conflicts with their peers and families, understanding their sexuality and romantic relationships, and determining which career paths best suit their abilities and interests.

As a clinical psychologist, one of my first tasks in providing optimal mental health care to new patients is determining if they are in good physical health. Obtaining a primary care doctor and getting annual physical exams is an essential first step in figuring if any physical issues could be affecting your emotional health and well-being.

Is some mental illness related to a vitamin D deficiency?

One study led by Ganji V. and colleagues and reported in the Nov 2010 issue of International Archives of Medicine showed people with current depression were more likely to be vitamin D deficient than those who had higher levels of vitamin D. The study was based on data from the Third National Health and Nutrition Examination Survey. Dr. John Cannell, an vitamin D expert and director of Vitamin D Council suggests that some forms of mental illness can be linked with reduced sun exposure, low 25-hydroxyvitamin D or 25(OH)D levels. Vitamin D research showed that this supplement may help improve some mental illnesses and encourage healthy immune functioning. In addition, emerging research shows a possible role for vitamin D in the prevention or treatment of type 1 diabetes, Alzheimer’s disease, heart disease, reducing inflammation, some cancers, and autoimmune diseases including multiple sclerosis.

How can I find out if I am vitamin D deficient?

Click here to read more on how Dr. John Cannell suggests you find out if you are Vitamin D deficient.

What dose is optimal for my physical & mental health?

Physican/Nutrition specialist Dr. Melina Jampolis in San Francisco, CA states “The current tolerable upper limit of vitamin D intake is 50 mcg (2,000 IU) per day. Taking too much vitamin D can cause nausea, vomiting, decreased appetite, constipation, weakness, and can raise blood levels of calcium, which can lead to irregular heart rhythms.” Click here to read more about Vitamin D uses, side effects, drug interactions and warnings.

Who is most at risk for being vitamin D deficient?

Groups at risk of vitamin D deficiency include breastfed infants, adults age 50 and older, people with limited sun exposure, people with milk allergy or lactose intolerance, people with fat malabsorption, people with dark skin, and people who are obese. (Because it is fat soluble, larger pools of body fat may act as a reservoir for vitamin D.)

Sources: Webmd.com, CNN Diet & Fitness, Substance Abuse and Mental Health Services Administration

Very few studies have examined the long term health consequences for people who divorce.
According to Dr. Gerald F. Jacobson, director of the Didi Hirsch Community Mental Health Center in Culver City, Calif., author of ‘The Multiple Crises of Marital Separation and Divorce “there has been a ‘disproportionate emphasis on the impact of divorce on children, and not enough attention to how divorce affects the former spouses.” Celebrities like Hollywood actress Eva Longoria and NBA player Tony Parker, who have recently made international news by filing for divorce after 7 years together, are not immune to the long term health consequences of divorce, as seen below. Erin Barry, San Antonio Spurs former player Brent Barry‘s wife has also recently filed for divorce, and has admitted to sexting with Tony Parker for months, perhaps leading to the demise of both marriages.

Both Dr. Gerald F. Jacobson and Dr. James J. Lynch, a psychologist at the University of Maryland, author of ”The Broken Heart: The Medical Consequences of Loneliness”, suggest that people’s reaction to divorce is similar to experiencing the death of a spouse. Feelings of anger, guilt and depression often become overwhelming. However unlike in bereavement, the former spouse continues on with their life, making it difficult to gain closure following a divorce.

Scientific research has long established the biological connection between emotional stress, and the development of physical illness. Untreated stress can lead to abnormal immunological functioning in those who have divorced, making them more vulnerable to all kinds of illnesses, including cancer. A study examining the health effects of divorce reveal that after a diagnosis of cancer, married people are most likely to recover, while the divorced are least likely to recover, indicating that the emotional trauma of divorce has a long-term impact on the physical health of the body.

Dr. Robert Segraves, a psychiatrist and marriage and divorce counselor at the University of Chicago Medical Center, points out that divorced people not only have higher suicide rates, but also higher rates of admission to psychiatric hospitals and outpatient clinics, more visits to non-psychiatric physicians than people who were married, single or widowed. Dr. Segraves points out ”There’s a lot of evidence that divorce is an overwhelming stress for most people, even if they are getting divorced for the right reasons. There’s tremendous internal and external reorganization required after a divorce. And the effects are not just short-term. We see a lot of people years later who are having trouble reconnecting with the opposite sex. Men, for instance, often have problems with impotence four or five years later because they’re scared to death to be reconnected.”

In a study of 79 men and 159 women who were separated or divorced and who went to a psychiatric crisis clinic, Dr. Jacobson found that time did not necessarily heal the wounds of divorce. While depression peaks immediately after the initial separation and then subsides, Dr. Jacobson found that those who are separated 14 months or more, whether or not they have filed for divorce, ”do not tend to improve further and may even worsen.” He also found that while women were most disturbed just before separation, ”men tend to be more depressed, anxious and suicidal after separation.”

Should you remain ‘friends with your ex” when no children are involved, such as in the marriage of Eva Longoria & Tony Parker?

While many mental health professionals purport that divorced spouses can continue to be valuable resources for one another, Dr. Jacobson found that ”more often than not, continued reliance may not be associated with better levels of mental health, particularly in women.” Results from this study suggest that ”disturbance will be less when there is a moderate amount of contact between the spouses and when emotional reliance is acknowledged when it exists.”

In spite of the negative impact divorce can have upon one’s health, divorce can also be an opportunity for positive growth. By learning and growing from the divorce experience, you will be better equipped to develop a healthy romantic relationship in the future. For more advice on how to move on and manage stress following a divorce, visit this article featured on Dr. Phil.com

For many, the first signs of holiday stress emerge around Halloween when signs of the holiday season become evident in retail stores. Seeing what’s in store for the coming months can evoke a sense of urgency in us, with many people feeling like there isn’t time to fit in everything. Unrealistic expectations of ourselves or others, coupled with the pressure this can place upon relationships can culminate in elevated levels of mental and physical stress. Can we survive the holiday season, and actually enjoy it? Learn to recognize and manage triggers of holiday stress.

Recognize common triggers of holiday stress

Strained relationships. The holiday season is typically a time when extended family members spend more time together. Leaving normal routines, hectic travel, and decreased personal space can all lead to conflict with the family members we ironically, want to enjoy. Even close-knit families who rarely experience conflict can begin to show signs of ‘too much togetherness’ when individuals are experiencing holiday related stress. Further, when family members come together, it’s common for people to fall back into ‘family roles’ that can re-open old wounds or conflicts. Even spouses/partners and children can get caught in the cross-fire of family turmoil, bringing on feelings of guilt and resentment.

Isolation & loneliness. Sometimes it’s the lack of family that can feel lead us to feel lonely during the holiday season. When the whole world seems to be getting together with loved ones, those of us who are closer to friends than family can feel isolated and abandoned when friends leave town for the holidays.

Overindulgence. An influx of holiday parties and gift exchanges can lead many people to eat, drink, and spend in ways that prove to be self-destructive. Overindulgence can have dire and long lasting consequences (debt, weight gain, unsafe behaviors, memories of embarrassing & unsavory behavior) that can linger long after the season is over.

Physical demands. Many of us feel overwhelmed with the demands of holiday traditions- shopping, sending cards, entertaining, visiting relatives and volunteering activities. Our regular antidotes to stress such as restful sleep and exercise are dropped as we struggle to keep up with an overflowing schedule. High levels of physical distress also leaves us susceptible to seasonal viruses, which can render our holiday plans futile.

How to minimize holiday stress and enjoy the season

Be creative. The holidays do NOT have to remain rigidly the same, year after year. By opening yourself up to change and letting go of traditions that have become too difficult or expensive, you afford yourself an opportunity to shape your holiday experience to reflect your current lifestyle and personality.

Be true to your feelings. If you’ve experienced a loss this year, or you can’t be with loved ones, it’s normal to feel sadness and grief. Don’t try to force yourself to be happy just because it’s the holiday season. Take time out to reflect and take care of yourself in a way that feels authentic, rather than ‘putting on a happy face.’

Connect with others meaningfully. If you feel lonely or isolated, seek out community, religious or other social events that can lend support and companionship. Volunteering your time to help others who are in need is a great way to lift your spirits and broaden your friendships.

Make peace with differences. Work on accepting family and friends as they are, even when they don’t live up to your expectations. Take a break from airing your grievances/grudges, even if it’s only for a brief period of time, so you can reacquaint yourself with family members without the stress of fighting.

Anticipate your limits. Think back to previous years and estimate how much together time you and your family can take before things begin to sour. It’s perfectly acceptable to set limits with others, including forgoing family gatherings if you suspect things will turn out disastrously. Perhaps it’s safer to visit individuals on a one on one basis.

Attempt to stick to a budget. Before you go shopping, decide how much money you can realistically afford to spend. Then stick to your budget. Keep reminding yourself that spending money will NOT not buy you or anyone else long lasting happiness.

Learn to say NO. Saying yes when you you’d prefer to say no will cause you to feel resentful and exhausted. Sometimes saying no can lead to conflict, but remind yourself that by saying no, you are giving yourself and others an opportunity to accept realistic expectations.

Try not to completely abandon healthy, safe habits. The holiday season does NOT have to be a free-for-all of decadence and risk taking behaviors. Holiday food and alcohol can certainly be enjoyable, but remember there can be too much of a good thing, since overindulging always comes with consequences.

Seek professional help when necessary. If you find yourself feeling chronically sad or anxious, overwhelmed with physical problems, unable to sleep, irritable and unable to enjoy things you used to, it’s likely time to seek help from your doctor or a mental health professional.

The holiday season should be a time of enjoyment, however you choose to celebrate them. By taking steps to prevent stress, you are lending yourself a renewed chance to make this year better than ever before.

For most American college students, the influx of new social opportunities, academic demands, pulling all nighters, and the ubiquitous college party scene can lead to high levels of stress. But students with bipolar disorder or other mental health problems, and students with a family history of mental health disorders, are especially vulnerable in a college environment.

The pressure of academic performance, social demands, and irregular sleep patterns are all triggers of depression as well as mania, the euphoric, revved-up state characteristic of bipolar disorder. In fact, college is one of the most common places people experience their first bout of depression or mania. According to Russell Federman, Ph.D, the director of Counseling and Psychological Services at the University of Virginia student health center, the desire to fit in and conform to the college lifestyle can cause students with mental health problems to abandon healthy behaviors, even their medications. Without the right treatment and support, bipolar college students face higher dropout rates, drug and alcohol abuse, and even suicide.

A 2006 study in the Journal of Affective Disorders compared a group of bipolar adults with a group of healthy adults who had similar IQs and social backgrounds. More than 60 percent of both groups entered college, but their achievements differed greatly: Nearly half of the control group received a college degree, compared to just 16 percent of the bipolar group.

Students with bipolar disorder or other mental health problems can succeed in college, but doing so requires dedication to a plan. The following points are ALL crucial and can make the difference between achieving your college success goals and dropping out or worse, losing control of your mental health.

* Taking the proper medications, and ensuring they are easily accessible for refills
* arranging for the appropriate counseling and medical care on campus in addition to outside support
* avoiding drugs and alcohol and even caffeine, as they can render medications ineffective
* maintaining a steady sleep and study schedule
* finding sources of peer support

In his 2010 book, “Facing Bipolar: The Young Adult’s Guide to Dealing With Bipolar Disorder”, Federman outlines what he calls the “four S’s of bipolar stability”: structure, stress management, sleep management, and self-monitoring. This framework includes sticking to a regular schedule of studying and sleep, and learning to recognize the signs that you are beginning to drift into mania or hypomania.

An organization called Active Minds is trying to open the dialogue about mental illness on college campuses. Founded by Alison Malmon in 2001, following the suicide of her older brother, the organization now has more than 200 chapters nationwide. Active Minds organizes events such as National Day Without Stigma and has partnered with the Depression and Bipolar Support Alliance to create peer support groups on college campuses.

This author, Dr. Christina Villarreal is a clinical psychologist in private practice in Oakland, CA.

Bipolar disorder, also known as manic-depressive illness, has become a commonly used term by the public, with many of us becoming familiar with it as a result of celebrities such as Bobby Brown, Ben Stiller, Britney Spears, and Jim Carey exhibiting symptoms or identifying themselves as having been diagnosed with this disorder. But what exactly IS Bipolar disorder, and how can you tell the difference between someone who meets the criteria for the disorder from someone who is just ‘moody’ or chooses to live an extreme lifestyle?

Bipolar is a brain disorder, or chemical imbalance that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. The symptoms of bipolar disorder are severe, and the criteria for receiving a diagnosis are quite specific. They are different from the normal ups and downs that everyone goes through from time to time, as well as more extreme mood shifts you might observe in others.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies Bipolar Disorder by the occurrence of one or more manic or mixed episode (also known as agitated depression) often accompanied by depressive episodes. So even if you’re depressed 99 percent of the time, experiencing just one manic episode qualifies you for a diagnosis of bipolar disorder according to this definition – but that still leaves most of us confused about who fits the criteria for a diagnosis, aside from the fact that the DSM-IV also differentiates between Bipolar I, Bipolar II, Hypomania, and Cyclothymia (all diagnoses that can be referred to as ‘manic depressive’.)

This article aims to explain the differences amongst these disorders in the simplest terms. Bipolar disorder is an illness that impacts a person’s thoughts, feelings, perceptions (both mental and physical), and behavior. It’s likely caused by electrical and chemical elements in the brain that are not functioning properly, with research suggesting that people are genetically vulnerable to inheriting the disease when their families have a history of its occurrence.

Typically, a person with manic-depression experiences moods that shift from high to low and back again, with varying degrees of severity. To receive a diagnosis of bipolar, these symptoms CANNOT be a direct result of alcohol or drug use. The symptoms are severe enough to lead to impairment in work, social, or academic functioning, and may lead to involuntary hospitalization to prevent harm to self or others. Note: to receive a diagnosis of a manic or depressive episode, a specific type, duration and number of symptoms MUST be present; refer to a mental or medical health professional or the DSM-IV for more details on this.)

A depressive episode can be identified by:

Mood Changes:

A long period of feeling sad, hopeless, worried, guilty or tearful
Loss of interest in activities once enjoyed, including sex.

Behavioral Changes:

Feeling tired, or ‘slowed down’
Having problems concentrating, remembering, and making decisions
Being restless or irritable
Changing eating, sleeping, or other habits
Thinking of death or suicide, or attempting suicide

May include psychotic or catatonic features as well.

A manic episode can be identified by:

Feeling like you can do anything, even something unsafe or illegal

extreme displays of emotion- including jubilant or euphoric expressions, rage, paranoia, agitation
Decreased need for sleep, yet never feeling tired

Inflated self esteem or grandiosity

highly talkative, or pressured speech

distractability, or being too easily drawn to unimportant or irrelevant stimuli
Dressing flamboyantly, spending money extravagantly, living recklessly
Having increased sexual desires, or indulging in risky sexual behaviors
Thoughts of suicide or other morbid/destructive behaviors

May include psychotic, or catatonic features

Bipolar I is defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, the person also has depressive episodes (typically lasting at least two weeks) but depression is NOT necessary for receiving a Bipolar I diagnosis, however the symptoms of mania or depression must be a major change from the person’s normal behavior.

Bipolar Disorder II is differentiated from Bipolar 1 in that it involves symptoms of hypomania (less extreme symptoms and for shorter duration compared to full-blown mania), as well as the presence of a depressive episode. This diagnosis is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.

Cyclothymia is a “bipolar-like” illness. People with cyclothymic disorder have milder symptoms than in full-blown bipolar disorder.

Bipolar disorder, if left untreated, can wreak havoc on the personal lives of people with the disorder. Unstable moods frequently disrupt or even destroy personal and work relationships. People may have difficulty finding a life partner, instead moving through a series of passionate, short-lived romances. Impulsive behavior can be self-destructive and lead to serious legal problems. At it’s worst, bipolar disorder can be lethal, leading to suicide or death of others. People with bipolar are also more likely to abuse drugs and alcohol. As many as 50% of people with bipolar may also have a problem with substance abuse, in an attempt to alleviate or enhance their symptoms. But bipolar disorder can be treated, and people with this illness can lead full and productive lives with the appropriate medical and emotional support. If you or someone you know is suspected of experiencing symptoms associated with Bipolar disorder, seek the help of a medical and/or mental health professional as soon as possible.

Sources: DSM-IV, webmd.com