What is Complex PTSD?

Although complex post traumatic stress syndrome (C-PTSD) is not yet formally recognized as a diagnostic designation, a case is being made in the psychiatric community for the recognition of this disorder as distinct from the currently defined form of PTSD. PTSD, as it is currently defined and diagnosed in Mansfield and elsewhere, is a result of exposure to acute trauma. It often occurs in individuals who have either witnessed or experienced tragedies, such as combat, a violent death, assault, or a natural disaster. C-PTSD is distinct from PTSD in that complex PTSD results from repeated trauma. It often develops as a result of prolonged sexual, physical, verbal, or emotional abuse. It can also occur in people who have survived a long-term hostage situation.

Causes of Complex PTSD

Whereas traditional PTSD is associated with acute psychological trauma, complex PTSD results from prolonged and systematic trauma exposure. Complex PTSD is often associated with relational abuse, such as spousal or child abuse. One of the distinguishing characteristics of C-PTSD, as opposed to “simple” PTSD, is the presence of disorders and problems with interpersonal attachment. Attachment in individuals who suffer from complex PTSD tends to take a pervasive insecure or disorganized form.

Diagnostic Criteria for Complex PTSD

The Centre for Addiction and Mental Health (CAMH) has put forth a potential set of diagnostic guidelines for complex PTSD:

I.                    Alteration in Regulation of Affect and Impulses

a.       Affect regulation

b.      Modulation of anger

c.       Self-destructive behavior

d.      Suicidal preoccupation

e.      Difficulty modulating sexual involvement

f.        Excessive risk-taking

II.                  Alterations in Attention or Consciousness

a.       Amnesia

b.      Transient dissociative episodes and depersonalization

III.                Alterations in Self-Perception

a.       Ineffectiveness

b.      Permanent damage

c.       Guilt and responsibility

d.      Shame

e.      Nobody can understand

f.        Minimizing

IV.                Alterations in Relationships with Others

a.       Inability to trust

b.      Revictimization

c.       Victimizing others

V.                  Somatization

a.       Problems with the digestive system

b.      Chronic pain

c.       Cardiopulmonary symptoms

d.      Conversion symptoms

e.      Sexual symptoms

VI.                Alterations in Systems of Meaning

a.       Despair or hopelessness

b.      Loss of previously sustaining beliefs

Many researchers advocate differences in diagnostic criteria for children versus adults. In this conceptualization of complex PTSD, the disorder is further divided into an adult symptom cluster and a childhood symptoms cluster.

A child and adolescent symptom cluster for complex PTSD would encompass the following domains:

·         Attachment

·         Biology

·         Affect or emotional dysregulation

·         Dissociation

·         Behavioral control

·         Cognition

·         Self-concept

An adult symptom cluster for complex PTSD symptoms would include:

·         Difficulty regulating emotions

·         Variations in consciousness, including psychogenic amnesia, dissociation, or intrusive flashbacks of traumatic episodes

·         Changes in self-perception, often involving a chronic sense of helplessness, along with irrational self-blame and feelings of shame and guilt

·         Varying changes in perception of the person perpetrating the abuse; this may involve attributing too much power to that person, being preoccupied with revenge, or even idealizing that person

·         Alterations in relationships with others; this may take the form of isolation and withdrawal, inability to trust, or reliance on the idea of a “rescuer”

·         Loss of faith or overwhelming sense of despair

Treating Complex PTSD

As with diagnostic criteria for complex PTSD, researchers advocate differences in treatment approaches in children versus in adults, in order to account for differences between childhood and adult reactions to and results of trauma. Some of the principles and guidelines that have been proposed for treating complex PTSD in children include:

·         Identifying and assessing current threats to the child’s safety and well-being

·         Relational and strength based diagnosis and treatment

·         Treatment aimed toward enhancing the child’s self-regulatory abilities to improve their coping abilities

·          Determine when and how it is appropriate to fully address traumatic memories

·         Preventing and managing psychosocial crises and ongoing relational issues

In adults, complex PTSD researchers have proposed six core components for treatment:

·         Safety

·         Self-regulation

·         Self-reflective information processing

·         Integration of traumatic experiences

·         Relational engagement

·         Positive affect engagement

Five Foods That Secretly Contain Caffeine

If you are the parent of a child with attention deficit disorder (ADD) in Foxboro, especially the hyperactive subtype of ADD, you’re probably careful not to give your child foods or drinks that contain caffeine. Caffeine is a central nervous system stimulant, and can sometimes exacerbate hyperactivity, impulsivity, and inattention in children with predominantly hyperactive ADHD. If you’re familiar with ADD and ADHD medications, this may surprise you. After all, the medicines that treat ADD and ADHD are also stimulants; however, unlike the methylphenidates and amphetamines used in ADHD drugs, caffeine doesn’t target the parts of the brain to have the same counterintuitive effect on hyperactive ADD symptoms.

Of course, you know that coffee, tea, and cola contain a significant amount of caffeine—often in combination with high levels of sugar that further contribute to your child “bouncing off the walls.” However, there are other products on the shelves of Foxboro grocery stores that secretly contain caffeine, although you might not realize that they do. These five foods actually contain caffeine, so you may want to choose other options for your ADD child to keep their energy levels in check. 

#1: Non-Cola Soft Drinks 

Most people in Foxboro are aware that colas like Coca-Cola and Pepsi contain a sizeable amount of caffeine. Not every soft drink contains caffeine; many lemon-lime sodas like Sprite and 7-up, as well as some grape and orange sodas, are caffeine-free. However, many other non-cola soft drinks do contain some amount of caffeine. You may want to avoid these or choose a caffeine-free version or alternative. Some of these sodas include:

·         Sunkist: 41 mg/12 oz

·         Dr. Pepper: 41 mg/12 oz

·         Barq’s Root Beer: 22.5 mg/12 oz

·         Mountain Dew: 54 mg/12 oz

·         Mello Yellow: 52.5 mg/12 oz.

Most soft drinks list the caffeine content on the can or bottle, so it always helps to check before letting your child drink it.  

#2: Chocolate 

Caffeine occurs naturally in cocoa beans, so most chocolate products contain some caffeine. The caffeine content varies from product to product, ranging from 9 or 10 mg in many products to as much as 31 mg in a bar of Hershey’s Special Dark Chocolate. Dark chocolates tend to have more caffeine than milk chocolate. Most chocolate purchased in Foxboro doesn’t contain quite enough caffeine to present a real problem for children with ADHD, but you may still want to limit chocolate because of the high sugar content. 

#3: Chocolate or Coffee-Flavored Ice Cream 

Many ice creams that have chocolate, as well as those that are coffee-flavored, actually do contain some amount of caffeine.

#4: Pain Relievers 

You may be surprised that some over-the-counter pain relievers in Foxboro have caffeine in them, especially pain medicines designed for headache and migraine relief. You may associate caffeine with causing headaches rather than curing them, but caffeine can actually help increase the effectiveness of the active ingredients (usually an NSAID) for treating headaches, as well as helping the body absorb the medicine faster. Some over-the-counter pain medicines that have caffeine include:

·         Excedrin Migraine Relief: 61 mg

·         Aspirin-Free Excedrin: 65 mg

·         Bayer Select Maximum Strength Headache Relief: 65.4 mg

·         Goody’s Extra Strength Tablets: 16.25 mg

·         Goody’s Headache Powder: 32.5 mg

·         Midol Menstrual Maximum Strength Caplets: 60 mg 

#5: Energy Mints and Energy Gum 

This one is probably obvious, but watch out for products with “energy” in their name if you’re trying to avoid things that contain caffeine. There are several kinds of mints, gum, and even chocolate candies that have added caffeine. They can be potent, with some containing as much as 50 mg of caffeine in a single breath mint.

ALTERNATIVE MEDICINE FOR ADD IN FOXBORO

Treating Obsessive Compulsive Disorder in Children

Treating Obsessive Compulsive Disorder in Children with Family-Based Exposure Therapy 

Obsessive-Compulsive Disorder is a relatively common anxiety disorder. OCD is characterized primarily by intrusive thoughts (“obsessions”) that cause significant and overwhelming anxiety, which often causes the person to engage in certain repetitious behaviors (“compulsions”) to try to temporarily relieve that anxiety. Although obsessive-compulsive disorder in Mansfield and the Boston area is more commonly diagnosed in adolescents and adults, this condition can also occur in children. OCD in children is arguably more difficult to deal with than obsessive-compulsive disorder in adults, and children often do not respond as well to psychiatric medications. However, a recent study has found compelling evidence that one form of behavioral therapy, called “Family-Based Exposure Therapy”, may be a particularly effective approach to pediatric obsessive compulsive disorder treatment. 

How is Obsessive Compulsive Disorder Diagnosed in Mansfield? 

Obsessive-Compulsive Disorder in Mansfield is diagnosed, usually by a psychologist or psychiatrist, based on an accepted set of diagnostic criteria. The ICD-10 lists the following criteria for a diagnosis of obsessive-compulsive disorder:

A. Obsessions and Compulsions.

·         OBSESSIONS are defined as:
 1.) Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, are intrusive or inappropriate, and cause marked anxiety or distress.
2.) The obsessions are not exaggerated real-life worries
3.) The person attempts to ignore or suppress the obsessive thoughts, or to neutralize them with a different thought or action.
 4.) The person recognizes that obsessional thoughts arise within their own mind, rather than delusionally believing they have been “inserted” by an outside party

·         COMPULSIONS are defined as:
 1.) Repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession, often according to rules that must be rigidly adhered to
2.) These behaviors or mental acts are aimed at preventing or reducing distress preventing a dreaded turn of events, BUT these behaviors are excessive or irrational and not connected to the thoughts and anxieties in a realistic way.

B. The person has recognized that the obsessions and compulsions are not reasonable or rational. (This does NOT apply to children.)

C. The obsessions and compulsions are distressing, time-consuming, and interfere with a person’s normal activities.

D. The obsessions and compulsions are not restricted to another comorbid disorder (such as generalized anxiety or major depression).

               

To diagnose a child in Mansfield with obsessive compulsive disorder, a psychiatrist or psychologist must rule out other possible diagnoses, including autism-spectrum disorders, attention deficit disorders, and other anxiety disorders. 

Family-Based Exposure Therapy: A Promising New OCD Treatment for Pediatric Patients 

Obsessive-compulsive disorder in children can be difficult to approach and treat. In Mansfield adults, SSRI medications are sometimes incorporated into treatment for obsessive-compulsive disorder. Although these medications can be effective for anxiety and depression in adults, however, they are not recommended for children. A better approach for treating obsessive compulsive disorder in children is to use behavioral therapies, such as cognitive-behavioral therapy or talk therapy.

Recently, a study conducted by the Bradley Hasbro Children’s Research Center has found that a technique called “family-based exposure therapy” was an especially effective approach for treating obsessive compulsive disorder in children between the ages of 5 and 8. Although CBT therapies have been well substantiated in adults and adolescents, there had previously been little research into their efficacy for young children.

Exposure therapy is often used to treat anxiety disorders in Mansfield, including obsessive-compulsive disorder. Exposure therapy is based on behavioral principles of “respondent conditioning”, famously discovered by Pavlov. This therapy approach aims to identify the thoughts and feelings leading to the anxiety response when a “trigger” is presented, and at reducing those responses though exposure to the stimulus. The “family-based” aspect refers to keeping the child’s family informed and involved in the treatment.

NEUROFEEDBACK FOR OCD

Lifestyle Tips for Dealing with Anxiety

Many people suffer from some form of anxiety disorder. Everyone feels anxiety from time to time, such as when final exams are approaching; a big job interview comes around; or when faced with financial problems. However, an anxiety disorder goes beyond normal anxiety, with feelings of worry and fear that are disproportionately overwhelming and may not even be attached to an identifiable trigger.

If you have an anxiety disorder, the best thing to do is to seek treatment. Some people are more predisposed toward anxiety than others, for reasons related to genetics and brain structure. Anxiety can be managed on a psychosocial level, with psychotherapy and cognitive-behavioral therapy; on a neurochemical level, with medications that correct chemical imbalances in the brain; and with neurofeedback therapy, which corrects underlying brainwave dysregulation associated with anxiety. A psychiatrist, counselor, or clinical psychologist can find a treatment plan that works best for you.

In the meantime, if you are dealing with anxiety on a daily basis, there are a few changes you can make to your diet and sleeping habits that may help you reduce and cope with your anxiety.

·         Eliminate foods and drinks that cause or contribute to anxiety. For many people, this means caffeine. Coffee, energy drinks, and other caffeinated beverages can cause or exacerbate anxiety due to the drug’s stimulant effects.

·         Avoid starches and sugars. When stressed out, many people reach for starchy or sugary foods as “comfort foods,” but these can actually worsen your anxiety later on by causing fluctuations in blood sugar.

·         Avoid excessive alcohol. Although some people feel a few drinks may help them unwind, others may actually feel more anxious or depressed if they become too inebriated. Alcohol also creates unpleasant hangover effects.

·         Exercise can help relieve anxiety. Exercise causes the release of mood-boosting, anxiety-reducing endorphins, an effect that persists for hours after you finish your workout. Cardiovascular exercises, such as running or cycling, are great for stress relief. You may also try yoga or tai chi, which incorporates meditation and breathing techniques that makes them highly relaxing.

·         Try deep breathing exercises. Remain mindful of your breathing, especially if you begin to feel worried or stressed. Slow, deep breathing has a direct effect on your heart rate and can reduce anxiety.

·         Avoid commitments and situations that will exacerbate your anxiety levels. You can’t always run away from what causes your anxiety, and social anxieties and phobias have to be overcome by exposure and desensitization. You may want to avoid taking on too many work tasks or interpersonal commitments if an overloaded schedule will cause your anxiety to flare up. Remember, it’s okay to say no.

·         Get enough sleep. Maintaining a regular sleep schedule can help reduce cortisol, a stress hormone. Herbal remedies or melatonin supplements can help with this, if needed.

If you have an anxiety disorder, you should seek mental health treatment to address the underlying issues that are causing your anxiety. There are several strategies that can help you deal with anxiety, and  plenty of rest and good nutrition are necessary for overall health and wellness, including mental health. 

The Three Types of PTSD Symptoms

Posttraumatic Stress Disorder, better known as PTSD, is a psychiatric condition that occurs in people who have been exposed to traumatic events. People who have experienced the horrors of war and combat can develop PTSD, but it can also occur in victims of sexual assault, victims of child or domestic abuse, and other traumatic events. There are three main categories of PTSD symptoms:

·         Re-experiencing symptoms

·         Avoidance and numbing symptoms

·         Hyperarousal symptoms

To qualify for a diagnosis of PTSD, a person must experience one or more re-experiencing symptoms, at least three avoidance and numbness symptoms, and at least two hyperarousal symptoms for at least one month.

“Re-Experiencing Symptoms” in PTSD

Re-experiencing symptoms in PTSD involve reliving the traumatic event. These symptoms may include:

·         Flashbacks or extremely vivid and intrusive memories

·         Recurring distressing dreams

·         Intense negative reactions to things that remind the person of the traumatic event

These symptoms can strike seemingly without warning in response to a trigger that reminds the person of the event. The memories may be so vivid that the person feels like they are literally experiencing the event again, along with all the feelings of fear and helplessness.

Avoidance and Numbing Symptoms in PTSD

The second set of PTSD symptoms involves avoidance of things that remind the person of the traumatic experience, and emotional numbing as a reaction to overpowering fear and helplessness.

·         Avoidance of stimuli that remind the person of the trauma, including certain conversation topics or things that remind the person of the event.

·         Avoidance of behaviors, places, or people that might cause an intrusive memory of the event

·         Inability to recall major parts of the trauma

·         Loss of capacity to feel certain emotions; feeling “emotionally numb”

Hyperarousal Symptoms in PTSD

An individual with PTSD may often be in a state of hyperarousal or hypervigilance. This set of PTSD symptoms includes:

·         Difficulty sleeping

·         Angry outbursts

·         Being tense or “on-edge” much of the time

·         Easily startled

Are PTSD Symptoms Different in Children than In Adults?

In children younger than age six, there are some behavioral markers that can result from PTSD that are not found in adults. This includes some regression:

·         Bedwetting or soiling themselves, when they had been previously potty-trained

·         Forgetting how to talk, or being unable to talk

·         Acting out the traumatic event in play

·         Unusally clingy with a trusted adult

The symptoms of PTSD cause marked psychological distress and interfere significantly with the person’s quality of life. There are treatments for PTSD, including talk therapy, medications, or a combination of the two. Talk therapies can help the person identify and deal with the guilt, shame, fear, and other feelings that are a result from the traumatic event. A qualified therapist can help them face the bad memories and make sense of what happened and how they feel about it. Along with psychotherapy, medications like Zoloft or Paxil are sometimes used to treat chemical imbalances in the brain that are associated with PTSD symptoms. 

NEUROFEEDBACK FOR PTSD

NEUROFEEDBACK IN BOSTON

What is Neurofeedback?

Neurofeedback and the Brain

What is neurofeedback? Neurofeedback therapy, also known as EEG biofeedback or simply neurofeedback, is a modern medical breakthrough which allows doctors to treat neurological diseases and disorders (or even minor problems) as they never have before. Doctors and patients, working together, are able to modify brainwave activity that has gone awry and subsequently caused unwanted issues or symptoms. Neurofeedback therapy is currently being used for a litany of neurological issues, and scientific research has back up the claim that it is an effective treatment method. Conditions neurofeedback is currently used to treat include:

• ADD/ADHD
• Anxiety
• Autism
• Chronic Pain
• Depression
• Fibromyalgia
• Headaches (Migraines, Tension Headaches)
• Insomnia
• Post Stroke Syndrome
• Obsessive Compulsive Disorder

 Now that you have a general overview, let’s ask a more practical question: “What is neurofeedback doing to in the brain?” First, let’s talk a bit about the amazing human brain. Believe it or not, your brain wants to function properly at all times. For whatever reason, genetics or environment, between the billions of neurons, synapses, and chemical reactions taking place everyday inside our heads, things can get a little off kilter. Brainwaves can become dysregulated, and may need a simple kick in the butt to get back on track. Once they do get back on track, however, they tend to stay there – and that is a true testament to how incredible our bodies are. Neurofeedback therapy serves as a catalyst for positive change in the brain, providing it with training so it can self-regulate. This remarkable therapy leverages the brains natural want to operate as one highly-functioning whole and harnesses that trait through guided brain exercises to treat some of the horrible disorders we listed earlier.

What is Treatment Like?

Now you may ask, “What is neurofeedback therapy like?” Well, here’s what is certainly is not: painful, tiresome, or harmful. The therapy is all completely noninvasive, has never produced a recognized side effect, and is meant to set you up for long-term independence – not a lifelong relationship with the doctor’s office. Treatment begins with a comprehensive assessment of each patient’s brainwave patterns, whereupon doctors will identify which ones have gone off track. After this doctors will develop a treatment plan and guide patients through targeted brain exercises using nothing more than EEG sensors and a monitor. No currents are ever sent into the brain, its patterns are simply read and interpreted – this is the feedback part of neurofeedback – so we know we are making lasting changes. The number of visits depends on the gravity of the neurological problem, but the bottom line is this: when treatment is complete, your brain will be keeping you out of the doctor’s office all by itself. What is neurofeedback not doing as a current part of your regimen?

Learn more about NEUROFEEDBACK THERAPY