November 6, 2015
Hey Passengers welcome aboard and back for another session on the good Doc’s couch. I really believe this was one of our better sessions. I would humbly encourage you to invite anyone you know to the train to review this interview. I found the information to be incredibly enlightening. So, let’s mozey on back to the Doctor’s car, oh and stop by the cafe car and bring me some salted peanuts in the shell and a diet coke please…
Kick off the music (See radio Broadcast Button upper right), I hope this helps
Dr. Dee: So, Chuckie, one of the passengers has made a special request to discuss coping with a family member who has Alzheimer’s disease. Are you game?
Chuckie: “CALL THE POLICE!”, not only is this woman a brilliant Doctor but, she reads minds as well! Come mere gurl! Gimmie a hug!
Chuckie: Yes, it seems that this topic has been a theme in my life in terms of coming in contact with friends dealing with this. How shall we begin?
Dr Dee: First of all I think we ought to talk a little bit about what exactly Alzheimer’s disease is. Alzheimer’s disease is a form of dementia. Not all dementia is Alzheimer’s but Alzheimer’s is characterized by dementia. This is a disease where a person gradually develops memory problems which are more and more severe. They begin by forgetting little things, and as the disease develops, they forget procedures we take for granted such as brushing their teeth getting dressed, and they forget people close to them and even their own name, as well as other personal bits of information. Usually the disease takes a slow course, and develops over several years.
Chuckie: I can see how this would be really sad, and frustrating for a family member.
Dr. Dee: Yes this can be very, very frustrating. In fact, the passenger who suggested this topic mentioned that from her perspective, dealing with a family member with Alzheimer’s is even more difficult to cope with than dealing with someone with a terminal disease.
Chuckie: Wow. That’s pretty heavy stuff. Why do think that might be?
Dr. Dee: Well, as with other situations, Alzheimer’s disease involves coping with a great deal of loss. But unlike divorce, where that person is still the same person you were married to, only they’re just not there anymore, and unlike most terminal diseases where that person may have physical decline, but is still essentially the same person, Alzheimer’s disease involves a relatively physically healthy individual, who looks the same as you’ve always known in most cases, except that they’re getting older. When you look at this person who looks the same as they’ve always looked, you expect them to know you as they’ve always known you, and behave, as they’ve always behaved. But they don’t. And they don’t because they are losing their memory and memory forms the basis of who we are. Not only that, Alzheimer’s is a slow moving disease. So, just as you get to the point where you feel you have accepted some loss of who that person was, something else of that person you know and love, fades away, and you are right back at the beginning again, having to mourn the loss of something new, that is now no longer there.
Chuckie: So, what can a person who has a family member who is suffering with Alzheimer’s do? How can they cope with this constant series of losses that can apparently go on for a number of years?
Dr. Dee: Chuckie, this is one of those cases where a really good support group can be a life line. In a support group for Alzheimer’s caregivers, a family member can meet with others who know exactly what the family member is going through. They can also offer helpful tips for coping with the little changes.
Chuckie: What kind of changes are common for family members of patients with Alzheimer’s?
Dr. Dee: Two major kinds of changes have to be dealt with. On the one hand, dealing with a family member who has Alzheimer’s requires changes in role and relationships. For instance, the Alzheimer’s patient may have been the one who handled the finances or the taxes or the cooking or the housekeeping. But gradually they become unable to carry out those roles, and someone else has to step in and begin to do them. This can be overwhelming and frustrating for the family member. Sometimes they have to learn completely new skills, such as in the case of dealing with finances. Sometimes it involves leaving their own job to devote themselves to full-time care of the Alzheimer’s patient. This can also be quite frustrating because jobs can define people in many ways, and to have to give that up can affect a caregivers self-esteem. Sometimes caregivers feel guilty about these shifts in roles. At other times, the may feel angry and resentful, that they now have to give up significant portions of their lives to become a caregiver. The other major change that goes along with that, is the process of letting go of the person you once knew and loved, and beginning to accept the person who is evolving before you. And that person changes from day to day and year to year, so again, this process of letting go and accepting can go on for years.
Chuckie: Is there any cure for Alzheimer’s disease? Can anything be done to help patients with Alzheimer’s?
Dr. Dee: Unfortunately, no, there is no cure for Alzheimer’s disease. But there are a few treatments that are available. However, the treatments, only appear to slow the progress of the disease. There are lifestyle modifications that can help in the earlier stages of Alzheimer’s. As a person becomes more and more forgetful, it may be helpful for family members to create simple scrapbooks including pictures of loved ones with a few words, describing who they are, such as a picture of a daughter, with the words, “your oldest daughter” underneath. Or even a picture list in the bathroom, describing what needs to happen in there, such as brushing teeth, bathing, toileting. Of course, as the dementia, increases, they may likely forget exactly how to brush teeth, or bathe, or toilet appropriately. Simplifying the choices that an Alzheimer’s patient has available to them can also be very helpful. For instance, if they have trouble deciding what to wear, cleaning out the closet of everything but 3 or 4 pairs of pants, 3 or 4 tops, 3 or 4 dresses, and a couple pairs of shoes, may be just what the doctor ordered.
Chuckie: What do you advise family members to keep in mind as they deal with loved ones who are gradually forgetting everything about who they are and what their lives have been like?
Dr. Dee: We need to always keep in mind that Alzheimer’s disease is no picnic for the patient either. They don’t suddenly wake up with dementia. It’s a gradual process where they often recognize that they are becoming more and more forgetful, and the world is gradually becoming more and more confusing for them. So, when they become angry or react in ways that don’t make sense, its helpful for family members to remember that the patient is often confused and frightened, and the world no longer makes much sense to them either. They are not intentionally trying to be hurtful and difficult, they simply can’t help what is happening to them. And, unfortunately neither can anyone else. If family members can find a way to reframe the behaviors of the Alzheimer’s patient in a way that takes into account their own confusion, helplessness, and fear of this strange world developing around themselves, it can not only change the way a family member behaves toward the patient, but it is often helpful for the family member as a means of coping, as well.
Chuckie: Thanks for addressing this impromptu topic. Any parting words?
Dr. Dee: Sure. I can’t stress enough how important it is to get connected to an Alzheimer’s support group. There are major changes that have to come, over the course of dealing with the family member with Alzheimer’s, including eventually placing them in residential care. This can bring about all kinds of feelings in family members, including guilt, anger, and fear. Having the support of others who have been through that fire, or are going through it themselves, can be a major means of coping.
Chuckie: Doc, as far as I’m concerned you knocked this one out the park. I know that many will be blessed by your willingness to let us partake of your knowledge. May your rewards be many in Heaven.
Dr.Dee: Thanks Chuckie, my pleasure.
Chuckie: Oh, Doc…one last question.
Chuckie: Knock, Knock…
Chuckie: Knock, Knock
Dr.Dee: “SIGH!” “…ok who’s there”
Chuckie: DOC! We need to get you some help! You are sitting here looking right at me and you axe, “WHO’S THERE?”
Dr.Dee: BOY BYE! GET OUT!!!
November 4, 2015
All aboard for day 3 of Mental Health week on the LifeTrain. Today we mosey on back to the clinic car and sit for a spell with my good friend, Dr. Emily Hath PhD. (Dr. E). Today’s topic of discussion is again…”Anxiety”. In this interview, we hope to give you some understanding about the nature of anxiety and what you might do to help yourself.
Reminder: You can listen to LifeTrain Radio while you surf our site…see button upper right…
Chuckie: Dr. E!
Dr. E: Chuckie!
Chuckie: We’ve missed you! I thought you had forgotten about us.
Dr. E: No my dear friend, I’ve had an extremely high case load lately but, no…I look forward to my rides with you on the Train, having some anxiety?
Chuckie: Well I did start a new position but, overall I’m not ready for meds yet.
Chuckie: Dr. E, give us a little initial insight on Anxiety.
The only shame is not getting help…
Dr.E: Well Chuckie, the chances are fairly high that either you or a loved one has had a history of anxiety. In any given year about 17% of us will have an anxiety disorder—and over our lives, about 28 % of us will have an anxiety disorder. And, if you have one anxiety disorder, then you probably have two or three anxiety disorders—and, possibly, depression. The most common anxiety disorders are panic disorder, social anxiety disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive compulsive disorder and specific phobia. 49% of the general population has a history of anxiety, depression, substance abuse or some of all three major problems.
Chuckie: In doing my homework for today I found that Anxiety disorders have effects on your health. Your thoughts?
Dr E: People with panic disorder are more likely to have mitral valve prolapse, hypertension, peptic ulcer, diabetes, angina or thyroid disease. In fact, men who have anxiety disorders are also at greater risk for cardiac disorders, hypertension, gastrointestinal disorders, respiratory illness, asthma, and back pain. Women with anxiety disorders are more likely to have a history of cardiac problems, hypertension, metabolic, gastrointestinal, dermatological, respiratory disorders and arthritis.
Chuckie: I also read that anxiety has been increasing.
Dr.E: Yes…The average high school kid today has the same level of anxiety as the average psychiatric patient in the early 1950’s. We are getting more anxious every decade.
Psychologists have speculated about the possible reasons for this increase in both anxiety and depression over the last fifty years. Some of the reasons may be a decrease in “social connectedness”—we tend to move more, change jobs, participate less in civic organizations, and we are less likely to participate in religious communities. People are far less likely to get married, more likely to delay getting married, and more likely to live alone. All of these factors can contribute to worry, uncertainty, anxiety and depression.
Chuckie: I was thinking, with all of technology and societal pressures do you think tha our “life” expectations have changed over the years?
Dr.E: Yes, excellent observation. We expect to have a more affluent life-style now then in say the 50s and 60s. We are driven by unrealistic ideas of what we need (“I need the latest ipod!!”), and we have unrealistic ideas about relationships and appearance. In the 1950’s sociologists would write about “The Organization Man” who worked for the corporation for his or her entire career. Today many people would love to have a job that had that kind of stability. And our expectations about retirement also lead us to feel anxious. We now have to rely on our own savings—rather than a company pension plan—to help us survive during retirement.
There is help…
And anxiety isn’t helped by the fact that we have all the bad news all the time. Turn on your cable stations and you can immediately see the latest catastrophe—sometimes as it is actually happening in “real time”. Bad news sells—and reminds us— that we can all be in danger. Even though we live longer, have better health care, travel is safer, we are richer, and we have safer cars— we now think that there is a disaster on the horizon. Because we are constantly bombarded with bad news, we think that we are in greater danger. We may not be in greater danger—but it’s what we think that counts in the way we feel. No wonder we are nervous wrecks.
Chuckie: Dr. E that’s about enough for this session although we could go much longer on this topic. When you return can we talk about some remedies?
Dr.E: Sounds like a plan my good man.
Well Fellow passengers, another therapy session in the can. Hope this helps.
All Aboard! The LifeTrain!!!
November 3, 2015
Hey passengers, in support of mental awareness week (with an emphasis on anxiety) I decided we should visit the good Doc (Doctor Diedra Hayman Ph.D) again to make sure we have a firm understanding of the A word:
Regular passengers here on the LifeTrain know that we often visit with one of my Psych Doctor friends to discuss issues of the mind, back in the medical car of the LifeTrain. I sat down awhile back with Doctor Diedra Hayman to discuss anxiety disorders. With all the stresses of today’s world I thought it might be helpful to periodically look at how we could manage this type of condition or perhaps offer help to a friend or family member who might be…a tad worried over things. So without further a due, lets knock on the good doc’s door and see what we can find out. But first, let’s set the music for the background read:
Chuckie: Hey Doc Doc! Before we get started with today’s topic, tell us, whats going on in your world…how are you?
Dr.Dee: Well, life is moving quickly. I am just about to send the puppy I’m fostering to her forever home, so hopefully my life will get back to normal soon. I am SO glad my kids are past the diapers and 2am feedings, stage. Nursing puppies takes you right back to those days!
Chuckie: Doc, today let’s talk about Anxiety. Just what is Anxiety disorder?
Dr.Dee: Well, an anxiety disorder is really when we take worrying, and raise it to the level of art! lol! Everyone experiences anxiety. Its that feeling of nervousness, or worrying a bit about something that is new, something that is old and bothersome, something that is out of the ordinary for our lives. But when we worry and stress to the point where it interferes with our daily lives…we cant sleep, we cant eat normally, we are having bad dreams or nightmares, we are worrying about any and everything, we dont want to go outside our homes, we panic…then it becomes disorder.
Chuckie: Is this your area of expertise?
Dr.Dee: As a generalist, I do have some experience working with anxiety. After major depression, it is probably one of the most common mental disorders.
Chuckie: As I understand it there are types of anxiety disorder, correct?
Dr.Dee: Yes, there is an anxiety disorder for every day of the week! Not really, but there are several anxiety-based disorders. Interested readers can do a google search for the details, but briefly, there is Generalized Anxiety Disorder, Post Traumatic Stress Disorder, Obsessive-Compulsive Disorder, Panic Disorder with or without Agoraphobia, Phobias, Social Anxiety, Separation Anxiety, Tic Disorder, and Dissociative Disorders, Somato form Disorders, Anxiety Disorder, Not Otherwise Specified. I may have missed a couple others, but those are the most common.
Chuckie: How do you treat anxiety disorders?
Dr.Dee: There are a variety of techniques for treating anxiety disorder. Systematic Desensitization is where a person is taught relaxation techniques, and then gradually exposed to the thing that causes them stress, while being asked to practice the relaxation. This can be done either through images created in the mind, or else, “in vitro”, or live, with an actual example of the anxiety provoking situation. Many cognitive-behavioral approaches are effective as well, and they tend to vary according to the type of anxiety. But essentially they teach the client to become aware of their thoughts, and then rather than accepting their thinking about an issue face value, they learn to question the validity of their thinking, and to replace faulty thoughts with more reasonable and helpful ones. I mentioned relaxation techniques as part of Systematic Desensitization, but those techniques alone can be taught as an effective means of coping with anxiety. Biofeedback is another means of treating anxiety. Here, the person is taught, through the use of a machine that monitors heart rate and blood pressure, to reduce the physical response to anxiety by slowing the heart rate and lowering the blood pressure. Lifestyle changes are very important. Often we are living in such a way, and at such a pace, that we may be unwittingly contributing to our own anxiety. And of course, there is medication management. There are a variety of medications available for the treatment of various anxiety disorders.
Chuckie: How do I know if the medication is working?
Dr.Dee: If there is significant reduction in anxiety symptoms, and the side effects are not intolerable, then you can assume the medication is having some impact. Its important to be alert to the medications, though. In the case of anxiety, some of the medications are actually addictive, such as the benzodiazepines (Klonipin, Xanax). If you dont want to risk addiction and withdrawal, request something other than a benzo, if at all possible. Some antidepressants are effective against anxiety symptoms, at different doses.
Chuckie: Any parting thoughts to leave us with on this subject?
Dr.Dee: Yes, anxiety can be a crippling disorder. It can make it difficult to impossible to get a job, keep a job, or even leave the house, for some people. Often, people become anxious because they attribute all kinds of faulty meanings to events that occur in their lives. One of the most effective treatments I know of for anxiety is trust in God. Knowing that ultimately, God is in control, makes it possible to manage even the most distressing anxiety, and even reducing it to zero. I encourage all who desire, to seek a knowledge of God, and to rely on Him for the solution to our deepest worries. God says “casting all your cares on Him, for He cares for you.”
Chuckie: Do you think we’ll ever get our own syndicated show?
Dr. Dee: Uhhh…no, Chuckie, I work on the “brief therapy” model. You are almost out of sessions for this treatment episode!
November 2, 2015
ALL ABOARD!!! Good day passengers! As you board the train I give you the customary business card. This one states:
There’s No Shame in Asking for Help
There is NO shame in asking for help yet, so many people are afraid to seek out counseling or therapy when they find themselves facing genuine crisis in their lives. It’s a stigma against mental
Mental Health Awareness week on the LifeTrain…
illness which has been holding fast for decades, and it’s doing the current population no favors to hold onto it. Nearly 20% of Americans are diagnosed with mental illnesses every year, but less than half of them actually seek professional help. What about those individuals who just need counseling to overcome a stressful point in their lives? What are therapy and counseling, anyway? Does having no diagnosed mental illness make it easier to seek help?
Therefore, I’m designating this week as Mental Awareness week here on the LifeTrain.
Counseling? Therapy? What Are They?
Counseling can be done by a counselor, psychologist or psychiatrist while therapy usually requires a psychologist or psychiatrist. The difference is that counseling is designed to address short-term goals or a single issue/situation where the individual needs help examining their motivations, their options and making a healthy decision. Therapy is more far-sighted and can involve everything from psychotherapy to behavioral therapy. Psychiatrists can even prescribe medication to help individuals handle anxiety, depression and other expressions of psychological distress.
In essence, counseling and therapy are both methods of one professionally trained individual helping another person understand themselves and their choices in life while offering support and a listening ear. Most people who initiate counseling are going through life stress, such as a divorce, loss of a job, the death of a family member or a career change. Any type of change, positive or negative, creates stress and that leaves individuals at a loss. Therapy offers a chance to speak to a sympathetic, objective individual who can use knowledge and experience to provide plausible options.
Why Is There Such a Stigma?
Although people are quick to say that there’s no shame in getting help when it’s needed, the overwhelming majority do not understand the purpose of counseling. One of the largest misconceptions is that behavioral therapy is to ‘fix’ someone who is ‘broken.’ It could be that a person has a phobia or an obsession which is interfering with their daily life. Behavioral therapy, counseling and even medication can help a person find a new lease on life.
The stigma goes hand in hand with ignorance. As mental illness is considered frightening by the public, very few people actively seek to learn more. The idea of someone being ‘crazy’ is used to dismiss behavior that we find either frightening, unpleasant or offensive. With the association between psychology, psychiatry and counseling and mental illness, the uneducated public feels it’s admitting to a ‘failure’ by seeking out professional help for life stress.
There is nothing further from the truth. Counseling, behavioral therapy, psychoanalysis and other therapy techniques are meant to help everyone. Life stress is something that all of us can understand; after all, regardless of circumstances, unexpected things happen to everyone. Just as we have come to understand that stress is as common as sunburn, so must we now educate ourselves and each other to know that all forms of therapy are merely medical treatment for the side effects of stress.
This week I will be sharing information from professionals on depression and other mental health issues so…
All Aboard! The LifeTrain!