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Co-Occurring Disorders with PTSD

Many people may think they have anxiety because they suffer from social anxiety, or they have difficulty making quick decisions or any decision at all. Or some may feel as though they seem to be functioning in “survival mode” in order to just get through the day. While it may be determined that they do have anxiety, in some instances, they may actually be suffering from PTSD, or Post Traumatic Stress Disorder as well as one or more co-occurring disorders.

PTSD Statistics

It has been estimated that almost 8% of Americans will suffer from PTSD symptoms at some point during their life. Women are twice as likely as men to develop PTSD, with the numbers 10.4% and 5% respectively. Approximately 3.6%, or 5.2 million adults in the U.S. have PTSD during the course of a given year.

PTSD Symptoms

Three different kinds of symptoms are experienced with PTSD:

  • First set of symptoms involve reliving the trauma in some way
  • Second set of symptoms occur when you purposefully stay away from places or people that remind you of the trauma; you become isolated from other people or feel numb
  • The third set of symptoms include feeling irritable, startling easily, or feeling on guard

Examples of PTSD Symptoms

While there are numerous symptoms reported with PTSD, following are some of the more commonly reported issues:

  • Loss of confidence in trusting your own instincts
  • Social anxiety
  • Difficulty at times separating reality from imagination
  • Waking up frequently at night; having a “fitful” sleep
  • Finding yourself flip-flopping on making a decision
  • Difficulty with short term memory retention
  • Finding it difficult to focus on a task, conversation, idea; difficulty with following through to the end of a thought process
  • Physical or mental lethargy
  • Feeling hopelessness, despair, or depression
  • Becoming exhausted after even small tasks; simple things become “just too hard to do”
  • Making poor life choices where you feel shame instead of making choices to change the situation to the positive
  • Confusion as to why you feel in a “fog” or feel “shell-shocked” by life in general
  • Exhibiting addictive behaviors as a means of escape

Co-Occurring Conditions with PTSD

Those that suffer from PTSD are also commonly diagnosed with other disorders such as depression, substance abuse, anxiety, difficulties with memory or cognition, as well as other problems with mental health or physiological changes.  The disorder itself is associated with impairment of the ability to function in social or family life – it is common to see problems with relationships, family discord, difficulties in parenting, and job instability.

For men, more than half with PTSD also have problems with alcohol; the most common co-occurring issues for men in order are depression, conduct disorder, and substance abuse.

For women, just under half of those with PTSD experience depression; the next most common co-occurring mental health issues are specific fears, anxiety, problems related to alcohol.

PTSD Psychiatric Care

PTSD is not just a “veteran’s ailment.” PTSD can occur across every socio-economic status and life stage. Call Dr. Hege for a confidential appointment at one of his convenient weekend and weeknight office hours for a comprehensive evaluation that addresses your primary and co-occurring issues.

Hormonal Changes Affect Women’s ADHD Symptoms

For women living with ADHD it is an ongoing challenge, not only through the monthly hormonal changes, but through the various life stages as well. With fluctuating hormone levels, ADHD symptoms can be exacerbated, mood swings or depression can occur, or the effect ADHD medication normally has can become ineffective.

Hormonal Changes a Life-Long ADHD Challenge

Finding the right knowledgeable psychiatrist is a choice that can impact you for a life-time. With the average age for initial diagnosis of women with ADHD at 36 to 38 years of age, it is critical for a treatment plan to take into account the hormonal changes that will be occurring over the next 20 to 30 years.

Estrogen and ADHD

For a woman with ADHD it is important to work with a mental health professional who is aware of the interaction between ADHD symptoms and estrogen levels. Looking at a woman’s monthly menstrual cycle, estrogen is at higher levels during the first two weeks and progesterone is higher during the last two weeks.

Estrogen may help ADHD medications work while progesterone may interfere with the effectiveness of those same medications. Due to the changing estrogen levels, the beginning two weeks of the menstrual cycle typically present with less complaints of bothersome symptoms. When the level of estrogen drops and progesterone increases during the last two weeks of the monthly cycle, increased complaints of exasperated symptoms and non-effective medication are often voiced.

Perimenopause and ADHD

Approximately 10 years before the onset of menopause a woman will go through perimenopause. During this extended time period of hormonal changes, the estrogen produced in the body slowly decreases until at the onset of menopause it has decreased by about 65%.

Perimenopause Symptoms Mimic & Worsen ADHD

The following list of symptoms experienced during perimenopause mimic those of ADHD as well as making any original symptoms of ADHD worse. It is thought that many women are diagnosed with ADHD around the time of these life-changes when the symptoms of ADHD combined with the symptoms of perimenopause, and then menopause, send them looking for help.

  • Mood swings
  • Irritability
  • Memory lapses
  • Forgetfulness
  • Depression
  • Fatigue
  • Difficulty with mental clarity
  • Trouble with word recall or retrieval
  • Difficulty sleeping

Hormonal Changes Continue into Menopause

The depression and cognitive deficits that occur with decreasing levels of estrogen as a woman enters menopause often bring a woman with ADHD to have difficulty with coping with daily life situations. Many women, beginning in their late 30s, often seek help for the first time when hormonal changes combine with ADHD symptoms. Others who have already been diagnosed with ADHD often find themselves with worsening symptoms that become overwhelming.

ADHD Treatment during Hormonal Changes

If you feel life changes are making you feel out of control and unable to cope with even normal daily routines, you may have undiagnosed ADHD. Help is available. For new diagnoses or for treatment adjustments during the years of hormonal changes, call Dr. Hege and regain control over your life once again.

Quit Smoking and Manage Withdrawal Symptoms

Addiction to nicotine is a difficult dependence to give up, and many smokers find themselves trying to quit smoking and kick the habit over and over again. Working with a knowledgeable mental health professional who can prescribe medication to not only help you quit, but help you manage withdrawal symptoms may be the only way you can finally succeed and break the hold nicotine has on your life.

Quit Smoking Statistics

If you are a smoker who wants desperately to quit smoking but have been unable to succeed on your own, you are not alone:

  • 70% of smokers want to quit
  • 40% of smokers will try to quit this year
  • 7% of those who try to quit will actually succeed on their first try; 93% will not
  • 50% of those who quit will relapse after drinking alcohol
  • 5% of smokers are able to quit cold turkey

If you are one of the 93% who are unable to quit the first time, second time, or successive times, it is time to seek the professional help you need in order to become an ex-smoker.

  • 90% of those who quit smoking before the age of 30 reduce their rate of death related to smoking
  • 50% of those who quit before the age of 50 reduce their rate of death from smoking

Signs of Severe Smoking Dependence

Smokers who are seriously dependent on nicotine may exhibit one or more of the following signs:

  • Smoking more than 1 pack of cigarettes a day
  • Smoking within 5 minutes of waking up in morning or from a nap
  • Continuing to smoke even when sick
  • Waking up at night to have a smoke
  • Smoking to help with symptoms of nicotine withdrawal

If you have even a couple of these signs of smoking dependence enlisting the aid of an addiction psychiatrist is thebest plan for success in smoking cessation.

Prescription Medications to Stop Smoking

Your psychiatrist has numerous medications available to prescribe and can provide referrals to support and adjunct services when developing your treatment plan to stop smoking, end nicotine addiction, and reduce any unpleasant withdrawal symptoms.

The medications that may be prescribed include:

  • Chantix (varenicline) – this medication not only lessens the pleasure one gets from smoking by interfering with nicotine receptors in the brain; it also reduces the symptoms of nicotine withdrawal. Chantix helps you lose your craving for smoking and nicotine.
  • Zyban, Wellbutrin or Aplenzin (bupropion) – the medication bupropion is known under three different brand names. It is an extended release anti-depressant that helps reduce cravings and symptoms of nicotine withdrawal.
  • Nortriptyline – this is an older anti-depressant drug that helps reduce tobacco withdrawal symptoms
  • Clonidine – this medication, used to treat high blood pressure has also been shown to help people quit smoking. When used as part of a smoking cessation plan it is often given in pill or skin patch form.
  • Other medications and even anti-smoking vaccines are being tested in Europe and the United States but are not yet FDA approved. Your psychiatrist has access to the most effective medications and strategies for a successful program to quit smoking with the least interference from withdrawal symptoms.

Nicotine Addiction Psychiatrist

If you want to successfully quit smoking call Dr. Hege for a convenient evening or weekend appointment and begin a new life as an ex-smoker.

Sexual Side Effects and Psychiatric Medications

Reporting a sexual side effect while using psychiatric medications is a common complaint for both men and women. The severity of sexual side effects vary widely depending on the person, how they react to their medication, the specific medication prescribed, the dosage taken, and any co-existing medical disorders such as heart disease, cancer, and diabetes.

Sexual Side Effects

Psychiatric medication may effect sexual function in a number of ways. The severity of sexual side effects may be minor, may ease up as your body adjusts or become a continuing issue that impacts life enjoyment. Sexual side effects include:

  • Erectile problems
  • Orgasm difficulties
  • Problems with arousal and satisfaction
  • A change in the desire for sex

Statistics of Sexual Dysfunction

Most of the research available on impaired sexual function and psychiatric medication focus primarily on depression and antidepressants. Sexual dysfunction however is also a concern for those diagnosed with anxiety disorders, mood disorders, bipolar disorder, and schizophrenia to name a few. While 35% to 50% of those with untreated major depression report some type of sexual issue, those taking SSRIs (anti-depressant medication) report 30% to 40% delayed orgasm, 20% report decreased libido, and 10% of men complain of erectile function.

Impact of Psychiatric Medications on Sexual Function

The following classes of medication listed indicate some common drugs within each class that have more reported sexual side effects versus those with fewer reported sexual side effects:

Antidepressants:

  • More reported side effects: Celexa (citalopram), Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline)
  • Fewer reported sexual side effects: Wellbutrin, Aplenzin, Forfivo XL (bupropion), Cymbalta (duloxetine), Remeron (mirtazapine), Viibryd (vilazodone)

Antipsychotics:

  • Increased side effects: Cozaril (clozapine), Risperdal (risperidone)
  • Fewer reported effects: Abilify (aripiprazole), Zyprexa (olanzapine), Seroquel (quetiapine)

Sedatives:

  • Increased sexual side effects: Valium (diazepam), Mellaril (thioridazine)
  • Less reported effects: BuSpar (buspirone)

Reduce Psychiatric Sexual Side Effects

The solution is not to stop the medication you need for your mental health issues but rather to work with your psychiatrist to find an effective medication or combination of medications that work for you and reduce any sexual dysfunction that you have been experiencing.

Call Dr. Hege for a confidential appointment – there are many avenues of treatment available to help you live a full and satisfying life. Let Dr. Hege help.

Opioid Addiction: Will You Become Hooked?

In the United States, approximately 2.5 million people are addicted to opioids. Opioid addiction has become a national concern with states already using a tracking system to enable physicians to check which patient is getting narcotics and if they are “doctor shopping” for medications. In addition, over half of the states in the U.S. are now also limiting the number of days an opioid can be prescribed in an attempt to decrease the numbers of those becoming addicted to, and over-dosing from opioids.

Recent Study on Opioid Addiction 

A recent study by the Center for Disease Control and Prevention (CDC) published in March of 2017 provided data regarding measurable clues that indicate what your chances of becoming addicted to opioid are. The clues involve the duration of a narcotic prescription and the type of narcotic prescribed. These two clues combined give a measurable indicator of one’s chance of becoming addicted.

Duration of Narcotic Prescription Clue to Addiction

In the study by the CDC reported in their Weekly Report, the duration of a prescription gave clues on how long a person may end up using a narcotic painkiller. Results show that if an opioid is used for only one day, there is a 6% chance of still using that drug a year later. Using that medication for a period of 31 days increases the chance of developing long term opioid use to 29.9%.

Type of Opioid Prescribed Indicator of Addiction Odds

Use of long-acting or extended release opioids were an indicator of developing issues with long term use. People who received a prescription for extended release narcotics had a 27.3% chance to still be using that painkiller a year later, and a 20.5% chance of using it three years later. Comparatively, those adults who were started on a prescription using a short-acting opioid only had a 8.9% chance of addiction one year later and a 5.3% chance three years later.

Opioid Addiction Psychiatrist

Prescription and illegal opioids are commonly abused because they are so addictive. Recovery is often impossible without a good support system and medications that assist with the withdrawal symptoms.

Call Dr. Hege for a confidential appointment and start the journey back to a full life without the gnawing cravings of opioid addiction.

Adults with ADHD Out of Sync with Rest of World

For those adults with ADHD, a common reported problem centers around the struggle with time management. Many with adult ADHD find themselves running late, not getting work done on time, difficulty organizing their time effectively, or just finding themselves out of sync with the rest of the world when it comes to following a routine time table.

Effects of Being Out of Sync with ADHD

Adults with ADHD may find they complete things too fast, making mistakes or leaving the task incomplete in their haste; others lose track of time or mismanage their time and find they end up being late for appointments or task completion. No matter if someone is too fast or too slow they feel a struggle to be in sync with the world around them, often feeling frustrated, anxious, ill-prepared, lagging behind or restless in the process.

Being Out of Sync Part of ADHD Experience

In the paper on adult ADHD written by Mikka Nielsen and recently published in Medical Anthropology, it was concluded that those with ADHD experience a state of desynchronization and inner restlessness with their surroundings and social connections, feeling like they are out of rhythm, out of sync, with the rest of the world.

Examples of Being Out of Sync with ADHD

Some common experiences where time management and feeling out of sync come into play include:

  • Difficulty with predicting or estimating how long a task will take to complete
  • Thinking about the present and not being able to plan effectively for the future
  • Typically running late for appointments or meetings
  • Finding yourself impatient and wanting to move on to the next thing
  • Looking for short-term rewards
  • Difficulty dealing with delayed gratification
  • Following an atypical sleep-wake schedule

Adult ADHD Help Available

If you find yourself constantly out of sync with the clock, schedules, and appointments, or feel scattered and unsure of how to manage and organize your time in a more functional and effective manner, it may be time to seek the help of an experienced specialist. If you are feel that you are letting yourself and others down by your poor time management, or that you do not feel a sense of accomplishment in life, it is time to seek help and treatment.

Local Adult ADHD Psychiatrist

It is time for a change. End the constant struggle. Call Dr. Hege for a confidential appointment today.

Withdrawal Drug Antabuse Effective for Cocaine Withdrawal

Cocaine withdrawal is a difficult feat to accomplish with the intense cravings and withdrawal symptoms that can torment a person for weeks and weeks. The odds for beating cocaine addiction dramatically increase with proper psychiatric care and cocaine withdrawal medication management. Working with an experienced psychiatrist trained in addiction and recovery can help you reach and maintain recovery from a life controlled by cocaine cravings.

Cocaine Withdrawal Medication Antabuse Effective

Working with a specialist with decades of experience treating patients with primary and secondary substance abuse and addiction issues is paramount to a recovery plan that is successful. One of the medications that may be prescribed to help manage cocaine addiction withdrawal symptoms is:

  • Antabuse / Disulfiram: This medication will help to minimize cocaine cravings and has been shown to improve abstinence and the recovery rates during the first three months of recovery. While Antabuse is generally used in the treatment of alcohol abuse it has shown positive results in the treatment of cocaine addiction as well.

Antabuse Effects on Cocaine Withdrawal

Cocaine primarily affects the neurotransmitter dopamine which directly affects the reward center of the brain – cocaine dramatically increases the level of dopamine in the brain which in turn causes feelings of euphoria that is commonly associated with the drug. In addition to increasing dopamine levels, cocaine increases norepinephrine which makes one feel they are full of energy. Euphoria combined with high energy makes cocaine addiction doubly difficult to recover from.

Use of Antabuse / Disulfiram blocks a specific form of dopamine which is an essential component in the body’s production of norepinephrine; Antabuse has a dual effect on the effects of cocaine use attacking the two main effects it has one the brain and body. Use of Antabuse makes using cocaine an unpleasant experience. While research data is bringing better understanding to the use of Antabuse with cocaine withdrawal, use of this medication is proving to be an effective part of a cocaine recovery treatment plan.

Cocaine Withdrawal Treatment Locally

Dr. Hege, a specialist in addiction and recovery, is a psychiatrist with over 25 years of successful treatment experience. The time has come to start on the road to your recovery. Call the office for a confidential appointment and comprehensive evaluation.

Professionals in Mental Health Need to Match Your Need

There are numerous choices to make when looking to find mental health professionals that can meet your needs in developing a successful treatment plan. There are over six different mental health professions with dozens of variations on the type or types of services they offer. It can be a confusing time deciding who to call, who is the right therapist for your needs, or figuring out just what type of mental health provider you do need.

Similarities and Differences among Mental Health Professionals

All mental health professionals who work with or treat individuals or groups, whether in a hospital, out-patient setting, group practice, or in private practice must hold a license to practice. Each state has its own specific rules and regulations for licensure for each type of profession that works directly with patients. The biggest difference found between the different types of mental health professionals can be found in the specialty or focus area and their educational background or degree held.

Mental Health Professionals

There are several different types of mental health providers to choose from when looking to find the right therapist or counselor for you. Some of the different types of professionals available in your community are:

  • Psychiatrist – A psychiatrist is a medical doctor and the only mental health professional that is not only a specialist in mental health care, but one which can prescribe medications. While your family doctor can also prescribe mental health medications they do not hold the background or specialized training and degree for the treatment of mental health disorders. A psychiatrist may also include adjunct services such as cognitive behavioral therapy, group therapy or support groups as part of your individual plan.
  • Psychologist – A psychologist may practice psychotherapy and usually has a doctorate degree, but not a medical degree. Their training may require thousands of hours of training and clinical experience that can include the diagnosis, psychological assessment, psychotherapy, individual, marriage and family counseling. In some states and settings a psychologist may hold a master’s degree and practice under specific guidelines.
  • Clinical Social Worker – A clinical social worker generally have a master’s degree in social work for a M.S.W. and will show L.C.S.W. if they are practiced in providing psychotherapy services. While a clinical social worker may work in private practice they are often found working in a hospital, mental health agency, or in conjunction with a psychiatrist.
  • Psychiatric Nurses – These nurses are registered nurses (RN) who have received specialized psychiatric training where they may provide some forms of psychotherapy. Psychiatric nurses are most typically found in a mental health facility or agency or working with psychiatrists or psychologists.
  • Marriage and Family Therapist – These therapists may hold a master’s degree but rules and regulations vary from state to state, where they may be practicing with a more limited degree and experience. In choosing a marriage and family therapist it is important to check on their educational background as well as experience and training received with mental health disorders.

Psychiatry and Psychotherapy

In addition to medication, psychiatrists may also choose to engage you in psychotherapy, whether in a group or through adjunct services connected to their practice. Some common types of psychotherapy offered include cognitive behavioral therapy, group therapy, family therapy, and psychodynamic therapy to name a few. Your psychiatrist will make the determination as to what your treatment program will include following a comprehensive assessment of your concerns and issues.

Choose the mental health professional who can meet all of your needs. Call Dr. Hege for a confidential appointment – evening and weekend appointments available.

Myth and Misconception Behind Psychiatric Sessions

Many people who have never seen a psychiatrist or mental health professional often have misguided perceptions or believe a myth about what to expect. If your idea of what goes on in a psychiatrist’s office comes from what you have seen on soap operas or in the movies you may have a set of expectations that could actually limit the ability of the therapist to do their best for you.

Pre-Appointment Mind Set

While it is important to make that appointment for help with any emotional, psychological or behavioral issues you or a loved one may be having, it is equally important to have an accurate idea of what to expect during your psychiatric session times. Having accurate perceptions in place will allow you to get the most out of each session and facilitate an active one-on-one working relationship where your therapist can develop and implement a successful individualized plan of treatment.

Common Myths about Therapy

Understanding what reality versus a myth is can let you take full benefit from your mental health services. Some of the most common misconceptions are:

  • “Therapy is supposed to make me happy.” While you may feel that you are happier with life and more comfortable overall, the intent of therapy is to assist you in becoming fully functional and connected with family, friends, work situations, school.
  • “I want to be cured in one session.” The entire process of therapy takes time with no quick fixes. Each person is unique with their own needs, perceptions, and motivation for change. The therapist needs to develop an individualized plan, making changes as progress evolves. Many people have more than one issue or concern which may require a higher level of coordination of services, or use of more than one type of medication.
  • “I want to be told what I need to do.” Many people go into a therapy session expecting to be told what to do to change their life or solve their problems. While a mental health professional will explore options, outcomes, or may refer for adjunct or group services, a therapist will guide rather than tell you what you need to do.
  • “Talking to friends and family is just as good as seeing a psychiatrist.” Having a good support base is important when you are going through a rough time, but mental health professionals have the training and experience to understand and treat basic to complex problems. A therapeutic relationship is also confidential, where you can feel free to discuss things you have never been able to talk about before.
  • “Only people that are crazy go see a psychiatrist.” Life is often stressful and full of challenging events and changes. In today’s world, getting help for psychological or behavioral issues is seen as part of keeping oneself healthy in both mind and body.
  • “If I try harder I should be able to get better on my own.” Sometimes people struggle for months and years before seeing psychological help. A medical, biological or behavioral component to some disorders require more than just trying harder to get better.

Having the courage to know you need professional assistance and seek out a psychiatrist to help you lead a full functional life is a sign of strength. Take the first step toward feeling better and making a positive change in your life – call the office for an appointment.

Binge Eating Disorder Managed With Vyvanse

Binge Eating Disorder, B.E.D., is the most common eating disorder affecting 1% to 5% of adults in the America. According to the National Eating Disorders Association about 50% of those with B.E.D. are either overweight or obese, however being diagnosed with B.E.D. involves more than just overeating. Only a trained and qualified health care professional can make the appropriate diagnosis and then develop the correct treatment plan that will be successful.

Cause of Binge Eating Disorder

With research and recent medical advances the exact cause of B.E.D. remains uncertain. There is some evidence that Binge Eating Disorder may be hereditary with the disorder linked to family genetics. There are some hypotheses that B.E.D. is caused by certain brain chemicals, or even certain life experiences such as life-threatening accidents or natural disasters.

Diagnosis of Binge Eating Disorder

The diagnosis of B.E.D. is very specific and all of the following symptoms must be present for a true and accurate diagnosis:

  • Regularly eating far more amounts of food than an average person would be able to eat in a similar time period
  • Feeling that the amount of food eaten is out of control during a binge
  • Becoming very upset by the episode(s) of binge eating
  • Binge eating typically occurs at least 1x/week over a 3-month period
  • Those with Binge Eating Disorder do not try to correct their excessive eating habits by throwing up or by over-exercising; B.E.D. is not part of another type of eating disorder.

In addition to meeting all of the criteria above, at least three or more of the following symptoms must also be present for an appropriate diagnosis:

  • Eating extremely fast
  • Eating beyond the feeling of being full
  • Eating large amounts of food when not hungry
  • Eating alone to hide how much is being eaten
  • Feeling bad about oneself after a binge has occurred

Degree of Binge Eating Disorder Exhibited

Along with an accurate diagnosis is the determination of the severity of the B.E.D. which your doctor will utilize in the development of an effective treatment program.  There are four levels of this disorder:

  • Mild degree with 1 to 3 binge eating episodes exhibited a week
  • Moderate degree with from 4 to 7 binge eating episodes a week
  • Severe degree where 8 to 13 episodes are reported each week
  • Extreme degree with 14 or more binge eating episodes every week

Treatment for B.E.D.

Vyvanse is the first and only medication approved to treat moderate to severe adult Binge Eating Disorder. Vyvanse (lisdexametamine dimesylate) is a prescription medication that your psychiatrist may choose to utilize in the treatment of your eating disorder. Following a comprehensive evaluation, an individualized treatment plan will be developed that may include Vyvanse, cognitive behavioral therapy, adjunct therapy, or support groups.

Binge Eating Disorder Psychiatrist

For qualified experienced care in the diagnosis and treatment of B.E.D., call the office of Dr. Hege to get your eating under control. It is time to enjoy life without the hidden struggle of binge eating.