Mental Health

Borderline personality disorder (BPD) is a mental illness categorized as having difficulty regulating emotions, difficulty controlling behaviors, and holding an unstable sense of self. People with BPD often experience emotions intensely and for extended periods of time, making it rather difficult for them to return to a foundational baseline after a particularly upsetting event. If you have BPD, you may experience symptoms of insecurity, impulsivity, feelings of worthlessness, and more, which can greatly affect your daily life. Unfortunately, there is much stigma associated with BPD, and between these and the symptoms experienced with the disorder, individuals with BPD are prone to self-injury and suicidal behaviors. Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy (CBT) which has been used to help treat those with BPD. The primary goal of DBT is to transform negative thinking and destructive thought patterns into more positive outcomes, such as building skills to better regulate emotions, reduce stress and anxiety, build self-management skills, control destructive habits, and more. Despite all of these wonderful outcomes, how does DBT address suicidal thoughts and behaviors specifically? One study sought to explore this very question. A 2015 study published in the journal JAMA Psychiatry analyzed the results of 99 women who were diagnosed with BPD and had previously had 2 suicide attempts and/or acts of self-injury within the past 5 years, attempts within the past 8 weeks before the study was conducted, and a suicide attempt within the past year. Participants were placed in either a standard DBT treatment program, a DBT skills training program, or a DBT individual therapy program. Results from the study indicated that while DBT is an effective form of support for those with BPD who are struggling with self-injury and/or suicidal behaviors, DBT skills training may lend itself the most to outcomes related to this area of concern. What skills are taught in DBT skills training? The following are just a few:

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have been clinically shown to have four major overlapping symptoms: restlessness, loss of energy or feeling fatigued much of the day, difficulty concentrating, and sleep disturbances of insomnia. Rumination can be another experience associated with either disorder and has been defined in previous studies as “a negative, repetitive style of thinking about present and past symptoms, loss, and failure.” When we ruminate, we tend to dwell not only on events that we can’t change, but also on the “negative” aspects of our lives. While rumination is dangerous for anyone, it can be especially dangerous for those with MDD and/or GAD due to the other symptoms experienced. A 2015 study published in the Journal of Abnormal Psychology sought to the effects of rumination on those with either or both disorders. The research study involved 145 participants, 38 of whom were diagnosed with MDD but not GAD, 36 of whom were diagnosed with GAD but not MDD, a dual-diagnosis group which consists of 38 individuals whom were diagnosed with both MDD and GAD, and 33 individuals with no diagnosis to serve as a controlled group. Participants completed interviews and also wore an electronic device that would produce signals throughout the day; individuals were asked to record their thoughts and whether they were “positive” or “negative” each time the device signaled them to. Results from the study showed the greater rumination predicted more symptoms of those experienced with MDD or GAD; it also predicted greater levels of social withdrawal, inactivity, and behavioral avoidance. This makes sense, because during those times that we engage in rumination, we’re so hyper-focused on what our lives our lacking – why would we want to participate in life more? Participants with either MDD or GAD experienced difficulty in engaging in motivated activity when they were ruminating. Overall, the study’s results show that rumination can cause a lot of damage. Why? Because it can take us away from the present moment, it can exacerbate the symptoms of a mental illness, and it can cause us to hold back on what is supposed to make life more enjoyable. Speak with your therapist about ruminating if it’s something that you struggle with. Identify tools to overcome it. It is possible to change your thinking patterns – cognitive behavioral therapy (CBT) is a common therapy tool for this.

Bipolar disorder (BD) is a brain disorder that causes unusual shifts in mood, energy, activity levels, and ability to carry out daily responsibilities. If you have been diagnosed with BD, you may experience mania and/or depression, depending on the type of BD you have. Mania is often characterized as having heightened energy, feelings of elatedness, a sense of grandeur and more. Depressive episodes involve extreme fatigue, sense of hopeless, sadness, and even suicidal ideation. While many people may address the challenges that are associated with BD, there are aspects of this disorder to celebrate: creativity! BD has long been linked to creativity, but it’s been relatively unknown how this sense of creativity positively impacts those with the disorder. Some past research has taught us that those with BD to a lesser extent have been shown to be more creative than those with severe cases of BD, but many people with the disorder tend to take on creative careers such as those in filmmaking, visual artistry, performing, writing, designing and more. A 2015 study published in Qualitative Health Research conducted focus groups with creative participants who were diagnosed with BD. During the focus groups, the researchers asked several questions, including:

If you’ve been struggling with a mental illness, you may not consider yourself to be happy at times. Dealing with the symptoms of a mental illness can be challenging and can even take away some of the things you used to love about life, causing disconnection and further distress. One hopeful outcome of treatment is that you will become much happier as you regain control back over your life. It may take some time for you to feel comfortable utilizing the skills you’re learning in treatment, but there are some activities that you can start doing today to boost your happiness in recovery. A 2014 study published in the Journal of Abnormal Psychology sought to explore diverse types of positive activities and how they can benefit a person’s well-being and overall recovery. Positive activities were defined as acts that promote well-being and protect a person from mental health conditions. Activities listed in the study were: thinking gratefully, acting pro-socially, thinking optimistically, savoring positive experiences, doing kind acts for others, counting one’s blessings, using one’s strengths in new ways, affirming one’s most important values, meditating on positive feelings towards oneself and others, visualizing one’s best possible self, and more. The study emphasized that these positive activities can easily become reflective in many areas of life; for example, building on one’s strengths and doing kind things for others could lead a person to take on new opportunities they wouldn’t have before, or may lead them to a new friendship they otherwise wouldn’t have been led to. As individuals build compassion and love for themselves and others through positive activities, they improve their well-being and chances for success in recovery. If you are currently in recovery, consider the activities mentioned above and reflect on these questions:

Narcissistic personality disorder (NPD) is a mental disorder in which the person has an inflated sense of self-importance and a deep need for admiration. Narcissism has been misconstrued as being the disorder as well, but narcissism is a spectrum that ranges from healthy to unhealthy. Those with healthy narcissism are confident in themselves and their capabilities, care about their appearance and health, and actively engage in self-love. Unhealthy forms of narcissism, such as constantly outdoing others in a negative way, believing one is superior to others, and using people to achieve fame, status, recognition, etc., are signs of NPD. Beyond these healthy and unhealthy forms, there are 2 sub-types of NPD: grandiose and vulnerable NPD.

If you have anxiety, you’ve probably noticed at one point or another your heartbeat escalating, your thoughts racing, and feelings of nausea, fatigue, dizziness, etc. Anxiety is caused by worry, nervousness, or unease typically surrounding an event or something with an unpredictable outcome. Thankfully, cognitive behavioral therapy (CBT) has been shown to help many people with anxiety; in fact, it’s one of the most effective, widely-used therapies for this issue. If you’re ready to incorporate CBT into your daily life, begin taking control over your anxiety by following these steps: Step 1: Begin taking note of your thoughts, feelings, and sensations in a log. Get a journal and write down every instance that you feel anxiety. What are your thoughts at the time? What situation is this regarding? Did someone say or do something to make you feel this way? How would you describe your feelings? What physical sensations are you feeling (ex. sweaty palms, heart racing, etc.)? Lastly, how did your anxiety influence the situation/interaction? For example – did it cause you to leave an event early? Not go at all? Taking inventory of these can help you become an investigator of your own reactions. Step 2: Recognize patterns that are coming from these notes. Is there a certain time of day you experience anxiety the most? What about a specific person or place that tends to lead you to a lot of anxiety? Highlight commonalities between your experiences – with assorted colors if that makes it easier for you. Step 3: Do a cost-benefit analysis. As you review the notes you’ve taken so far, write another list that weights out the benefits and the consequences to having this anxiety. For example, how has having anxiety helped you? In what situations has it caused more pain or discomfort, when it didn’t really need to? This is your change to get an understanding for how anxiety is affecting your life. Step 4: Create alternative ways to react. What can you think to yourself that will make you more at ease, more confident, and less worried? For example, if you’re nervous about going to a work gathering, write the following thought: “The gathering will go well, and I’m excited to get to know other people.” Even if you don’t necessarily feel that way, stick with these positive thoughts. Step 5: Practice daily, no matter how you’re feeling. This is a great start to CBT – towards changing your thought processes towards something more positive and productive. Practice this every day, no matter how you’re feeling.

There are times when we see changes in our loved ones – changes they may not directly be able to see. When it comes to mental illness, stigma often causes people to either fear having one or to fear others who have one. If your loved one does not believe they have a mental illness, but you are certain there are obvious signs of this, they may be in denial. This can be particularly challenging, especially if you want your loved one to seek help. A 2015 study titled “Assessing and Improving Clinical Insight Among Patients in ‘Denial’”, emphasized the difference between denial and lack of insight – does your loved one reject the notion that they have a mental illness or have symptoms of one, or have they simply not recognized the connection between their thoughts, feelings, and experiences and how they relate to mental illness? Denial is often considered a psychological defense mechanism, while lack of insight could be due to symptoms being perceived as a sign of something else, having neurocognitive deficits that make it challenging to form connections between instances such as these, or having a unique way of thinking about symptoms, mental illness, etc. If your loved one has been open to talking about mental illness with you, you may want to consider having them speak to a therapist. Motivational interviewing is a technique that helps those with apprehension come to their own realizations about their mental health and recovery options. Rather than push the client towards choosing recovery, the therapist may gently probe them with questions and will remain supportive and neutral during the entire process. Some people with a lack of insight to their mental illness don’t seek treatment because they don’t know they need to – this could be a wonderful time to help them gain insight into their experiences. If your loved one doesn’t believe they show signs of a mental illness, but you can see it’s potential for significantly reducing their quality of life, you may want to speak with a professional about staging a family mental health intervention. Untreated mental illnesses often get worse over time and could lead to the development of either another mental illness or an addiction, as a person tries to self-medicate to cope with their symptoms. Getting several friends or family members together with clear examples could help your loved one understanding the truth.

Willie Nelson once said, “Once you replace negative thoughts with positive ones, you’ll start having positive results.” There’s no question that mental health recovery can be a scary journey – after all, it involves change, growth, and transformation – all of which most of us are nearly terrified of. However, our perception is what guides us through life, and having a positive perception of your recovery can give you the motivation that you need to succeed. When it comes to mental health, a reputable treatment program can provide you with essential tools to help you better manage your symptoms. While you’re working hard in your program by attending individual and group therapy sessions and activities, you want to ensure you’re taking major strides on your own as well. Positive psychology is a great foundation to motivate, inspire, and uplift your spirits during this time of change. As explained by a 2014 study published in the Eastern Asian Archives of Psychiatry, positive psychology is an umbrella term used to describe positive emotions and aspects of being such as creativity, optimism, resiliency, empathy, compassion, humor, life satisfaction, and more. How can you incorporate positive psychology into your recovery? The following are a few excellent exercises:

There are several types of bipolar disorder (BPD), but symptoms most often involve extreme mood swings, with manic and/or depressive phases. Both may last weeks or months, with manic phases including symptoms of high energy, racing thoughts, reduced need for sleep, impulsive actions and loss of touch with reality – some describe this as feeling like a “god” or “on top of the world”. Depressive phases typically consist of feeling sad or hopeless, significant weight loss, feelings of worthlessness, insomnia or getting too much sleep, decreased ability to think or concentrate, and more. According to a 2013 study published in Current Psychiatry Reports, an estimate of up to 45% people with BPD also have an alcohol use disorder (AUD). A 2015 study titled “Bipolar Disorder Comorbid with Alcohol Use Disorder: Focus on Neurocognitive Correlates” denotes that both BPD and addictions such as alcoholism share common mechanisms: high impulsivity, executive dysfunction, increased likelihood of sensitivity to stressors, and more. There are several reasons why an alcohol disorder may take place alongside BPD:

They both sound similar – codependency and dependent personality disorder (DPD) – but are they the same? What level of dependency constitutes as having a mental disorder versus an unhealthy view of relationships? Whether you’ve recently been diagnosed or are concerned about a loved one, there are some distinct differences between the two. Both can be very distressing and there are ways to treat each – but DPD is classified as a mental disorder whereas codependency is not. The following is a brief breakdown of what each means:

Goal-setting has been used in a variety of instances as an effective way of monitoring progress. People with mental illness often have trouble meeting their goals, as serious mental illnesses can involve symptoms that can be challenging to overcome. With the right treatment program, a person can develop tools to help them better manage their symptoms while strengthening their grasp on recovery. Personal goal-setting is an excellent way to identify specific milestones that you want to surpass. A 2017 study published in the journal Issues in Mental Health Nursing involved the assessment of 27 individuals who were invited to set goals they wish to have achieved by the end of a week-long Recovery Camp dedicated to those with serious mental illness. The researchers identified four collective goal-setting themes from participants: Connectedness – many people in recovery soon discover that they are not alone. Goals for recovery may involve reaching out to others for support, speaking with someone from group therapy or a group activity, or participating and interacting in more recovery-related activities. Developing Healthy Habits – this could include eating more nutritiously, practicing better self-care, thinking more positively, treating oneself with more kindness on bad days, getting better sleep, exercising more, etc. Challenging Oneself – in order to boost your progress in recovery, you could set goals to challenge yourself; examples of this may include partaking in an activity or doing something that’s good for you that you wouldn’t have tried before, practicing forgiveness of yourself and/or others, being assertive and telling others the truth even if it’s challenging, and more. Recovery – goals that are recovery-based may involve meeting with a therapist once a week and reviewing progress, making the decision to speak up more in group therapy, practicing the tools you’ve learned in therapy once a day, etc. Goals can serve as excellent reminders of how far you’ve come, where you’re at, and where you’d like to be in the future. You can track your goals by taking notes, writing them down on a calendar, keeping a diary, creating a progress chart, planning out the steps, selecting a timeframe, and more. Share your thoughts with your therapist so that you have another person to help keep you accountable.

Approximately 1.5 million people are diagnosed with schizophrenia each year; schizophrenia is a long-term mental disorder experienced with symptoms of hallucinations, delusions, difficulty with thinking and concentration, lack of motivation, and more. Onset of this disorder can be hard to tell, but signs often including a sudden change of friends, a drop-in school grades, sleeping problems, and irritability. There is much stigma that surrounds mental illness, but unfortunately those with schizophrenia receive much stereotyping due to media and societal misunderstanding. As a 2015 study published in Social Psychiatry and Psychiatric Epidemiology confirmed, realistic opinions regarding schizophrenia and other mental disorders is associated with lower prejudicial attitudes and social rejection.