Mark Myers Expert Answer(selective Mutism)

Mark Myers Expert Answer to: I have a son who had selective mutism from 6-8 years. He is now 16 and has been diagnosed with OCD. He also appears to be suffering from severe depression. Are these linked? Selective Mutism, as you may well know, is predominately found in children. However, some adults do experience it as well. This disorder is characterized by a person persistently failing to speak in select settings, which continues for more than 1 month. These individuals do talk to other people, usually family members. The diagnosis of Selective Mutism, does fall under the anxiety disorder spectrum. This spectrum would also include OCD. In fact, it is not unusual for OCD, or other types of anxiety disorders to coexist with Selective Mutism. It also does put a person at greater risk to develop other anxiety disorders later in life. view full answer

Mark Myers Expert Answer to: Why do I hate myself and how do I stop?

 Why do I hate myself and how do I stop?Why you hate yourself is not important as to what to do about it. Often times, individuals find themselves in a bad spot. How they got could be influenced by genetics, life events, childhood upbringing, and/or current relationships(family, friends,work). Rather then focusing on the why's, invest your energies into changing thoughts and behaviors that are allowing you to struggle   click here for more

Mark Myers Expert Answer to:I'm extremely depressed and angry about being unemployed for some time. How do I go on without having a mental breakdown?

In today's economy, I am sure you are not alone. There are many people who share your plight. The fear you face is understandable. Individuals could experience the following feelings: worry, unproductive, boredom, self defeated, and pessimistic, to name a few emotions. It is important that you take steps to try to take control over areas of your life that you can. Click for more

Genetic Link to Internet Addiction Identified!

Internet addiction is not a figment of the imagination, according to a study published in the Journal of Addiction Medicine. Interestingly, the study also found that the link occurs more frequently in women. Read more: http://www.digitaljournal.com/article/332082#ixzz278nRQWi9

Mark Myers expert answer to: I keep punishing myself, always doing the opposite of what I should. How can I quit doing this?

Mark Myers expert answer to: Depression: I keep punishing myself, always doing the opposite of what I should. How can I quit doing this? There is a self defeating cycle you have gotten yourself into. When you do not accomplish tasks that you like to, you beat yourself up. The more you beat yourself up the less confident you more

Antidepressants For Older Adults? Be Careful!

A study published in The British Medical Journal this month raises questions about the risks of antidepressant medications for adults 65 and older who have been diagnosed with depression. The major conclusion of the article -- that care should be taken in prescribing and in selecting which antidepressant medication to prescribe for older adults -- is unquestionably correct and is nothing new. However, the specific findings of this study -- that taking antidepressants was associated with increased death rates and other adverse consequences, and that the new antidepressants (SSRIs ) may have greater serious risks than those associated with previous generations of antidepressants -- are provocative, important and uncertain.

The study's two major findings are frightening on their face.

Compared with older primary care patients who had diagnoses of depression in their records but who did not take antidepressants, those who did take antidepressants had higher rates of death, attempted suicide, falls, fractures, upper gastro-intestinal bleeding and heart attacks.

Those who took SSRIs (which are the most commonly prescribed antidepressants) had higher rates of death, stroke, falls, fractures and seizures than those who took tricyclics or other earlier forms of antidepressant.

Because of possible implications for current standards of practice, the importance of this research and of doing prospective future research to resolve questions that this study leaves unanswered cannot be overstated.

In recent years, much research has indicated that older adults who are depressed -- especially those who also have a chronic physical condition -- and who are not treated for depression are at increased risk for disability and premature mortality. Specifically, previous studies have linked depression to greater functional decline, increased risk of falls and greater cardiovascular mortality among older persons who are not taking antidepressants. As a result, there has been a push to screen for depression and to treat it, using both psychotherapy and antidepressants. This study seems to call this standard approach to depression into question.

In addition, it is known that SSRIs have fewer side effects (e.g., dry mouth, constipation and cardiovascular complications) than earlier forms of antidepressants. Are they also safer? The findings of this study suggest that they may not be. Should preferences regarding antidepressants for older adults therefore change?

Carol Coupland and her colleagues, the authors of this new study, are modest in their conclusions and recommendations, saying only, "The potential risks and benefits of different antidepressants ... need careful consideration when these drugs are prescribed for older adults."

Why not issue an alarm about the use of antidepressants, and particularly about the use of SSRIs, by older adults? First, this study examines patient records in ways that identify associations of facts but do not reveal causation. The standard way to establish causation would involve random selection of depressed patients prescribed antidepressants. In the BMJ study, the decision was not made randomly, raising the possibility that an unidentified factor led physicians to prescribe antidepressants, and particularly SSRIs, to their depressed patients who were at greatest risk for adverse outcomes.

Similar studies have demonstrated that antidepressants are associated with reduced risks of suicide and reduced risks of death from conditions such as strokes and cardiac disease.

Second, this study does not adequately distinguish between older adults with major depressive disorder (MDD) and those with other mood problems, and it does not adequately examine those with moderate or severe MDD compared to those with mild disorders. Clinical research regarding the use of antidepressant medications indicates that they are more effective for people with disorders that meet the threshold for a clinical diagnosis, particularly if moderate to severe . It would be useful to repeat this study leaving out people with mild depression or without depression at all, keeping in mind that a diagnosis of depression in a patient's chart is not necessarily accurate.

Third, this study does not clearly distinguish between those who began the study with a serious physical condition and those who did not. It would be useful to follow patients with serious physical illnesses and depression to see whether -- as other studies suggest -- treatment for depression brings down their risk of death and other adverse consequences.

Despite these reservations, the findings of this study are very important both with regard to overall risks of antidepressants for older adults and with regard to the possibility that SSRIs have more adverse consequences than earlier generations of antidepressants.

Are antidepressant medications dangerous for older adults? Would it be preferable to treat depression only with psychotherapy despite evidence that the combination of psychotherapy and medication is generally more effective than either alone? Should earlier-generation antidepressants be used more frequently than SSRIs despite evidence that the SSRIs have fewer side effects? This study does not give definitive answers, but it does reinforce the fact that the use of antidepressants by older adults is not risk-free. Physicians and their patients should clearly exercise caution.

Coupland, Carol et al. "Antidepressant use and risk of adverse outcomes in older people: population based cohort study" in BMJ, August 2, 2011. http://www.bmj.com/content/343/bmj.d4551

Harrison, Pam. "Depression in Older Adults Increases Mortality Risk". Medscape News, February 26, 2010. http://www.medscape.com/viewarticle/717663

Fergueson, James. "SSRI Antidepressant Medications: Adverse Effects and Tolerability" Journal of Clinical Psychiatry, February 2001. http://www.ncbi.nlm.nih.gov/pubmed/14514497http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/

Jorge, Ricardo et al. "Mortality and Post-Stroke Depression: A Placebo-Controlled Trial of Antidepressants" in American Journal of Psychiatry, October 2003. http://www.ncbi.nlm.nih.gov/pubmed/14514497

Glassman, Alexander et al. "Psychiatric Characteristics Associated with Long-term Mortality Among 361 Patients Having an Acute Coronary Syndrome and Major Depression: Sever-Year Follow-up of SADHART Participants" in Archives of General Psychiatry, September 2009. http://archpsyc.ama-assn.org/cgi/content/abstract/66/9/1022

Fournier, Jay et al. "Antidepressant Drug Effects and Depression Severity: A Patient Level Meta-Analysis" in Journal of the American Medical Association, January, 2010. http://jama.ama-assn.org/content/303/1/47.full

Bartels, Stephen et al. Evidence-Based Practices in Geriatric Mental Health in Psychiatric Services, November 2002. http://www.ps.psychiatryonline.org/cgi/content/full/53/11/1419

Mark Myers expert Answer to: Dating and Relationships: How can a man who doesn't trust anyone find a girlfriend/wife?

Mark Myers expert Answer to: Dating and Relationships: How can a man who doesn't trust anyone find a girlfriend/wife? The fact that you see this issue as your problem,that is a good start. Often times individuals with trust issues may blame their struggles on others(women cannot be trusted) rather than themselves(I have a trust issue). I would first suggest recognizing behaviors and thoughts that would reflect your trust issues. This could be done by writing down thoughts throughout the day. At days end, go back and review your journaling. It is important to start recognizing unhealthy thoughts("Woman cannot be trusted) and behaviors("I need to check up on her") and begin to replace them with healthier thoughts/behaviors .Once you give credibility to your mistrust thoughts, you start losing the battle. Initially there are going to be struggles. Just like a lot of issues, hard work and consistency could break this pattern. I would suggest having an outside source be able to give you objective feedback. In most cases, this would be a therapist who works with a Cognitive Behavioral or Solution focused approach.

3 Steps to Change a Habit

Habits rule our lives!  We have habits to get us up and going in the morning.  There are habits that help us end our day.   Habits have been studied by behavioral scientists for many years.  Researchers agree on one simple fact and that is the best way to form a habit is to change an existing habit.  Neuro-pathways in our brains form over time.  Eliminating a habit is much more difficult than tweaking an old habit to have a new impact.  Think about it this way.  To create a path through the woods, you have to travel the same path repeatedly until the path is well worn.  If you travel the same path for a time, adding a slight change here and there, dimension is added to that basic path without starting something entirely new or erasing what was already there.  The same is true of our brains when it comes to habits or learning, for that matter.  You really can’t unlearn something, but you can change or shape it to be what you need.

Pulitzer prize winning author Charles Duhigg discusses the concept of the Habit Loop in his book The Power of Habit.  Each habit consists of a feedback loop in three parts centered around a craving.  For example, an individual who craves caffeine at 2:00pm may have developed a Habit Loop that looks like this:

STEP 1:   Pick a habit to tweak.  First, you must understand what need the habit meets for you. For example, you want to stop buying coffee after work.  The habit you want to break is spending money on coffee every afternoon.

STEP 2:  Use an old trigger to create a craving for the new element of that habit.  So change your route home to avoid the coffee shop where you like to stop and bring a drink you like for the route home.

STEP 3:      Practice your new routine every time you are presented with the cue.  If your cue is the end of your work day, take your new route home and  enjoy your homemade lowfat latte on the ride home.

Sounds easy, right?  Actually, changing a habit requires consistency and hard work.  The more often you rehearse the feedback loop, the more likely you will be to maintain your new habit.  While the craving and reward remain the same, the conscious decision to follow your new routine when cued will allow you to adjust your habit to a more productive behavior.

Janet Myers

Law Battles Synthetic Drugs

President Obama signed the Synthetic Drug Abuse Prevention Act of 2012 into law on July 9 as part of S. 3187, the Food and Drug Administration Safety and Innovation Act. The legislation bans synthetic compounds commonly found in synthetic marijuana (“K2″ or “Spice”), synthetic stimulants (“Bath Salts”), and hallucinogens, by placing them under Schedule I of the Controlled Substances Act click for more

Students Taking Stimulants Not For High, But For a Higher SAT Score

He steered into the high school parking lot, clicked off the ignition and scanned the scraps of his recent weeks. Crinkled chip bags on the dashboard. Soda cups at his feet. And on the passenger seat, a rumpled SAT practice book whose owner had been told since fourth grade he was headed to the Ivy League. Pencils up in 20 minutes. The boy exhaled. Before opening the car door, he recalled recently, he twisted open a capsule of orange powder and arranged it in a neat line on the armrest. He leaned over, closed one nostril and snorted it. Throughout the parking lot, he said, eight of his friends did the same thing. The drug was not cocaine or heroin, but Adderall ... click for more

Mark Myers Expert Answer to:I'm extremely depressed and angry about being unemployed for some time. How do I go on without having a mental breakdown?

In today's economy, I am sure you are not alone. There are many people who share your plight. The fear you face is understandable. Individuals could experience the following feelings: worry, unproductive, boredom, self defeated, and pessimistic, to name a few emotions. It is important that you take steps to try to take control over areas of your life that you can. Click for more

A codependancy issue: Engaging in addictive dialogue

Addicts enjoy the the feeling of getting high, weather it be drugs or alcohol. They also enjoy the function it may serve(feeling more comfortable in social settings, enjoying the escape, etc.). It is safe to say that a good portion of addicts would continue to use if outside influences(family, legal, employment)didn't make it more uncomfortable for them to use. The impact of their use must outweigh the benefits derived from their use, otherwise there would be no incentive to stop.

Family members forget this when they are discussing their significant others substance use. They allow themselves to engage in an addictive dialogue. Addictive dialogue is any discussion that detracts from the dependent's substance use and impact of it. Discussion turns onto other areas, or areas that would hold him/her less accountable. Examples would include: shifting blame("if you didn't nag I wouldn't drink so much."), avoiding accountability("I will not drink as much","I will cut back.") minimizing("I know plenty of people who drink more.) or other misdirections. The more gray area an addict can create in the discussion about their use, the more likelihood they can continue to use. Family members could get more focused on the discussion and avoid addressing the actual use.

It is important to not allow subjectivity to be a factor in addressing use. This would especially hold true if the subjectivity is the addicted persons. Shift more of a focus on measurable or objective discussions. An example would be an addict saying they will be cutting back. That is a gray area. Cutting back how much? If someone is drinking a case a beer a day, forty beers a day is cutting back. A statement such as "I will not drink at all" is more realistic to gauge. Another example is discussing the belief about legalization of marijuana with an adolescent detracts from discussing his or her using. If as a parent you do not want your youth using mind altering drugs, the legalization of it is irrelevant. Stay in a black or white focus. The clearer you are in your expectations, the easier it will be for the addict or alcoholic to stay on track. Once you start engaging in a addictive dialogue, the greater the chance the addicted person will be less accountable for their actions.