Mobile Apps for Tracking Moods Improve Care

Passive tracking of vocal and behavioral indicators of symptoms via a smartphone app can be an effective way to improve depression in a time-sensitive and accurate fashion.  A recent randomized clinical trial compared the use of an app to track indicators with “usual” care for depression, and, although the sample size is small, the results are very promising. For the …

Recovering from Disaster

Recovering from Disaster – Reclaim Your World

It seems appropriate to write about an aspect of recovering from disaster. We have been through an extraordinary period of natural and human caused disasters these past few months. And while every experience is different, one thing that successful recovery requires, is the capacity to reengage with the world as it is, and with a sense of the possibility of …

Fear of Catastrophe

Fear of Catastrophe

How to respond to the fear of catastrophe? Many people are having trouble getting to sleep these days. Fear of catastrophe has reemerged as we contemplate the craziness of nuclear war. This seems like a good time to review what we know about situations where there is the potential for something really bad to happen but the magnitude and nature of that …

PTSD Prediction

For people who have been exposed to violence or trauma, and who naturally experience some symptoms of anxiety, what approaches are most useful for PTSD prediction? The majority of people exposed to violence or trauma do not go on to develop posttraumatic stress disorder or PTSD, but, depending on the nature of the trauma (sexual trauma has the highest risk) …

Media Violence – Psychological Effects

A lot of attention has been focused on the question of whether exposure to media violence is linked to an increase in violent behavior. Less attention has been focused on the question of the other psychological effects of exposure to media violence. The recent study presented at the British Psychological Society’s 2015 annual meeting suggests that a significant number of …

Stress and Trauma as Risk Factors for Bipolar

I have long been interested in the relationship between traumatic experiences and bipolar disorder. A couple of years ago I gave a presentation at the University of California, San Francisco, Bipolar Disorder Clinic on the topic. I got interested in the issue because I noticed how many of the women in my clinic with bipolar disorder also had childhood PTSD. …

Mood Swings – What Causes Them?

What causes mood swings? What do we think about when someone says their mood has been “up and down?”Among the most common causes of mood shifts are the following: A mood disorder such as bipolar, or an atypical depression. Bipolar as a cause is obvious, but an atypical depression can also be associated with mood swings. In the case of bipolar …

Passing on PTSD to Children

At a recent scientific meeting, Rachael Yehada showed that traits that are related to posttraumatic stress disorder PTSD can be passed on to children during pregnancy. Mothers in New York City who were pregnant on September 11, 2001 and developed post-traumatic stress disorder (PTSD) had children with low cortisol in their blood (a sign of PTSD). But if the fathers …

Media Makes PTSD Much Worse

  It was a sunny October day in 1989. Game 3 of the Battle of the Bay baseball World Series between Oakland and San Francisco. Then the largest earthquake in almost a hundred years hit the bay area. I was, as it happens, in my therapist’s office, my wife was at work. I rushed home to make sure that all …

PTSD Psychotherapy Affects Gene Activity

  Mind-body dualism seems alive and well in the land of mental health. I am still surprised how often someone will say, “well that’s not a biological depression.” Meaning that it is the kind of depression that can be understood as a result of events in that person’s life, or that it can be treated effectively with therapy, or that …

Child Abuse Update

Twenty years ago the National Research Council (NRC) issued a comprehensive report on child abuse. That report noted that child abuse was much more common than previously thought and called for urgent action. This past week the NRC and the Institute of Medicine (IOM) released an update: New Directions in Child Abuse Research. The good news – physical and sexual …

Childhood Trauma – Brain Effects

Experiencing trauma in childhood is associated with changes in the brain during teenage years, according to a study of 117 adolescents using magnetic resonance imaging (MRI). The researchers compared MRI’s from age 12 with MRI’s from age 16. They asked the teenagers about childhood trauma and also did psychiatric diagnostic interviews. There were significant differences in how the brains of teenagers …

Stress and Your Brain

Stress has a major affect on our bodies and our brain. The release of catecholamines (adrenaline and related chemicals) and cortisol causes significant changes throughout our body that are designed to prepare us for “fight or flight.” By shutting down all non-essential functions the stress response system prepares us for a life and death struggle Nowadays there are no life …

On the Borderline

I am writing a presentation for the UCSF Bipolar Program on the topic of the relationship between Borderline Personality Disorder and Bipolar Disorder and I thought I would jot down some of my thoughts in a quick post. Borderline personality disorder involves a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity” which begins by early adulthood …

10% of Americans Suffered Childhood Sexual Abuse

Approximately 10 percent of American adults were sexually abused as children, according to a study reported in Comprehensive Psychiatry. They are more at risk of psychopathology and suicide attempts than are adults who were not sexually abused as children. This study fits with other evidence. The global prevalence of child sexual abuse has been estimated at 19.7% for females and 7.9% for males, based …

reclaim your world

Reclaim Your World

Why You May Need to Reclaim Your World Threats from disasters, and other dangers in the world around us, can lead us to withdraw from normal activity and then we may need to reclaim our world from fear. I have always loved what I now call the territorial sports: the cross country skiing, running, hiking, bicycling, etc. These are sports …

Retraumatization

After nearly 20 years of work in the field of post-traumatic stress disorder, one thing that continues to trouble and baffle me is the phenomena that was described by Freud as the repetition compulsion.  Why is it that people who have been victimized in terrible ways are at much higher risk of being victimized again.  One would think that they would be …