Tag Archives: Treatment

PTSD Veteran

PTSD and Veterans

Veterans risk their physical safety, and that is only the beginning. Many veterans exposed to combat suffer with behavioral health issues as a result of their service. The suffering can be intense. Posttraumatic Stress Disorder (PTSD) may impact as many as 20% of Iraqi war veterans. While it may not seem possible, there is help. PTSD is one of the most intense and debilitating issues one can have, but there is very effective treatment that works very quickly and the results last.
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male eating disorder

Male Eating Disorders

Dangers of Beauty

Beautiful people everywhere…what new club or exotic resort destination can boast this tag line? Your kitchen before the second sip of coffee. Whether we are skimming a magazine, surfing the web, or flipping channels, images of thin women and muscular men without much body fat, are likely to bombard our psyches. While the majority of Americans have increased their waist sizes, the aesthetic ideals promoted by swimsuit and organic health shake ads alike are leaner than ever before.

Men and Eating Disorders

Body image issues surrounding our weight or body shape are very common. And there are huge industries bolstered by our obsession with becoming or staying thin, “fighting” aging and becoming more muscular. For decades women in the United States have increasingly suffered with eating disorder symptoms. Younger and younger females are presenting with severe symptoms, and many men and boys are also receiving diagnoses and treatment for eating disorders. Without question, women have suffered in greater numbers from eating disorders than men. Yet it has been important in recent years for treatment providers to begin to recognize the growing need for awareness of the increasing number of men suffering from these issues. In addition to more men developing eating disorders, there are other hurdles for men regarding eating disorders.

Anorexia Nervosa and Men

Many clinicians are not socialized in their training to assess for eating disorder symptoms in men. Even more striking are gender based diagnosis problems like amenorrhea, being listed as a symptom of Anorexia Nervosa. Clearly men are not ever going to lose their menstrual cycles. Not only does this complicate a diagnosis- it skews the way clinicians see potential sufferers. And as we can imagine it shapes how men who suffer may see their own problems- as something not masculine.

Male Shame

Shame and embarrassment accompany many mental health issues, and eating disorders are no exception. But, these distressing emotions may be even more frequent and intense for men suffering from an eating disorder. While the norms have been changing, eating disorders are still not something that many men people admire have admitted to having. Without any cultural models of someone we respect admitting they suffered and recovered, it makes it more difficult for men to come to terms with the problem and get help.

Combined Obstacles to Treatment

So we have a man who is likely confused, ashamed, and embarrassed with his suffering. Men are already at baseline less likely to share feelings or ask for help from a mental health professional, and that makes diagnosis less likely. Even if an accurate diagnosis and the motivation exist, men often still struggle to find treatment providers. There are obvious reasons, but the majority of eating disorder specialists have had much more experience treating women. Likewise many outpatient groups and even residential eating disorder treatment centers are not equipped to treat men.

Causes of Increase in Male Eating Disorder Diagnoses

It is unclear how much of the increase in male eating disorders is about improvements in clinician diagnosis, increased willingness of men to share symptoms, or changes in the culture that have increased the actual prevalence of symptoms. Hopefully professionals will become more attuned to looking for signs and asking men important questions that reduce embarrassment and shame, and eventually build the trust necessary to express the suffering that is a hallmark of eating disorders. While it is unclear what is causative, there does seem to be a correlation between how men have been depicted in magazines and the increase in eating disorders. Men pictured with their shirts off in magazines increased 11 times from the 1950s to the 1990s. It isn’t clear whether these images are causative or reflective, but it is clear that men’s behaviors have certainly changed over time and that has resulted in changes in their physiques and the numbers diagnosed with eating disorders.

Eating Disorder Research

My hope is that Eating Disorder research will continue to get the funding it needs, and that includes evaluating public policy and educational programs. Changes requiring models to be above a Body Mass Index (BMI) in some European countries are an interesting proposal. If these and other policy changes could be implemented long-term and if evaluations of their impact are significant, it could be a feasible method for preventing the development of the number of eating disorders we are seeing now.

Effective Eating Disorder Treatment

Unfortunately, in terms of treatment, Anorexia Nervosa is still very difficult to treat. But it is critical that anyone experiencing symptoms seek treatment. The Maudsley Family Based treatment approach has some of the best results. Although the clinical and research communities have a long way to go, people with an Anorexia Nervosa diagnosis are well advised to engage a professional for treatment. On a more optimistic note, the scientific literature demonstrates that Bulimia Nervosa and Binge Eating Disorder (BED) are very responsive to treatment. Cognitive Behavior Therapy (CBT) has been effective at treating both of these eating disorders. So if anyone believes she/he may be experiencing distress around eating behaviors and body image issues, I strongly encourage them to contact a qualified psychologist, mental health counselor, social worker, or medical professional with experience using empirically supported treatments for eating disorders.

Despite the obstacles for anyone, male or female, suffering with an eating disorder, there are good reasons for optimism. Aside from the good efficacy rates for Bulimia Nervosa and Binge Eating Disorder, more and more clinicians are being sensitized to the problem. This has been reflected in a few residential treatment centers designing programs that are appropriate for men, and societal attention to the impact our overvaluation of beauty may be having on body image and eating behaviors. There are also a number of research labs investigating integrating different treatment modalities in hopes of finding a more effective treatment for Anorexia Nervosa. Dissemination of cognitive behavioral therapies (CBT) and behavioral therapies to greater numbers of clinicians, who in the past may have hesitated from treating patients, or who may have been using techniques that are not helpful. So greater numbers of sufferers should have access to properly trained therapists. The first step is opening up to the possibility that the suffering may be treatable- and then asking for help.

Chris Brown Violence

Chris Brown Anger Management Incident

Anger Management Interview

Chris Brown was interviewed about his new album, F.A.M.E. (Forgiving All My Enemies) on Good Morning America yesterday.

Forgiveness is a difficult concept for individuals, clinicians, and even scientists (although some of the physiological studies on forgiveness are fascinating). Reports indicate that there was a significant anger outburst following a line of questions by Robin Roberts about the domestic violence case involving Rihanna from a few years ago.

Unlike a mood disorder like major depression, where sufferers often experience episodes that may pass (although they may reoccur later), anger disorders can be chronic if left untreated. Anger is an emotion that can be incredibly adaptive given the right set of conditions. I often reference Mothers Against Drunk Driving (M.A.D.D.) as an example of a prosocial use of anger to help produce considerable positive changes in society. And it is clear that anger can provide the energy and action tendencies that helped our ancestors survive when they were defending themselves against a competitor. And many times, anger will go away on its own when it isn’t avoided or left unchecked. But, for those of us who really struggle- anger experiences, grudges, rumination, etc. can go on for decades.

In today’s modern society anger is still incredibly common, which is what makes it particularly difficult to understand. If we all experience it, unlike major depression, how can it be that it is abnormal? And that is just it, anger isn’t abnormal. But, for those of us who aren’t able to fully experience and tolerate it without engaging in self-destructive (or aggressive) acts to dissipate it, it can be associated with all kinds of detrimental outcomes including violence, heart attacks, drug abuse, GI problems, bad relationships, etc.

Fortunately, similar to major depression, there is scientific evidence that anger problems can be successfully treated. There are four techniques that have support, and I believe a few more methods will likely demonstrate effectiveness soon.

1)Relaxation Training
2)Cognitive Restructuring (questions remain about mechanisms)
3)Problem Solving
4)Communication Skills

These have all shown significant treatment success. So, there is reason to believe any of us, or our loved ones can find some help, if anger has become a problem. Unfortunately, many methods still used by clinicians may even make things worse, so it is always important to ask a therapist what techniques they are using and what scientific evidence supports that approach.

Above is a quick video link to an interview The Daily conducted yesterday about the specific incident, but it isn’t intended to reference too many specifics, because those are largely unknown. Rather it is intended to address general issues regarding anger management, and how celebrities may have to deal with things a little differently (This was an interesting line of questions by the journalist that hasn’t been asked before). But, it is clear that in this day and age, celebrities often focus our attention on serious societal issues. Anger management from a cognitive behavioral therapist can be scheduled by contacting a specialist at New York Behavioral Health.

Road Rage Parking

Dr. Ryan Fuller on Good Morning America- Road Rage Erupts Without Anger Management Skills

Road Rage Erupts Without Anger Management Skills

Road rage erupts without anger management skills.  John Berman of ABC News interviewed clinical psychologist, Dr. J. Ryan Fuller, about how anger and aggression can arise while driving and parking, and how the nervous system and evolutionary psychology may explain particular risk factors for road rage and other forms of violence.

New York City resident, Mr. Oscar Fuller, faces seven years in prison after punching a woman over a parking space. Typically violence related to automobiles is known as road rage and stems from driving behaviors.

This recent tragedy erupted after a woman was standing in a parking space and saving it for her boyfriend. This resulted in Oscar Fuller punching her and she is now in a coma.

Watch Good Morning America Video Here

Yoga: Mental Health Benefits

Yoga- Health Benefits Says Science

Has yoga gone mainstream in America? Well, it’s certainly not for just celebrities anymore. More and more people in this country are discovering the health benefits of a regular yoga practice. A list rattled off by Sat Bir Singh Khalsa of Harvard Medical School and the Division of Sleep Medicine at Brigham and Women’s Hospital in Boston of problems with which yoga has been found (by research) to help seems endless (anxiety, depression, weight loss/management, sleep, back and neck pain, digestion, blood pressure, etc.). Sounds somewhat like a cure-all, doesn’t it? Experts in the art, however, are very careful not to make claims like that, but research has shown that yoga can boost the immune system, reduce stress, and help you handle all sorts of stress and pain more effectively, even those associated with cancer, improving quality of life. That benefit alone (stress relief) would seem to make yoga a positive goal on everyone’s list.

The US National Institutes of Health tells us that the proper practice of yoga features a combination of posture, breathing, body awareness, relaxation, and meditation. And it’s important for novices to find a good instructor who puts the right balance of emphasis on these three: posture, breathing, and meditation. Want a healthier body? Add yoga to your life.