Depression Archives - Khiron Clinics

Understanding the Stages of Grief

Araminta — Fri, 24 Jun 2022 05:00:13 +0000

The loss of a loved one is always difficult. Whether a loss is sudden or expected, coping in the aftermath can feel impossible. Loss can bring about many complex feelings, and over the years, experts have worked to understand the stages of grief and how people move through the grieving process.

The Five Stages of Grief

Psychiatrist Elisabeth Kubler-Ross outlined a theory of five distinct stages of grief that people go through after a loss:^[1]

Denial – the first stage of grief, denial helps people protect themselves from the pain of their loss. It can be incredibly difficult to accept that someone has died, and there is a lot of painful information to process. Denial is a common defence mechanism that provides a buffer to the shock and pain of the situation, helping people to process their loss in their own time.
Anger – after denial comes anger. The extreme emotional discomfort and pain of processing a loss is redirected and expressed as anger, and people may feel angry at everyone and everything as they process their feelings.
Bargaining – bargaining helps people hold onto hope as they grieve. Quite often an if/then scenario, this stage is often accompanied by guilt, as people think about how they could have done things differently and wish they could go back in time to change things.
Depression – an intense sadness accompanies this fourth stage of grief as people face the reality of their loss. They can feel fatigued, may withdraw from their loved ones, and lose interest in things that once brought them joy. Depression experienced while grieving is not necessarily a permanent mental health condition but rather a response to the grieving process.
Acceptance – acceptance is the final stage. Acceptance does not mean that it is any less painful or that people will never feel sad or angry anymore. Instead, they come to terms and start to move on with their lives.

There is no timeline for people to accept their loss, and this is not a comprehensive list. Many other emotions may arise during the grieving process, including detachment, resentment, and even relief, especially if they have watched a loved one suffer from a long illness.

Different Stages of Grief

There are many interpretations of the stages of grief. For example, psychiatrist Colin Murray Parkes developed a model of grief based on attachment theory which outlined four phases instead of five:^[2]

Shock and numbness – closely related to the denial stage in Kubler-Ross’s theory; this is the first stage of Parke’s theory. In this stage, people feel overwhelmed when coping with their loss and may feel physical distress leading to somatic symptoms.
Searching and yearning – people begin to search for comfort and become preoccupied with the person they have lost.
Despair and disorganisation – in this phase, people may become angry and upset, finally realising that their loved one is gone.
Reorganisation and recovery – similar to the acceptance stage, in this phase, people begin to come to terms with their loss. The sadness and longing may not disappear, but people start to move towards healing.

As with the five stages of grief, there is no timeline to move through each phase; the processing of emotions is a very personal experience.

Traumatic Grief

Traumatic grief can occur in response to a sudden, unexpected, or violent death of a loved one. The shock of the situation can be intensely traumatic and cause conditions such as prolonged grief disorder and complicated grief disorder.

For those who have experienced traumatic grief, their recovery process may not fit into specific stages, or they may get stuck in one stage. The symptoms of traumatic grief can include:

Emotional numbness
Difficulty sleeping
Increased anxiety
Loss of appetite
Trembling and shaking

Traumatic grief symptoms are often more intense and persistent than regular grief.

Coping with Grief

There is no one way to cope after losing a loved one. The grieving process is non-linear, and people may experience different aspects at different times.

There are several ways to help people come to terms with their loss, such as:

Return to a hobby – having a hobby such as crochet, painting, or gardening can give people an outlet for their emotions and provide them with something else to focus on.
Reach out to family and friends – speaking with loved ones can help process emotions and help people feel connected to others who can relate to what they are going through.
Practice self-care – the mind and body are connected. Eating a balanced diet, staying hydrated, and exercising regularly can boost your mental and physical health and can also help combat stress and fatigue.
Note down grief triggers – birthdays, anniversaries, and holidays can bring difficult feelings to the surface, no matter how long it has been since a loss. By knowing what might be a trigger, people can plan what they want to do, whether that is spending the day with a friend, honouring their loss, or simply sitting with their emotions.

Even with the best efforts, grief can be intensely challenging to manage and can get in the way of daily life. If you find that you are unable to move past your grief, professional treatment may be helpful.

If you have a client or know of someone struggling with grief and loss, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential programme and outpatient therapies addressing trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] Newman L. Elisabeth Kübler-Ross. BMJ. 2004;329(7466):627.

^[2] Parkes CM. Bereavement in adult life. BMJ. 1998;316(7134):856–859. doi:10.1136/bmj.316.7134.856

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What Is an Empath and How To Stop Absorbing Others Emotions

Araminta — Fri, 12 Nov 2021 05:36:13 +0000

Although having empathy for another person enables many to understand their pain and joy, this essentially becomes an empath’s pleasure and pain.

Empaths have many positive traits, including:[1]

Being intuitive
Pick up on dishonesty or hidden emotions
Being incredibly caring
Seeing the world in unique ways

However, there are many downsides to being an empath. Negative aspects can include:[2]

Being overwhelmed by intimacy – you may feel suffocated or panicked by your partner’s feelings
Avoiding conflict, even when conflict may be necessary
Feeling as though you don’t fit in
Difficulty setting boundaries
Trouble dealing with emotional overload

Combatting the Difficult Traits of Being an Empath

There are many ways to combat the problematic sides of being an empath. These include setting boundaries, making friends with the word no, practising mindfulness, and identifying triggers. We delve into each below.

Set Boundaries

Constantly dealing with the emotions of those around you can be exhausting, especially if people often come to you when they encounter problems. In this instance, you may find yourself feeling on edge around them. You may even experience mental exhaustion as you attempt to continuously deal with other people’s thoughts and feelings.[3]

However, this can be mitigated by setting firm, healthy boundaries with your loved ones. Healthy boundaries are essential for everyone, but as an empath, they are critical. This is because setting boundaries can help you focus on your own emotions and problems.

Boundaries can look different for everyone. Depending on your needs, boundaries may include turning down a few social invitations to rest and recharge rather than going out. Boundaries may also consist of encouraging people to seek other forms of help when you’re feeling overwhelmed.

As empaths typically tend to avoid conflict, setting boundaries may seem challenging. However, by establishing them, you can boost your own emotional health and well-being.

Make Friends With the Word No

As touched on above, empaths will avoid conflict as much as possible. This may lead to you saying “yes” to things you don’t necessarily want to do, such as attending an event or allowing people to unload their problems onto you.

Saying “no” goes hand-in-hand with setting non-negotiable boundaries. It’s a great way to make space for your own mental and physical well-being. When you say “no”, make sure you’re clear and firm, but be kind too. Saying “no” in a flimsy tone may lead people to be persistent. They may even demand that you say yes or attempt to change your mind.

Although you may worry about saying “no”, the best part of doing so is that you don’t have to justify yourself. If you’d like, you can, but saying “unfortunately, I can’t make it this weekend” or “thank you for the offer, but I have to decline” is a perfectly valid answer.

Practice Mindfulness

One of the signs of an empath is that they can feel overwhelmed very quickly. This may be from continuous socialising, large crowds, or sensory overload from loud noises or strong smells.

As an empath, it is essential to take steps to protect yourself against feeling overwhelmed. An excellent way to take a step back from the emotional ‘noise’ is to utilise mindfulness practices such as meditation.[4]

Meditation, for example, will provide you with a safe space to come back to at the end of the day. Mindfulness can also assist you when it comes to developing tools you can use in daily life.

Good mindfulness practices that you can incorporate into your life include, but are not limited to, the following:

Journaling
Yoga
Knitting
Walking

Identify Your Triggers

If you’re an empath who finds yourself feeling engulfed in emotion somewhat easily, try keeping a notebook handy. Making a note of how you feel at various times of the day and jotting down what triggers you will help you identify what causes you to feel overwhelmed. In turn, you can begin to plan for what to do when this happens again. You can also determine how to avoid any pessimistic emotions in the future.

For instance, you might find that certain social situations overwhelm you due to the number of people in attendance. The presence of certain people may also leave you feeling uneasy. You can either plan to avoid these events or cut down on attending them entirely in recognising this. After all, your mental health and well-being should be your priority.

Conclusion

Being an empath can sometimes seem like a curse rather than a blessing, especially with the extra emotional noise you have to deal with on a daily basis. However, being an empathic person is something to be proud of – you’re kind, caring, and love helping others. As this can be tiring, be sure to follow some of our tips and remember to look after yourself as well as your loved ones.

If you have a client or know of someone struggling with their mental health, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] Thompson, Russel L. et al. “Five-Factor Model (Big Five) Personality Traits And Universal-Diverse Orientation In Counselor Trainees”. The Journal Of Psychology, vol 136, no. 5, 2002, pp. 561-572. Informa UK Limited, doi:10.1080/00223980209605551. Accessed 8 Nov 2021.

[2] Heym, Nadja et al. “The Dark Empath: Characterising Dark Traits In The Presence Of Empathy”. Personality And Individual Differences, vol 169, 2021, p. 110172. Elsevier BV, doi:10.1016/j.paid.2020.110172. Accessed 8 Nov 2021.

[3] Wuest, Judith. “Setting Boundaries: A Strategy For Precarious Ordering Of Women’s Caring Demands”. Research In Nursing & Health, vol 21, no. 1, 1998, pp. 39-49. Wiley, doi:10.1002/(sici)1098-240x(199802)21:1<39::aid-nur5>3.0.co;2-u. Accessed 8 Nov 2021.

[4] Raab, Kelley. “Mindfulness, Self-Compassion, And Empathy Among Health Care Professionals: A Review Of The Literature”. Journal Of Health Care Chaplaincy, vol 20, no. 3, 2014, pp. 95-108. Informa UK Limited, doi:10.1080/08854726.2014.913876. Accessed 8 Nov 2021.

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The Bravest Challenge: Parenting, PTSD, and the Past

Araminta — Thu, 22 Jul 2021 15:55:11 +0000

We receive no formal training in parenting – and although it’s the most rewarding job in the world, it’s also one of the scariest. We never want to hurt or damage our children in any way, and if we were denied something as a child, such as safety or reassurance, we want to make sure we deliver it to our own children.

If you’re reading this article, there is a chance you’re worried about how your past is impacting your parenting. You might have a formal diagnosis of PTSD, or you might have recognised some of its symptoms in yourself and are curious. Maybe you didn’t have a great childhood experience growing up, and you’re worried about becoming a parent. Whatever your situation, it’s never too late to seek help. There is no such thing as a perfect parent after all.

Understanding the Role That Attachment Style Has on Your Relationships

We aren’t responsible for how we were raised – as children, our upbringing was totally out of our control. However, our early life relationships can affect how we relate to others both as children and when we grow up. This is called our attachment style – of which there are four. They are not mutually exclusive, and it is common to have a mix of two or more.

The attachment styles are:

Secure

This style comes from having a consistent, predictable, and trustworthy caregiver. This translates into being an adult that successfully navigates conflicts and builds relationships easily.

Insecure-Ambivalent

This results from an inconsistent caregiver – they might have been caring at times, but also volatile and unpredictable. As an adult, this can lead to fear of abandonment and strong dependency on others.

Insecure-Avoidant

This attachment style arises from a disengaged and emotionally distant caregiver that ignores your needs to be loved, accepted, and seen. This leads to dismissing your own emotions as an adult and struggling with intimacy.

Disorganised

This style is the result of a chaotic and abusive caregiver that is a source of fear. As children, we still crave attachment, so we form a bond with the parent despite the relationship’s negative impact on us. It translates into feeling high levels of fear, irritability, anger, depression, despair, and defeat. Adults with disorganised attachment often subconsciously repeat the parental behaviours they witnessed as a child.

Attachment Styles and PTSD

Unsurprisingly, research has found that insecure-avoidant and disorganised attachment styles correlate higher with instances of PTSD in adults. ^[1] Whatever your attachment style or styles are, it will affect how you parent – whether you’ve learned to suppress your emotions and not react to situations or overreact and lose your temper at insignificant things.

Post-traumatic stress disorder, or PTSD, can cast a shadow over our lives. Past energy from unresolved trauma can trigger us and cause us to act in certain ways, e.g. we might flare up in anger or fall into depression. These triggers can seemingly come from nowhere and make it feel like we are re-experiencing the original trauma, and they can be alarming, not only for us but for our loved ones around us.

Most research around parenting and PTSD centres on war veterans as often, people only associate trauma with the most extreme instances. However, traumatic events come in many guises, and PTSD can occur after any stressful, dangerous, or scary event. It could have happened over a long time period, such as physical abuse or be a one-off event. ^[2]

Often, parents with PTSD worry they aren’t parenting as well as they can or that their trauma will be passed on to their children. They hold themselves to an impossibly high standard to mitigate this risk, ending in a cycle of self-blame and disappointment. This doesn’t have to be your reality – studies have shown that a PTSD diagnosis does not necessarily correlate with parenting risk. ^[3]

Parenting is difficult, and you’re allowed to make mistakes. It’s important to remember that you can always review whether or not your reaction is appropriate for the situation. If you’ve overreacted to something minor, take a step back from the situation and give yourself time to relax. The same applies to underreacting – firm boundaries are essential for balanced emotional development, and children need guidance.

If you’ve made a mistake, you should be willing to apologise; however, genuine apologies require a committed effort to change. In the meantime, you could try explaining to your children what the reality of living with PTSD is like and how it affects the way you act. This will help them understand that the reaction is related to you and your past rather than them and will hopefully prevent them from internalising your actions and behaviour.

Of course, altering long-standing well-entrenched behaviours takes time and often requires professional intervention. There is nothing wrong with seeking help – overcoming past trauma isn’t easy alone. It doesn’t mean you’re a bad parent – it actually signifies wanting the best for your children.

Trauma-informed professionals can help you understand how your past affects your parenting and show you healthy coping strategies for managing your PTSD symptoms.

At Khiron Clinics C+A, attuned therapists can help you work through and process any unresolved trauma using specialist techniques and methods. Please contact us today.

Sources

[1] Woodhouse, Sarah et al. “The relationship between adult attachment style and post-traumatic stress symptoms: A meta-analysis.” Journal of anxiety disorders vol. 35 (2015): 103-17. doi:10.1016/j.janxdis.2015.07.002

[2] Costello, E Jane et al. “The prevalence of potentially traumatic events in childhood and adolescence.” Journal of traumatic stress vol. 15,2 (2002): 99-112. doi:10.1023/A:1014851823163

[3] Muzik, Maria et al. “Psychopathology and parenting: An examination of perceived and observed parenting in mothers with depression and PTSD.” Journal of affective disorders vol. 207 (2017): 242-250. doi:10.1016/j.jad.2016.08.035

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Mental Health and the Menopause

Araminta — Fri, 09 Jul 2021 05:47:17 +0000

Menopause, and perimenopause, bring changes to a woman’s body with various physical symptoms, but the years leading up to it, and the transition itself, also affect the mind and a person’s mental health.

During menopause, mood changes such as sadness, lack of concentration, irritability, lack of motivation, aggressiveness, and stress are common and cause emotional strain.^[1] These mood changes combined with distressing physical symptoms can result in the onset of mental health disorders such as depression and anxiety.

Additionally, if an individual has a pre-existing mental health condition, menopause is known to potentially exacerbate symptoms.

In this article, we will uncover the connection between menopause and mental health, the most commonly associated conditions, and tips to help cope with this transitory time in a woman’s life.

Effects on Mental Health

Menopause is defined as marking the end of the menstrual cycle, twelve months after a woman’s last menstrual period. Perimenopause is the time leading up to menopause when estrogen and hormone levels drop. Perimenopause can last anywhere between four and twelve years.

The key hormones which control the female reproductive system are estrogen and progesterone. These hormones are produced in the ovaries. During menopause, these hormones – particularly estrogen – drop, while the levels of follicle-stimulating hormone (FSH) and luteinising hormone (LH) increase.^[2]

The fluctuations in the hormone levels cause biochemical changes to the brain and nervous system, resulting in various physiological and psychological symptoms. These symptoms can be mild or acute and may be emotionally distressing.

Symptoms include:

Physical Symptoms: insomnia, hot flushes, fatigue, night sweats, and memory loss.
Mood changes: sadness, lack of concentration, irritability, lack of motivation, aggressiveness, and stress.
Mental Health Disorders: depression and anxiety.

Women may experience similar symptoms due to hormone fluctuations through premenstrual syndrome (PMT), premenstrual dysphoric disorder (a severe form of premenstrual syndrome), and postpartum depression. All these conditions are driven by hormonal changes in the body.

Decreased estrogen levels are particularly significant in affecting mood changes as estrogen modulates neurological processes related to our stress response, cognition, and emotional regulation.

Most women transition without experiencing mental health issues; however, an estimated 20%^[3] of women experience psychological difficulty.

It is rare for someone with no history of mental health disorders to develop a severe mental health issue during this time. Most women who experience significant mood difficulties have suffered from a similar issue in the past.^[4]

It is important to note that midlife, when menopause typically occurs, is a time of flux and stress for many women that may contribute to the onset of depression and anxiety. Women at this time in their lives may feel burdened with life changes, which could include:

caring for children
caring for aging parents
grown children leaving home or returning home
career changes
changes in romantic relationships
concerns about the health of a partner or family member
growing older

Menopause and Depression

Women appear to be vulnerable to depression during perimenopause and in the years after menopause. Clinical trials are yet to find a clear link between depression and menopause; however, research shows that rates of depression significantly increase during these years.^[5]

Women with a history of clinical depression, postpartum depression, or severe PMS in their younger years are more likely to experience a relapse of these symptoms during these years.

In rare instances, the estrogen changes and associated menopausal psychosocial stresses can contribute to the vulnerability of developing major depressive disorder (MDD).^[6]

Menopause and Bipolar Disorder

Research suggests that hormones play a role in the development of bipolar disorder. The hormone fluctuations during menopause have been shown to increase the severity of symptoms in some women. One in five women already suffering from bipolar disorder reported severe emotional distress as they transitioned.^[7]

Research has additionally demonstrated that it is usually the depressive episodes, rather than the manic, which become more pronounced and acute during menopause. This is most likely due to the decrease in estrogen levels.

Menopause and Schizophrenia

Estrogen has antidopaminergic properties, which are the main qualities of any antipsychotic medication. The decrease in estrogen levels during menopause effectively removes this protective aid and can aggravate or trigger psychotic conditions such as schizophrenia.^[8]

Schizophrenia is typically diagnosed in young adulthood; however, there is a second peak in diagnosis among women around menopause. Those with pre-existing schizophrenia may experience an increase in symptoms or a deterioration of their illness and may require a new level of treatment.

Coping with Mood Changes

As well as the fluctuating hormone levels, physical health changes are common during the menopause years, and these can additionally contribute to our mental health. Here are some tips to help protect your mental health during the perimenopause and menopause years:

Remember it is temporary – the physical and physiological shifts during menopause can be frightening. It would be easy to think that they will not pass; however, the symptoms will fade over the years and not be present all the time.
Be aware – mood changes are likely linked to hormone levels, a lack of sleep, stress, or other co-occurring health issues.
Making lifestyle changes – eat a healthy, balanced diet, increase exercise, sleeping well, socialise with positive peers, and control stress levels. All are factors that can help to reduce potential symptoms.
Ask for help – talk to friends and family to share your challenges and receive support if you are struggling. If the symptoms are severe and persistent, speak to your GP or a medical professional, as numerous treatments are available to help alleviate symptoms.

Menopause is a period which all women go through as they reach mid-life. Menopause affects all women differently, with a range of symptoms ranging from mild to acutely distressing. If you or a loved one is suffering from mental health issues during menopause, do not struggle alone – seek help today.

If you have a client, or know of someone who is struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

[1] “How Can Menopause Affect Your Mental Health? – Mental Health UK”. Mental Health UK, 2021, https://mentalhealth-uk.org/blog/how-can-menopause-affect-your-mental-health/.

[2] “The Reproductive Endocrinology Of The Menopausal Transition.”. Reference.Medscape.Com, 2021, https://reference.medscape.com/medline/abstract/21419147.

[3] “Menopause And Mood Disorders: Overview, Pathophysiology, Etiology”. Emedicine.Medscape.Com, 2021, https://emedicine.medscape.com/article/295382-overview#a1.

[4] “Menopause And Mental Health – Harvard Health”. Harvard Health, 2020, https://www.health.harvard.edu/womens-health/menopause-and-mental-health.

[5] Bosworth, H. B. Depression Increases In Women During Early To Late Menopause But Decreases After Menopause. 2021.

[6] Albert, Kimberly M., and Paul A. Newhouse. “Estrogen, Stress, And Depression: Cognitive And Biological Interactions”. Annual Review Of Clinical Psychology, vol 15, no. 1, 2019, pp. 399-423. Annual Reviews, doi:10.1146/annurev-clinpsy-050718-095557. Accessed 6 July 2021.

[7] “Women With Bipolar Disorder”. Webmd, 2021, https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-women.

[8] Gupta, Rina et al. “Menopause And Schizophrenia”. Menopause International, vol 18, no. 1, 2012, pp. 10-14. SAGE Publications, doi:10.1258/mi.2012.011116. Accessed 6 July 2021.

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Emotional Breakdowns – What is Really Happening?

Araminta — Fri, 02 Jul 2021 05:09:45 +0000

People often say they’re having a breakdown. The Rolling Stones even had a transatlantic hit about a girl whose 19th Nervous Breakdown was imminent, and in times of acute stress, pressure, or both, it can feel that way. In the 21st Century, that term is thankfully outmoded and unacceptable, but the human stress response has not correspondingly evolved beyond the state that gave rise to the term.

Most of the time, we can forge on, dust ourselves off and prepare for the next “crisis”, but in some cases, an emotional breakdown is a very real and much more serious affair.

Physical and psychological symptoms may present as:

panic attacks
difficulty breathing
hallucinations
excessive fear
paranoia
extreme mood swings
unexplained outbursts
detachment from reality (and self)

People exhibiting signs of emotional suffering need support to help them return to a more balanced state and function normally in day-to-day life without a sense of crippling overwhelm.

What Are the Signs?

In Western cultures, some early indicators may be:

increased absenteeism from work or other appointments
lack of attention to personal hygiene
disturbed sleep and eating patterns
trembling or shaking
muscle tension
gastrointestinal and cardiovascular symptoms
dry mouth
lack of focus or recall
unexplained aches and pain

Some people might comfort eat, while weight will seem to fall off others as they are unable to eat due to stress and worry, and at the more extreme end of clinical markers, people can experience suicidal ideation.

What is Really Happening?

This kind of response often indicates an underlying and often undiagnosed co-morbidity with other mental health conditions such as depression, anxiety, or PTSD, with signs varying from person to person and many things potentially being at the root of an episode. Relationship breakdowns, especially in the young, are “one of the greatest harms” that can occur for most humans, with the concept of “Love Trauma Syndrome” being introduced by Richard B. Rosse in 1999.^[1]

Most of us have experienced the feeling of having a broken heart. We have witnessed the phenomenon in others, with each person experiencing and exhibiting symptoms in differing ways and for varying durations. This is just part of the natural process of healing and the human condition, but in some, what has come to be the standard practice of processing these emotions becomes maladapted and can go on for what is considered to be an excessive time period, spilling over onto the unhealthy end of the scale for the sufferer.

Things can become so bad that standard treatment methods like Cognitive Behavioural Therapy are rendered ineffective, and more complex and multi-disciplinary treatment protocols are required. As with many emotional and mental disorders, the root cause of self-regulatory behaviour can be found in childhood or adolescence, driving automatic and unhelpful thought responses and patterns such as perfectionism throughout life.

The Cult of Personality

“Personality has the power to uplift, the power to depress, the power to curse, and power to bless.”

– Paul Harris

Studies have shown a correlation between personality type and attachment styles and a higher likelihood of depression and emotional breakdown.^[2] Often, those with a more robust concept of self who have been on the receiving end of parental and other support network-derived positive affirmation are predisposed to having a stronger personal identity and are less dependent on others for their own sense of security and happiness.

Perfectionism also plays a role in more than its fair share of mental health issues and can lead to burnout and other forms of emotional and physical breakdown. A study undertaken on athletes showed that multiple disciplinary athletes were less likely to exhibit stress and burnout than those who specialised or who were effectively fixated on one particular activity, which can become obsessional in and of itself.^[3] Those with perfectionist personalities can obsess over details and never feel a sense of satisfaction or a job well done, which can compound over time, leading to a catalogue of unhelpful emotional responses, including breakdown.

Emotional Rescue

Understanding that the prolonged habits and behaviours which led to the breakdown in healthy functioning is the key to producing meaningful and lasting results in treatment or, to quote the Rolling Stones again, emotional rescue is paramount.

The simplest explanation is that a “breakdown” is the culmination of an inability to deal with and clear the trauma held by the body, particularly the parasympathetic nervous system, as a response to any or all of the underlying conditions mentioned earlier. These unfinished stress cycles need to find completion with the help of new generation psychotherapeutic treatments informed by neuroscience and developed in America.

This ground-breaking treatment will not re-trigger traumatic events and can help to create a healthy internal voice in the sufferer’s mind to enable them to move forward and break any unhealthy cycles they are stuck in.

Sources:

^[1] Mouchan, Razieh et al. “The Effectiveness Of Schema Therapy On Reducing Symptoms Of Emotional Breakdown”. 2016, Accessed 21 June 2021.

^[2] Moradtalab, Shahnaz, and Asghar Jafari. “Prediction Of Depression In Students With Emotional Breakdown Based On Attachment Styles And Self-Concept”. International Academic Journal Of Humanities, 2014, Accessed 21 June 2021.

^[3] Garinger, Lindsay M. et al. “The Effect Of Perceived Stress And Specialization On The Relationship Between Perfectionism And Burnout In Collegiate Athletes”. Anxiety, Stress, & Coping, vol 31, no. 6, 2018, pp. 714-727. Informa UK Limited, doi:10.1080/10615806.2018.1521514. Accessed 21 June 2021.

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Somatic Experiencing

Araminta — Fri, 11 Sep 2020 04:30:50 +0000

Somatic Experiencing is a body-centred treatment for trauma, first developed by Dr. Peter A. Levine, author of Waking the Tiger: Healing Trauma and In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness.

Levine began to develop Somatic Experiencing following his observations of animals in the wild. He noticed that, when facing threat, animals display a range of threat responses similar to humans – fight, flight, and freeze. Unlike humans, however, Levine noticed that animals were adept at releasing the physical energy charged up by the threat response, able to recover quickly and return to a state of internal homeostasis. Humans, unfortunately, have a much harder time releasing this energy.

Even though we may be safe now, our nervous system can become ‘stuck’ in its threat response. When we live our day to day lives with a frozen threat response, we continue to sense danger in the environment, are on high alert and in a state of high reactivity. Alternatively, we become numb and apathetic, unable to live fully in the present.

Somatic Experiencing helps to restore clients to health by assisting them in releasing their frozen energy and gaining a visceral understanding of safety.

Trauma and the Brain

Let’s simplify the brain into two basic primary modes; ‘safe’ and ‘survival’. Safe mode allows us to relax, engage with others, and learn new information. When we are safe, we are healthy, open, and sociable.

In safe mode, the branch of the Autonomic Nervous System^[1] (responsible for regulation of physiologic processes) activated is the Parasympathetic Nervous System, responsible for rest and digestion.

In survival mode, we are on high alert, constantly surveying our environment for threat, and highly reactive to stimuli. Or we are emotionally shut down, numb and apathetic to our surroundings. Decisions in survival mode are often fear-based. In survival mode, it is the Sympathetic Nervous System (responsible for the fight/flight response) that is activated.

In the face of threat, we enter survival mode, which ensures our safety. When the threat has passed, we may still be in survival mode, because the threat was overwhelming that we froze. While our threat responses aim to ensure our survival, they can be detrimental to our health if they are prolonged. Prolonged activation of our threat response leads to a range of physical and psychological health issues^[2], including anxiety, depression, poor concentration, strained interpersonal relationships, flashbacks, and other mood and personality disorders.

How does Somatic Experiencing work in Practice?

To release the grip of our frozen threat responses on our well-being and functionality, the accumulated energy from the response must be discharged. A trained SE therapist guides the client in becoming aware of their physical sensations when talking about their past experiences. The client’s narrative of the experience is not the centre of focus in therapy, Instead, focus is placed on the physical, inner sensations that arise when the experience is revisited.

Unlike traditional talk therapies, which take a ‘top-down’ approach, focusing on cognitive processing, Somatic Experiencing uses a ‘bottom-up’ approach, where focus is given the bodily sensations linked to traumatic memories.

In the early stages of SE therapy, clients are educated on the nervous system and how it is affected by a traumatic event. This serves to dispel any confusion as to why a person is experiencing difficult trauma-related symptoms.

Before visiting the traumatic memories, therapists help clients to resource their own innate strength, peace and resilience by discussing positive aspects of the client’s life, perhaps people or places that bring them a sense of peace and calm.

Once the resources for strength and resilience have been identified, a gradual revisiting of the traumatic memories can take place. This stage of the process, known as titration, allows clients to slowly accept the memory and the associated feelings. The process is gradual to prevent overwhelm and retraumatization.

As the memories are revisited, the trained SE therapist will witness and track the clients sensations and physicality, such as a change in breathing, postural shifts, or a change in tone of voice. The client collaborates with the therapist by informing them about invisible sensations, like a change in body temperature or a dizzy feeling.^[3]

When sensations arise, clients may respond by shaking, trembling, or crying. There may be muscular tightening, clenching of hands, clenching of the jaw. These phenomena are considered to be a release of the frozen energy, and are encouraged. At the same time, the therapist will help the client come to a calmer state by encouraging the use of the cultivated resources at the beginning of therapy^[4]. Over time, the movement from activation to calm becomes a lot smoother, and further exploration can take place.

What are the Benefits of Somatic Experiencing?

Somatic Experiencing offers a range of benefits to clients who have experienced trauma, such as child abuse, neglect, sexual abuse, violence, natural disasters, or motor vehicle accidents.

Following a course of SE therapy, clients may experience^[5]:

A greater sense of self
Increased confidence
Reduction in PTSD symptoms
Improved concentration
Improved relationship with one’s body

Unresolved trauma permeates into all aspects of our lives. It can lead to a host of disruptive and inhibitive physical and psychological symptoms that get in the way of us being able to fully live our lives. With Somatic Experiencing, clients can find that healthy functioning is restored, and maladaptive behaviours, or survival strategies, can be reduced. Ultimately, Somatic Experiencing helps clients find balance and regulation in their nervous system, which is integral to leading a healthy life.

If you have a client, or know of someone who is struggling and could benefit from participating in treatment modalities such as somatic experiencing, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and out-patient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

Sources:

^[1] McCorry, Laurie Kelly. “Physiology of the autonomic nervous system.” American journal of pharmaceutical education vol. 71,4 (2007): 78. doi:10.5688/aj710478

^[2] Selye H. The Stress of Life. New York: McGraw-Hill; 1956.

^[3] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: [Accessed 25 June 2020].

^[4] Healthline. n.d. Somatic Experiencing: How It Can Help You. [online] Available at: [Accessed 25 June 2020].

^[5] Khan, K., 2018. How Somatic Therapy Can Help Patients Suffering From Psychological Trauma. [online] World of Psychology. Available at: [Accessed 5 August 2020].

The post Somatic Experiencing appeared first on Khiron Clinics.

The Relationship Between Post-Traumatic Stress Disorder (PTSD) and Depression

steve — Fri, 25 Oct 2019 07:19:34 +0000

It is understood that Post Traumatic Stress Disorder (PTSD) and depression are often linked. This is supported by researchers who found that those who have been diagnosed with PTSD, roughly 48% to 55% have also experienced present or previous depression^[1]https://www.verywellmind.com/ptsd-and-depression-2797533 – accessed 16/10/2019, indicating a deeper understanding of the relationship is between the two conditions. Overall, depression is one of the leading co-occurring diagnoses in people with PTSD.

A recent study published in Psychiatry Research^[2]Blakey, Shannon & Yi, Jennifer & Calhoun, Patrick & Beckham, Jean & Elbogen, Eric. (2019). Why do Trauma Survivors Become Depressed? Testing the Behavioral Model of Depression in a … Continue reading was able to highlight reasons why traumatic experiences can often lead to depression. Evidence was found to show that when stress that was induced by trauma began to impede the survivors functioning in day to day activities it can predict the onset of depression.

Depression is the most commonly found mental health condition and affects around 1 in 10 people at some point in their lives. Research has found that people who have had PTSD are between three and five times as likely to also have depression, implying a strong correlation between the two conditions.

The DSM-5 describes the following symptoms of depression; low mood and/or tearfulness, apathy to previous interests and pleasures, a significant weight change, insomnia and difficulty sleeping, hypervigilance or fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death and/or suicide. To be diagnosed with depression a person will have experienced five or more for two weeks or more and will not be able to “snap out of it” or feel positively about the future^[3]https://www.nhs.uk/conditions/clinical-depression/ – accessed 16/10/2019.

Meanwhile, PTSD is a condition which relates to negative emotions such as shame, guilt, anger, and disgust, as well as impairments in the ability to effectively regulate these emotional states^[4]McLean, Carmen P., and Edna B. Foa. “Emotions and emotion regulation in posttraumatic stress disorder.” Current opinion in psychology 14 (2017): 72-77.. DSM-5 diagnostic criteria specifies that a person must have experienced a traumatic event, must experience symptoms that include intrusive thoughts, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity, and these symptoms must significantly affect a person’s ability to function as they did before the event, or cause major distress^[5]National Collaborating Centre for Mental Health (UK. Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care. Gaskell, 2005.. While these emotions are normal responses to traumatic events, a person diagnosed with PTSD will experience these feelings persistently for over a month^[6] https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets – Post Traumatic Stress Disorder – accessed 16/10/2019.

PTSD and depression have overlapping characteristics, these have been most commonly recognised as;

Difficulty sleeping, either due to flashbacks in the form of intense nightmares, by which the person re-experiences traumatic events, or feeling like thoughts are on a continuous loop of negative thoughts, preventing a person from falling or staying asleep.

Losing interest in things that you used to enjoy, or take pride in. This can be seen in a person dressing differently, neglecting personal hygiene, withdrawing from hobbies, feeling an aversion to or apathy towards sex or food.

Feeling irritable or short tempered. This can be due to feeling your mind is absent, or busy working through unprocessed trauma. It is common to feel that people are unable to understand you, or keep up with your line of thoughts, making it often frustrating to communicate with people who do not understand psychological conditions^[7]https://www.webmd.com/depression/depression-ptsd-vs-depression#2 – accessed 16/10/2019.

Lastly, people who suffer from PTSD and/or depression can feel a desire to withdraw from relationships or social situations, preferring instead of the feeling of safety in solitude, often developing an emotional detachment from other people who once acted as islands of safety.

According to Matthew Tull PTSD and depression are connected by the increase of exposure to trauma^[8] https://www.verywellmind.com/ptsd-and-depression-2797533 . Taking into consideration that those with depression are more susceptible to trauma, this alludes to an urgency to treat depression before it allows cumulative traumatic events, as a result of depression, to develop into PTSD.

A dual diagnosis such as PTSD and depression require professional treatment, as each diagnosis can exacerbate the other if left untreated. Furthermore, if PTSD alone is left untreated, the risk of developing depression as a result is far higher.

While there has been much research on the treatment of PTSD, no method has been shown to work for all those with the condition^[9] Brom, Danny, Yaffa Stokar, Cathy Lawi, Vered Nuriel‐Porat, Yuval Ziv, Karen Lerner, and Gina Ross. “Somatic experiencing for posttraumatic stress disorder: a randomized controlled outcome … Continue reading. This supports the argument that increasing the options for treatment beyond CBT/DBT means treatment is more widely accessible and effective. Previous research has shown that a “one size fits all” is ineffective for treatments of more complex psychological disorders.

At Khiron Clinics, we are able to treat both PTSD and depression using holistic practices such as Somatic Experiencing, Structural Dissociation Therapy, Psychoeducation, fitness training, nutritional therapy, among many others. By processing traumatic memories in a safe and trauma informed environment, we are able to achieve symptom reduction and regulation.

The selection of these treatments are grounded by the International Society for the Study of Trauma (ISSTD) guidelines for the treatment of trauma^[10]http://www.isst-d.org/ – accessed 16/10/2019 and are delivered by some of the best treatment specialists in the UK, supported by leading national and international dignitaries in the sector.

Khiron Clinic’s carefully constructed programme has been proven to reduce symptoms and stabilise dysregulated symptoms, such as those identified by the DSM-5 as the leading characteristics of PTSD and depression.

If you have a client, or know of someone who is struggling with PTSD, depression, or both concurrently, reach out to Khiron. We believe that we can stop the revolving door of treatment and misdiagnosis by providing effective residential and out-patient therapies for underlying psychological trauma. Allow us to help you find the path to effective, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).

References[+]

References
↑1	https://www.verywellmind.com/ptsd-and-depression-2797533 – accessed 16/10/2019
↑2	Blakey, Shannon & Yi, Jennifer & Calhoun, Patrick & Beckham, Jean & Elbogen, Eric. (2019). Why do Trauma Survivors Become Depressed? Testing the Behavioral Model of Depression in a Nationally Representative Sample. Psychiatry Research. 272. 587-594. 10.1016/j.psychres.2018.12.150.
↑3	https://www.nhs.uk/conditions/clinical-depression/ – accessed 16/10/2019
↑4	McLean, Carmen P., and Edna B. Foa. “Emotions and emotion regulation in posttraumatic stress disorder.” Current opinion in psychology 14 (2017): 72-77.
↑5	National Collaborating Centre for Mental Health (UK. Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care. Gaskell, 2005.
↑6	https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets – Post Traumatic Stress Disorder – accessed 16/10/2019
↑7	https://www.webmd.com/depression/depression-ptsd-vs-depression#2 – accessed 16/10/2019
↑8	https://www.verywellmind.com/ptsd-and-depression-2797533
↑9	Brom, Danny, Yaffa Stokar, Cathy Lawi, Vered Nuriel‐Porat, Yuval Ziv, Karen Lerner, and Gina Ross. “Somatic experiencing for posttraumatic stress disorder: a randomized controlled outcome study.” Journal of traumatic stress 30, no. 3 (2017): 304-312.
↑10	http://www.isst-d.org/ – accessed 16/10/2019

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