Category Archives: Depression

Babies, New Moms and Depression

 

A government advisory group recommended last month, that new mothers and pregnant women be screened for depression.

The recommendation, which may or may not be adopted, is a welcome recognition that there are unique psychological issues that new and expectant mothers face.

Yet, I have some serious reservations about the recommendations and how they might be implemented.

First, one of the major reasons for the suggestion appears to be that psychological counseling is now covered by the Affordable Care Act. The implication being that we don’t need to worry about mental health unless it’s covered by insurance.

Mental health counseling is indeed covered by the ACA in some cases and the federal government has mandated that mental health, if covered, is entitled to parity with other medical treatment. The result has been that many private insurance firms have dropped mental health coverage and the few that do cover it, reimburse patients at such a low rate that most patients are not able to benefit from it.

Secondly, and perhaps most importantly, I am concerned  that the report’s sponsor’s version of mental health treatment, is really just a gateway to encourage medication usage.

According to the New York Times, “The panel said evidence showed that cognitive behavioral therapy. (CBT, as it is commonly known, is a type of talk therapy,)  was helpful to mothers.” The study opined that the use of some antidepressants during pregnancy could cause “potential serious fetal harms,” but that “the likelihood of these serious harms is low.”

Let’s just call this what it is, another victory for Big Pharma. Another group of people who may never have considered drugs will get immediate access to a range of medications they may take for the rest of their lives.

I have advocated Cognitive Behavioral Therapy and other non-pharmacological approaches with my patients for many years and will continue to recommend them over pharmaceuticals.

Very few of the studies compare interactive interventions before recommending medication and few have proven medication does not affect an unborn baby. I would caution any prospective mother to be very careful about what she puts in her body while her baby is developing.

The only exception would be a patient who is suicidal and clearly needs medication to stabilize and manage her severe mental status.

While I agree that depression screening and treatment will help many new and expectant mothers, allowing them to receive counseling and hopefully forestall more serious mental illness, drugs are not always the first line of defense. All mental health factors need to be carefully considered prior to prescribing an anti-depressant medication.

In my next post I’ll offer some more natural suggestions that might help.

Are you Grounded?

Pop culture is filled with ways to keep you grounded psychologically but Biological Psychologist Helena Riess, Ph. D. says that it’s just as important to be physically grounded.

“We’ve gotten away from nature,” Dr. Riess says, “and we don’t even realize the negative impact it has on our health.”

When she refers to the concept of “grounding”, Dr. Riess means actual physical contact with the ground and nature. The benefits can range from the psychological well -being of relaxing in a natural environment to the physical impact of clean air.

Additionally, studies have shown that gardening and contact with bacteria in the soil can have a beneficial impact on human health. Ask any gardener how they feel after a day in the dirt and you can’t help but see the positive impact.

Dr. Riess says she is a firm believer in grounding or “earthing” as a way to control stress and improve overall wellness. Contact with the ground can release negative ions that build up in the body and can counteract the impact of free radicals according to Dr. Riess. She points to Clinton Ober’s groundbreaking book on the subject as the basis for the movement.

She uses a variety techniques to help her and her clients keep in contact with the earth even when engaged in daily activities- such as sleep, work, and even walking.

“The impact on sleep and stress levels is significant,” she notes.

 

Depression and Concussions

For the last few years the study of athletics and concussions has focused on the long-term impact on individuals who suffer multiple incidents over their careers.

But as a Sports Psychologist, pain management specialist and head injury expert, I see patients who have symptoms of depression almost immediately after their injuries. This can be true whether they suffered a concussion on the highway during an accident or on the football field, after a particularly jarring tackle.2014_Concussions

The difference is that until recently we never had a baseline reading of symptoms before the concussion.

Now a new study, done by a researcher at Penn State University, has confirmed what most psychologists and medical experts already know. Namely, that depressive symptoms can start to show up within days of a concussion.

In reading the article from Huffington Post, my biggest revelation was that the psychologist overseeing the study, was surprised by his results.

Anyone who has suffered from a concussion understands the psychological implications and, in hindsight, knows that the physical trauma can be a far easier recovery than the psychological recovery.

It is imperative that parents and loved ones understand this and make sure that help is provided. And by help, I do not mean simply medications which cover up the symptoms. Supportive, long-term Cognitive Behavioral Therapy is one effective method that patients can use after their injury.

In my practice I have incorporated mindfulness, visualization, EMDR, and breath work to assist with the healing process.

We’ve already seen a marked drop in participation in football, at some levels, and an increase in concussion awareness from the NFL to Pop Warner as well as other sports. But until there is an admission that psychological recovery is just as important as physical recovery the issue will not go away.

As long as teams push players to ‘tough it out’ and return to the game before their symptoms have been treated, the more long-term damage were are doing to our children and grand children.