Talk Therapy changes the Brain and helps with Depression and Bipolar

by Garth Mintun, LCSW, ACSW

This week I watched the PBS special “Depression: Out of the Shadows.” Dr. Dennis Charney, the Medical Director and Dean of the medical school at Mount Sinai, presented on a panel of experts with Jean Pauley. He stated that depression “on average is 35% genetic and 65% environmental.” (This is for the average person; people with histories of depression or who are bipolar will have higher percentages of the genetic factors). He stated that medication and talk therapy access different parts the brain, thus the change these treatments produce take place in different areas of the brain. Research indicates that people who undergo both psychotherapy or talk therapy and anti-depressant or bipolar medications show more progress in lessoning their depression or bipolar symptoms than they would if they simply engaged in one method of treatment. For more information, please go to the PBS web site to see the video clip or read the transcript of the discussion with Dr. Charney, the panel of experts, and Jean Pauley at: http://www.pbs.org/search/search_results.html?q=dr+dennis+charney&btnG.x=8&btnG.y=10

This report is very good news. It is excellent in its ability to help people understand bipolar and depression and it also attempts to deal with the stigma of mental illness. I suggest that psychotherapists recommend this PBS series to their clients suffering from depression. Often in my practice in Indianapolis, I find that clients on medication for depression or bipolar show improvement when participating in talk therapy/counseling. These clients tend to experience a decrease in their levels of anxiety and lessoned feelings of the inertia when they come in to psychotherapy on medication. Consequently, people are able to deal with difficult core interpersonal issues with less anxiety and vulnerability than they would if they were not on anti-depressant and or bipolar medication.

The other piece of good news is that “talk therapy “actually changes the brain as well, producing biological effects. This program shows how people who have been suffering from long-term depression can perhaps see how their “talk therapy” actually changes the way they think in profound ways and compliments the medication therapy approach.

Often people go to their family practice physicians just for medication, rather than also attending talk therapy. After reviewing the research, people suffering from depression and bipolar may want to receive more comprehensive help by adding psychotherapy to their treatment. Again, the PBS show “Out of the Shadows” is an excellent vehicle for consumers to understand depression and bipolar and learn about ways that they might go about receiving help.

Electronic spying: Impact on couples in the Modern Information Age

By Garth Mintun, LCSW, ACSW

In this modern information age with the Internet, mobile phones and GPS systems, we can share or obtain information at a breathtaking speed. The playing field between the small entrepreneur and the corporation is more equal then ever before, as information is much more widely available and accessible at all levels.

For relationships, this comes as a mixed blessing. While this technology certainly has its advantages, it also provides ample opportunity for crossed boundaries and a lack of privacy. For example, one’s wife, husband, partner or significant other can rather easily spy if they think their partner is not being truthful. Your partner might do this by checking your emails, text messages and phone numbers on your mobile phone, your history on the internet, and transportation monitoring via the GPS locator system.

In the years of being a practicing professional working with relationships and families, it is becoming much more common for me to hear about “evidence collected” via information technology. My sense is that, in adult relationships in the modern age, there is a growing dynamic involving the lack of direct communication about emotional needs and desires. Often, couples state that they quite simply “don’t have time” for this level of communication, given the combination of most people working over 40 hours per week, responsibilities of children, and the pressures of the economic recession.

This “busyness” impacts couples by increasing the possibility that their needs will not get met. The hectic schedule and lack of quality time together tends to reduce communication to purely the essential, and prevents the repair of past emotional wounds. Often the result of this involves one partner blaming the other excessively and the other partner passively resisting the blame by either “stonewalling” or “shutting down”. Couples play the roles of “chase and run.” This can play out when one person is the pursuer in the relationship and the other “runs” by shutting down and not responding (the silent treatment). Couples may reverse roles week by week or day by day. However the pattern created prevents the relationship from growing and old emotional wounds are not healed as the problems intensify.

When emotional wounds are not healed in the relationship, trust breaks down and partners can become fearful that the other is meeting their needs elsewhere. That is when the cell phone monitoring begins to take place and the history of the internet sites comes into play, as one of the partners “collects evidence”. In this modern information age, the information is easy to collect and privacy is invaded. Often then the partner confronts the other with the allegations of betrayal and both partners feel like the victim. The partner that “collects the evidence” feels betrayed because of the traces they had found of their partner’s intimate communication with another individual and the other person feels violated because of the “spying”.

When confronted with marital crisis, couples will sometimes turn for help to a psychotherapist at the point when the “evidence is collected”. The couple begins to work to overcome trust issues, anger, and sadness. The couple also begins to address the breakdown from a chronic period of time when the couple did not significantly repair their emotional disconnect. The relationship can be repaired at this stage if the couple chooses to prioritize time and attention with one another. This step involves setting time aside for weekly therapy and arranging “dates” or time together during the week to “wipe the slate clean.” This provides the couple with a basis to engage in the process of rediscovering why the couple originally came together in the first place.

In summary: if you find yourself “collecting evidence” on your partner, or if you find you are beginning to shut down, then it is time to receive professional help for your relationship. A psychotherapist can be very helpful by assisting you with making time for your relationship. Secondly, once the couple feels the relationship is a priority again, they can work on the emotional barriers that have been keeping them from intimate connection. Thirdly, as the trust builds, the need for electronic tracking will become obsolete. Psychotherapy can help both partners remember the initial “sparks” in their relationship and he provide guidance as both individuals to work together to rekindle those sparks.

Men Following Traditional Gender Roles Often Won't Accept Help or Counseling

by Garth Mintun, LCSW, ACSW

You are not alone among men who feel they cannot receive help. You cannot help it; you have been socialized to not receive help and are a part of learned gender roles that have existed in our North American society for over 300 years. Here are some facts regarding men.

1. Men, like the western lone hero solve all their problems and other peoples problems by themselves.
2. Showing emotions is a weakness to avoid at all cost.
3. Being close or emotionally vulnerable to another man could be perceived as “gay” and that makes me withdraw emotionally and want to appear invincible.
4. Suicide is the leading cause of death for white males between the ages of 15 to 24 and the rates increase dramatically as men age.
5. Men commit suicide up to 8 times more then women and twice the amount of women are diagnosed for depression. 50% fewer men are in counseling then women.
6. Men die in this country 7 years on average before women die.
7. 90% of the homicide/suicide offenders are men
8. Men bond through drinking together or sports activities, fact or Myth? ( myth-relationship is at a superficial level)
9. Men often rely on one woman usually to meet all emotional needs.
10. Boys are nine times more likely to suffer from hyperactivity then girls

Along with these facts are certain “ codes of masculinity ( Pollack and Levant) which requires men to be aggressive, dominant, achievement oriented, competitive, rigidly self –sufficient, adventure seeking , willing to take risks, emotionally restricted and constituted to avoid all things feminine” Quotes from “New Psychotherapy for Men, by William S Pollack and Ronald F. Levant

How Men can take Action

Your personal crisis is your opportunity to change. Take advantage of this experience, i.e., failed relationship (s), career burnout, events that lead to depression, anxiety, and isolation and reach out for help. Please don’t try to be a super hero from Hollywood and ask for help from your support system or receive professional help.

First educate yourself on how the myths of gender are unrealistic in real life and often consists the opposite for us. Never being vulnerable means emotionally “breaking “sooner or later and becoming more vulnerable. Paradoxically, becoming more vulnerable and giving your restricted feelings a voice may make you stronger.

Secondly, go into a consulting or counseling relationship to work on emotional crisis, depression, situational crisis to “stop the emotional bleeding”, help repair some of the relationship (s) and learn how you catch yourself personally in the Male Myth or gender role bias. A therapist/consultant who is aware of male issues and has done his own work on himself is a must with this kind of work.

Thirdly, after one to one counseling, go to a men’s therapy or support group and learn how to interact with other men who want to become more authentic and break out of the gender role box. The combination of education, one on one counseling and therapy/support group is the best combination promoting authenticity with inner peace in the world.

Do you need Help with Depression?

Garth Mintun, LCSW, ACSW

How do you know if have “clinical depression”? The best way to find out is to talk to a mental health professional. A few “red flags” may help you decide to seek help.

1. Do you feel tired or have low energy all the time?

2. Do you either get too much sleep or not enough sleep?

3. Do you either eat very little or too much?

4. Do your friends tell you that you have changed and “are not yourself”

5. Do you feel isolated and alone?

6. Have you lost your support group, i.e., friends, family, relatives, work buddies, partners, spouse, boy/friend or girlfriend?

7. Do you feel sad and not know why?

8. Do you sometimes day dream of what the world would be like without you?

9. Do you notice it is difficult to focus at work and home and your productive nature has suffered?

10. Do you notice that you rarely smile, laugh or joke?

11. Do you sometimes become angry at the slightest provocation beyond the scope of the event?

12. Do you feel at a loss but don’t know what to do about it?

13. Do you find your concentration at work and at home is decreased, as though you feel you have an intermittent memory problem?

Saying yes to three or more of the above would indicate that you need to talk with a mental health professional and if you answer yes to eight, this is a strong indicator that therapy or counseling could be generally helpful.

You might also consider the strength and nature of your support system, and ask yourself if it is adequate and responsive to your needs.
Isolating and withdrawing from your normal activities can be a strong indicator of depression.
Both depression that is related to an event in your life and clinical depression tend to present with similar symptoms and both can benefit from mental health services

Research is consistent in finding that depression has best treatment results when the client receives a combination of medication and talk therapy services. Recent research indicates that when the side effects of medication are accounted for, talk therapy does at least as well as medication and perhaps better (see webMd.com for more details). Also indicated in the research is that talk therapy is mandated when the symptoms of clinical depression are severe (see depression-guide.com for more details).

Often a mental health professional and/or a psychotherapist can help you find a therapeutic group as well as individual counseling to help address the symptoms and causes of depression. When nurturing and caring people are seemingly absent in your life professional help in the form of individual therapy and group therapy can be very beneficial. The therapist and /or group can become the support you need until you find a natural support structure.

Often clinical depression has ramifications for a marriage, relationship and/or if one has children. Sometimes there are secondary effects on families and couples in which the other person becomes angry, sad or feels like they lost their “old friend, they once knew”. Whatever is the case for a person suffering from depression it is imperative to receive help quickly because depression has the potential to escalate to suicide or death wish ideation? With extreme severe depression, with suicide and death ideation, hospitalization inpatient/outpatient intensive such as partial hospitalization or ILP may be necessary. Insurance generally covers treatment for this service as well as out patient therapy.