Suicide: Can Thoughts of Suicide Be Prevented?

Mental health professionals are trained to help a person understand their feelings and can improve mental wellness and resiliency.

Depending on their training they can provide effective ways to help.

Psychotherapy such as cognitive behavioral therapy and dialectical behavior therapy, can help a person with thoughts of suicide recognize unhealthy patterns of thinking and behavior, validate troubling feelings, and learn coping skills.

Medication can be used if necessary to treat underlying depression and anxiety and can lower a person’s risk of hurting themselves. Depending on the person’s mental health diagnosis, other medications can be used to alleviate symptoms.

Click here to see more at the National NAMI Site

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Study: Child & Family Focused CBT Improves Symptoms of Pediatric Bipolar Disorder

From Psychiatric News Alert. A form of cognitive behavior therapy that involves the child with the family may be efficacious in reducing acute mood symptoms and improving long-term psychosocial functioning among children with bipolar disorder, according to a report appearing online in the Journal of the American Academy of Child and Adolescent Psychiatry.

Previous studies have found that family-based psychosocial treatments are effective adjuncts to pharmacotherapy among adults and adolescents with bipolar disorder (BD).

Amy E. West, Ph.D., of the University of Illinois-Chicago, and colleagues, randomly assigned 69 youth, aged 7 to 13 with bipolar I, II, or not otherwise specified (NOS) disorder (according to DSM-IV-TR) to either child and family focused CBT (CCF-CBT) or standard psychotherapy. CFF-CBT integrates principles of family-focused therapy with those of CBT and actively engages parents and children.

Both treatments consisted of 12 weekly sessions followed by six monthly booster sessions delivered over nine months. Independent evaluators assessed participants at baseline, week 4, week 8, week 12 (post-treatment), and week 39 (six-month follow-up).

They found that the CFF-CBT participants attended more sessions, were less likely to drop out, and reported greater satisfaction with treatment than controls. CFF-CBT demonstrated efficacy compared with standard psychotherapy in reducing parent-reported mania at post-treatment and depression symptoms at post-treatment and follow-up. Global functioning did not differ at post-treatment but was higher among CFF-CBT participants at follow-up.

For more on bipolar disorder in adolescents, see the Psychiatric News article “Link Found Between Glutamate, Adolescent Bipolar Disorder.

Antidepressants Have Positive Effect on both Positive and Negative Stimuli

Antidepressant medicines, combined with cognitive-behavioral therapy (CBT) may produce optimal therapeutic effect, according to  Yina Ma, Ph.D., a research scientist at Johns Hopkins’ Lieber Institute for Brain Development. In Molecular Psychiatry she reports: “Antidepressants act to normalize abnormal neural responses in depressed patients by increasing brain activity to positive stimuli and decreasing activity to negative stimuli in the emotional network and [by] increasing engagement of the regulatory mechanisms in” the key region in mediating the regulation of both positive and negative emotions, she explained.

Although both antidepressant and cognitive-behavioral treatments:

“Affect emotion-related and prefrontal circuits to a similar end state of normalized emotional network and prefrontal activity, the mechanisms by which each treatment acts may differ. Although it has been proposed that CBT targets prefrontal function as it focuses on increasing inhibitory executive control, the current findings raise the possibility that antidepressants may act more directly on the emotional network. Taken together, a combination of an early antidepressant medication and follow-up CBT may therefore result in a better therapeutic effect, a possibility that needs to be directly addressed in future research.”

English: 2D structure of antidepressant nefazodone

English: 2D structure of antidepressant nefazodone (Photo credit: Wikipedia)

To read more about how antidepressants work in the brain, see the Psychiatric Newsarticles, “What Is the Link Between SSRIs and Fear Extinction?” and “Study Uncovers More Clues About Antidepressants’ Action.” 

 

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What is Depersonalization?

Depersonalization is a dreamlike feeling of being disengaged from your surroundings, where things seem “less real” than they should.

People who suffer from severe depersonalization say it feels as if they are watching themselves act from a distance without a sense of complete control. Although it is, itself, harmless, the experience can be extremely disturbing.

The condition is thought to be caused by an imbalance of brain chemicals. As with other dissociative disorders, the feelings are usually triggered by life-threating or traumatic events, such as extreme violence and war.

Depersonalization is also a common symptom in many different mental disorders such as Schizophrenia, Depression, Anxiety, multiple personality disorder, PTSD and Bipolar disorder. Its symptoms include:

    • Feeling as if you are watching yourself as an observer
    • Feeling you are not in control of your actions
    • Feeling disconnected from your body
    • Feeling like you are in a dream
    • Feeling everything around you isn’t real

Cognitive Behavioral Therapy is helpful, however there are no medications approved to treat depersonalization.

More detailed information at: Medical News Today

Study: Cognitive Restructuring Helps Prevent Depression in At-Risk Teens

(From Psychiatric News Alert) A cognitive-behavioral prevention program, when compared with usual care, showed significant sustained effects in preventing depression in teens at high risk for depressive illness, said William Beardslee, M.D., a professor of child psychiatry at Harvard Medical School, and colleagues in JAMA Psychiatry.

The study included teens that were (a) offspring of parents with current or past depressive disorders, and (b) had themselves present or past depressive symptoms. The teens were randomly assigned to either (1) usual care, or (2) a cognitive-behavioral prevention (“CBP”) program. The CBP program involved eight weekly group sessions and six monthly group booster sessions, in which the teens learned how to deal with negative or unrealistic thoughts. The subjects were evaluated for depression at intervals over 33 months. Over the period, and for the sample as a whole, the intervention was significantly effective, with 37% of the teens in the CBP group experiencing a depression, compared with 48% in the usual-care group.

“We were quite pleased that the effects noted in our earlier analysis nine months after enrollment were sustained at 33 months, as it is difficult to demonstrate longer-term prevention effects,” Beardslee told Psychiatric News. At the nine-month follow-up, 21 percent of the teens randomized to the CBP condition had experienced depression, in contrast to 33 percent in the usual-care group.

During the past decade or so, there has been an explosion in mental illness prevention research such as that conducted by Beardslee and his colleagues. See the Psychiatric News article “Future Looks Promising for Mental Illness Prevention” to read more about the research. Also see “Maintenance Cognitive-Behavioral Therapy and Manualized Psychoeducation in the Treatment of Recurrent Depression…” in the American Journal of Psychiatry.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is a blend of two therapies: cognitive therapy (CT) and behavioral therapy. CT was developed by psychotherapist Aaron Beck, M.D. in the 1960’s. CT focuses on a person’s thoughts and beliefs, and how they influence a person’s mood and actions, and aims to change a person’s thinking to be more adaptive and healthy. Behavioral therapy focused on a person’s actions and aims to change unhealthy behavior patterns.

CBT helps a person focus on his or her current problems and how to solve them. Both patient and therapist need to be actively involved in this process. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns recognize and change inaccurate beliefs, related to others in more positive ways, and change behaviors accordingly.

CBT can be applied and adapted to many conditions, including depression, bipolar disorder, Anxiety disorders, eating disorders, schizophrenia and schizoaffective disorder. For instance, people with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person’s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognize when a mood shift is about to occur. CBT also helps a person with bipolar disorder stick with a treatment plan to reduce the chances of relapse (e.g., when symptoms return).

With schizophrenia, the disorder generally requires medication first. But research has shown that CBT, as an add-on to medication, can help a patient cope with schizophrenia, helping patients learn more adaptive and realistic interpretations of events. Patients are also taught various coping techniques for dealing with “voices” or other hallucinations. They learn how to identify what triggers episodes of the illness, which can prevent or reduce the chances of relapse. CBT for schizophrenia also stresses skill-oriented therapies. Patients learn skills to cope with life’s challenges. The therapist teaches social, daily functioning, and problem-solving skills. This can help patients with schizophrenia minimize the types of stress that can lead to outbursts and hospitalizations.

CBT for schizoaffective treatment shares elements of each of the foregoing. Over the past two decades, CBT for schizophrenia and schizoaffective disorder has received considerable attention in the United Kingdom and elsewhere abroad. While this treatment continues to develop in the United States, the results from studies in the United Kingdom and other countries have encouraged therapists in the U.S. to incorporate this treatment into their own practices. In this treatment, often referred to as cognitive behavioral therapy for psychosis (CBT-P).

For more information, see the National Institute for Mental Health Site and NAMI.

From: National Institute of Mental Health and NAMI National.