Tag: depression

treatment resistant mental illness, depression, man, counseling

4 Things You Didn’t Know About Treatment Resistance in Mental Illness

Written by dev on September 15, 2021. Posted in Blog.

What is Treatment Resistance in Mental Illness?

As we work to break the stigma surrounding mental health, it is important to recognize a mental illness that is rarely talked about: chronic treatment resistance. Chronic treatment resistance in mental health is essentially when a patient does not respond to proper dosage and duration of prescribed medication at least two times. For example, if a client with depression is prescribed a common medication such as sertraline and sees no difference in symptoms for an extended amount of time, then tries another medication such as citalopram for another extended amount of time and still fails to see improvement, that patient may have chronic treatment resistance.

1. Treatment Resistant Depression Is Common

The National Center for Biotechnology Information (NCBI) reported that one third of depression patients experience treatment resistance. Millions of people suffer from depression every year and billions of dollars are spent by the United States on depression treatment and research. Those who do have treatment resistant depression are more likely to succumb to the mental illness as they are not able to respond to treatment. Therefore, that one third of patients have increased disability, cost, suffering and suicide rates.

2. You May Not Actually Have Chronic Treatment Resistance

Clinicians may not be able to diagnose a patient 100% accurately given every person’s unique genetic make-up and response to medication. According to NCBI, “Patients with TRD are not so much treatment-‘resistant,’ but rather, the heterogeneity of the condition ‘depression’ implies that patients are not receiving treatments that are matched to their individual diathesis.” In simpler terms, because depression is so unique to every person that struggles with it, it can be hard to pinpoint the exact medication, dosage and duration that will cure the patient’s symptoms. However, this does not mean that those with treatment resistant depression are falsely diagnosed, the above information is just a theory in scientific research studies.

3. There is a Scale Clinicians Use to Determine Treatment Resistance

The “scale” is essentially a threshold or percentage of severity or improvement in which a clinician determines if a patient has chronic treatment resistant mental illness. Since research of treatment resistance began, several models have emerged as a way to determine a patient’s treatment resistance. More recently, the trial and failure of two adequate medication routes is what determines a patient is treatment resistant.

How to Determine Treatment Resistance in Mental Illness

If a person is experiencing the same or higher percentage of depression symptoms after the trials, it is likely they have treatment-resistant depression. If a person experiences lower rates of symptoms with higher improvement levels, that person likely has found the right treatment plan for them and would not be categorized as treatment resistant, even after the second medication trial. NCBI states “In major depression and in generalized anxiety disorder, response is usually defined as a 50% decrease in symptom severity (but it has also been defined as a 25% decrease in patient selection for trials focusing on treatment resistant depression).” Other mental illnesses such as schizophrenia and OCD have lower symptom severity percentages.

4. There’s Plenty of Ways to Help Someone With Treatment Resistant Mental Illness

The most common and also simplest way to help manage symptoms in those with treatment resistant mental illness is therapy with a certified mental health professional. Counselors are trained to get to the root of the problem and make patients feel safe, heard and valued. For those that feel isolated or alone in their depression can find great benefit in having a constant (like a counselor) in their corner. Additional medications can also help those who have treatment resistant mental illness by addressing other, maybe milder symptoms; this is called augmentation. Augmentation usually does not include adding another antidepressant to a patient’s routine. Instead, it can be specific medications for bodily issues such as thyroid hormone levels which can affect a person’s mood. Other methods can be a bit more intense.

Electroconvulsive therapy, or shock therapy, can sound scary to some people based on previously established stigmas from pop culture. However, over half of electroconvulsive therapy patients benefited or saw immediate improvement using this method, according to the Consortium for Research in ECT.

What’s Next?

If you or someone you know is not responding to proper medication trials, or have been diagnosed already with treatment resistant mental illness, On Demand Counseling can help. Our licensed mental health professionals will work with you to feel happy and healthy again. With locations across Northeast Ohio, ODC is easily accessible and provides a multitude of programs and services for every individual’s needs.

3 Ways to Get Rid of Negative Self-Talk

Written by dev on March 25, 2021. Posted in Blog.

What is Self-talk?

Self-talk, also known as your internal dialogue, is influenced by your subconscious and can reveal your thoughts, beliefs, questions and ideas. When your self-talk is negative, it can affect your mental health entirely. Self-talk begins at a young age and can be influenced by our social environment. Friends, family and teachers can all influence the way you think abut yourself— both good and bad.

Become Self-Aware

Sometimes it’s hard to recognize when you’re talking down on yourself, but the first step to getting rid of any negative self-talk is to become aware of when you’re doing it. For example, you try on an article of clothing, look at yourself in the mirror and think “Wow, I look awful. I’m so fat that I can no longer look right in my clothing.” That’s negative self-talk. When you find yourself doing this, try saying something like, “I’ve gained a little weight. But that’s O.K., my body is always changing. I am healthy.” Rephrasing your negative thoughts has a huge impact on eliminating negative self-talk. You’ll feel uncomfortable when you first try rephrasing yourself, and that’s because you’re so accustomed to talking poorly to yourself and about yourself. Give it time, and eventually you’ll feel comfortable enough in your skin to rephrase and improve positive self-talk.

Journal in 3rd Person

Journaling is a practice that many counselors suggest to their clients to keep a clear head space and reflect on their moods. Journaling can also be a way to practice positive self-talk. Instead of journaling in a first-person point of view, you can try writing in third-person— meaning you will write from the perspective of an outsider. “Caroline had a bad day today. But, she had the right to. She’s allowed to have bad days when things upset her.” Weird, right? That’s O.K.! Just like we discussed previously, you’re going to feel uncomfortable doing all of these things. If you feel too strange writing about yourself, try starting out with shorter sentences or bullet points rather than full pages.

Identify

The Mayo Clinic identifies four common types of negative self-talk: filtering, personalizing, catastrophizing and polarizing. Let’s break it down.

Filtering: magnifying the negative aspects of a situation and filtering out all of the positive ones

Example: You paint a picture for your friend, who loves it and raves about how good of an artist you are. You then realize a small detail you missed and can’t stop thinking about how awful it looks, rather than accepting the compliments.

Personalizing: automatically blaming yourself when something bad happens

Example: Your friends cancel their weekend plans with you because they’re busy, but you take it upon yourself to assume they don’t want to spend time with you.

Catastrophizing: Automatically anticipating the worst

Example: You’re on your way to work and you slip and fall causing you to rip a hole in the knee of your pants. This is the worst! Your whole day is now ruined!

Polarizing: Only seeing things as good or bad

Example: There’s only two things you can be: perfect or a failure.

All four of these types are damaging to your mental health, and cause extra stress on your every day life.

If you or someone you know is struggling with mental health, give us a call at 330-270-8610 or visit us at ondemandcounseling.com.

What is SAD? And 3 Effective Ways to Combat It

Written by dev on December 14, 2020. Posted in Blog.

Depression can affect anyone and everyone, regardless of race, ethnicity, social and economic status or gender. But a form of depression that is not talked about enough is seasonal affective disorder, otherwise known as SAD.

What is SAD?

SAD is a form of depression where people are affected negatively by shorter, darker days due to seasonal changes. For example, summer days in Ohio are longer and warmer, while winter days end with the sun setting around 5 p.m. and the weather turning colder.

Who does SAD affect?

SAD can affect nearly anyone, but especially those who live in parts of the world where seasonal changes are more extreme. According to HelpGuide, women and younger people are affected the most out of any other group of people.

What are the symptoms of SAD?

Fatigue and mild depression are very common in people experiencing SAD. Other symptoms can include:

Sleeping too little or too much
Change in appetite
Weight gain
Feeling hopeless or guilty
Depression
Stress and irritability
Decreased interest in usual activities

How does SAD affect me?

SAD can affect your body due to many factors, with circadian rhythm being one of them. So, what is a circadian rhythm? A circadian rhythm is your body’s internal clock. Once established, your body will know when it’s time for bed versus time to wake up, and it will know when it’s time to eat. For instance, if you are someone who wakes up at 8 a.m. every day, eats lunch at noon and goes to sleep by 10 p.m., your body will get into the habit of adjusting to those patterns. Because of the established routine, extreme changes in weather or daylight will interrupt your body’s circadian rhythm and throw your body out of sorts thus causing changes in temperament and other bodily functions.

Other causes of SAD can include the production of melatonin and serotonin. Melatonin is the hormone that triggers sleep and serotonin is a neurotransmitter that regulates your mood. When the balance of melatonin or serotonin is off, your body can begin to feel drowsy or lacking energy. Reduced sunlight causes lower levels of serotonin making it more likely to become depressed and lose interest in normal activities while an increase in melatonin will cause you to become sleepier.

How can I avoid SAD?

It’s not easy to avoid SAD as it is your body’s go-to state when it is thrown off by seasonal changes. It’s also difficult for a doctor to diagnose patients with SAD, which is why it is important to ensure you are taking care of yourself year-round to help ease the symptoms of SAD. Read the below tips to help lessen the symptoms of SAD and improve self-care.

Get some exercise

Exercising has many benefits on your body and mind. If you have any built-up stress or tension, exercising can help release negative thoughts or feelings. If you do not have exercise equipment or belong to a gym, try taking a walk outside. The fresh air and natural light from the sun can also help to improve your mood, regardless of temperature.

Read a book

If you haven’t picked up reading, now is the time! SAD can make you feel disconnected from the world, and diving into a good book can help make you feel a part of something and pique your interest again. You may feel motivated by a storyline or connect with the characters in the book.

Journal

At times when it feels like no one is listening, journaling can be beneficial. Journaling helps you put your feelings together and write down whatever is bothering you. There are many forms of journaling such as guided journaling, bullet journaling, etc. Guided journals can be bought online through companies like Amazon and bullet journaling is as easy as writing short sentences of fragments in a notebook.

Pick up a hobby

Colder weather can affect your usual outdoor activities or daily routine, so picking up a new hobby can help ease your boredom or anxiety levels. There are plenty of fun and engaging hobbies to dive into while staying indoors. If you’re crafty, try knitting or scrap-booking. If you’re not-so crafty, try learning a new language or cooking.

How can On Demand Counseling benefit me?

On Demand Counseling offers mental health services in Mahoning, Columbiana and Trumbull counties. Counseling can be beneficial when you are wondering how to avoid SAD. Counseling and mental health services can help in the prevention and treatment of mental illnesses. Call us today at 330-270-8610 or visit our website for more information.