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NeuroStar TMS

About NeuroStar TMS

NeuroStar Advanced Therapy (TMS) for depression has the largest clinical data set of any TMS treatment. Clinical studies with over 900 people have shown that NeuroStar may help achieve remission for people living with depression.

For many people, depression symptoms significantly improved or went away after 4 to 6 weeks of treatment with NeuroStar Advanced Therapy.

In a NIMH-funded, independent, randomized, controlled trial, people treated with TMS NeuroStar Advanced Therapy were four times more likely to achieve remission compared to patients receiving the placebo treatment!

Only NeuroStar Advanced Therapy (TMS) has durability over 12 months.

NeuroStar-Durability-Chart

 

 

 

 

 

 

 

 

 

 

 

Source: NeuroStar TMS Therapy Clinical Results

Gabby Lundy, Exult Healthcare

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Mental Health & Chronic Illness: Selena Gomez

Last Wednesday, pop singer and television producer, Selena Gomez was admitted to a psychiatric hospital. She is told to have suffered a panic attack after a recent health setback related to her two recent hospitalizations for “low blood cell count” post-kidney transplant. Gomez has Lupus and underwent a kidney transplant in September of 2017 because of Lupus-related complications.

Selena Gomez has been open about her struggles with Lupus–a chronic illness that causes –and with mental health since 2015. Early in 2018, Gomez received outpatient psychiatric treatment to address anxiety. However, Gomez is not the only person whose mental health has suffered as a result of dealing with a chronic illness.

Chronic Illness and Depression

Chronic illnesses of all kinds can cause or worsen depression in the following ways:

  • Increased feelings of isolation
    • Taking off more time from work, school & social events for treatment and self-care
    • Feeling like no one understands your condition
  • Increased fatigue in some chronic illnesses may make depression-related fatigue worse
  • Inflammation symptoms (in some chronic illnesses such as Lupus) which have some evidence pointing to causing or worsening depression
  • Enhanced life, work, financial, and relationship stressors as a result of the chronic illness

Taking control of your mental health can be one piece of dealing with a chronic illness and your overall health. Doctor Heals Mind has a variety of treatments available for depression and other mental health issues. Please check out our depression treatment page to find a solution that best fits your needs.

Source: “Selena Gomez’s Hospitalization Highlights a Problem With The Way We Treat Chronic Illness and Mental Health” by Julia Metraux, The Mighty via Yahoo! LifeStyle

By: Gabby Lundy, Exult Healthcare

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Who Can Help Treat My Depression?

Mental health treatment can be found from a variety of professionals, especially for depression. Knowing your own symptoms and needs can help you determine what type of care provider is needed to best treat your depression. You may even see more than one of these professionals at a time to get the best care possible. Let’s break down some differences between these mental health care professionals.

Primary Care Doctors

Your general doctor may be the first person you see to access care. They can:

  • Recommend a behavioral health provider such as a therapist, counselor, psychiatrist, etc.
  • Prescribe and monitor medication
  • Monitor your progress and follow up over time

Psychiatrists

Psychiatrists have medical degrees (MD) and specific training in mental health conditions. They can:

  • Assess your symptoms to make an informed diagnosis
  • Assess the need for medication
  • Prescribe and monitor medication
  • Provide psychotherapy

Licensed Counselors, Therapist, and Social Workers

All three of these providers have a master’s degree (MS), a doctorate (Ph.D.), or another type of graduate-level certification. They have completed an internship and one (or more) years of supervised practice. They can:

  • Assess your symptoms to make an informed diagnosis
  • Provide talk therapy (also known as counseling)
  • Offer specialized counseling, such as family or marriage therapy

Psychologists

Psychologists have a master’s degree (MS) or a doctorate (Ph.D./PsyD) in psychology. They are not medical doctors nor can they prescribe medication (in most cases). However, they can:

  • Assess your symptoms to make an informed diagnosis
  • Provide talk therapy (also known as counseling)
  • Conduct psychological testing
  • Refer you to a psychiatrist for medication

Psychiatric Nurse Practitioners

Psychiatric nurses are register nurses (RN) that also have graduate-level education in mental health. They can:

  • Assess psychiatric conditions
  • Prescribe and monitor medication
  • Follow up with medication management and coordination of care

If you feel like medication may be part of your mental health treatment, Dr. Bhargava, a board-certified psychiatrist, may be able to help. Visit our Depression Treatment page for more information.

If you are more interested in talk therapy, Exult Healthcare has licensed therapists and counselors that have a variety of specialties. They also offer transcranial magnetic stimulation (TMS) treatment if therapy and medications are not working for you.

 

Source: https://www.aetna.com/individuals-families/mental-emotional-health/depression-care-providers.html

Gabby Lundy, Exult Healthcare

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College Depression

“Going to college is an exciting time in the lives of young people, but for some students depression gets in the way. Whether it’s their first brush with the disorder or not, college can act as a catalyst for the onset of depression in many young people, and, on their own for the first time, the timing couldn’t be worse” – childmind.org

Depression in college students is a topic that is not often talked about but is common for first semester college students.  Most of the time, first semester students have a hard time adjusting to a new environment; picking up a heavy work load, being away from home, and have to make new friends.  Parents can often worry and try to get involved, but that’s not always easy when a child is potentially living three to four hours away from home.  If you have a student that is distancing themselves from the outside world, letting go of their hobbies and ambitions, and acting out of character for more than two weeks it is possible that your college student could be facing depression.

 

Depression is not always an easy topic to discuss, and most people only think an individual is depressed when they are sad.  That is not the case, depression comes in many forms. For some students, it could be that he or she is more irritable, lashes out, and pushes away their support systems (friends, family, significant others).  Other students could be indulging in binge drinking or substance abuse to try to “forget about their problems” or “make their problems go away”. It is important to notice the signs and act quickly.  Encourage your student to seek on campus help or seek help in their area.

If you are worried about your college student and feel that they are facing depression and do not want to acknowledge it themselves, Exult Healthcare has services that can benefit you.  Depression is usually treated with medications, psychotherapy, or a combination of the two.  If these treatments do not reduce symptoms, transcranial magnetic stimulation (TMS) and other brain stimulation therapies

may be options to explore.  However, each case of depression is unique and is treated accordingly. There is never a “one-size-fits-all” for treatments here.  Please check out our treatments tab and find out more about how Exult Healthcare can benefit you today.

 

 

Written By: Lauren Thompson, Exult Healthcare

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BINGE EATING

Binge eating disorder develops based on a mixture of genetic, environmental and social constructs. The focus on this blog is the social/ family aspect of eating patterns.

Food is such a major component of cultural, social and family dynamics. It is used as part of celebrations, for religious ritualization, cultural events and a learned self-soothing habit. We have cake for birthday parties, a cultural dish to help when you are sick (like chicken soup), and a special treat when you are sad (warm cookies) or a special dinner on major occasions. Having food for every occasion can lend to the use of food as a negative coping skill because it has become a learned behavior. Binge eating / obesity will run in families due to the way food is used to deal with feeling or emotions. Memories are strongly tied to our senses: taste reminds use of a positive experience, the smell of food may remind us of a family member that cooked, and touch could be helping cook a special meal and the sound of a specific food cooking to bring back a special memory.

“From infancy, we establish a connection with our caregivers based on how our most instinctual needs are met. “ (Karges, 2018) One of our most instinctual needs is food and it is a major part of the bonding moments with a mother.  According to Hamberg, The sharing of food can increases closeness to others like our parents making our favorite dessert when we are upset or sharing food at times of crisis. The use of food can become a supportive behavior and if no other self-soothing behavior is taught then food become the primary means to sooth self and others. The use of food in as a coping and self-soothing tool within the family can lead to binge eating disorders among members. According to Karges, some ways self-soothing through food is taught is by giving a food as a reward, a bribery to behave a certain way or used to comfort a child in destress. It is like replacing their favorite blanket or toy with a cookie every time they get upset.

There is also a genetic connection with binge eating and comorbid disorders like depression so families have learned to cope with the depression by using food.  In the study, Parent binge eating and depressive symptoms as predictors of attrition in a family-based treatment for pediatric obesity, There is a correlation between parental mental illness and binge eating disorder and children developing the same patterns of behavior and diagnosis. If the behavior continues then it will be passed down multi-generationally.

The best way to assist in treating or preventing binge eating disorder is through the family system by changing eating patterns and the use of food in emotional regulation. In order for recovery to become effective the family needs to be involved in treatment to help reduce familial patterns in future generations and to support positive change.

 

References

Braden AL, Madowitz J, Matheson BE, Bergmann K, Crow SJ, Boutelle KN. Parent binge eating and depressive symptoms as predictors of attrition in a family-based treatment for pediatric obesity. Child Obes. 2015;11:1659.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382825/

Hamburg, M. E., Finkenauer, C., & Schuengel, C. (2014). Food for love: The role of food offering in empathic emotion regulation. Frontiers in Psychology, 5. doi:10.3389/fpsyg.2014.00032 https://www.frontiersin.org/articles/10.3389/fpsyg.2014.00032/full

Karges, K. (2018). Binge Eating Disorder and Family Patterns of Self-Soothing. Eating Disorder Hope. Retrieved from https://www.eatingdisorderhope.com/information/binge-eating-disorder/binge-eating-disorder-and-family-patterns-of-self-soothing.

 

Written By: Karen Limme LPC Intern, Exult Healthcare

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Reading Between the Lines, Bibliotherapy

Have you ever heard of bibliotherapy? I’m always trying to identify ways to start working on recovery from depression, but I never thought much about one of the first steps I took – reading. I was surprised to learn that reading books for medical treatment dates to World War II, when it proved effective for wounded veterans. Bibliotherapy also seems to be helpful for depression.

Even though I first learned that “depression” was the name for my problems when I was in my twenties, a couple of decades went by before I really studied the disorder. That may seem odd since I’d been in therapy on and off for many years and had also taken a number of antidepressants. I think the delay in trying to learn more was one sign of my resistance to treatment as well as a denial of how seriously depression was affecting my life. Besides that, neither psychotherapy nor medication had helped me for very long.

Something was missing, and reading about how I could help myself opened new possibilities. It was like the healing effect of writing. There was something about getting new concepts and ideas into my mind, as well as down on paper, that made an enormous difference. These activities helped me get a real start on recovery.

Feeling Good

There are claims that reading self-help books on depression may be do more than get you started. There is some evidence that it may also work as the primary therapy for major depressive disorder. I find that a bit far-fetched. Even if I could have read all the thousands of self-help books on depression, that activity alone would never have dealt with the severe illness I lived with. Apparently, though, working with the best self-help books can work for people with mild to moderate depression.

If you’re familiar with David Burns’ classic Feeling Good: The New Mood Therapy, you can read in the introduction about formal studies on the therapeutic effectiveness of reading self-help books – specifically that one.

In the study Burns discusses, about 75% of the participants no longer met the criteria for a major depressive episode after four weeks spent reading his book – using no other therapy. All had met the criteria for major depressive disorder (not just a single episode) going into the study. That rate of recovery is impressive, even though it was clear that those with severe depression needed additional help. But did recovery hold up over time? To answer that question, the participants were interviewed and tested again after three years.

The diagnostic findings at the three-year evaluation confirmed [earlier improvement] — 72% of the patients still did not meet the criteria for a major depressive episode and 70 percent did not seek or receive any further treatment with medications or psychotherapy during the follow-up period. … While it is encouraging that many patients seem to respond to reading Feeling Good, it is also clear that some patients with more severe or chronic depressions will need the help of a therapist and possibly an antidepressant medication as well. p. xxviii

One or two studies are hardly conclusive, but these were promising findings. More recently, several studies have been conducted on the effectiveness of other self-help manuals. For the most part, the findings are similar to the studies from the 1990s cited by Burns. According to a 2007 Wall Street Journal article(subscription required), bibliotherapy is most effective when used in conjunction with other forms of therapy.

Cognitive Behavioral Therapy

Feeling Good and most of the popular self-help workbooks use the model of Cognitive Behavioral Therapy (CBT). This approach helps you identify specific patterns of thinking that support a negative view of yourself and reinforce the emotional lows of depression. The method teaches you to counteract these habitual patterns with more realistic ones so that your mind opens to a balanced interpretation of experience rather than one that is always negative.

CBT techniques lend themselves especially well to working on your own. Many therapists either provide worksheets for daily practice or recommend the use of workbooks that include blank forms in which you can note these patterns and then write your own words to counteract them.

I would imagine, then, that the benefit of workbooks comes not just from reading but also from interacting with the content and practicing new skills. For me, both the reading and writing have helped a lot because I find there’s a powerful restorative effect from formulating words and concepts to pinpoint what I’m experiencing.

Reading and Neuroplasticity

There doesn’t seem to be a lot of research about why bibliotherapy works, but I’ve run into untested ideas that relate the process of reading to the recent emphasis on neural plasticity. That’s the ability of the brain to form new neural circuits and activate areas of the brain that haven’t been functioning well. The concept is that learning by reading helps form new circuits that can change habitual thought patterns. By introducing new possibilities and neural connections, parts of the brain that are less, or more, active under the influence of depression can be restored to a the patterns of non-depressed brains.

But whatever might be going on with the brain, I know I’ve felt more hope for recovery and made progress on my own by reading books – and, just as important, reading blogs and other online sources of information. The process of absorbing new ideas through the impact of written words can be helpful whether or not you like to use workbooks and practice exercises.

 

Written by: John Folk-Williams, Storied Mind,

Twitter: @StoriedMind

 

The views of the article and writer and are not expressly the views of Exult Healthcare, although Exult Healthcare has consulted the author for use and proper attribution of the article.

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Looking Under the Shadows

During severe depression something people take solace in the idea that they could end it all but a majority of people never act upon it due to religious views, support systems, family commitments or the knowledge that the depression will pass. Sometimes the emotional pain becomes seemingly so unbearable the idea of suicide leads to action.

Normally, the person thinks family members would be better off without them because they are a burden. The depression feeds into negative thoughts that feel like truths like “you are worthless” or “you will never amount to anything”. They can not see beyond the reality that the depression is projecting. The current depression is all consuming and the future looks like a dystopia.

A person with severe depression usually isolates themselves to the point that they feel there is no one to turn too.

They have anhedonia, a loss of pleasure in things and activities, so what normally would make them happy and pull them out of the depression. They loss the ability to concentrate and the world is just a blur and they are unable to make logical and informed decisions. They are afraid to ask for help or are embarrassed that they cannot cope with things on their own. The darkness seems for engulfing that they can not look up to see the sun. The all-encompassing nature of depression makes it hard to untangle from it on their own.

Some Warning Signs of a Pending Attempt:

  • feeling hopeless
  • feeling intolerable emotional pain related to depression
  • having an abnormal fascination w/ death and dying or talking about suicide or dying
  • having mood swings from happy to sad
  • increased irritability
  • talking about issues related to anger, guilt or shame
  • have an increase in anxiety
  • experiencing changes in personality, routine, or sleeping patterns
  • Decrease in hygiene
  • Unable to get out of bed
  • personality changes
  • an increase or recent usage of drugs and alcohol
  • engaging in risky behavior that could lead to an accidental death
  • putting their affairs in order like giving away important possessions
  • resolving issues or staying goodbye to people
  • gathering means to commit suicide
  • increased isolation
  • feeling they are a burden to others
  • seeming to be unable to experience pleasurable emotions from normally pleasurable activities
  • negative thoughts like “I’m useless.” or “Everyone would be better off if I was not here.”
  • relationship issues
  • bullying
  • trauma

Please seek help, if you or someone you know is suicidal.  Assistance can be provided at your local ER or mental health facility.

The National Suicide Prevention Lifeline is always open. You can reach a trained counselor at 800-273-TALK (800-273-8255) or chat online at  https://suicidepreventionlifeline.org/

Text the Crisis Support line at 741741

Written by: Karen Limme, LPC-Intern

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Eating away a Disorder

According to the CDC almost 40% of adults over the age of 20 are considered obese. Obesity is defined as having a body mass index (BMI) of 30 and above. Obesity remains the leading cause of heart disease, diabetes and certain types of cancer. For many, weight gain is a result of medical issues or a side effect of medications.

Image result for binge eating graphicsFor others it could be due to disordered eating behaviors that include stress eating, eating when full, eating in secret or feeling loss of control while eating. Emotional eating is the act of using food to satisfy one’s emotional needs rather than to satisfy hunger. Most people identify as emotional eaters, after all, who hasn’t come home from a hard day at work and wanted to eat pizza or sat down with a pint of ice cream after a break-up?

Although this might sound like binge eating, it is very different from an actual diagnosis of Binge Eating Disorder (BED). BED is characterized by out of control eating that occurs frequently, is out of control and leaves a person with intense feelings of guilt and shame. BED occurs when a person eating an amount of food not normal for them in one sitting, at least twice a month.

Image result for binge eating infographic

In a binge episode, people tend of eat thousands of calories of highly processed foods (e.g. pizza, fast food, ice cream, candy, cookies), rapidly, in secret and until they are uncomfortably full (even then some). People tend to use the term “binge” to describe over eating, but BED is an eating disorder that needs to be addressed by a multidimensional team of professionals like a medical doctor, dietitian and a therapist.

Written by Cynthia D’Sauza,

Clinical Director, LPC, LMFT, PhD

 

BED-7 Test ( This test is a diagnostic and does not reflect Exult’s view)

1. During the last 3 months, did you have any episodes of excessive overeating?
2. Do you feel distressed about your episodes of excessive overeating?
3. During your episodes of excessive overeating, how often did you feel like you had no control over your eating?
4. During your episodes of excessive overeating, how often did you continue eating even though you were not hungry?
5. During your episodes of excessive overeating, how often were you embarrassed by how much you ate?
6. During your episodes of excessive overeating, how often did you feel disgusted with yourself or guilty afterward?
7. During the last 3 months, how often did you make yourself vomit as a means to control your weight or shape?

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Doing More in May

Mental Health Awareness is during May. The stigma behind mental health has hurt the growing community and kept mental health in the dark.

A stigma is an association of negative feelings towards something or someone. The stigma for mental health has become a barrier to people processing and seeking help for their own illness.

The National Alliance on Mental Illness has decided to spend the month of May, raising awareness about the effect predispositions cause. The campaign #curestigma or #stigmafree has spread across their social media platforms. The goal is to keep the conversation about mental health in a constant stream.

Key mental health statistics include:

  • One in five adults in the U.S. lives with a mental health condition.
  • One in 25 (10 million) adults in the United States lives with a serious mental illness.
  • Sixty million people in the United States face the day-to-day reality of living with a mental illness.
  • Half of all lifetime mental health conditions begin by age 14 and 75 percent by age 24, but early intervention programs can help.

Understanding mental health and the illness that ensues has become a critical part of our society. So many suffer from different types such as depression, bipolar, borderline, schizophrenia, etc. While, some types are beginning to be decriminalized, there are other types that need a higher level of compassion. May is a month that highlights the need for more information and understanding of mental health.

 

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Nutrition and Mood: A Diet to Battle Depression

Depression is a global epidemic affecting the lives of millions of people worldwide. Research has delved into the, social, bio-chemical and pharmacological means of fighting depression. One novel approach suggests that a balanced nutrition rich in green leafy vegetables, nuts , fruits, seafood and low in red meats can promote a sense of well being.

Research carried out in Australia’s Deakin University showed that amongst 67 subjects who had depression and started on a healthy diet developed a significant improvement in their mood, energy, activity levels and sleep. This research was published in the January 2017 issue of BMC Medicine.

Nutrition plays a definitive role in a lot of therapeutic modalities such as those for hypertension, diabetes and other cardiac conditions, all impacting an organ- the heart. Hence, depression which stem from certain imbalances in the brain could also be assisted by nutritional therapy. These results have promoted psychiatry programs to teach their residents about the importance of diet in the management of mental illnesses.

 

So, what should you eat: research suggest a diet based on the Mediterranean style of eating( high on seafood, olive oil, green leafy vegetables, fruits, yogurt and cheese) and low on trans-fat rich foods like red meats.

As stated by Ms Loretta Go from Balwin, a change in her diet greatly impacted her mood, uncontrollable crying spells and insomnia- an effect which Prozac did not achieve.

So if you are at risk or suffering from depression, consult a dietitian and adopt healthier choices to experience a change!

From: Contributor, S. Mitra

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