Substance Abuse/Alcoholism: Do the myths make the shot?

Hello, Beautiful (Pollen-Filled) World!

Unfortunately, my allergies have kicked in really terribly, so I haven't been feeling superb since you guys last heard from me. I've basically been huddled up in my room wondering what I'm being punished for (honestly, I'm surprised my lungs haven't exploded out of me since I've been sneezing so much).

I didn't go to my internship from Monday through Thursday, as I normally do; but rather went for more hours on Wednesday and Thursday since Jessica (my amazing, front-desk buddy 💞) took those two days off (basically, I helped cover for her). Oh wait! I forgot to mention that I'll be taking next week off as my spring break 👏; so YAYYYY!!!! But don't you guys worry, I will still be coming in for an hour to A New Beginning to meet with a yet-to-remain-unnamed therapist to do a disorder of the week (so, there will still be a post and everything... I'm really having fun learning about the different mental health issues, and refuse to take a break from it)😆

Other than that, I don't have any exciting stories to tell this week (sorry!), so let's get straight into the disorder of the week (this one was a super-duper exciting one): substance abuse/alcoholism!!!!

As always, here are some general statistics regarding the disorders:

• * Substance Abuse:
• In the US, the abuse of alcohol, illicit drugs, tobacco costs us more than $700 billion annually through healthcare, lost work efficiency, and crime related costs
• In 2009, 23.5 million people (12 years of age or older) required treatment for an alcohol or drug abuse problem
• Of those people, only 11.2% (2.6 million people) received 
• ** Alcohol:
• In the US, 86.4% of people (18 years of age or older) have drunk alcohol at some point in their life
• Of the adults who needed treatment for their alcohol-use disorder, only 8.3% received it at a specialized facility (most of them being men)
• In the US, it is estimated that 623 thousand adolescents (ages 12-17) had an alcohol-use disorder
• In the US, this is the 4th leading (preventable) cause of death

Something that surprised me about these statistics was that even adolescents (even those as young as 12!) could have an alcohol-use disorder. 

This week, I met with Grace again, and conducted a survey and looked through everyday media relevant to substance abuse and alcoholism before I came in. Starting off the meeting by asking her what misconceptions clients generally came in with to her in terms of substance abuse/alcoholism, I learned that most alcoholics come in with denial, which is the first phase of alcoholism. So, the therapist has to help with that thought process when they say "I'm not an alcoholic." They also come in saying "I can just stop drinking if I want to," which I'll discuss as a myth below. The denial part was very interesting to me because if they don't think they have a drinking problem, why are they seeing a therapist?

From here, Grace and I discussed more about substance abuse/alcoholism using the survey questions as a basis:

Misconceptions:

• Myth: Alcoholism isn't a disease, but a lack of willpower, self-control, and moral failure. 
• Truth: Nope! Alcoholism and substance abuse are very much real disorders.
• Myth: Substance abuse and alcoholism come about from lifestyle, not genetics.
• Truth: Genetics is the primary reason that alcoholics have alcoholism, although environment also contributes to it. 
• Myth: If one really wants to, he/she can control their addiction on their own or through group meetings. 
• Truth: The most successful treatment options are Narcotic Anonymous (NA) and Alcoholics Anonymous (AA). These are group meetings in which recovering alcoholics or drug addicts who have a desire to stop drinking/using drugs attend. They become recovering alcoholics or drug addicts when they work the 12 steps with a sponsor and attend the meetings regularly. 
• Myth: Using prescription medicines/a patch to control urges are simply replacing the previous addiction. 
• Truth: Some alcoholics take Antabuse to help stop drinking; however, it usually doesn't help because alcoholism is just a symptom of a disease, and a therapist needs to help address the spiritual and emotional aspects, as well as physical. 
• Myth: Addicts and alcoholics are easily identifiable (low socioeconomic background, unemployed, male, etc.)
• Truth: These are simply stereotypes. Alcoholism is a disease and impacts all society. 
• Myth: You cannot abuse prescribed medication.
• Truth: False, because these medicines are just like any other drug (but simply have benefits toward an illness).
• Myth: Relapse means failure and weakness. 
• Truth: Because it is a disease and an addictive one, it can be hard to break the habit. Alcoholics have been using alcohol as their main coping skill, and when they struggle with accepting powerlessness over alcohol, they turn to it for help.
• Myth: Drug addiction is worse than alcohol addiction.
• Truth: No! Many take longer to develop alcoholism versus drug addiction, but they both impact every organ of the body and will end in death if the person doesn't get help. 

From here, we moved onto the portrayal of substance abuse/alcoholism in the media. 

• Days of Wine and Roses
• The main actress role is an alcoholic (due to her husband), and the husband tries to get her sober without going to AA. She ends up dying from her drinking problem. This is a very accurate representation of alcoholism, and the consequences of not getting help. 

• Leaving Las Vegas
• Ben Sanderson, the protagonist in the movie, is an alcoholic and it costs him his friends, family, and job. He ends up trying to drink himself to death in Vegas, but build a relationship with Sera. Sera, although she originally agreed to not judge Ben, ends up urging him to go see a therapist, making Ben furious. He doesn't get the help he needs and dies from over-drinking. This accurately shows how alcohol damages personal relationships, and can lead to death without proper treatment. 

• The media glamorizes drug use and alcohol (as shown through parties in movies, etc.)
• Our culture advocates for behaviors that they present as "better-living," but are very detrimental. 

So where do all of these misconceptions come from regarding alcoholism and substance abuse? Once again, it is our culture and from our misunderstanding of these mental health issues. It's also from powerful organizations that advertise and sell liquor to our environment, which is prone to so-called "better-living" through chemistry. 

Before I get to my usual closing line, I was just wondering if you guys have any ideas on what you'd like to see as a product for my project. I have a slight idea, but am not sure if I really want to go through with it... Thank you! You guys are the best :D

I hope you guys like my Week 6 post! Thank you all for following me on this journey, and showing me so much support!

Lots of love 💗,

--Saleena 

Sources: 

*Trends and Statistics (2015, August). Retrieved March 14, 2017, from https://www.drugabuse.gov/related-topics/trends-statistics

**Alcohol Facts and Statistics (2017, February). Retrieved March 14, 2017, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Trauma/PTSD: Is it really about being 'traumatized for life'?

Hello, Beautiful World!

This post will be a little different (divided into 'weekend' and 'week') as an exciting event occurred over the weekend related to my past two posts (Week 3 & 4). Without further ado, lettuce begin (idk why I just wrote that, but just go with the flow here):

Weekend (particularly Sunday):
On Sunday, as some of you may have seen on my snapchat, I went to the NEDA (National Eating Disorder Association) Walk with A New Beginning from 6AM to 9AM. Before I get into that though, let's have a little storytime session: I had to get up at 4AM!!!!! That was wayyyy too early since I haven't had to get up before 8AM since school ended. What was worse was that I couldn't fall asleep until 11:30PM the night before; so, I basically had to live off of ~4 hours of sleep.

Anyways, I woke up to an absolutely silent house (no normal human gets up that early), and realized that I make so much more noise when I'm trying to be quiet.

It took about half an hour to drive to the zoo. It was super dark outside (I don't like driving in the dark, so this was my first long drive in the dark). There were practically no cars anywhere (very eerie). I made it to the zoo, and it was soooo cold and dark (sorry, I've said dark like a million times).

But what surprised me was how many people had showed up for this walk! Everyone was so lovely and sweet and supportive despite the ungodly time we were up at, the cold, and the darkness. We set up our booth, and bam!

    

We saw an amazing sunrise. The sky literally looked like cotton-candy (seeing that made getting up worth it) :D There were awesome guest speakers, a relaxing yoga session, and the mile-long walk in the zoo was also super fun! Who knew the zoo animals are most active and awake that early?!

 At this event, A New Beginning also won first place for raising the most amount of money for the NEDA fundraiser (YAY TEAM!)😁

Side Note: While the zoo was super fun, it triggered my allergies and I woke up Monday feeling terrible (are anyone else's allergies kicking up?)

Week On-Site:

Getting to the disorder of the week, trauma/PTSD, we're going to start off with some general statistics:

• Trauma:*
• Every year, trauma "accounts for 41 million emergency department visits and 2.3 million hospital admissions" in the US
• The amount of lives lost to trauma (30% of all life years lost in the US) is equal to the combined rate of lives lost from cancer, heart disease, and HIV
• In the US, 70% (~223.4 million people) of adults have experienced some type of traumatic event**
• PTSD:**
• It is estimated that 1 out of 9 women develops PTSD (women are twice as likely to have PTSD as men)
• In the US, it is estimated that 8% of the population (~24.4 million people) have PTSD at any given time
• Of the 70% that have experienced some type of traumatic event, up to 20% develop PTSD (~44.7 million people who were or are struggling with PTSD)

What I found most interesting about these statistics was that of the millions of people that experience trauma at some point in their life, only about 20% develop PTSD. In other words, I was surprised that trauma didn't always lead to PTSD. 

Before meeting with Grace Brooks, a clinical therapist at A New Beginning who specializes in abuse/trauma/neglect, I conducted a survey and looked through everyday media relevant to trauma/PTSD. Starting off the meeting by asking her what misconceptions clients generally came in with to her in terms of trauma/PTSD, I learned that people come in feeling like they are permanently damaged. If a client has trauma and has no resources at the time of the trauma to process those feelings, that trauma is hard wired in the limbic system (the emotional part of the brain). As an adult, experiences in their life can trigger the original trauma and they experience feelings as if they are emotionally younger (they also may be experiencing emotions from their past). Their reaction seems like an overreaction. Some clients believe the symptoms of PTSD that are occurring in their adult life (depression, anxiety, self-defeating coping skills like an eating disorder) have nothing to do with the way they were raised. Many have no memories of any trauma in their past, and have difficulty assessing memories. 

Grace Brooks, MA, LISAC, LPC

From here, Grace and I discussed more about trauma/PTSD using the survey questions as a basis:

Misconceptions:

• Myth: Trauma only occurs after a life-threatening event. Everyone who faces such an experience will also get PTSD. 
• Truth: No! The life-threatening event is the trauma, and without support from family or professionals when it occurs, symptoms from PTSD can appear.  
• Myth: One can get through trauma alone if he/she is strong. 
• Truth: Trauma recovery cannot be done on your own. Clients need a professional to help them resolve the trauma. It has nothing to do with strength, except courage to get help.  
• Myth: If the trauma occurred a long time ago, you cannot change anything about it.
• Truth: By accessing the limbic system, the client can resolve their trauma no matter when it occurred. Treatment involves assisting the client to their memories of trauma. For instance, writing a timeline of behaviors from your past.  Mental health therapists use various skills to resolve the trauma (to name a few: EMDR therapy, Gestalt therapy, or Somatic Experiencing). Gestalt is using empty chair to reenact the feelings from the trauma by visualizing your abuser in the chair. Somatic Experiencing works with physical sensation, and helps the client access those sensations and release feelings from the trauma that have not yet been processed. Complex PTSD are many traumas that were experienced, and you can use the same techniques mentioned above. With treatment, negative cognitions, such as "I am bad," that are hard wired in your limbic system when you were a child can be replaced to "I am good" by creating new neural pathways from your limbic system to your prefrontal cortex. 
• Myth: For PTSD, one only needs to process the trauma to become fine. 
• Truth: Only talking about it will not help. Treatment has to be experiential by accessing the wounded ego state where the trauma is hard wired. An ego-state is an entire system of thoughts, feelings, and behaviors from which we interact with one another. 
• Myth: PTSD only affects war veterans.
• Truth: Anyone who experiences trauma or any life threatening experiences can experience PTSD symptoms. 
• Myth: People suffer from PTSD right after they experience a traumatic event.
• Truth: No, it takes time for the trauma to manifest into PTSD. If you have a therapist working with you in the immediate present when the trauma occurred, you won't have the symptoms of PTSD because you will have created a place where you can feel safe again and have processed the trauma. Also, when it manifests is different for everyone (anywhere from six months to twenty years).

Some things that can be myths or truths, depending upon the case:

• To say that trauma affects everyone the same is a very broad statement that is both true and false. It can be true because of the similar symptoms present in patients (for example, most everyone has startled experiences). However, it can also be false because just because some people don't have a startled response does not mean that they don't have PTSD. So, while there is a certain set of criteria (aka core symptoms) patients have to meet, they may not have all of the same symptoms besides those ones. 
• Trauma both can and cannot affect one for the rest of his/her life. If you do put in work and effort during recovery and therapy, you can certainly get much better in terms of your reactions to situations. However, if you don't work on it, your reactions get much worse and you can start to close-in on yourself. Basically, do the trauma work and you can get better. Recovery is possible. 
• Trauma most definitely can negatively impact one's personality/character. But get through treatment, and you can become a survivor instead of a victim. Also, getting through trauma work allows one to be there for others, building compassion by knowing at a deep level what others are going through. 

Since the media plays a huge role in how we perceive things, I also asked Grace how she felt regarding the portrayal of trauma/PTSD in If I Stay, Forrest Gump, Saving Private Ryan, Iron Man 3, and Sling Blade.

• If I Stay
• It's definitely a good portrayal of trauma (it's traumatizing to witness one's whole family dying and being the only one to survive). 

• Forrest Gump
• During the scenes in the movie in Vietnam, if it was a real person, it would absolutely cause trauma (even if they didn't necessarily portray it as so in the movie). 

• Saving Private Ryan
• Anyone in a war, unless they found some resource to process the trauma on the spot, would have trauma. The characters were in the midst of war, which is a life threatening event, so PTSD is possible.

• Iron Man 3
• Tony Stark does faces trauma and PTSD after his involvement in the alien war invasion in The Avengers (this can be seen by his symptoms: reclusiveness, outbursts of anger, etc.).

• Sling Blade
• This movie is actually what is shown to students studying trauma in graduate school (it shows how trauma develops into PTSD). 

Something interesting that I have slowly been realizing is that emotional trauma (repeated invalidating messages, etc.) is the basis for a lot of disorders. People end up believing and internalizing these messages, creating a negative core belief in themselves that gets in the way of them being able to reach their goals and living a successful life. It's actually deemed to be 'the silent killer' of the mental health world.

So where do all of the misconceptions surrounding trauma/PTSD come from? One source is social media. People who think they're knowledgable about these disorders go ahead and spread the wrong information throughout the internet. It can also be due to to research that had been later proved invalid (the former information just stuck around even after being proved wrong). Lastly, sadly to say, sometimes even professionals give incomplete information because they may not be fully-versed in mental health issues. 

 I hope you guys like my Week 5 post! Thank you all for following me on this enlightening journey, and showing me so much support!

Lots of love 💗,
--Saleena



Sources:

*Trauma Statistics (2014, February). Retrieved March 6, 2017, from http://www.nationaltraumainstitute.org/home/trauma_statistics.html

**PTSD Statistics (n.d.). Retrieved March 6, 2017, from http://www.ptsdunited.org/ptsd-statistics-2/

Binge-Eating Disorder: Making it Easier to Digest the Truth

Hello, Beautiful World!

This week was absolutely, mindblowingly awesome! Dr. Anné so kindly invited me to join her for her Channel 3 news segment on Good Morning, America on Wednesday on eating disorders 😆! It was such an honor to be able to join her in the studio (even if it was only behind-the-scenes).

Literally me after being invited...(but in more professional clothes)

I don't normally do story-time, but this was such a memorable experience and I really want to share it all with you guys! To begin with, I had to wake up a lot earlier than usual to get to the studio on time (with extra time to spare in case I mess-up with my driving skills somewhere). This extra time came in handy because it was a nightmare to drive on 7th street. People were driving in the middle lane, there were too many cars, the lanes were so tiny, and you couldn't make a left turn at so many places. I missed the turn to the studio because there was no place to make a left-turn; so, I had to drive an extra five-minutes ahead, make a U-turn, and find parking at the studio for normal people like me (not employee parking). I got there before I had to, and used the extra time to take some photos and sit in the lobby to check social media. Here's a funny little story: the doors in the studio were really weird (almost magnetic), and when I went to open the door, it opened mostly without my effort. The problem was that my hand was stuck in the handle, and so I had to awkwardly enter the studio being pulled by the door. How embarrassing! There was a couple inside looking at me all funky. I have seen and used a door before, people (just not that type of door)!

Outside of the studio (I took this photo from my car... in a non-creepy way, of course)

Showing off on social media (aka Snapchat)

Pardon my terrible photography skills... this is inside the lobby

Photos of people that work there? 

More lobby photos...

Some other events happened... blah blah blah... and we're finally in the studio!!!!! It was so cool watching all of the dynamics and efforts that went into a live news channel 😋. Dr. Anné went live, and it was wonderful seeing her talk about what she's so passionate about. Despite the bumpy morning, she was so calm, cool, and collected. You can watch the whole segment online somewhere I'm sure. All in all, it was pretty awesome, and I'm so grateful to have been presented the opportunity to come along :D

A beautiful panorama of the studio

Dr. Anné live!

Watching the weather segment was pretty awesome!

Getting to the disorder of the week, binge-eating disorder (aka BED), we're going to start off with some general statistics (I was really happy to read in last week's comments that you guys like this section and find it helpful 😁):*

• A 2007 study found that 3.5% of women and 2.0% of men have had BED during their life, making it more common than anorexia and bulimia, and breast cancer, HIV, and schizophrenia
• ~0.2-3.5% of females and ~0.9-2.0% of males will develop BED
• "Sub-threshold BED occurs in 1.6% of adolescent females"
• "Research estimates that 28.4% of people with current BED are receiving treatment for their disorder"
• "BED often begins in the late teens or early 20s, although it has been reported in both young children and older adults."
• Males account for 40% of those with BED

What I found most interesting about these statistics was that although BED is so much more common than breast cancer, only about a fourth of the people with BED are receiving treatment, compared to those getting treatment for breast cancer. Why is the treatment rate so low?

Before meeting with Jennifer Denkers, a clinical therapist at A New Beginning who specializes in eating disorders, I conducted a survey and looked through modern, everyday media relevant to BED. Starting off the meeting by asking her what misconceptions clients generally came in with to her in terms of BED, I learned that people come in feeling like they lack willpower. Feeling like they're lazy, and that they just can't get this right. That maybe they're just addicted to food because they really like it. They don't understand that there are underlying emotional issues behind their disorder, and that it's not because something is wrong with them. That common trend of people with mental health issues feeling as though they're the problem? It even continues to apply to eating disorders. 

Jennifer Denkers, LPC

From here, Jennifer and I discussed more about BED using the survey questions as a basis:

Misconceptions:

• Myth: Binge-Eaters have weak willpower
• Truth: Absolutely not! BED usually comes about from two factors:
• Underlying emotional factors (unmet emotional needs, trauma, etc.)
• Brain chemistry
• Myth: BED isn't a real disorder. Everyone overeats at some point in their life. 
• Truth: Although it is true that people do sometimes eat beyond the point of being full, BED is a a very different pattern of overeating (those with BED eat a lot of calories in one sitting in secrecy, but tend to eat very little in front of others). It includes a lot of rituals, secrecy, and an element of lacking control.
• Myth: BED is the same as bulimia.
• Truth: The difference between bulimia and BED is that people with bulimia have compensatory behaviors (exercise, laxatives, purging, etc.), while those with BED typically do not. 
• Myth: BED is rare. 
• Truth: We can see this is false simply through the general statistics I listed earlier. In fact, BED has only been recognized recently, which is why people didn't seek treatment (because they didn't see it as a psychological issue). This goes to answer my earlier question about why treatment rates are low. 
• Myth: BED treatments include discipline and diets. 
• Truth: Typically, treatment focuses on helping patients incorporate movement that works with their lifestyle. Also, it provides education on how our body utilizes food (along with food in general). However, the main focus should be on the underlying emotional factors that come into play.

Some things that can be myths or truths, depending upon the case:

• People tend to think that those with BED are overweight or obese. This is not necessarily true as there are binge-eaters who aren't overweight. 
• Side note: in fact, there are even healthy people can be overweight. 
• Although stress can play a role, BED doesn't only affect women who are stressed-out. As shown by the earlier statistics, men are also affected by BED. 
• Weight-loss surgery doesn't cure BED because a lot of what underlies BED is more emotional core issues. Surgery only really helps with the physical aspect of things, not reaching the emotional aspect. Hence, binge-eaters can still eat their way back and gain weight. So, surgery can be a tool, but not a treatment. 

Since the media plays a huge role in how we perceive things, I also asked Jennifer about she felt regarding the portrayal of BED in Elf, Super Size Me, and Charlie and the Chocolate Factory. 

• Elf:
• Scene: Elf is home alone, and eats pasta covered in chocolate, marshmallows, syrup, and more sugary, junk food. 
• Not necessarily a portrayal of BED because it's not always sugar that's consumed excessively. Also, this scene doesn't show the shame, guilt, and secrecy that people with BED feel afterwards. 

• Super Size Me
• This is more of a depiction of disordered eating (and not knowing the effect of food on our body) rather than BED. It's basically showing how overeating foods that aren't nourishing for the body affects the body and general health. 

• Charlie and the Chocolate Factory
• Scene: Augustus eating a lot of chocolate in the factory and in his day-to-day life.
• This is more compulsive, over-eating than BED. Not necessarily all binge-eaters binge on chocolate, and they won't eat in excess in front of others (they binge in hiding). 

BED as a mental health eating-disorder diagnosis has not been around as long, making it hard for people to see their behavior as a psychological issues that needs treatment. Also, by nature, our culture is very shaming of those who are overweight, obese, or don't live a 'healthy lifestyle.' This is perpetuated by different media, including the diet and fashion industry. For example, magazines put much emphasis on celebrities and their weight gain/loss. We need to shift our focus away from such labelling and stereotypes, and work to simply be healthy individuals. 

 I hope you guys like my Week 4 post! Thank you all for following me on this enlightening journey, and showing me so much support!

Lots of love 💗,

--Saleena 

Sources:

*Overview & Statistics (n.d.). Retrieved February 28, 2017, from https://www.nationaleatingdisorders.org/binge-eating-disorder

Anorexia and Bulimia: Starving to be Understood

Hello, Beautiful World!

This is going to be one, very exiting post as I'm entering uncharted territory. Although anxiety and depression were amazingly interesting topics, this week I'm going to be learning about two disorders I know very little about: anorexia and bulimia. The media examples will be all-new, so hopefully you guys will find that section even more interesting!

Before I begin, as always, I'd like to present some general statistics (and the definitions from NEDA) on anorexia and bulimia*:

• Anorexia (aka Anorexia Nervosa): a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
• Affects 0.9% of the female population in America 
• 1 in 5 people with anorexia die by suicide
• 50-80% of the risk for anorexia and bulimia is genetic
• ~half of anorexia patients have comorbid anxiety disorders, and 33-50% have comorbid mood disorders
• Bulimia Nervosa: a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge-eating.
• Affects 1.5% of the female population in America
• ~50% of bulimia patients have comorbid mood disorder, and more than 50% have comorbid anxiety disorders

Something that really surprised me (but also didn't, oddly enough) was that patients with these eating disorders also suffered from other mental health issues, such as depression and anxiety. This was shocking because of the incidence; but also not, because I think these eating disorders are related in part due to a lack of self-confidence, poor self/body-image, and unhealthy eating behaviors. 

Similar to previous weeks, I conducted a survey and looked through modern, everyday media relevant to these eating disorders (and perhaps what contributes to them) before going in to meet with... Dr. Anné! To those who have never been graced with her wonderful, calming presence, Dr. Anné is a licensed clinical psychologist, eating-disorder specialist, and the founder and clinical director of A New Beginning. 

Julie T. Anné, PhD.

Her Beautiful Office

In terms of our meeting itself (which ended far too quickly), we started off the discussion by talking about what types of misconceptions patients generally come in with. Similar to anxiety and depression disorders, patients with anorexia and bulimia tend to come in feeling ashamed about their issues. However, the biggest thing that differentiates these patients is that they come in thinking that they will never fully recover from their eating disorder. This is the biggest, most common myth in the eating disorder realm. People can and do fully recover. Eating disorders, like anorexia and bulimia, are not like alcoholism (once an addict, always an addict). Although recovery can be hard and arduous, it is absolutely possible to achieve by getting through all of the layers of the disorder, thus preventing relapse.

From here, Dr. Anné and I discussed more about eating disorders, especially anorexia and bulimia, using the survey questions as a basis:

Misconceptions:

• Myth: Eating Disorders are solely about food, weight, and appearance.
• Truth: Anorexia and bulimia are very complex, seemingly abstract disorders. They are very deep-seeded psychological coping mechanisms that utilize one's body image and relationship with food, and use that to meet deeper psychological needs. 
• Myth: Eating Disorders are a choice ("someone is choosing to do this, starving him/herself, so they can simply choose to start eating again").
• Truth: Eating disorders are not a choice, but rather compulsive disorders, in a way. Although one has a choice to get help regarding his/her eating disorder, one does not have a choice to simply start eating again. Anorexia and bulimia are unconscious coping mechanisms, becoming an emotional lifeline for people until they develop healthy ways to deal with their emotional issues. 
• Myth: Anorexia and bulimia affect mostly females, especially in adolescence. 
• Truth: At least 10% of those who develop eating disorders are males; however, this percentage is likely greater because these are the only the men that have stepped forward to get treatment. Although eating disorders are very shameful for women, they're even more so for men because of the societal association between eating disorders and women. In terms of age, there is an uprise in middle-age disorders, meaning there are more and more clients in their 30's, 40's, 50's, and 60's with eating disorder issues with:
• one-third always having had an eating disorder, but never getting over it nor seeking treatment
• one-third having had an eating disorder that went away and then came back
• one-third being brand new cases (never having had an eating disorder)
• Myth: Bulimia is an effective means of weight control.
• Truth: With bulimia, although one will lose weight initially, it actually puts weight on him/her as the disorder continues. 
• Myth: Anorexia means eating only a very small amount of food, and bulimia is a simply a cycle of binging-purging (with purging being done through self-induced vomiting). 
• In terms of anorexia, you can have "anorexia" thought and behavioral processes even though you may be eating a relatively normal amount of food (whether that be counting every calorie or measuring the amount of food eaten). 
• In terms of bulimia, purging is a compensatory behavior to undo the calories consumed while binging. Hence, purging can also be carried out through intense exercise and restrictive dieting behavior (eating a lot one day, and then starving/eating less the next).

Some things that can be myths or truths, depending on the case:

• When it comes to eating disorders, many people say that they are caused by families and peers through their body-image related comments, or the media and photoshop. However, anorexia and bulimia are multifaceted disorders, a multitude of factors creating 'the perfect imperfect storm.' Although one contributing factor can be a family culture that focuses on body image, appearance, and weight, this alone will not cause an eating disorder. There has to be enough of the risk factors that come together, making one vulnerable. From here, something like the media can help pull the trigger. Some other primary, risk factors include:
• Biochemistry in the brain that is obsessive-compulsive and/or anxious in nature
• Temperament that is perfectionistic - one who wants the perfect body-image, high achiever, etc.
• Being a highly sensitive person (HSP) - one who is easily affected by interpersonal judgement, conflict, and constantly seeks approval from others
• Low self-esteem, lack of self/self-identity/self-confidence, lack of personal empowerment, being a people-pleaser (can come from anxiety or depression disorders) 
• Since these characteristics allows for other people to have too much influence over one's life, and suddenly, one's body becomes the only thing one can control (and this is where the eating disorder comes into play). 
• Trauma or a history of dieting (sometimes, but not always)
• Can you tell someone has anorexia or bulimia simply by their appearance? 
• No, because lots of people with an eating disorder look perfectly normal, especially in the case of bulimia. Someone can be anorexic in mentality, but weigh normal or slightly lower than normal, not making an impact on his/her appearance. 
• Yes, because there are some symptoms of eating disorders that cause changes in appearance:
• Bulimia: may have swollen parotid glands; tooth enamel eroded by stomach acid
• Anorexia: thin, dry hair; dry skin (because low fat intake or content in the body can decrease estrogen, impacting hormones and the skin); lanugo (fine, white hair that grows on the face)

Since we talked about the media and photoshop during our discussion on the survey questions, I asked Dr. Anné how she felt regarding the portrayal of eating disorders in/through Never Enough, barbie dolls, and models in popular runways (Victoria's Secret and New York Fashion Week).

• Never Enough 
• Recovery is about more than just gaining weight. It's about getting to the roots of the different pieces that have created the problem, and rebuilding them (especially one's self-esteem, how one deals with emotions, and feeling in true control over oneself). Simply gaining weight is not an effective form of treatment alone, because neural pathways have been formed and run the risk of going back to the eating disorder behaviors as a coping mechanism to gain a sense of control if nothing else changes. Too many times, treatment is focused solely on behavioral aspects, and not enough on the underlying creation of an emotional foundation that will help the patients be more emotionally resilient and eating disorder resistant. Treatment has to be multifaceted, like the disorder, to allow for full recovery and to prevent relapse. 

• Barbie Dolls
• There are many things a parent can do to promote better, more positive body-image in kids, building self-esteem and confidence from a young age. Barbie dolls don't promote that, because no one actually looks like that. Instead, parents should avoid talking about body-image, diet, and weight at home; they should rather have a healthy relationship with their body, self, and food as an example for their kids. 

• Models in popular runways (NYFW, VS, etc.)
• How are runway models seen as models for how people should look like, men or women?! Companies tend to use very young females to sell items to women in older-age groups, creating a fraudulent image of what is and what one is capable of. It can be very damaging to one's self-esteem and confidence. Rather, we should want to see models with healthy curves, and celebrate the natural body. 

Eating disorders, such as anorexia and bulimia, are so complex that it is very hard for a layperson to understand them. We look at someone with an eating disorder and it looks so simplistic. Just eat! We don't understand that eating disorders are compulsive disorders, not allowing a person to do what he/she knows he/she should be rationally doing. These disorders are even too complicated for generalists, who end up referring these patients to specialists in order to be treated most effectively. It can be difficult to understand that eating disorders are not just about food, rather about deeper, psychological processes. Beyond that, anorexia and bulimia can be very scary, making it difficult for us to try and understand them; it's hard to see someone starving and be able to understand the reason behind what they're doing. People with anorexia and bulimia need to be looked at and treated through a compassionate and knowledgable lenses, because they need to know and realize that recovery is possible. 

To talk about my own experiences this week, it was absolutely amazing to be able to learn about two disorders I knew next to nothing about. Dr. Anné provided such wonderful insight, and it was a delight to be able to talk with her. In terms of what I did for the rest of the week, I mostly helped with the business side: putting together folders for events and for new clients (this included stapling close to 400 sheets of paper, and putting step-sheets and business cards in 170 folders!). 

I hope you guys like my Week 3 post! Thank you all for following me on this enlightening journey, and showing me so much support on previous posts!

Lots of love 💗,

--Saleena 

Sources:

*Eating Disorder Statistics (n.d.). Retrieved February 22, 2017, from http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

Depression: All about getting deep-rest

Hello, Beautiful World!

How has another week gone by already?!? Time is going by way too fast, and I simply don't know what to do about it (maybe it's having too much free time and not much stress). I've been going through a new book almost every day, which means I'm going to bed later and later than normal.

It's been another amazing week at A New Beginning (it's becoming my second-home!) 😊 Before I go ahead and begin talking about this week's mental health issue, I'd like to thank everyone who reads my blog because last week, I was announced blog-of-the-week! I'm so so happy that people are enjoying my topic/project/content so far, and I wanted to let you guys know that I really really appreciate it, and am so grateful for each and every one of you 😘💕.  I'd also like to give a shout-out to four amazing people that mean so much to me: Dr. Anné, Taana, Mr. Chadwick, and my dad. This project would be nothing without the experience and knowledge I'm receiving from my internship at A New Beginning; and my 'week 1' post about anxiety wouldn't have had much substance without my meeting with Taana. I'd like to thank Mr. Chadwick for turning this simple idea into an actual project, and guiding me through it since he became my faculty advisor. Last but not least, thank you to my dad for always being there for me, and showing so much patience. I wouldn't be anything without the support and love he unconditionally gives me (from providing feedback on my posts to paying for the gas to get to my internship 😂). 

                                  

Now, I'll begin with the mental health issue of the week: depression (are my puns getting better or worse?). Once again, I'd like to start off by giving some general statistics on depression (that AP Stats class is becoming very handy, I'm beginning to realize):

• ~7%, or about 16 million, adults in the USA had a major depressive episode in their life in 2015.*
• Major depression reduces the life span of a person, and "accounts for the most years lived with disability of any mental or behavioral disorder."*
• The percentage of Americans taking antidepressants has increased from 6.8 to 12% from 1999 to 2012.*
• By 2020, the global market for depression drugs is predicated to be worth over $16 billion.*

Something that seemed to be of interest to me about these particular statistics was that despite the increase of Americans taking antidepressants as a form of treatment, they were still suffering with depression for a longer time than those with other mental health issues. The question that I came up with is: are antidepressants not truly beneficial in the long-term? If not, then what form of treatment is, and why?

Similar to last week, I conducted a survey and found modern-day media about depression before going in to meet Taana (don't get too comfortable... we'll soon get to meet a different therapist 😉). We started off the discussion by talking about what types of misconceptions patients generally come in with (just kidding... I actually forgot to ask this question during the meeting, and had to email her to ask it; but we'll overlook that tiny detail). Similar to anxiety disorder clients, those with depression also come in feeling shame and guilt that they haven't been able to 'fix' their depression or just 'get over it.' As we talked about this, I began to see a similar thread between the different mental health issues: the guilt, the shame.

From here, we talked more about depression as a disorder, once again using the survey as a basis for the questions: 

Misconceptions:

• Myth: Depression is rare, and only affects people of certain backgrounds, race, and/or gender.
• Truth: Depression is a lot more common than people realize; we can see this simply by looking at how many people get at least one depressive episode during their whole lifespan. In terms of it affecting people of certain backgrounds, races, or gender, depression is fairly universal. However, the statistics do tend to vary among cultures and genders due to whether it is culturally acceptable to report symptoms of depression and receive treatment. The actual incidence of depression is likely much higher than what is reported. 
• Myth: Depression implies a weak character/personality.
• Truth: Depression is very challenging for people to deal with, requiring a lot of strength and energy from a person compared to someone without it. So, instead of weakening one's character/personality, it builds his/her inner strength and courage.  
• Side note: antidepressants do not affect one's character/personality.
• Myth: One can get rid of his/her depression simply by putting a stop to his/her wallowing, and thinking more positively.
• Truth: Absolutely not! Statements like this show that depression is so dangerously misunderstood in our society. It invalidates the person, and makes them feel shame and embarrassment when they can't just "get over it" or control their symptoms through "will power." Myths like this are damaging because they often prevent people from seeking readily available and effective treatment, especially when the myth is put forth by family members, teachers, or friends. 

Some things that can be myths or truths, depending upon the case:

• Although depression can be caused by a negative incident, there are many other causes as well: 
• Genetic pre-disposition (genes for depressive disorders can be passed along just like eye or hair color)
• Hormones (especially in teenagers)
• Side note: symptoms of depression in teenagers are more likely to be irritable mood, isolating behavior, or acting out with risk-taking or angry behavior
• The grief process (feelings of depression are normal for a certain period of time after someone has experienced a loss - which can include loss of a relationship, loss of a job, loss of a goal one has been working toward, loss of lifestyle, in addition to loss of a person one is close to. If one doesn't mourn and process the loss in a healthy way, it can trigger an ongoing depression and/or suicidal thoughts)
• Traumatic events (especially where people feel powerless)
• Emotional trauma (repeated invalidating messages)
• Depression can also result from some medical conditions
• Someone on antidepressants doesn't necessarily have to take them for the rest of his/her life. The length of this form of treatment depends on a variety of factors: type of depression, the severity, what the trigger/cause is, and whether people are willing/able to use the skills taught in therapy.
• Antidepressants are the most common form of treatment because they appear to be a fairly easy solution (one can simply get them from a primary care doctor, making it easier because he/she only has to ask one person and that too in secrecy). In fact, not all medical doctors are specialists in mental health issues; so when people go for the easier route through their primary care physician, they might not be getting the specialized information and care that mental health issues often require. However, medications aren't necessarily the most effective form of treatment, because they only treat the symptoms. With using medication alone, if a person stops taking the medication, their symptoms can return. Medications can also have side-effects that must be weighed with the benefits. Studies have also shown that regular exercise may be just as effective as taking antidepressants. When a person has Major Depression, the best course may be a combination of medication and therapy. However, therapy typically produces the most long-lasting results with fewer relapses. Why psychotherapy? Because it involves a holistic process of looking at everything going on in the person's life and how things may be impacting them, and creates a plan to help the person move forward with healthy behaviors, a healthy relationship with themselves, and healthy relationships with others. It aims to help people get to the root cause(s) of what may be causing the disturbance for them, helps people to face challenges in their lives in a healthy way, and helps to corrects any unhealthy beliefs that may be getting in the way of people reaching their potential. There is even some evidence that the process of therapy helps to re-wire a person’s brain in a healthy way. The reason antidepressants are used more commonly is because often it seems like an easier solution, and people may be (unnecessarily) fearful of the process of therapy because they don’t have enough information about what therapy is like, and/or they feel overwhelmed by their problems and again, feel shame and guilt that they can’t “just fix it” themselves. 
• This answered my original question on the effectiveness of antidepressants in the long-term!
• The most common symptom of depression doesn't always have to be feeling sad. It's just as common for people to feel: numb, flat, unmotivated, and tired. Also, some may feel unable to find pleasure, even in things they used to like. That being said, others may certainly feel more tearfulness and sadness. Sometimes, people have thoughts that life is not worth living or that they would be better off not living anymore. This is the most serious and dangerous symptom of depression, and is a big red flag that the person needs the help of a mental health specialist IMMEDIATELY. 

From here, we moved onto the portrayal of depression in media. Although I had hoped to discuss four movies/books (13 Reasons Why, Big Hero 6, Inside Out, and Frozen), I could only analyze two of them with the therapists as they hadn't seen/read some of the other examples. If you guys have seen/read anything else that you thing portrays depression accurately/inaccurately, let me know in the comments please!

• Frozen:
• Scene: When Elsa feels trapped by the family, and is secluded in her room for many years (also, Anna's rejection from Elsa in terms of their sisterly bond)
• Yes, this does accurately portray depression. However, the reengagement between the two sisters later in the movie isn't natural.

• Inside Out:
• Scene: When the family relocates to San Francisco, Riley feels very sad, alone, insecure, and unhappy. 
• This is yet another accurate scene from Disney! Apparently, Inside Out really hits all the details (you'll definitely see more references to this movie)! 👍

In terms of where these misconceptions stem from, the answer is still the cultural shame and the social stigmas. People don't have accurate information because of the limited ways for the right information to be spread. Mental health issues are not an open topic. Not talked about. People don't ask questions because of the guilt and shame they feel. They're too afraid to ask and get accurate information. Because of all of the misinformation (such as the statements I previously discussed), family members can be rude, and also, people can be their own, harshest critics. To combat this situation, we need more public health campaigns, allowing mental health issues to be more widely and openly addressed in our culture. 

Sorry, I know this post is getting a bit long, but I wanted to talk a little bit more about my on-site experience as an example of the social stigmas we can even unconsciously hold. Although no notable changes have occurred in my plans for my project, there has been an ongoing experience that has surprised me while being onsite. I'd like to provide some background before I begin on what I do exactly on the typical, on-site day. For the most part, I help Jessica at the front desk, attending to client calls, collecting payment, and making appointments. I also make files/folders for new clients, and organize/print out any paperwork or fliers that will be necessary. Here are some pictures of A New Beginning, making it easier for you guys to visualize the environment:

The super, calming front lobby (p.s. the chairs are too soft to be real)

Oh look! You can see the front desk (unfortunately, you can't see me sitting there as I usually do) 😆

Spending time at the front desk, I got to interact with a lot of the clients, and in doing so, my whole point-of-view on mental health issues changed. Everyone who comes in looks so normal, and I'd never have thought they were struggling with a disorder. This shocked me because I didn't realize that I myself held such shallow stereotypes and misconceptions in mind. But, after this experience, I'm beginning to see that everyone is only human, and everyone truly has their own story. Their own problems. I know that probably sounds cliched, but it was so eye-opening. I'm so grateful for this experience, not only for making a great project, but for teaching me a lot about how I see others. 

I hope you guys like my Week 2 post! Thank you all for following me on this journey, and showing me so much support!

Lots of love 💗,

--Saleena 

Sources:

*Psychologists Think They Found The Purpose Of Depression (2017, February). Retrieved February 14, 2017, from http://www.huffingtonpost.com/entry/psychologists-think-they-found-the-purpose-of-depression_us_589e58a8e4b080bf74f03c45