Category: Treatment - Beyond The Body

Beyond The Body

Access to Eating Disorder Treatment Still Lacking

3/14/2017

A successful recovery for those with eating disorders is highly dependent upon early intervention. However, many patients feel as though they aren’t receiving access to the care that they deserve, even after discussing their concerns with their GP. This can be tremendously demoralizing for patients who have worked up the courage and bravery to seek out help.

“Eating disorders are a competitive disorder – to say to someone you are not ill enough for treatment, you need to be thinner, you are basically saying go away, make yourself more ill”.

To read the full article, visit:
http://globalnews.ca/news/3276396/young-women-with-eating-disorders-arent-getting-the-help-they-need-study-says/

There's An App For That - Eating Disorders Treatment Goes Mobile

3/7/2017

Access to care is one of the largest barriers facing individuals with eating disorders. An innovational approach to eating disorder treatment is emerging, however, in response to this issue. Mobile applications have emerged that enable patients with eating disorders to connect with their treatment provider electronically between sessions. Patients can log their food intake/meals as well as thoughts, behaviours, and emotions (and more) throughout the day, which can be viewed by the treatment provider electronically. The application enables users and their respective health care providers to recognize patterns and associations regarding the disordered behaviour.

In addition, patients can communicate with their treatment provider electronically in between formal appointments. Such mobile applications have also offered user’s the ability to access acute crisis support services and chat lines. Mobile access to support may not only help in addressing the issue of access to care, but may be extremely valuable for those who are less comfortable seeking care in-person, those who are geographically isolated from treatment facilities, or those who are less confident in seeking help. It would also provide an opportunity for continued care and support between formal appointment sessions.

Read more here:
http://abcnews.go.com/Health/treatment-eating-disorders-mobile/story?id=45898259

PTSD and the Utility of a Therapy Dog

1/9/2017

In this short clip from CBC's TV show Hello Goodbye Canada, viewers meet Lawrence and his family. Lawrence is a veteran with PTSD, who discusses his experiences in the military and how his family and therapy dog Lynx have helped him overcome his mental health struggles. We also learn that Lawrence is headed to BC to participate in an Equine Assisted Mindfulness program, which is another piece of his therapy program.

"They're all pieces of that puzzle that makes me not the mess I was," Lawrence said. "It feels good, it feels good to be who I am today."

The Healing Effects of Music

1/2/2017

In this TEDMED talk, concert pianist Zsolt Bognor speaks briefly to his experience of depression and how he found comfort and healing in classical music. Bognor also shares with viewers two of his favourite pieces by Austrian composer Franz Peter Schubert who was believed to have struggled with depression too.

Do you think music can be therapeutic when it comes to mental health? What songs do you listen to that provide you with solace or work to lift your spirits?

A Look Into Anxiety Treatment Clinics

12/5/2016

In this fantastic article, readers learn all about the Anxiety Research and Treatment Centre at St Joseph's Hospital in Hamilton. While the article offers us snapshots into the treatment programs offered at the clinic, and the impact it has had for those who have struggled with anxiety disorders, we also learn some basics about anxiety including the prevalence of these conditions, the various types of anxiety disorders, and the treatment options for these conditions from medications to therapy such as CBT.

More than that, the article also informs us that while such anxiety clinics are under increased demand, this may not necessarily be due to increased incidence, but more related to decreased stigma and more individuals coming forward for help. We also are advised to remember that some anxiety or stress can be healthy and we need to continue building resiliency rather than over-medicalize stress.

"But those who are able to joke about a disorder may have never actually experienced it, and wouldn't want to.

Symptoms of an anxiety disorder include changes in thinking, behaviour, emotions, and physical sensations that cause distress and impair your ability to function at work or socially.

Anxiety disorders are the most common mental illness, and can affect anyone in any walk of life — about 30 per cent will experience one in their lifetime — and are often made worse by an accompanying "comorbid" mood disorder, depression, or substance abuse disorder.

Anxiety has been around as long as humanity. The emotion is an evolutionary adaptation, a reaction in the central nervous system giving our bodies a jolt to react to a challenge or danger; the "fight or flight" mechanism"".

For the full article, visit:
http://www.thespec.com/news-story/6981046-thought-distortion-anxiety-disorders/

Renowned Surgeon and Author Dr. Sherwin Nuland Shares His Story of ECT

11/21/2016

Dr. Sherwin B. Nuland was a renowned physician who practiced surgery for more than thirty years, in addition to teaching at Yale School of Medicine, his alma mater, and penning over a dozen books many of which explored lessons he had learned through his career in medicine. One of his books, "How We Die: Reflections on Life's Final Chapter ", won numerous accolades as Nuland explored the concept of death with dignity.

What many may not know about Dr. Nuland, who passed away in 2014, was that he struggled with severe depression in the midst of his surgical career in the 1970s. Dr. Nuland spent time in psychiatric institutions, and tried various antidepressants, however none were successful and his mental illness seemed refractory to traditional treatments. Though staff psychiatrists suggested a pre-frontal lobotomy as the next step, a resident suggested electroconvulsive therapy (ECT) instead, a treatment method that had become less popular since the introduction of pharmaceuticals, but could be beneficial and came without the consequences of a lobotomy that may affect his medical career.

In this powerful and must watch TED talk, Dr. Nuland discusses the history and development of ECT, as well as shares his story of "relief, redemption and second chances" as he describes how ECT helped treat the depression which was so severe that it had rendered him essentially non-functional.

Benzodiazepines and PTSD

10/11/2016

Benzodiazepines are a type of medication which fall under the sedative-hypnotic class, and work by enhancing the activity of the neurotransmitter GABA. While benzos are most well-known for their sedating and anxiolytic effects, they have been used in the treatment of those with seizures, alcohol withdrawal, for anesthesia purposes, as well as for insomnia and mental health issues like anxiety (particularly in the short term).

Interestingly from a historical perspective, benzos were also the original treatment for PTSD, and were thought to be beneficial in treating PTSD symptoms rapidly, particularly anxiety and trouble sleeping. While statistics range from 30% to upwards of 74% of those with PTSD being treated with benzodiazepines of some kind, there is growing evidence that suggests that these medications are not effective in treating the core symptoms of PTSD (i.e. hyperarousal, dissociation, and avoidance).

In addition, studies have also suggested that use of benzodiazepines for those with PTSD may be in fact be harmful with risks that far outweigh the benefits. The studies below suggest that we should be very cautious in prescribing benzos for PTSD due to the high rates of comorbid substance use disorders (a serious risk given the tolerance/withdrawal associated with these meds), in addition to suggestions that benzos may in fact worsen overall severity of PTSD, depression and treatment outcomes for those who are affected.

To learn more, check out these articles:
https://www.ncbi.nlm.nih.gov/pubmed/26164054
http://www.ptsd.va.gov/…/newsl…/research-quarterly/v23n4.pdf

Gabapentin: A New Treatment for Alcohol Use Disorder

9/27/2016

If you've heard of the medication gabapentin before, you'll recall that it is most often used in the treatment of seizures as well as neuropathic pain.

However, addiction medicine specialists have been beginning to use the medication in the management of patients with alcohol use disorder, due to growing evidence that gabapentin, when used at moderate-high doses and compared to placebo, increases abstinence rate and days free of heavy drinking. In addition, studies also demonstrate that gabapentin can reduce withdrawal symptoms and aid in long-term recovery by reducing anxiety, insomnia, and cravings.

The most common side effect of the medication is sedation and drowsiness. Doses tend to commonly range from 900-1800mg per day in TID divided dosing, but can be as high as 3600mg a day.

To find out more, check out one of the RCTs that examined the utility of gabapentin for alcohol use disorder:
http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1764009

Think Like A Psychiatrist - Psychotic Symptoms and A Previous Diagnosis of Neurosyphilis

8/24/2016

Put your knowledge and skills to the test with the case of Mr. C, a 61 year old man, who presents to clinic for follow-up on his antipsychotic medications that are used to manage psychosis and depression. He currently uses chlorpromazine 100mg/day and has had no psychotic symptoms in the last 3 years.

In terms of his psychiatric history, Mr. C first began to experience auditory and visual hallucinations at age 48, as well as a decline in cognition that led to his retirement from employment shortly thereafter. He has had 3 inpatient psychiatric admissions, and has continued to be treated with antipsychotics as discontinuation often leads to relapse of his psychosis.

While Mr. C has a history of aortic regurgitation, CHF, HTN, and sensorineural hearing loss, he also describes a history of cocaine abuse from 21-45. More interestingly, he also reveals a diagnosis of syphilis at 48yo, which went untreated for many months until he was diagnosed with neurosyphilis (tertiary syphilis) after developing abnormal gait, blurred vision, and general weakness.

Do you think Mr. C's psychiatric symptoms are related to his diagnosis of neurosyphilis? What tests would you order? What would you advise him on further management/treatment?

"Psychosis in Treated Neurosyphilis: Is Now The Time To Stop His Antipsychotic?" by Kamalika Roy, Richard Balon, and Varma Penumetcha.

New Research Findings May Lead to Better OCD Treatments

7/25/2016

Researchers at Duke University have made a significant advancement in understanding ‪‎OCD‬, as they announced last Friday that they have identified a receptor in the ‪‎brain‬ that may cause the disorder. Though their research was originally conducted in mice, it opens doors for the development of new more targeted and likely more effective medications and treatments ...

"When comparing regular mice to mice that lacked the Sapap3 gene, researchers discovered that the mice without it often had an overactive direct pathway, seemingly explaining why they are so prone to repeating the same actions over and over. When scientists did even more digging, they realize that a specific chemical receptor, called mGluR5, was consistently active in the brains of the mice who lacked Sapap3. This finding suggests that mGluR5 may control the hyperactivity of the brain circuits that coordinate action, thus possibly explaining why so many people with OCD have both obsessive thoughts and obsessive actions."

To read more about the study click here:
http://www.bustle.com/…/173805-what-causes-ocd-scientists-m…
http://thescienceexplorer.com/…/researchers-find-switch-ocd…

For the original abstract click here:
http://www.biologicalpsychiatryjournal.com/…/S0006…/abstract