pi3: March 2020

Tuesday 31 March 2020

Day #225: Class presentations

For the past week we have been utilizing online resources so that classes can continue while we are all social distancing. While this is means that we mostly use Zoom, we also have message boards and other resources that we can use. However, these resources are sometimes a poor substitute for in person classes. This is especially apparent when we have certain assignments for the class, such as a group presentation.

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Why Victims of Microaggressions Need Allies

American culture is infused with subtle messages about what’s normal or not normal, and what is good or bad. These messages are reinforced through daily interactions that, for those whose race, nationality, sexual orientation, faith, disability or other attributes differ from cultural norms, can often cause exclusion or alienation. Even though they might be unintentional, microagressions — also called subtle acts of exclusion (SAE) — inflict harm. SAE insidiously reinforce bias.

Statements such as, “I didn’t expect you to be so eloquent,” or “I can’t pronounce your name, so I’ll just call you ‘Taj,’” are pervasive, and go mostly unchecked. Yet they wear on victims’ physical and emotional well-being by making them feel different or less than. Still, pointing out the offense to a coworker, an acquaintance or a stranger can be awkward, or even perilous.

But for a witness or bystander, ignoring an SAE or pretending it didn’t happen leaves the subject feeling invisible and silently condones the act. Because of this, the need for allies who are willing to stand up to SAE is extremely important. While it’s likely that the initiator will focus on the intent behind the remark, what in fact matters is the impact the remark had on the other person.

One of the most critical aspects of inclusion is that it must happen actively. It’s not enough to say you’re an ally and then not speak up in the face of adversity. When you witness an SAE, you have choices. You can sit by and let it happen, you can speak up to the initiator or you can speak to the subject.

Let’s focus on how to speak up to the initiator.

If there’s a possibility of a productive conversation without negative repercussions, the best course of action is to say something. Use these guidelines for how to safely interrupt and address an SAE.

Pause the action. This first step, pause the action, does not need to be hostile or abrupt. A simple “Wait, what did you just say?” or “Excuse me, but I don’t think you meant to say that” work very well at stopping the action without making the person speaking feel upset or thrown off.
Assume good intent. We have been socialized to commit SAE. They’re part of many people’s beliefs and vernacular. So, assume the person didn’t mean to commit an exclusionary act.
Explain why the action was paused. This, again, should not be a hostile interaction. Simply state that what was just done or said was an act of exclusion, and that people say or do these things all the time, but they’re actually super harmful. There’s no need to lecture the person on what they did. Simply plant the seed.
Have patience but expect progress. Systemic change is never instantaneous. Expect progress over time. Hold people accountable but don’t get frustrated if it takes a few more reminders and “pause the actions” to really start to see change.

The importance of allyship can’t be overstated. If each of us spoke up every time we saw or heard an SAE taking place, we’d become better at these types of conversations. Greater social accountability would result and change would be affected more rapidly.

Just as in every civil rights movement throughout history, change occurred because of allies and accountability. When more people spoke up, it created power in numbers and increased awareness.

It’s time to shift the conversation around microaggressions from a shame filled association to the truly unconscious and socialized nature of these SAE. We want to manage the guilt that comes with committing an SAE in an attempt to humanize these experiences and create room for conversation and growth. By lessening the shame and educating others on the macro, not micro, impact of these acts, we instill a call to action: If you see something, say something. Don’t call out, call in.

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Self-Isolation, Meditation & Mental Health in Times of COVID-19

Most of us have never before experienced enforced self-isolation and lockdown. What can we learn from people who have voluntarily gone into isolation for prolonged periods of time?

A group of people who self-isolate regularly are meditators, be it monks spending years in caves or laypersons going to silent retreats. Although there are big differences between meditation retreats and lockdowns, we can learn much from linking the two.

When people begin and end meditation retreats, they often have trouble adjusting. Many experience alienation from everyday life, and some struggle with their changed role or idea of self.¹ Going into and out of isolation can create similar effects.

In my research with meditators, I learned that many report that not talking to others, having no eye-contact, and being on one’s mobile can be deeply unsettling. In turn, social life during the coronavirus lockdown varies from person to person, depending on if we live with somebody (and how our relationship is), if we are prepared to communicate online and by phone, or if we are more extrovert or introvert. Some people now have increased online contact with people from long ago or further away, while others feel disconnected and become depressed, anxious, and fearful. Sometimes we can make changes by reaching out to others and trying to connect virtually, at other times we might be able to change our mind-set and use our alone-time in a positive way, but sometimes we are stuck in sadness, fear and anxious insecurities.

Being alone and being lonely are two different things. This difference partly comes about by choice — whether we choose to be on our own or whether we are forced to be — and partly by how connected we feel with ourselves, with others, or with our tasks and passions.²

What is crucial during both self-isolation and meditation retreats, is how we deal with our emotions and thoughts. During meditation, when we become still and the busyness cedes, our emotions and thoughts rise to the surface. This can be difficult.

The pandemic fills many of us with anxiety, fear and insecurity about our health and our financial situation, and leads to grief over the loss of normalcy, of activities and of people. When these emotions become overwhelming, some develop problematic thoughts and habits, ranging from circling deeper into anxious or depressive thoughts to addictive behavior, getting lost in magical thinking, or obsessively cleaning their hands and surfaces.

Mental health advice often recommends meditation and mindfulness to learn to deal better with negative thoughts. These practices can help us to be more aware of what is happening and to respond skillfully, rather than reacting unconsciously. If we have learned to do this, it can help to give us stability in the face of adversity.

However, if we begin to practice while we experience difficulties, meditation is not always safe.³ Sudden memories of trauma can either induce a fight or flight mode, or make the mind go numb. Both reactions will not enable us to process and integrate what is going on and leave us feeling worse than before. If we want to work with difficult emotions and memories, the first step is to establish stability. Only when we remain in the “window of tolerance” between excess emotion and numbness are we properly aware and rational enough not to be carried away or avoid looking at what is going on. If you have a history of trauma or struggle with strong emotions, it can be necessary to be helped by a therapist or trauma-sensitive mindfulness teacher to be able to learn to meditate without provoking more difficulties.⁴ Therapists are currently preparing to offer more and more services online, and helplines such as Samaritans cannot offer therapy but at least an open ear to those who struggle.

My research shows that some life phases are better than others for working through our difficulties. Defenses are built for a reason: to protect us. If we are well, it makes sense to let go of them in order to heal and integrate all aspects of ourselves and become whole. Yet sometimes, going deeper into problematic thoughts and emotions can lead to more difficulties. This is particularly true if we are feeling unstable, alone or in a situation of uncertainty.³ In such cases, focusing on coping rather than healing as a first step is important. When therapists work with traumatized clients, the first step is to establish stability and a feeling of safety before looking back at past difficulties.⁵ If we are on our own without therapeutic help, we can increase stability by establishing healthy routines. Remember which activities make you feel good, keep your mind stimulated and let you stay as active as possible. The latter also helps us to be less “in our heads.” It will also counter the effects of sitting still, which have become apparent in my meditation research, such as changed appetite and sleep patterns, and sometimes, due to reduced stimulation of one’s senses, changed experiences of one’s body, of the self or the world around us.

The number of people who try meditation is currently increasing, judging by the spike in downloads of meditation apps.⁶ People not only have more time but research has shown that people feel drawn to meditation in times of change and crisis. Meditation can indeed help, but it is important to see if the time is right. Apps don’t offer the same support and help in times of distress that communities and teachers can and won’t help to avoid misunderstandings of concepts, techniques and ideas by providing context or adjusting meditation techniques.

My own research, as well as traditional Buddhist texts, show that some meditation practices are more dangerous than others; extreme developments amongst the practitioners I interviewed included meditation-induced psychoses, suicidality and other serious psychological difficulties.¹ Amongst my sample, negative effects were most likely when practitioners meditate for very long times, or when they use certain techniques including intense breath work or work with energy movement in the body. These techniques often promise to have faster results in helping us to heal or awaken, but they also carry a high risk. Traditionally, these techniques were therefore kept secret until practitioners were advanced enough. But now we can find these techniques on YouTube without any warning about their dangers.

Some meditation blogs encourage practitioners to go on solitary retreats during the lockdown. This can be good if we have been practicing for a while, but it can also cut us off too much in a time when we need connection.

If you have psychological problems, meditation can be overwhelming or lead to misunderstandings of ideas; therefore, it can be useful to have a good teacher or therapeutic support.⁷ Never push or strive during meditation practice, as this is often causes people to develop problems. Practicing self-compassion is of utmost importance.

Also, research shows that meditating while we are upset can reinforce negative patterns.⁸ If meditation doesn’t feel right, don’t do it. Some discomfort is normal, when we are getting used to sitting still and being with our thoughts and emotions — mindfulness has wrongly been sold as just making us relaxed or happy. However, when we meditate on our own and without support, we need to be careful about staying within our window of tolerance. Be aware of what is going on for you and tune into your body and mind. If you are in doubt, it will be better to get qualified support before you continue.

When meditators encounter problems, the strategy they reported in my research as the most helpful, is to ground themselves. This includes focusing on feeling the ground under one’s feet, using one’s body more, and connecting with others.

Grounding can also help non-meditating people during self-isolation. Ask yourself if you’re connected to the different parts of your body, to the world, and to others and try to find a way to balance the different areas: Use your body by exercising and working in your house and garden, use your mind by learning new skills or by being creative, don’t avoid feeling your emotions, and connect with people from different areas of your life.

Meditators work with awareness, insight and compassion. All three are crucial to our wellbeing, whether we are meditating or not: We need to stay aware and mindful of what we are doing and feeling, which will help us to appreciate the moment and to find joy in small things. We need to use insight and discernment in how we use media. We need to understand whether we are catastrophizing and generalizing rather than having a more differentiated view. And most importantly, we need to keep our heart open and be compassionate — not only to others, but also to ourselves. Let’s not beat ourselves up for feeling the way we do — instead, let us open our heart to all these hurting parts of ourselves and allow ourselves to grieve.

When we are able to do these things, our isolation can become a fruitful time. There lies a potential in this time of self-isolation that we could tap into: a chance for being more creative, for finding new ways to live or work, for settling into better habits, for clearing up our space, for connecting with people anew. Just like meditation retreats, isolation can mean times of difficulties as well as growth and happiness. Let’s be mindful, insightful and full of compassion for others and ourselves to avoid the pitfalls, keep us safe and to make the best of this time possible.

References

Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PloS one, p. 20.
Arendt, H. (1973). The Origins of Totalitarianism. Orlando: Harcourt.
Compson, J. (2014). Meditation, trauma and suffering in silence: Raising questions about how meditation is taught and practiced in Western contexts in the light of a contemporary trauma resiliency model. Contemporary Buddhism, 15(2), 274-297.
Treleaven, D. A. (2018). Trauma-sensitive mindfulness: Practices for safe and transformative healing. London: Norton.
Van der Hart, O., Brown, P., & Van der Kolk, B. A. (1989). Pierre Janet’s treatment of post-traumatic stress. Journal of traumatic stress, 2(4), 379-395.
Meditation App Downloads Increase Because of Coronavirus. (n.d.). Retrieved March 29, 2020, from www.adweek.com website: https://ift.tt/2QryKLQ
Masters, R. A. (2010). Spiritual bypassing: When spirituality disconnects us from what really matters.Berkeley: North Atlantic Books.
Delorme, A., & Brandmeyer, T. (2019). When the meditating mind wanders. Current opinion in psychology, 28, 133-137.

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How To Build Up Psychological Resilience (M)

The simple technique that reduces the risk of depression.

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How to Cope with Coronavirus Anxiety When You Already Have an Anxiety Disorder

When you already have an anxiety disorder, and a real pandemic hits, you can feel especially lost and terrified.

Clinical psychologist Regine Galanti, Ph.D, helps her clients recognize that their anxiety is a false alarm—“it’s not your house on fire, it’s a pizza burning in the toaster.” But because of Coronavirus, she said, your house is actually ablaze.

In other words, it makes sense that you’re anxious.

It makes sense that your symptoms have flared up or gotten worse, agreed Emily Bilek, Ph.D, a clinical psychologist and clinical assistant professor at University of Michigan.

Bilek noted that people understandably have genuine fears about their jobs, their health, their homes, their finances, and the pandemic’s short- and long-term impact on society.

But while your anxiety might be peaking, there are many helpful actions you can take. One of the best steps is to schedule a teletherapy session with your therapist (or find a therapist to work with). Here are other tips to try:

Set limits. Keeping the TV on your favorite news network and scrolling social media all day long puts you in a constant state of anxiety. “[H]earing about all the danger increases our perception of the threat,” said Galanti, who has a private practice in Long Island, N.Y. Instead, she encouraged readers to carve out specific times to check for updates. This way you stay informed without being blindsided and bombarded with negative information.

Another helpful limit to set is not talking about the pandemic: “Tell your friends and family that you’ll be changing the subject when it comes up,” Galanti said. “This will not only help limit your anxiety, but also help others as well.”

Practice sustainable self-care. Prior to the pandemic, you might’ve relied on a slew of self-care practices: You went to a specific yoga studio you love, meditated on your commute, and took long weekend walks. Not having these habits when you need them most might lead you to over-do it at home.

Instead, Bilek recommended picking realistic, attainable activities. Do a 10-minute yoga video on YouTube. Drink plenty of water. Take 5-minute deep breathing breaks from work. Take care of yourself in small ways.

Schedule daily worry sessions. “It’s normal to worry right now, but it doesn’t have to take over your day,” said Galanti, also author of the new book Anxiety Relief for Teens: Essential CBT Skills and Mindfulness Practices to Overcome Anxiety and Stress. When a worry thought pops up, she suggested jotting it down quickly and re-reading this list during a 15- to 20-minute worry session.

Curb caffeine. Bilek noted that we tend to use caffeine to cope with negative feelings, such as boredom and fatigue. However, “this can make us more vulnerable to physical feelings of anxiety, and thus panic attacks.” Plus, she said, caffeine can mimic the physiological symptoms of different health concerns.

Instead of mindlessly chugging three cups of coffee or soda throughout the day, slowly savor one small cup in the morning with your breakfast.

Spot patterns in your panic. If you’re prone to panic attacks, it’s easy to confuse those symptoms (e.g., shortness of breath) with the respiratory symptoms of Coronavirus, Galanti said. This can lead you to go to the ER and risk possible exposure to the virus.

This is why it’s important to pay attention to what precipitates your symptoms. Galanti pointed out that panic symptoms typically come and go, while virus symptoms do not. So, if you’re having trouble breathing as you’re watching the news or thinking about the pandemic, it’s panic.

“The best way to manage panic [attacks] is to embrace them. I know that sounds counter-intuitive, but the more you face panic, the more you’ll see that [panic attacks aren’t] as dangerous as you fear and that you can cope with them.”

Get good sleep. Bilek stressed the importance of maintaining a consistent sleep schedule—waking up and going to bed at the same time—even if your days are much more flexible now. Replace TV watching or social media scrolling with one soothing practice. For example, before bed, you might listen to a self-compassionate meditation, take a warm bath, or try one of these sleep-promoting yoga poses.

Get grounded. When Bilek’s clients are overwhelmed with worry or anxiety, she suggests they identify things in their environment that they normally don’t notice. This can include searching for a unique shade of green, counting the number of different sounds you hear, or looking for an interesting texture, she said. “By focusing on our senses, we are necessarily brought into the present, even if just for a moment.”

Look to your values. “We can’t change our circumstances, but we can choose what kind of person we want to be in this crisis and act in accordance with our values,” Galanti said. For example, instead of searching for toilet paper on Amazon again, you do a craft with your kids or watch Frozen 2 “for the bazillionth time.” Instead of checking the news, you FaceTime with your mom.

If you’re still struggling with increasing, worsening symptoms of anxiety, don’t hesitate to seek professional support. In fact, you can talk to a licensed therapist right now. You can get through this. And you will.

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The Soy-Based Foods That Reduce Heart Disease Risk

A study has found that this food cuts the risk of early death by 10 percent.

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Light and Darkness in Bipolar Disorder: Q&A with Jim Phelps, MD

Dr. Jim Phelps is the author of a textbook on bipolar spectrum disorders, A Spectrum Approach to Mood Disorders: Not Fully Bipolar But Not Unipolar—Practical Management (W. W. Norton &...

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Bad Mental Health Affecting My Health & Relationships, I’m So Confused What Do I Do?

I’m not yet diagnosed, I can’t afford yet to properly get a consultation and in my country free mental health facilities are quite scarce and it’s not easy to book with the overwhelming amount of people in need of it too and covid19 is upon us.

I was always a shy, and insecure person, it was also normal for me to think a lot during the night but in 2018 it got a whole lot of intensity and I haven’t been the same since. At the start I was elevated I was starting to know myself through church activities and I was happy I felt like I had a purpose, the feeling slowly deteriorated when fights again at home started, we were financially unstable which added more tension, and then I witnessed once again domestic violence, at first I thought I was okay at least but I started panicking randomly, my heart suddenly beats faster and awful thought in my brain started fluttering. It started affecting my singing at the choir. Lastly it took a toll on my health. I have skin asthma, my skin was already flared up but I observe as my mental state gets more intense, my body quickly declined. I started having infections, my skin condition got worse and became more sensitive. I easily got tired despite I was used to the moderate school works.

My thoughts about myself, the self-loathing, got intense as months go by. It got so worse that my head would ache. I was surprised at how intense every feeling I have. Me being stuck in the house because I’m physically sick didn’t help since I felt helpless and hopeless. I’m usually described as a positive person, it was out of character for me to attempt suicide.

Fast forward to now at least I got over my infections and my skin is slowly recovering. Compared to then I can “somewhat “control” my panicking and whatever was that intensity. I try to disconnect myself from emotions but I don’t know if that’s healthy or not, I know I’m still frustrated but I don’t want to go back to those dark times again lose my health again. I’m doing the opposite I had back then, with me having intense emotions I disconnect and be numb. I internalize my emotions and thoughts back then so I’m more vocal but I unintentionally hurt my family.

If I were interviewing you in person, my first question would be what happened in 2018? You have identified that as a time in which your symptoms had worsened. I’m wondering what caused you to have a change in symptoms. Knowing that information might have helped me to better understand what the problem may be.

A number of things you mentioned are likely contributing to your mental health symptoms including the fight that occurred at home, being financially unstable, and witnessing domestic violence. These are indicators of the instability of your home life. In fact, it’s possible that the problems in your home are the main source of your symptoms.

In addition to the chaos in your home, you’re experiencing physical health problems including a sometimes out-of-control skin condition. The skin condition seems to be exacerbated by the problems of your life. The exacerbation makes you physically sick and further intensifies your symptoms, seemingly to the point of attempting suicide. Thankfully, your attempt was unsuccessful.

Currently, you seem to have recovered to a degree but are now experiencing emotional numbness. This emotional numbness may be a defense mechanism against the extremely negative feelings you had experienced previously. One might even consider the emotional numbness as a temporary Band-Aid or a buffer or sorts. It works for now but it’s important to address the underlying problem.

The best solution is to consult a mental health professional, in person, but understandably that may not be an option at this time. The coronavirus is making it difficult for people to engage in normal daily activities. You might not get an in-person consultation but you may be able to access a professional via the internet or over the phone. Consultations via the Internet are not the norm but that may change given the current pandemic. In that case, I would recommend contacting your local mental health facility to determine if they are providing treatment via phone or the Internet. Many facilities are adapting to the current changes.

In the meantime, there are a number of things you can do. I would recommend journaling. Studies show that it can be quite cathartic and clarifying to write during times of distress. Having this documentation could also assist in your treatment.

You should also keep in contact with friends or other support systems in your life. Even though we all have to engage in social distancing, we can still interact via the Internet. It would help for you not to be alone at this time. The more support you have, the better you may feel.

It’s important to keep in mind that you seem to be living in a chaotic family situation. You mentioned that you sometimes engage in self-loathing. Self-loathing is an extreme dislike for oneself. This would suggest that you are blaming yourself for whatever’s going on in your life. It’s important not to blame yourself for things that are not your fault. Things are happening to you which are outside of your control. You are reacting to the situation and you need more assistance than you are getting.

People who are inclined toward self-loathing are often depressed and thus it’s important that you attempt to reach out to your local mental health facility about what services are available. That would be your wisest course of action. This is especially important because of your attempted suicide.

Try consulting with your local mental health facility and hopefully they will have the services you need. If you ever feel that you are a danger to yourself, contact emergency services. They will provide immediate assistance, even during a pandemic. Good luck, stay safe and please take care.

Dr. Kristina Randle

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Google knows more about me than I do. Further comment on Harari article.

Again I have the eerie feeling that one of the phrases that sticks in my mind from reading Yuval Harari’s books, namely that “Goggle knows more about you than you know about yourself.” is absolutely correct. My March 24th MindBlog post points to an article in the Financial Times by Yuval Harari on the world after coronavirus (brought to my attention by my son Jonathan’s March 21 Facebook post). Google has been watching, and so knows that I would be interested in a Financial Times letter to the editor on March 28 titled ‘So, professor Harari, who am I supposed to trust?’ It is passed to me via my google news app on March 29. I hit the link and read the two paragraph letter, but then when I try to return to the link later I hit a paywall. Turns out a friend has just told me about http://archive.is/ which will attempt to archive the content of any URL you send to it. It retrieves the text of the snarky comment on Harari:

Yuval Noah Harari is a stimulating and interesting figure, even if his arguments aren’t designed to stand up to sustained questioning (“The world after coronavirus”, Life & Arts, March 21). But even using the loosest standards, I was still surprised to see him spend five columns on panic-inducing thought experiments about governments surveilling me under my skin, in which China, Israel and North Korea are set up as perfectly representative nation-states . . . only to then spend three columns begging us all to trust our governments and the experts and wash our hands.

His previous work suggests that Professor Harari wants to be one of the experts in whom we should believe. If he really wants to earn my trust, he must decide whether I’m meant to be terrified of my government, or to trust it completely, or if I should only trust experts who can’t maintain a single line of argument over two pages.

Justin Evans

Washington, DC, US

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Problems with Best Friend

I’ll give you the short version of what’s happening; My best friend and I got into a game around the same time, just before I moved cross-country. We only ever talk on the phone, and this past year, she’s been telling me some alarming things. She thinks two characters from the game we like are her….. let’s just call them “imaginary friends” and talks to them out loud when I’m on the phone with her. She’ll do this for minutes on end. Her falsely religious mom is abusive, and has been rude to me whenever I visited in the past. Her mom is probably unstable herself, actually ENGAGING with these “imaginary friends” according to my best friend, saying “if she fights with them, she doesn’t care about them” and stuff like that. My friend is only a year older than ME. Also would like to mention my friend thinks everything has a “spiritual” or “supernatural” cause, (such as “demons cause her problems”, or “if she prays hard enough, angels come down to help her”, etc.) She also believes herself to be a psychic, and her mom enables this behavior by using holy water on my friend, and whatever woo stuff she brainwashes my friend with. Her mom hates me because after she talks to me for a while, she has to start the process of brainwashing my friend all over again. Sometimes, I feel like I’m her only beacon into reality. I’ve exhausted all I can do; I’ve offered her resources she can use to help herself, and she finds excuses not to use them, I’ve listened to her nonsense, and called her mom’s bluff millions of times. Can you guys give me a professional opinion on what may or may not be going on here, and give me suggestions on what I need to do at this point? Because observing this is beginning to affect my own shoddy mental health. Thanks!

Your friend seems to be believing in things that are not real. These ideas seem to be facilitated by her mother. Her mother thinks one way about the world and she is sharing it with her daughter. She may be being indoctrinated by her mother.

The possibility also exists that your friend has a mental illness. It’s difficult to know what illness but possibly a psychotic disorder. I could never know what disorder she may or may not have from a distance. She would need to be evaluated by a therapist, in person, to know what disorder she may have, if any at all.

You are doing all you can but as you can see your power is limited. You should continue to express your concern for your friend and encourage her to seek help. After you’ve done that, realize that you’ve done all you can. She is free to believe in anything she wants. The hope obviously is that she would believe in things that are real, and not in things that are not real.

You mentioned that this is beginning to affect your own mental health. In that case, you may have to put limits on the amount of time you spend interacting with your friend. As I mentioned above, you should do what you can but realize that you can only do so much. You can’t make people do things they are not willing to do. You suggested that she seek help and she ignored you. You cannot force her to seek help if she does not want it.

It’s difficult to watch someone you love engage in behavior that is detrimental to their well-being. In some ways, it’s the most difficult position to be in, watching what amounts to a slow-motion train wreck. Unfortunately, that is sometimes the reality of life. People have to want to seek help and have to be willing to get it. For those who are unwilling to get it, there’s virtually nothing you can do. The only time you can force someone to seek help is when they are a danger to themselves or to others. Even in those cases, the danger has to be imminent in order to receive immediate help. It does not seem as though your friend is in imminent danger nor a danger to herself or to others. Theoretically, believing in ideas not based in reality are dangerous for one’s psychological health, however, it is not enough to qualify for inpatient hospitalization.

Do your best and hope for the best. Encourage her to seek help. Realize that your power is limited in this situation. Keep your distance so that you can protect your own mental health. Good luck and please take care.

Dr. Kristina Randle

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Monday 30 March 2020

Coping with Losses Due to COVID-19

Weddings, graduations, business meetings, travel, friends and family gatherings have been interrupted. Some activities we may have been looking forward to have been wiped out or postponed. Some people’s reaction can be anger, anxiety or stress. Others are mourning what could’ve been in sadness and frustration.

A friend whose yearly tradition has been to enjoy the national college basketball tournament during March (March Madness) with his sons and their families is lamenting his loss. For his family, March is usually a time to watch their favorite basketball players and teams compete, and most importantly, an opportunity to bond with one another as a family.

Many college students have mixed feelings about doing online classes. Professors may be more lax during these times. On the other hand, many of them have gone home, away from friends and activities that keep them connected and feeling joy in the middle of their usual stress.

Many parents are adjusting to working from home, “home-schooling” their children and keeping them busy enough. Stress levels have heightened for them. Those whose jobs’ have been suspended or eliminated are concerned about their financial instability going forward. More relevant, many are experiencing the uncertainty of their loved ones’ physical well-being or even the potential loss of a life.

No matter how subtle or devastating your loss is, you need validation, and you are not alone. As you deal with your losses, remember that fighting, running away, or numbing yourself from your feelings can affect your emotional, mental and physical health. It can feel overwhelming and confusing to deal with so many fused emotions. So, here are three skills to help you cope with these unsettling times:

Give yourself permission to feel and experience the pain. It’s normal to grieve for a loss, and one way is to embrace the difficult emotion. Imagine you are holding this emotion as if it were a wounded creature (e.g., butterfly, bird, puppy, or kitten) or a unique and delicate flower gently on your hands.¹ Take two to three minutes to hold your difficult emotion in that way instead of resisting, escaping, suppressing, or ignoring it.
Social distancing may be exacerbating your mental and emotional challenges. Though there may not be someone there to support you in the moment, studies have shown that you can literally console yourself and produce oxytocin (love hormone) when no one is around.² Put your hand or two hands to your heart, hug yourself, or pat your arm, or leg as you give yourself words of comfort like you would to a loved one in moments of pain. This will allow the release of oxytocin to help you in that moment of difficulty.
The overwhelming emotions you are experiencing may be making it difficult to fall asleep as your thoughts continue to race from one situation to another. Once you are in bed, close your eyes. Make a conscious effort to notice the lines, shapes and shadows behind the lids of your eyes.³ Have you ever consciously noticed what’s behind your eyelids? Maybe it’s pitch black. Whatever you see, observe all its details quietly and without evaluating or thinking about what you see. When your attention drifts, gently return to noticing behind your eyelids. The goal of this exercise is not necessarily to help you fall asleep, but to focus on what you see behind your eyelids. Continue noticing and gently refocusing as needed. You may even fall asleep because you are no longer carrying on a conversation with your mind. Try it and see what happens!

For sure, we will all get through this unique challenge. Don’t let despair beat you down. Establish a daily routine, ensure you implement different activities throughout the day that you enjoy. Stay connected with your loved ones through available means. Stay present and seize the opportunity to start new hobbies and activities that you now have time for!

“The sun never quits shining. Sometimes, clouds just get in the way.” – Unknown

Sources:

Steven C. Hayes, A Liberated Mind: How to Pivot Toward What Matters, New York: Avery, 2019.
Kristin Neff, Self-Compassion: The Proven Power of Being Kind to Yourself, NY: William Morrow, 2011.
Jan Pilotti, “Mindfulness for Sleep,” Association for Contextual Behavioral Science, https://ift.tt/3dIcasw

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Bipolar & Substance Abuse Disorders: A Complex Diagnosis that Demands Integrated Medical & Psychological Care

The word “bipolar” has become colloquially associated with anything that changes rapidly or is unpredictable: the weather, technology, sports teams, politics, or even a teenager’s attitude. But for roughly 46 million people worldwide, being “bipolar” is far more serious than typical unpredictability, mood swings, or temperamental behavior. And, when bipolar disorder is complicated by substance use disorder (SUD), the situation can become incredibly dangerous for the individual and those around them.

Recognizing the symptoms of bipolar and the complicating factors of substance use disorder is crucial for physicians, mental health advocates, law enforcement, and anyone who lives with or loves someone who suffers with bipolar tendencies. To break through the stigma, World Bipolar Day aims to raise awareness of bipolar disorders with activities that provide education, support, and improve sensitivity around the illness. Most importantly, shedding the stigma around any mental illness starts with understanding the disorder itself and devising a holistic treatment and support plan that addresses the prevalence of confounding substance use disorders.

The Bipolar/SUD Connection

The statistics are startling: People with bipolar disorders are 11 times more likely to also have a substance use disorder. Over half of people diagnosed with bipolar disorder have a history of illicit drug abuse and 44% of bipolar patients have abused or are dependent on alcohol.

What drives this connection? In many patients, it’s the struggle to simply feel okay.

Bipolar disorder causes extreme and lengthy fluctuations from manic, hyperactivity to deep, debilitating depression, with episodes lasting for days or even weeks at a time. During the manic period, patients have boundless energy, can’t sleep, and feel invincible. The euphoria may even drive them to engage in dangerous behaviors like high-risk sex, spending sprees, extreme activities, and other behaviors that can have a dramatic impact on their health, safety, and their family. During the depressed stage, patients suffer from extremely low energy, lack of motivation, have zero interest in daily activities, and are highly susceptible to suicidal thoughts.

With both mental and physical symptoms that swing widely like a pendulum, those with bipolar disorder often turn to substances to help them feel “better.” During a depressive stage, stimulant drugs like cocaine, amphetamines, and methamphetamine can restore the “high” of the manic phase, helping to pull patients out of the depression, albeit artificially and certainly with substantial risk to their overall health. Others turn to alcohol in the hopes to simply temper the wild swings but with obvious negative effects.

Dual Diagnosis Demands Dual Approach

These co-existing disorders create a serious challenge when patients seek treatment. Treating bipolar disorder most often requires the use of antipsychotic and mood stabilizing medications. But many of these conflict with alcohol and other substances. That means the patient must be detoxed first in order to treat the underlying bipolar condition.

At the same time, patients are often resistant to treatment that eliminates the euphoria. They’ve experienced such debilitating lows that they crave the “high,” and the thought of eliminating that — to restoring to a normal baseline — sounds dull, boring, and not at all appealing. As a result, many avoid seeking treatment until they’ve reached a depressive state, but that’s also when they’re most vulnerable — approximately 15% of people with bipolar disorder commit suicide and 25-50% attempt suicide at least once.

That’s why treating bipolar and substance abuse disorder demands a holistic approach that not only addresses the substance issue but also teaches the patient lifestyle techniques that contribute to healthy mood and brain function. A comprehensive care team that includes both medical and psychological specialists working together is crucial for dealing with the physical addiction and the mental health challenges.

In addition to enabling safe, medically supervised detox and providing access to safe, effective medications, this dual-treatment approach incorporates healthy habits that are critical for long-term success, such as a nutritious diet, exercise, better sleep habits, all of which naturally contribute to a healthy brain.

Family and Community Support Is Vital

In addition to treatment, having the emotional support of family and friends is essential for successful bipolar/SUD treatment. Recognizing that the individual 1) can’t control their sometimes wild and erratic swings, 2) is at serious risk of grave consequences as a result, and 3) needs a supportive environment for recovery is critical. Family and friends must be sensitive to the complexities of the co-existing disorders and treatment and provide as much intellectual, emotional, spiritual, and occupational support as possible.

A large part of the challenge around treating bipolar/SUD — or any mental health issue, for that matter — is the stigma around coming forward with issues related to our emotional or mental state. If someone suffers a broken arm, we have no problem discussing the details surrounding how it happened and the diagnosis and treatment, but so many feel fear and shame around an impaired brain. That silence puts so many people at risk.

If you know someone suffering with bipolar/SUD, or any mental health issue, it’s imperative that you reach out. Let them know you’re concerned and offer to go with them to see their primary care doctor. Many communities also have local mental health crisis centers where individuals can get an immediate assessment and referral to a mental health professional.

Of course, if the situation is urgent and your loved one is in immediate danger, don’t hesitate to call 911 and explain the situation. Many people avoid this out of fear it will result in a law enforcement response, which could further intensify the situation. But if you explain the circumstances, most agencies will send an ambulance, rather than the police, and most emergency responders are trained in mental health triage.

Finally, if you or someone you love is dealing with a serious mental health issue, contact the National Suicide Prevention Lifeline at 1-800-273-TALK or text HOME to 741-741, the Crisis Text Line. These services are confidential and free, and you’ll be connected immediately to an individual who can help, provide local resources, and send information about help in your area directly to your device.

To learn more about World Bipolar Day and ways to get involved, visit www.worldbipolarday.org.

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Day #224: Review – Cortical and Subcortical Effects of Transcutaneous Spinal Cord Stimulation

Well it's been two weeks since the last critical review so it's that time again. As usual, my PI gets a copy and so do all of you. Since I've done several of these now (this is number six) I have a category just for these reviews called critical reviews. This is a really new study which tries to help tease apart what we are actually stimulating when we apply transcutaneous spinal stimulation. I think it's a super interesting paper and I hope you think so too.

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The Music That Boosts Mental Energy (M)

How to use music to give your brain a boost.

→ Support PsyBlog for just $5 per month. Enables access to articles marked (M) and removes ads.

→ Explore PsyBlog's ebooks, all written by Dr Jeremy Dean:

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Podcast: Smoking Weed for Anxiety – Fact vs Fiction

Cannabis, weed, marijuana, pot. It goes by several names, but we all know what it smells like. As weed becomes more mainstream, we on the Not Crazy podcast want to know: Is marijuana really an effective treatment for anxiety? Is it just a coping mechanism? Or a vice? In today’s podcast, Gabe and Jackie look at the research and weigh out the evidence. They also interview Eileen Davidson, a rheumatoid arthritis patient who regularly uses marijuana as a medicine to see what she has to say.

What’s your take? Tune in for an open-minded discussion about weed.

(Transcript Available Below)

SUBSCRIBE & REVIEW

About The Not Crazy Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from Gabe Howard. To learn more, please visit his website, gabehoward.com.

Jackie Zimmerman has been in the patient advocacy game for over a decade and has established herself as an authority on chronic illness, patient-centric healthcare, and patient community building. She lives with multiple sclerosis, ulcerative colitis, and depression.

You can find her online at JackieZimmerman.co, Twitter, Facebook, and LinkedIn.

Computer Generated Transcript for “Anxiety- Smoking Weed” Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Not Crazy, a Psych Central podcast. And here are your hosts, Jackie Zimmerman and Gabe Howard.

Gabe: Welcome to this week’s episode of the Not Crazy Podcast. I’d like to introduce my co-host, Jackie.

Jackie: And that guy is my co-host, Gabe.

Gabe: And today we are going to be talking about. I’m not even sure what to call it. It’s been known as marijuana. It’s been known as cannabis. It’s been known as wacky tobaccy, if you go back to like my grandparents. I guess pot is the street name now.

Jackie: You sound like so, Grandpa Gabe, right now. You’re like, what are the kids calling it these days?

Gabe: Well, just

Jackie: It’s weed, Gabe. We’re talking about weed.

Gabe: But I mean, it used to be grass. It has had a prolific number of slang names. I mean, sincerely. Right?

Jackie: Yes, that is true.

Gabe: And I went to a dispensary the other day and I was like, hey, I’m here to buy pot and they’re like cannabis, sir? And I was like, well, weed. And they’re like, marijuana, sir? So I think that there is some attempt to make a demarcation between slang terms of marijuana and non-slang terms of marijuana. Is that what you’re seeing out in the world, Jackie?

Jackie: I think it depends on where you are obtaining said marijuana, right? If you’re purchasing it from a store, they’re like, yes, we sell marijuana here. If you’re going to the corner, you’re probably going to buy some weed. I think it just depends on where you’re getting it. Same stuff, different name.

Gabe: And this is not unusual, especially in America. Language is always evolving and different generations have different terms for different things. Remember when sick meant like you were sick and cool meant you were a bad ass? Now sick means that you’re a bad ass. And if you say cool, kids just look at you like you’re just, you’re just stupid.

Jackie: Which is like how I’m looking at you right now, because the more you talk just the older you sound. Low key, you sound like a real old guy right now.

Gabe: I love how you use low key, another slang term that I am not familiar with. But moving on to the topic at hand, marijuana is everywhere and depending on what Internet site you’re on. Marijuana is either the magical cure for everything, literally, no matter what problem you have physically or mentally, it can absolutely, unequivocally cure it. Or marijuana is satanic. If you even walk past it, you will murder your entire family. You won’t go to college and your eyes will inexplicably turn red. And our research, Jackie, of course, showed that the truth lies somewhere in the middle.

Jackie: As it does with most things, but what we’re focusing on today specifically is the use of marijuana, weed, pot, grass, reefer, whatever you want to call it in terms of treating anxiety. And I’m really excited to talk about this because this is something that is like polarizing. People either thinks it is like the end all be all, cures anxiety or they’re like, it doesn’t help at all. And you should definitely not use it for anxiety.

Gabe: One of the things that I think about is my Diet Coke habit, I’m gonna go with habit for the sake of today’s show. I have an anxiety disorder. I suffer from a lot of anxiety. And when I get really twitchy and out of sorts and I’m just really stressed out, worried, panic. You know, the racing thoughts start to come in when I’m on the verge of an anxiety attack. I stop everything that I’m doing. I find a fountain machine of Diet Coke, which usually involves going someplace, taking a walk someplace, getting in my car. There’s a whole ritual surrounding me getting a Diet Coke. And I can state unequivocally that when I do this ritual and I’m sitting in the corner and I’m drinking my fountain Diet Coke, my anxiety is relieved 100%. This does not make Diet Coke a cure or a treatment for anxiety. And I think that that might be some of what’s happening with marijuana, because no medical study shows that it’s a treatment for anxiety. And again, medical studies are ongoing. But as of right now, there’s nothing that states that anxiety is cured or treated by marijuana.

Jackie: You’re right. And part of me wants to be like, no, you’re wrong, it totally helps because I think it actually does help a lot of people. The problem is, you know, that I love my stats. The stats do not show this. I actually pulled up three different studies specifically on this topic. One study from 2019 is from The Lancet Psychiatry. It looked at the effects of cannabinoids on mental health for nearly 40 years of research, which is like a lot of research. And their findings basically said there was scarce evidence to support that cannabis helps to improve mental health symptoms. Forty years of research in this one study saying like meh, probably not that helpful. But there was another study in 2018 in Cannabis and Cannabinoid Research, which is like, how is there even a journal dedicated to this? But there is. Sixty two percent of people who use CBD use it for a medical condition. And the top three are pain, anxiety, and depression. So my takeaway on this is we don’t have proof in the science that it works, but we do have proof that people are using it for these reasons and are finding benefit in it.

Gabe: And in some ways, this is a tough one, right? Because I think about the number of people that tell me that I should not take prescription medications for my bipolar disorder because after all, I just need diet and exercise, better sleep hygiene. I just we’ve done so many shows on this. It’s just it makes my little head want to explode. But I still go back to the definition of treatment and cure. And the definition of treatment and cure is not I feel better when I’m done. It actually impacts the disease and puts you in a better place when you’re done. Lots of things make you feel better. Jackie hugging my wife makes me feel better. Having a strong support system makes me feel better. These things are not treatments. They’re encouraged. They’re important. And they may well help you. But I just get really, really anxious. I just get really, really anxious when people are like, oh, I treat my anxiety with this because there’s so many reasons. But let’s touch base on this for a moment. Marijuana in this country is kind of messed up, one dependent on the state that you live in, you might actually be committing a crime. That’s number one. But in every state in our union, there’s multiple types of marijuana. Right? There’s the good growers. There’s the growers that are overseen by the government in the states where it’s legal. And then there’s the person that’s just like randomly growing it. And we don’t know what kind of job they did, what kind of a strain they did, or whether or not they doused it in rat poison. And all of these things are marijuana to the end user. That worries me as well, because there’s no consistency here.

Jackie: I have a lot of feelings about that. Yes. Correct. No consistency given the fact that our government has not legalized it universally, which means that it cannot be regulated universally. Even if it is legal where you are, it automatically means it’s more expensive. So you may still be going to a street dealer regardless. So the consistency factor is definitely an issue. However, cycling back for a minute, while it is not proven that it is an effective treatment, I think that judging by 62 percent of users and everybody else, including a 2017 study in the International Journal of Drug Policy, where people believe that cannabis is an effective way to treat conditions in place of prescriptions for anxiety and depression. What this tells me is in terms of symptoms, management, it can be or it is effective depending on who you talk to. So is it treating anxiety? I don’t know. I don’t have the science, but is it treating the symptoms of anxiety? Yeah, it looks like it does. And are those one in the same? I don’t think that they are. I think that you can have plenty of medications that treat the actual underlying problem and lots of medications that treat the symptoms of the problem.

Gabe: Obviously, I can’t disagree with anything that you just said. However, there have been similar studies on whether or not cigarettes help you cope with anxiety. And the reality is that cigarettes have been studied for a long, long time. And the research shows unequivocally that cigarette smoking actually does not help with anxiety. However, when they asked people if it helps them, they said yes. You line up all of the smokers and you say, Hey, does smoking relieve anxiety? They’re all going to say, yes. The science is very clear that in fact it increases anxiety, but they believe that it’s helpful. This is the problem with self-reporting, right. A lot of people believe that things that are dangerous for them or are actively hurting them are, in fact, beneficial.

Jackie: I don’t know. I feel like there’s some aspect of placebo in this. Where, yes, the stats from the scientists are saying this actually causes anxiety and the people who are using it are saying, no, I feel better after doing it. So who’s right? I don’t think there’s is actually a right and wrong in this, which goes against everything that I normally say because there are science leading one way. But if the person says, I feel better after this, doesn’t it mean that it’s good for that person?

Gabe: Potentially, I think we go back to my Diet Coke addiction. The reality is, is drinking as much Diet Coke as I do could be harmful. I should drink way more water and I should go for more walks and I should call my mom more and I should tell my wife I love her more. Life is personal choices. And when it comes to the legalization of marijuana, from a political standpoint, I think it should absolutely be legal because it’s it’s been found to be no more dangerous for you than smoking or alcohol. And in fact, in some cases, much safer. But moving that aside, to answer the question of somebody suffering from anxiety, should they use marijuana as a treatment? I’m gonna go with no. However, somebody suffering from anxiety, should they use marijuana as a coping mechanism? That’s a personal choice. And Gabe is there. So I sort of feel the one-two punch. You should still get treatment from the medical establishment. But we all have coping skills. Look, people watch Family Guy on repeat to get through the day. That’s just a coping mechanism. But please don’t send me an email and tell me that Family Guy is the treatment for depression because not.

Jackie: I think the root of this whole conversation is we’re just talking about vices, right? Like your vice is Diet Coke. We’re talking about cigarettes and weed and Family Guy. Right? Whatever your vice is. I think we can unequivocally agree that vices help with stress management. Right? That’s why people drink, right? They’re stressed out or they’re angry. They want to erase the feelings that they’re feeling in that moment. That’s why we have vices. That’s what they do for us. But you’re right, you can’t say that like the good outweighs the bad. And all of those vices right? You are consuming a metric shit load of aspartame. Is that good? Probably not. I don’t know, but it makes you feel better. So, you know, are we talking long-term health? Are we talking short term? I don’t think it really matters. Does marijuana help with anxiety? Maybe it could. I don’t know. I think it’s so personal. And I think that, again, we just don’t have enough research at this point to say one way or the other, because even the studies that we’re quoting right now, they’re all looking for different things. They’re looking for is it effective? They’re looking for do people think it’s effective? Are they using it in place of something else? There’s no study that really has touched on all the bases that we have yet in terms of is it effective for this? Is it effective for this in conjunction with prescribed medication? We don’t know. So I guess choose your own adventure as long as you’re smart and healthy and not a dumb dumb.

Gabe: I really just want to hit hard on what Jackie said about the “we don’t know.” There are so many people that just believe that it is the cure for everything. And there’s so many people that believe that it is the most horrible thing. It’s just a pox on our nation. Those are not the two camps that we should be in. We should continue the research. We should find out what is good and what is bad. I just want to be clear that any type of self-medicating is dangerous.

Jackie: A lot of people use this to self-medicate. Self-medicating, we know is dangerous, especially when you’re not being honest with your health care team. So this is one of those things that, you know, if it works for you, that’s great. But don’t force it on anybody else because we just don’t have the research to back that it is actually effective.

Gabe: We’ll be right back after these messages.

Announcer: Interested in learning about psychology and mental health from experts in the field? Give a listen to the Psych Central Podcast, hosted by Gabe Howard. Visit PsychCentral.com/Show or subscribe to The Psych Central Podcast on your favorite podcast player.

Announcer: This episode is sponsored by BetterHelp.com. Secure, convenient, and affordable online counseling. Our counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counseling is right for you. BetterHelp.com/PsychCentral.

Jackie: And we’re back talking about using marijuana as a treatment for anxiety.

Gabe: Jackie, we’ve talked about the stats, we’ve talked about the study, we’ve bantered back and forth. Let’s talk to somebody who uses marijuana for her anxiety disorder and also for rheumatoid arthritis. Can you give her an introduction? Because she was very candid and very awesome. It was great of her to call in.

Jackie: Yes, sure. We invited our friend Eileen, who we know through advocacy, to come on and talk about why she uses marijuana to help with her anxiety, but also why she uses it for her RA. And I think she’s going to have a lot of helpful insight on this.

Gabe: And we’re going to roll that interview right now.

Jackie: We’re here with our friend Eileen. Gabe and I know Eileen outside in the real world, but we thought she’d be a really great guest to bring on the show today. So welcome, Eileen.

Eileen Davidson: Hi, my name is Eileen Davidson and I live in beautiful Vancouver, British Columbia, which has been worldwide known for longer than it’s been legal in Canada to have very, very good weed.

Gabe: We are so super excited to have you because you are willing to publicly talk about using marijuana or cannabis. Why are you so public about using it? Because in many places it’s still a crime. And even the places where it’s legal, it’s still very much looked down upon. But you’re like, hey, I smoke weed.

Eileen: Well, because I also believe in the medical component of it. I live with rheumatoid arthritis and mental health issues. So to me, it’s very medical. And because I don’t really drink because of my autoimmune disease, it’s also a tiny bit recreational and it’s legal in Canada.

Jackie: Eileen, are there any specific symptoms that you’re using medical marijuana to treat?

Eileen: Yes. So living with a chronic illness comes with multiple different types of symptoms, as well as side effects from the medications used to treat these diseases. So, particularly with rheumatoid arthritis, I have chronic fatigue, consistent chronic pain as well as sometimes nausea. So that is another reason why I actually do enjoy smoking marijuana because it really tackles the nausea and then also helps with the loss of appetite that I can experience. And then it also helps with not being able to sleep because of pain. And it’s helped with a number of the medications that I’ve gone through that have caused vomiting. And so it’s kind of a drug that I don’t use for just one specific thing, but a multitude of different things.

Gabe: I do like that you’re so open about it.

Eileen: I wasn’t always open about it, though. I used to be actually very against marijuana.

Jackie: Ooh, what changed your mind?

Eileen: Debilitating diagnosis of rheumatoid arthritis. So I’ve been around it a lot before because my earliest memories of it are my father smoking weed while doing these creative, surrealistic paintings. My dad was kind of a hippie and so like my childhood is basically memories of the smell of oil paints, marijuana and the sound of Pink Floyd playing to these crazy paintings. So, but it was illegal back then. So I felt very conflicted a lot because I was like, why are you smoking marijuana when that’s supposed to be a drug, as they’re telling you in school? And so I didn’t really understand. I never wanted to touch drugs my whole life. I’ve never touched anything other than coffee, marijuana and alcohol, a little bit of wine, but being diagnosed with something that causes severe pain and having to go through medications that have a lot of side effects. At that time, I was like, well, this is medicinal to me, so I’ll try it. And I felt like an idiot being against it before. My diagnosis really opened my eyes to this isn’t really in the same line as like heroin or cocaine and things like that. Though, I never tried those. And it was also really helping people. People like me who were in diagnosis of cancer, M.S., Parkinson’s, all sorts of things. What I didn’t expect is that it would also help with my mental health.

Jackie: And did you discover that just sort of like happenstance, you were like, oh, I kind of feel good everywhere right now? Or was it more of something that you actually tested? You were like. I’m feeling really anxious. Let’s see if this helps here.

Eileen: I would say it first started off with me noticing that it did have an effect on my mental health. When I first started smoking weed, I didn’t know about THC, CBD and how it would kind of interact with me. So I would try something, not know what kind of strain it is and then kind of feel full-blown anxiety attack. But then I would also try a different one and feel super relaxed. And so I discovered that I had to kind of watch which strains helps with my anxiety and didn’t help with my anxiety and to kind of research so that I could be better informed.

Gabe: So my next question is sort of somewhat of a controversial one, because it sounds like you’re self-prescribed, like a doctor didn’t prescribe this, it’s kind of a trial and error on your behalf, is that correct?

Eileen: Yes. Now, I do follow guidelines of places like the Arthritis Society because they are a wealth of knowledge for people like me who are interested in supplying medical cannabis. But when you have a hook up, it’s also cheaper.

Gabe: As funny as that is, though, do you tell all of your doctors that you’re utilizing cannabis as a treatment or do you keep that on the down low?

Eileen: I tell them, because I think it’s important to be honest with your doctors about every aspect in your health. It’s really important to listen to the patient voice when it comes to their needs. And that’s including their medications. And marijuana can be a medication.

Jackie: So let me ask you this in conjunction with telling your doctors about this. Before you started using weed for anxiety. Were you prescribed medication for anxiety and if so, were they working?

Eileen: Yes, I’ve tried a couple of different medications for anxiety. I did find that they worked. I was on them for a number of years. Medication you won’t find the perfect drug in one-go usually. It’s a number of drugs you have to try. I tried three or four for my anxiety and depression. I tried over 18 for my rheumatoid arthritis. And I don’t know how many strains of marijuana I’ve tried for everything I go through. So that’s what you have to learn. And what works for one may not work for the other.

Jackie: So do you think that it works better for your anxiety than the prescriptions did?

Eileen: No, I definitely don’t think it works better or worse. I think they work together.

Gabe: I really like what you’re saying there, and I don’t know if I agree or disagree, I’m really on the fence about a lot of this stuff, which is one of the reasons that we wanted to interview somebody who is actually utilizing cannabis and marijuana for treatment because we wanted to tell the whole story. But one of the things that I think about so often are the people who are self-medicating, the people who are suffering from bipolar disorder, depression, anxiety, schizophrenia, psychosis, and they run out, they meet somebody on a street corner or in an alley and they buy marijuana and they’re like, oh, look, I’m treating my mental health issues. And that sounds so incredibly scary to me. And I just want to make sure that none of our listeners are hearing that that works. What are your thoughts on that?

Eileen: Don’t ever, ever do that. I’ve seen how that turns out. I know about good people who are at risk for having negative psychoactive effects from marijuana and need to watch out for that. Like I said, if it doesn’t work for you, it doesn’t work for you, but it might work for someone else. So it’s really important to keep an open mind.

Jackie: So I have one more question that’s kind of getting into the specifics. There are a boatload of different ways at this point that you can sort of consume marijuana in the world we live in today. And I’m wondering, have you experimented with this in terms of efficacy for anxiety? Is it better to smoke it or eat it? Is CBD oil the way to go? What is the best way to use this for anxiety that you’ve discovered for yourself?

Eileen: Well, depending on what you’re experiencing with your anxiety, if I just finish something and I need to relax from it, I’ll probably smoke a joint. But if I need to go somewhere where I might be experiencing anxiety and I don’t want to be high, then I’m going to take some CBD oil. But I know my triggers now. I don’t have the negative effects that maybe I had when I first started because I’ve self experimented and also I watch how much I am taking and I take generally pretty good care of myself overall.

Gabe: Eileen, thank you so much for being here, where can folks find you online if they want to learn more about your advocacy because you’re huge in the rheumatoid arthritis community?

Eileen: Well, thank you. They can find me online. I go by Chronic Eileen, which I guess has a little bit to imply with being a chronic. But also chronic illness. So that’s Chronic Eileen, and Eileen is E I L E E N, and they can find me at ChronicEileen.com or Instagram or Facebook or Twitter.

Gabe: Well, we really appreciate you being here. Thank you so much.

Eileen: No problem. Thank you so much for having me.

Gabe: I always love it when we have guests on, Jackie.

Jackie: I do love a good guest. Eileen is awesome. She is a really great advocate online. You should follow her. Everything that she does,

Gabe: Fan girl.

Jackie: She’s a lovely person.

Gabe: Well, Jackie, obviously we picked her for a reason, we know that she’s a great advocate. What did you think of everything that Eileen had to say?

Jackie: I felt like it was really great that Eileen mentioned that not only does she use this, we’ll say off label, non-approved, but she also uses it in conjunction with her medication. This isn’t a replacement for her medication. It helps with her medication and that she’s very honest with her doctors about her usage.

Gabe: I like that she actually used the word recreational at one point because I think that sometimes, advocates for marijuana, they’re so heavily focused on its medical benefits, which there are medical benefits. There aren’t any approved for mental health reasons, but there’s medical benefits approved for physical reasons, physical health reasons. There are so many. I like that she was open about the fact that there’s a recreational aspect. I think it’s a more moderate and realistic and reasonable point of view.

Jackie: Yeah, dude, I mean, sometimes people smoke weed for fun and that’s the only reason why they use it. And for those people who do use it for medicinal reasons, you can’t lie that sometimes it’s still a fun hobby recreationally.

Gabe: One of the things that I want to talk about is something that I just I hear constantly and that’s people saying, well, marijuana can’t possibly be bad for you because it’s all natural. I hear this constantly. All natural, all natural. How can something all natural be bad for you? It drives me insane. And the reason why is because there’s all kinds of all natural things that are very, very, very dangerous. Strychnine is all natural. Poison ivy is all natural. I don’t think anybody listening to our show is going to get buck naked and rub poison ivy all over their body. Because after all, it’s all natural. How bad could it be?

Jackie: You know, I bet if you told people to rub poison ivy on them and they would lose weight, they would do it. Which just goes to show that, yes, something could be natural, but you still have to be a smart person and you still have to use common sense when using whatever that natural substance is.

Gabe: The thing is, I agree with you. And this just shows the level of misunderstanding that we have. I want to be clear, rubbing poison ivy on your body will not make you lose weight at all in any way. Period. Please do not send e-mail to the Not Crazy podcast saying that you did it. I hope that you are paying attention when you listen to this part because it’s very, very important. Bad things occur in nature, just like good things do. The other very, very important part that we want to remind you of is always work with your doctor. Always.

Jackie: Always, always, always. And even if you live in a state where this is illegal right now, when it feels kind of like you shouldn’t tell your doctor about it, you need to, because they need to know these things in order to provide you with the appropriate treatment. And if there’s a part of you that’s worried about telling your doctor, is there a part of you that thinks that this method of treatment is wrong? I don’t know. Maybe that’s something worth figuring out in your head if you’re hesitant to tell your doctor.

Gabe: Jackie, that was a show. Listen up, listeners. If you liked our podcast, please subscribe to it on whatever podcast player you downloaded this show on. And please tell your friends. Share us on social media and use your words. Tell people why you liked it, email it, bring it up in support groups, pass the word around. We’re giving away free stickers. All you have to do is email show@PsychCentral.com, and in the subject line write stickers and we will send them your way. We will see everybody next week.

Jackie: Thanks for listening, everyone.

Announcer: You’ve been listening to Not Crazy from Psych Central. For free mental health resources and online support groups, visit PsychCentral.com. Not Crazy’s official website is PsychCentral.com/NotCrazy. To work with Gabe, go to gabehoward.com. To work with Jackie, go to JackieZimmerman.co. Not Crazy travels well. Have Gabe and Jackie record an episode live at your next event. E-mail show@psychcentral.com for details.

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Treating Eating Disorders: Adding a Dietitian to the Care Team

Eating disorders are complex illnesses that benefit from a multifaceted approach. As an eating disorder therapist, I often collaborate with dietitians. I interviewed my lovely colleague, Alex Raymond, RDN, CEDRD,...

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Vulnerable robots induce prosocial behavior in groups of humans.

Interesting work from Traeger et al.:

Significance

Prior work has demonstrated that a robot’s social behavior has the ability to shape people’s trust toward, responses to, and impressions of a robot within human–robot interactions. However, when the context changes to interactions within a group involving one robot and multiple people, the influence of the robot on group behavior is less well understood. In this work, we explore how a social robot influences team engagement using an experimental design where a group of three humans and one robot plays a collaborative game. Our analysis shows that a robot’s social behavior influences the conversational dynamics between human members of the human–robot group, demonstrating the ability of a robot to significantly shape human–human interaction.

Abstract

Social robots are becoming increasingly influential in shaping the behavior of humans with whom they interact. Here, we examine how the actions of a social robot can influence human-to-human communication, and not just robot–human communication, using groups of three humans and one robot playing 30 rounds of a collaborative game (n = 51 groups). We find that people in groups with a robot making vulnerable statements converse substantially more with each other, distribute their conversation somewhat more equally, and perceive their groups more positively compared to control groups with a robot that either makes neutral statements or no statements at the end of each round. Shifts in robot speech have the power not only to affect how people interact with robots, but also how people interact with each other, offering the prospect for modifying social interactions via the introduction of artificial agents into hybrid systems of humans and machines.

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Why Am I So Jealous?

From a teen in the U.S.: Jealousy for my girlfriend: I’ve been dating my girlfriend for two months now and my jealously for her has been toxic in our relationship. Whenever she goes out with her friends, her friends upload pictures to social media, or achieves something beneficial to her, I turn to my jealous side and act grumpy and sometimes sad. She knows that I’m jealous of her but I just can’t stop.

Yes. You can stop. It’s important that you learn now, before you do permanent damage to a promising relationship.

I’m sure you already know that the jealousy has nothing to do with your girlfriend. From what you wrote, she isn’t doing anything inapporpriate. The problem is inside of you. Your insecurity and/or low self-esteem is getting in your way and is showing up as jealousy.

Do you feel you don’t deserve the girlfriend? Are you convinced that you aren’t attractive or interesting enough to hold onto someone who loves you? Are you sure that rejection is the end of the world and that you can’t handle that possibility? The common denominator of all of them is fear — fear that you aren’t quite enough or don’t have the skills to be in a close relationship. Those are ideas, beliefs, and attitudes that you need to work on.

Your fears will not be reduced by controlling her activities. If you make controlling demands, she will eventually do exactly what you fear: She’ll give up on you and put as much distance as she can from you.

As a teen, you are not at all alone in these feelings. Jealousy is a normal emotion that everyone has to learn how to deal with as they become adults. Most teens are unsure of themselves when they start a new relationship. Most teens are afraid of rejection.

The teen years are the time when people develop the skills needed to be close to someone and both the self-confidence to risk rejection and the skills to handle it if it happens. If you have friends you trust enough to talk with about your feelings, you will find that many of them feel as you do. Some have better ways to cover it than others. Some have developed enough strength to manage their jealous feelings and may be able to give you some ideas for how to develop yours.

You do need to take a hard look at yourself and try to figure out the root of your fear and what you need to do about it. If you can’t do that on your own, do consider seeing a therapist to work on it with you.

In days of social distancing, you may not be able to find a therapist who will work with you face to face but many therapists are now offering online therapy. You can also join a forum here at Psych Central. The forums are social communities of people who are struggling with the same issue and who offer support and advice to each other. There are also several self-help workbooks on building self-esteem for teens available at bookstore sites. Working your way through one of those is also a good place to start.

I wish you well.

Dr. Marie

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Sunday 29 March 2020

COVID-19 and Touch Deprivation

No-one can escape the fact that the world has changed beyond recognition in just a few short weeks. The body count continues to rise and is a stark reminder to us of how vulnerable humans can be to nature. Furthermore, usually frantically busy streets and cities are now deserted, shopping malls are closed, restaurants and bars are shut down and much of the world’s population is under virtual “house arrest.” Social distancing and lockdown are the buzz phrases of the hour.

How can we look after our mental health in a world where isolation (by necessity) has become more prevalent than ever and in fact, the new “norm.” What will the world be like after this threat passes? How many of these new and supposedly temporary “norms” will continue long into the future?

One of my biggest concerns as a therapist relates to the subject of touch deprivation and its future effect on society.

People of my age group will remember with great sadness the horrifying images from Romanian orphanages back in the 1980s (at the time the communist regimes across Eastern Europe disintegrated). News reports showing hundreds of babies and toddlers, in endless rows of cots, who had died or gone insane, because they had never been picked up or touched. What this reminded the world in a very graphic manner is that human touch is a basic human need just as much as food and water, without it humans simply cannot thrive.

In South American, France, Italy and Spain, warm hugs, affection and touch are an integral part of everyday life, yet the United Kingdom, along with the USA and most of Eastern Europe are already amongst the most touch-deprived nations in the world. Social distancing will undoubtedly exacerbate the situation in these countries and introduce it to the others.

Whilst the current climate of social distancing and isolation is an emergency and temporary measure to slow the spread of this invisible killer virus, history teaches us that emergency measures introduced during crises have a tendency, to stick. Income tax, for example, was introduced in 1799 by the then Prime Minister William Pitt the Younger, as a temporary measure to fund the costs of the Napoleonic Wars, we are still subject to it some 221 years later!

So how can we meet these basic needs during such challenging times?

Firstly, given that most of us are lucky enough to live with our loved ones and families, be sure to regularly touch and hug those you are confined with (unless of course, they have symptoms in which case they should self-isolate in a separate room) otherwise, make the most of these circumstances to build emotional and physical intimacy with those you live with. Secondly, if you have animals, be sure to pet them as often as possible. Above all (especially if you do not have family or animals around), at least keep your sensory and kinesthetic “muscles” alive. Do this daily, by touching (and feeling) things with texture! Polished stones or crystals, smooth wooden surfaces, soft toys, silk, fur, etc. Pay more attention to how the shower feels on your body and to the sensation of your clothes on your skin. Doing these simple things will bring you back into your body and keep your sensory acuity active.

To counter the effects of isolation (for yourself and others) be sure to stay in regular touch with people you know, especially those you may not have spoken with for a while. Check-in with them by webcam, telephone or even a good old fashioned letter in the mail. It is more important than ever to stay in touch and keep contact with the people you know during this period of physical distancing, doing so will hopefully prevent isolation and touch deprivation becoming a “norm” for future generations.

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