What’s Love Got to Do With It? Everything!

Love is the force that binds us, one to another. A husband’s love for his wife, a mother’s love for her child, the love shared by siblings, the love of lifelong friendships — these are the ties that define us as human beings. Love gives us the courage to persevere in the face of life’s challenges. It gives us the resilience to bounce back from disappointments and comforts us in times of tragedy. Love adds sweetness to life’s successes and allows us to share its joys. What’s love got to do with life? Everything!

So, what happens when love ends? When a spouse or partner dies? Or love crashes on the jagged reef of divorce? The loss of love can have dangerous mental and physical repercussions that exact a toll beyond normal grief. A new study found that the lingering stress caused by the loss of a spouse or partner to death or divorce increased the risk of chronic illness. Men and women who were divorced or widowed were 20% more likely than married people to develop heart disease, diabetes or cancer, according to a recent survey of 8,600 adults from 51 to 61 years old by University of Chicago researchers.

The ending of a long-term relationship, whether from death or divorce, “really destroys financial assets, and it destroys health assets in the same way,” said University of Chicago sociologist Linda Waite, a co-author of the study. Financial strain, loneliness and uncertainty about the future create significant emotional stress. For some, the necessity of moving into more affordable housing or housing that is physically easier to maintain adds additional loss to their grief. Divorcing couples must cope with their children’s feelings of loss as well as their own. The duties once shared by two parents can feel overwhelming when only one parent is shouldering the burden. Combined, these things add to the burden of grief that follows the loss of a loved one, creating a persistent, overwhelming feeling of stress.

Over time, continuous stress erodes both our physical and mental health. Stress from grief or marital strife weakens the immune system, making us more susceptible to chronic disease, depression and anxiety. Strengthening existing relationships and building new relationships can help ease the strain, but some people will need professional psychiatric help to weather the storm and deal with their loss.

Sense of Fatalism Encourages Risky Behavior in Teens

A surprising number of teens expect to die young. In a seven-year study of 20,000 teens in grades 7 through 12, 15% felt it was highly likely that they would die before they reached their 35th birthday. Published in the July issue of Pediatrics, the unexpected results have caused researchers at the University of Minnesota to wonder if it is a feeling of hopeless fatalism rather than a sense of invulnerability that leads teens to engage in risky behavior.

The magnitude of teen-aged pessimism took researchers by surprise. University of Minnesota researcher Dr. Iris Borowsky told the Associated Press, Adolescence is “a time of great opportunity and for such a large minority of youth to feel like they don’t have a long life ahead of them was surprising.”

Males (15%) were slightly more likely than females (13%) to think they would die young. Living in a more stable family situation appeared to decrease the feeling of risk. Only 10% of teens who lived with both biological parents felt at risk, while 18% of those who lived with only one or neither of their biological parents felt they would die early. Lack of financial stability significantly increased the feeling of risk. Twenty-four percent of teens with a parent receiving public aid believed they would die at an early age. Racially and ethnically, the breakdown of perceived risk of early death was highest for groups exposed to the greatest deprivation and violence:

• 30% Native American
• 26% Black
• 21% Hispanic
• 15% Asian/Pacific Islander
• 10% White

While fatalistic teens did not die more often than their more optimistic peers (only 94 of the 20,000 teens participating died during the seven-year study), they were more likely to engage in unsafe behavior, including drug and alcohol abuse, unprotected sex, attempted suicide, and getting into fights that resulted in serious injury. Teens who believed they would die young were seven times more likely to contract AIDS than their positive-thinking peers. The perception that life was hopeless appears to have encouraged greater risk taking.

Psychiatrists are looking at the study in hopes of developing better methods for identifying at risk teens. It is hoped that the detection of fatalistic attitudes and thinking will help the medical community identify and treat at risk teens before they engage in dangerous behavior.

Can Insomnia Be Inherited?

A new study presented at Sleep 2009, the 23rd Annual Meeting of the Associated Professional Sleep Studies, suggests that insomnia may be inheritable. The study of 1,436 eight- to 16-year-old twins found that the same genes that impact depression and anxiety affect adolescent insomnia. Study results are consistent with the results of similar studies connecting insomnia to depression and anxiety in adults. Shared genetic effects suggest a probable genetic link between the three disorders.

According to an online article posted on the Science Blog, lead author Phillip Gehrman, assistant professor of psychiatry at the University of Pennsylvania School of Medicine, said researchers had expected to find a sleep-specific genetic indicator and were surprised to instead find a shared indicator with depression and anxiety. A number of previous studies have indicated a causal connection between insomnia and depression/anxiety. Chronic insomnia can lead to the development of depression or anxiety, and depression or anxiety can cause insomnia. The discovery that the same genetic effect links all three conditions sheds new light on their interconnectedness.

Periodic sleeplessness is normal, generally lasting only a few days and going away on its own without treatment. However, more intense levels of insomnia lasting several weeks can be triggered by stress. Such chronic insomnia will not go away without treatment and can cause serious short- and long-term health problems when left untreated. If you or your child exhibit chronic insomnia — sleep problems that last for more than a week — you should be screened for depression and anxiety. Likewise, those diagnosed with depression or anxiety may also need to be treated for insomnia. 

In another study reported at Sleep 2009, cognitive behavioral therapy was shown to help alleviate chronic insomnia. By learning to identify thoughts and patterns that interfered with sleep, nearly 60% of study participants aged 14 to 81 were able to alleviate insomnia and decrease or stop using sleep medication. Even when depression and anxiety exacerbate insomnia, researchers found cognitive behavioral therapy to be an effective method of treating chronic insomnia. To find out more about cognitive behavioral therapy, visit the Marks Psychiatry website.

Combating Dangerous Pattern Perceptions

Perceiving patterns where none exist, a psychological phenomenon called pattern perception, is a mental coping mechanism used by many people to combat uncertainty when events spin their lives out of control (see our June 10 post). It’s a phenomenon that’s on the rise in these times of economic uncertainty where rising unemployment, catastrophic investment losses, mortgage foreclosures, and a host of other worrisome factors have shattered people’s faith in their ability to control their future.

That loss of control generates an extreme anxiety that can impel people to create and act on connections and associations between innocuous, unrelated events, according to research published in the journal Science. In a series of experiments conducted by Jennifer Whitson of the University of Texas-Austin McCombs School of Business and Adam Galinsky of Northwestern University’s Kellogg School of Management, researchers found that people can trick themselves into seeing nefarious conspiracies behind government pronouncements or business announcements.

Structure and order have a calming effect on our psyches while chaos generates anxiety that can lead to panic or depression. The desire for order can become so overwhelming that people fantasize connections between events to bring order to a world that they feel has become dangerously chaotic.

“Feelings of control are so important to people that a lack of control is inherently threatening,” Galinsky explained. “While some misperceptions can be bad or lead one astray, they’re extremely common and most likely satisfy a deep and enduring psychological need.”

The danger comes when people believe in or act on the imaginary patterns they have created. Illusory stock market trends can lead to poor investment decisions and increased financial anxiety. Imagined conspiracies between co-workers can increase job stress to intolerable levels. Delusional thinking can cause marital stress and jeopardize personal relationships. Fantasized government agendas can lead to paranoia and panic.

Exerting phantom control over chaotic events in our lives through pattern perception can hide a very real need for psychiatric help in coping with anxiety, panic disorders or depression. The combination of cognitive-behavioral therapy and psychodynamic therapy practiced by Atlanta psychiatrist Dr. Tracey Marks is effective in helping people find healthy ways to cope with and mitigate the uncertainties that pervade life today without resorting to harmful pattern perception.

Are Stereotypes a Self-fulfilling Prophecy?

We all understand the peril of stereotyping. Judging any group by a single set of often negative characteristics ignores both the breadth of human experience evident in any group of people and the unique individuality of each member of the group. Yet, stereotypes persist. The problem seems to be how we exercise the human need to identify others by comparing them to ourselves — How is he like me? How is she different from me?  

When those comparisons are used to generalize groups of people, we tend to emphasize how we are different from the group. By focusing on differences, often by accentuating negative traits, we build stereotypes by defining ourselves as separate from others. However, when we apply the same process of differentiation to individuals we meet in daily life, we tend to emphasize positive traits, looking not for how the individual is different from ourselves, but how he is the same. By emphasizing commonalities, we break down stereotypes.

Psychologists have theorized that stereotypes can be a self-fulfilling prophecy, that people internalize stereotype messages, living up – or down — to those expectations. In a recent study published in the journal Experimental Aging Research, psychologists at North Carolina State University in Raleigh tested the theory, using the stereotype that older people have faulty memories. Seniors aged 60 to 82 were given a recall test. Triggering the stereotype, half the group was told the test would examine the effect of aging on memory. The other half was assured that age-related bias had been removed from the test. Those in the first group performed remarkably, fulfilling the negative expectations of the stereotype.

Stanford psychologist Claude Steele calls this phenomenon “stereotype threat.” Numerous studies have shown that when a message purporting to define who and what we are is repeated, we internalize and come to believe it, whether or not it is true. The phenomenon affects widely diverse groups from African Americans to jocks to teenage girls. The same phenomenon can be used to effect positive changes in self-image. By changing their internal message from negative to positive, cognitive-behavior therapists can help patients improve self-esteem and decrease anxiety and depression.

June Bride, July Blues

There’s something about June and brides. Surpassed only by Valentine’s Day as America’s most popular wedding date, thousands of brides choose to be married in June. For the typical year it takes to plan a modern American wedding, these women, and often their mothers (and to a slightly lesser extent their intended and both families), immerse themselves in the myriad details necessary to plan the perfect wedding.

Of course, weddings are exciting; and today’s typical wedding includes scores of intricate details and “crucial” decisions. It’s easy to get so caught up in the details of planning the wedding that brides and grooms forget to focus on the importance of the life change they are making. Though it often becomes an all-consuming event, in reality the wedding is just a small moment in a marriage. Moving from the autonomy of being single to the shared decision-making and compromise necessary to build a successful marriage is a major life change. Unfortunately, the cultural pressure to create the perfect wedding often overshadows the true meaning and challenges of this life-changing event.

Some women become so immersed in the bride role that the return to normalcy is such a let-down that it triggers a type of depression called “wedding withdrawal” or “post-wedding blues.” Once the big day is over and the honeymoon ended, the humdrum reality of newlywed life sets in. In a short week, brides go from being the center of attention with a full planning calendar and social agenda to the ho-hum daily reality of fixing meals, going back to work, and adjusting to married life. From sharing the bathroom to pooling money and making decisions together, marriage is filled with new challenges. Many newlyweds, however, find the role of wife less glamorous and exciting than the role of bride and depression can set in.

If you find yourself feeling sad after the wedding is over, talk to your spouse. Talk about the reasons you chose to get married, your commitment to each other, and your love for each other. Seek help from a psychiatrist skilled in cognitive-behavioral therapy if your depression lasts. As you plan your wedding, work to keep the event in its greater perspective. Your wedding day is just the first step in a lifelong celebration of your life together with your new spouse.

Depression Twice as Likely to Strike Women

Women are twice as likely as men to suffer major depression, according to a new report released by the U.S. Department of Health and Human Services. Analyzing the most recent research on women’s mental health issues, the report, Action Steps for Improving Women’s Mental Health, examines the role gender plans in treating and coping with mental illness issues such as depression, anxiety, and post traumatic stress disorder brought on by trauma and violence.

Analysis discovered that not only are women twice as likely as men to suffer depression, but women suffer anxiety disorders at a rate two to three times greater than men. Women are also at far greater risk than men for post traumatic stress disorder, a discovery that could significantly impact the treatment of female war veterans returning from Iraq and Afghanistan. In fact, the study found that any history of violence, trauma or abuse increased a woman’s risk of developing depression, post traumatic stress disorder, anxiety and panic disorders. It also increased the tendency to engage in risky behaviors.

In a press release, Acting Surgeon General Dr. Steven Galson said, “Mental illness is often incorrectly perceived as a weakness, which prevents women from recognizing the signs and symptoms and seeking treatment. In order to reduce stigma, we need to encourage open, honest conversations.”

Depression, anxiety, panic disorders, and post traumatic stress disorder are treatable conditions. In a key finding, the federal report found that family and interpersonal relationships in a woman’s life not only play a significant role in a woman’s ability to cope with and recover from mental illness, but that strong, positive relationships offer women some modicum of protection from mental illness.

In an effort to encourage dialog about women’s mental health issues and address stigmatizing misconceptions about mental illness, the U.S. Office of Women’s Health (OWH) has produced a free, downloadable booklet to educate women about steps they can take to improve their health and reduce their risk for many diseases, including depression, anxiety, panic disorders, and post traumatic stress disorder. Click here to download the free OWH consumer booklet Women’s Mental Health: What It Means to You.

Women’s Sleep Habits Linked to Mood

When mom doesn’t get enough sleep, the whole family suffers. In women, there’s a definite connection between sleep and mood. Worry, stress and anxiety can interfere with sleep, and sleep problems can increase depression and anxiety symptoms. According to a 2007 National Sleep Foundation study on women’s sleep habits, the relationship between sleep and mood is bi-directional. More than half of the women surveyed in the NSF poll said they had felt unhappy, sad or depressed in the past month, and one-third (36%) had felt hopeless about the future. Most reported problems sleeping, and 40% had been diagnosed with a sleep disorder.

Biology affects a woman’s sleep habits. The NSF study analyzed sleep patterns at each stage of a woman’s life:

• Menstruation. Menstruating women slept longest, averaging 7 hours, 32 minutes of shut-eye; however, 67% reported insomnia several nights a week. One-third experienced sleep problems during their cycle.
• Pregnancy. Women got more sleep during pregnancy than at any other time — approximately 8 hours, 14 minutes per night — although 84% complained of insomnia several nights a week and 30% said they never got a good night’s sleep.
• Post Partum. Women slept least — an average 7 hours, 46 minutes — after childbirth. Nearly half (47%) reported never getting a good night’s sleep, and 84% experienced chronic insomnia, 90% related to child care. Two in every 10 women experienced post partum blues or depression.
• Perimenopausal. During menopausal transition, women got the least amount of sleep (7 hours, 12 minutes). More than half (59%) reported insomnia a few nights each week; and 43% experienced a sleep disorder, hot flashes or night sweats that interfered with sleep.
• Postmenopausal. Postmenopausal women slept an average 7 hours, 19 minutes but had the highest incidence of sleep disorders (50%) and insomnia (61%). Forty-one percent used a sleep aid several nights a week.

Because of the link between sleep and mood, psychiatric treatment that addresses both issues through cognitive-behavioral therapy and psychodynamic therapy can be most effective. A board-certified psychiatrist like Dr. Tracey Marks with considerable experience treating sleep disorders can help you find workable and lasting solutions to sleep better and enjoy life more.

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