Sleep Problems and Psych Disorders: The Relationship

Research has found that sleep problems which used to be viewed as a symptom of mental health disruption may actually be a contributing factor for psychiatric disorders. Studies at Harvard Medical School confirm that sleep problems affect between 10% to 18% of adults in the general U.S. population; the percentage of adult patients seen in psychiatric practices with chronic sleep issues jumps to 80%.

Sleep Problems Point to Increased Risk for Psychiatric Disorders

Patients with a diagnosis of anxiety, depression, bipolar disorder and ADHD commonly report being plagued with sleep problems. While sleep dysfunction was once viewed as a symptom, clinical data supports the hypothesis that adult sleep problems raise the risk for developing a psychiatric disorder. In long term studies it was found that adults who reported a history of insomnia were four times as likely to develop major depression on re-evaluation three years later, indicating the sleep disruptions developed before the mental health disorder.

Sleep Problems versus use of Antipsychotics

Sleep issues and insomnia began to be more closely looked at in the 1970’s. The sleep problems were thought to be directly tied to use of antipsychotics at the time; however, data indicates a long history of sleep disturbance complaints long before use of antipsychotics began. Today it is more widely believed that chronic sleep problems puts one more at risk for the development of psychiatric issues and that treating the sleep disorder can actually assist in alleviating symptoms of a co-occurring mental health problem.

Sleep Disorders in Psychiatric Patients

Of the more than 70 types of sleep disorders the most common problems are insomnia, obstructive sleep apnea, unpleasant sleep movement syndromes and narcolepsy. The University of Brazil Medical School reports the type and impact of the sleep problems vary by the psychiatric diagnosis with examples noted below:

  • Up to 90% of adults with major depression experience a sleep problem
  • One-in-five adults with depression suffer from obstructive sleep apnea
  • Depressed adults with insomnia less likely to respond to treatment, at a higher risk for relapse and are more likely to die by suicide
  • Up to 99% of adults with bipolar disorder experience insomnia or restless sleep
  • In adults with bipolar depression up to 78% sleep in excessive amounts
  • More than 50% of adults with anxiety disorders have dysfunctional sleep patterns
  • Sleep problems precede anxiety disorders 27% of the time
  • Sleep dysfunction precedes depression 69% of the time
  • 68% of adults with PTSD report sleeping problems
  • Long term studies indicate that insomnia or other sleep disruptions worsen before a manic episode or bipolar depression

Sleep and mental health are interconnected though not yet completely understood. Neurochemistry studies do indicate that having a good night’s sleep promotes a healthier outlook, while chronic sleep problems can set up an arena for negative thought processes and emotional vulnerability. Call the office for a comprehensive evaluation with Dr. Hege who will work with you to get your sleep patterns and mental health issues back into functional ranges.

Bipolar Depression Controlled with Latuda

Bipolar’s depressive episodes can be difficult to treat. Very often the use of anti-depressants to treat bipolar depression can have unexpected and unwanted effects. Patients diagnosed with clinical depression without a bipolar component often have several treatment options to choose from, but options for bipolar depression are more limited and the side effects may prove more limiting than any positive outcomes hoped for.

Bipolar Depression Difficult to Treat

Bipolar depression has been a very frustrating component of bipolar disorder to effectively treat. Research studies often report mixed findings or contradictory conclusions. Recent data has found little support for the trial or use of anti-depressants to treat bipolar depression.

Latuda: An Atypical Anti-Psychotic for Bipolar Depression

Latuda or lurasidone, a relatively new medication, was first approved for the treatment of schizophrenia in 2010. Since that time Latuda has been approved for use in the treatment of bipolar depression. While the use of anti-depressants in bipolar depression remains a controversial issue, the prescribed use through an experienced and well-practiced psychiatrist does have positive results and provides those with bipolar depression another treatment choice option that helps to alleviate depression symptoms.

Over the past year I have used Latuda for more than 100 patients. It has been quite helpful for many of these patients who have bipolar depression and/or treatment resistant depression. It usually does not cause weight gain. Latuda is a member of the second-generation antipsychotic medicines. The other members are Zyprexa, Risperdal, Seroquel, Abilify, Geodon, Fanapt, and Saphris. It appears that the only member of the family that is equally less apt to cause weight gain is Geodon. However, Geodon does not have an indication for bipolar depression and more often causes restlessness or muscle pulling then does Latuda.

Most insurances cover Latuda now. It costs several hundred dollars per month if you have no insurance. However, the company provides free Latuda through their patient assistance program to those who qualify.

Common Side Effects of Latuda

Patient reports indicate that the use of Latuda has been well tolerated. Some of the most common side-effects documented include:

  • Somnolence or a strong desire to sleep which affects 22% of patients
  • Akathisia or a feeling of inner restlessness that makes it difficult to sit or stay still for long periods of time; this side-effect is reported in 15% of patients
  • Nausea has been reported in 12% of patients
  • Fasting glucose levels have shown a significant increase in up to 14% of patients

Less common side-effects patients complain of include:

  • Muscle stiffness
  • Muscle twitching
  • Uncontrollable movements of the eyes, lips, tongue, face, arms or legs

Many to all of the side effects from use of Latuda are often dosage related. Your psychiatrist can often control the degree or impact of the side-effects by changing the dose prescribed. In addition to Latuda, your bipolar depression practitioner may utilize other medications and adjunct therapies that as a whole treatment regime bring the highest level of success for the management and treatment of bipolar depression.

Bipolar Depression Psychiatrist

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Dangers of Psychiatric Self-Diagnosis

Proper psychiatric diagnosis requires expert clinical knowledge, extensive training and a foundation from years of experience working in the field. In addition, a comprehensive understanding of psychological disorders and how they are related to one another can make a critical difference in choosing which treatment plan will be the most effective and successful.

Self-Diagnosis Delays and Prevents Correct Treatment

Psychology Today reports that with the ease of being able to “Google” anything today, hundreds of thousands of people self-diagnose reaching their own conclusions about what may or may not be “wrong.” Unfortunately self-diagnosis is often incorrect, delaying and often preventing proper treatment. For example, almost 70% of people who report anxiety as their main concern also have depression – with self-diagnosis, a second or even third disorder which needs to be treated can be completely overlooked.

Medical Problems Missed in Psychiatric Self-Diagnosis

While there is always a danger with the process of self-diagnosis of a psychological syndrome, one of the greatest dangers is that a serious medical disease may be missed. It is not uncommon for a medical problem to masquerade as a psychiatric syndrome, such as those that present with changes to their personality, depression, or psychotic behaviors – treating symptoms with over the counter medications from self-diagnosis would not be the proper treatment when the correct diagnosis may be a serious neurological, cardiac, or endocrine problem.

Common Dangers of Psychiatric Self-Diagnosis

When self-diagnosis is wrong then proper care and treatment can be delayed or the wrong treatment can be instituted which can negatively affect any hoped for outcomes. Receiving a proper diagnosis takes a well experienced psychiatrist or mental health professional to not only determine what the problem is, but to sort through what the problem is not. Some common dangers of psychiatric self-diagnosis include:

  • Missing the nuances a proper diagnosis demands – those with mood swings for example may self-diagnose manic-depression or bipolar disorder when they may have a borderline personality disorder with major depression, other complicating factors or different combinations of diagnoses altogether
  • Misdirecting the mental health professional with complaints related to self-diagnosis
  • Providing self-treatment based on an incorrect decision
  • Denial or inability to correctly interpret symptoms and behaviors displayed that disrupt one’s life
  • Many personality disorders are not openly reported as they are a problem to others, not one’s self

Self-Diagnosis versus Clinical Diagnosis

Self-diagnosis can have life-impacting consequences on one’s life. Discussing symptoms and noted behaviors with a clinical specialist is imperative to starting the treatment strategy that fits and is successful. If symptoms or behaviors are causing distress in your home, work or social situations, seek out a professional. There’s no issue with educating yourself about symptoms; however, leave the diagnosis to an experienced psychiatrist. Please call the office to set up an appointment and make sure you get the right diagnosis.

The Many Faces of Mental Illness

Mental illness may affect someone as close to you as your next door neighbor, or mental illness may be a reality you or a family member will come to face. If you’ve been struggling but have never sought treatment for a mental health issue before, it’s common that over time the ability to cope with ordinary life demands may reach a point that help is finally sought.

Mental Illness Surrounds All of Us

Twenty-five percent of adults experience mental illness in any given year; the percentage takes on an even more personal importance when saying one out of every four adults suffer with some form of mental illness. One-out-of-four brings the issue home. The National Alliance on Mental Illness reports one-out-of-four means that over 60 million adults in the U.S. who may have difficulty coping with life, and many who may be living life unfulfilled who could be on the road to positive change working with a practiced mental health professional.

Symptoms of Mental Illness

The Canadian Alliance on Mental Illness and Mental Health indicates that having a mental illness does not mean an emotional reaction to an event or situation – it is normal to experience feelings, for example, of sadness, loss, anger, fear, agitation or panic related to a real-life occurrence. With the wide variety of diagnosed mental disorders, the combination of different symptoms needs to persist over time and dramatically impact one’s life roles, social and family relationships, work history, behavior, or even the ability to perform basic self-care and hygiene.

Stigma of Mental Illness

With one-out-of-four experiencing mental illness and one-out-of-17 living with a serious mental illness like bipolar disorder, schizophrenia, and major depression, one would think the awareness and willingness to seek help would be commonplace. Typically however, people wait a long time to seek help, if they ask for help at all.  The person may know something is wrong, or that they are “different,” yet they fight through life struggling to get by.

Reality of Mental Illness

Anyone of any age, religion, race, or socio-economic background can have a mental illness. Being diagnosed with a mental illness does not mean that you are a weak person, or that if you really wanted you could “get over it.”  The reality is that you can recover with treatment. Stop waiting to make the decision to get help; your life is waiting to begin anew.

Atlanta Mental Illness Psychiatrist

Dr. Darvin Hege is a psychiatrist in Atlanta. Call to set up an appointment and make a change for the better.

Dual Diagnosis Brings Complex Challenges

The U.S. National Survey on Drug Use and Health found that almost 8 million adults have both a mental illness and a co-occurring substance abuse problem. This “Dual Diagnosis” describes a complex relationship where those with mental health issues also have a problem with substance abuse, and likewise, those with a substance abuse problem who also have a psychiatric disorder. Dual diagnosis requires a mental health practitioner experienced in the complex and often complicated treatment strategy.

Confusing Symptoms with Dual or Co-Occurring Disorders

It can be difficult to diagnose a psychiatric illness in those who are substance abusers because it is common for drug abusers to exhibit psychiatric symptoms. The National Alliance of Mental Illness reports that psychiatric disorders induced by substance abuse can continue to impact a person’s life long after the drug or alcohol abuse has been curtailed.

Substance abuse can trigger panic attacks, depression, severe anxiety, delusional thoughts, personality disorder, and even psychotic behavior, all of which may continue to plague a person long after detoxification. Proper dual diagnosis is critical in establishing a successful treatment plan.

Dual Diagnosis Requires Specific Treatment Planning

Dual diagnosis needs a specially designed treatment plan, as dual disorders also come with an increased severity of medical, social and emotional issues. Dual disorders alone increases the chance of relapse as well as the psychiatric disorder becoming more pronounced in daily life functions. In addition, those with a dual diagnosis generally require a longer period of treatment with more gradual evidence of progress seen over time.

Complex Challenges of Dual Diagnosis

Dual diagnosis typically come with an increased rate of relapse, hospitalization, and homelessness, not to mention an increased chance of developing HIV or Hepatitis C infections due to risk-taking behaviors. The combinations of mental health disorders and forms of substance abuse that can be diagnosed show great variability, and thus each person with a co-occurring diagnosis does need their complex treatment plan uniquely constructed.

Severity of Disorders Change Over Time

Being followed and managed by a competent dual diagnosis psychiatrist is a priority for treatment plan success. Either diagnosis, whether of a mental illness disorder or substance abuse, may be evaluated as one or the other being severe or mild, or both severe — or by the degree of impairment they bring to daily life functions. The severity levels and impact change over time with the treatment plan modified to properly meet changing needs as they occur.

Atlanta Dual Diagnosis Psychiatrist

Dr. Darvin Hege is the Atlanta dual diagnosis psychiatrist of choice and expert in the field. Call the office for an appointment to start getting your life back under control.

Psychiatric Meds: Generic vs Brand Name

If times are tight, the search for ways to find discounts or save money is a common occurrence. Generic medications are often substituted when allowed, primarily due to insurance coverage policy or as a means to reduce co-pay cost out-of-pocket. Many prescribed physical health medications are used long term for chronic health issues or disorders, just as treatment for psychiatric and mental health conditions often involve long term pharmacological treatment. The monetary savings however may not be in the patient’s best interest who may discover generic is not the “right fit” for their needs.

Generic and Brand Name Psych Med Differences

The FDA’s definition of a generic drug is that it is pharmaceutically equivalent to its brand name drug, containing the same active ingredient, same strength, same dosage form as well as delivery of drug (i.e., swallowed, a patch worn, or injected). The generic version must perform approximately the same as the brand name drug. The key word approximately indicates that there will be a small or slight difference in the manufacture of the generic drug, whether it be inert ingredients added, coloring or dye used, as well as the shape or form.  In addition, the pharmacy uses a variety of manufacturers so that while the prescription itself may not change, the medication may appear different from month to month.

Generic Psychiatric Medication Concerns

While the majority who take generic psychiatric medications experience no problems, there are thousands who face increased side effects, exacerbation of their mental health symptoms, behavioral changes, development of allergies or a significant relapse that could require hospitalization. Generic psychiatric medications are supposed to deliver the same amount of active ingredient to receptors in the brain, however differences in the formulation of the product may cause more harm than help. An experienced and practiced psychiatrist is able to work with you on finding a generic medication that will work, as well as modification of the drug, dose or timing so that cost savings can be achieved without loss of mental health gain.

Top 10 Psychiatric Generic – Brand Name Medications

The top 10 prescribed U.S. psychiatric medications are ranked in a study. The medication with the highest ranking is Xanax or alprazolam used for anxiety at almost 48 million prescriptions per year. The psychiatric medication Seroquel or quetiapine, typically used for bipolar disorder or depression is ranked number 10 with over 14 million scripts per year.  The other psychiatric medications ranked in the top 10 of prescribed meds are Celexa/citalopram, Zoloft/sertraline, Ativan/lorazepam, Prozac/fluoxetine HCL, Lexapro/escitalopram, Desyrel/trazodone HCL, Cymbalta/duloxetine, and Valium/diazepam – in total, the top 10 ranking prescriptions exceed 270,000,000 a year. Working with an expert in both generic and brand name psychiatric medication is the best way to ensure you have a successful mental health treatment plan.

Atlanta Psychiatric Medication Doctor

Call Dr. Darvin Hege, the Atlanta psychiatrist of choice for successful medication management of your mental health needs using generic, brand name or a combination of psychiatric medications that work for you.

Risk of Psychiatric Disorder after TBI

Psychiatric News reported on studies that shows after a traumatic brain injury, TBI, there is an increased risk of developing a psychiatric disorder. The most common disorders found after a TBI are PTSD, panic or anxiety disorder, depression and social phobias. In addition, significant complaints that impact daily life include problems with memory, sleep, concentration and focus. In the U.S., with some 2 million sustaining a TBI every year, it is important to increase awareness to psychological, emotional and physiological problems that can occur after TBI.

TBI Increases Risk of Psychiatric Disorder to Over 400%

A 30+ year study the American Journal of Psychiatry just published in April 2014 shows dramatic increases of the development of a major psychiatric disorder after a TBI, while pre-existing mental illness can increase the severity of the symptoms. Developing bipolar disorder risk increased by 28%, depression increased by 59%, a diagnosis of schizophrenia increased by 65%, and the development of organic mental disorders increased by 439%. Research data presented illustrates that the additional risk was not credited to any family history of psychiatric illness, nor was the risk of a TBI shown to happen more to someone who was accident prone.

Mental Health Illness after TBI Needs Psychiatric Evaluation

With increasing awareness of the all-encompassing impact a TBI can have on the emotional, psychological health and well-being of a person, earlier diagnosis and proper treatment can begin for any developing psychiatric disorders. Finding a qualified psychiatrist experienced in frequent initial medication adjustments and modification following a diagnosis of psychiatric disorder after a TBI is critical.  Mental health illness responds to pharmacological treatment no matter if the disorder developed from a TBI or not.

Atlanta TBI Psychiatric Disorder Specialist

If mental health concerns begin to interfere with your life after a concussion, closed head injury, or TBI, it is time for a comprehensive psychiatric evaluation to determine if a psychiatric treatment plan is in order. Contact us for help.

Time for Spring Mental Health Checkups

Spring is the time of year where spring cleaning and spring checkups are the norm. It can also be a great time to have a mental health checkup and address any concerns about changes in behavior or personality. Psych Central reports on the study by a United Kingdom neuroscientist indicate that one out of four adults suffer from a mental disorder at some point during the year. In addition, in the U.S., Canada, and the UK, mental disorders are the leading cause of disability with depression and anxiety diagnoses occurring most often.

Early Detection with Spring Mental Health Checkups

Psychological well-being is often taken for granted. When a mental illness or disorder begins to impact your work, social or home life, it is an important time to seek mental health evaluation and guidance. Early detection, discovered during a mental health checkup for example, provides for early treatment through a combination of a pharmacological plan and cognitive behavioral therapy. The idea of a spring mental health checkup along with increased education of the public may improve not only the ability to recognize early mental health problems, but may result in early detection and intervention.

10 Most Common Mental Health Disorders reports spring mental health checkups given by qualified mental health disorder psychiatrists may provide early detection of a mental health illness. Early detection and treatment through an experienced practitioner can put your disruptive behaviors or fears into check and allow you to get back to enjoying life once again. The 10 most common mental health disorders in the U.S. are:

  1. Mood Disorders
  2. Personality Disorders
  3. Eating Disorders
  4. ADHD
  5. Phobias/Fear
  6. Anxiety Disorder
  7. Panic Attacks
  8. Bi-Polar
  9. Schizophrenia
  10. Autism Spectrum Disorders

Spring Mental Health Checkups in Atlanta

If new, old or changing behaviors, personality or mental health have started to concern you or your family, it may be time to have a spring mental health checkup.

Call Dr. Darvin Hege to schedule a checkup today.

Chronic Stress Leads to Mental Health Disorders

In today’s world, living with daily stress has become a common complaint across the nation and the world. Regular stress factors include common fears and anxiety related to random acts of violence or attacks in previously “safe” locations like malls, movie theaters, while riding public transit or in attending classes at universities and public schools. Newly released studies from the University of California at Berkeley have discovered that those who suffer from chronic stress in their lives experience long term changes in areas of the brain that govern emotion and memory. These changes within brain structure have been determined to increase the propensity to develop mood disorders and anxiety.

Chronic Stress on Brain Function

Researchers from the Berkeley campus report in the Journal of Molecular Psychiatry that living with chronic stress or emotional trauma has the direct effect of disrupting the delicate balance of neurons and their synaptic communication sequence. This disruption is often revealed by demonstration of an inappropriate flight or fight response, the development of a quicker fear response, and a decreased ability to self-monitor or adjust the mix of physiological and emotional responses.

Stress vs. Chronic Stress

Stress can be a positive force at times, making a person more aware of their surroundings after a stressful encounter like a car accident or violent attack. Stress can also help push a person to perform at a higher level, learn new ways to live with or reduce stress, increase the communication between family, friends or with others who are experiencing the same or similar stress trigger, or to finish work by a specific deadline. Chronic stress creates a regular constant bombardment of thoughts, feelings, doubts, fear or anxiety that acts to wear the body and mind down. Living with chronic stress has a significant negative impact on both the emotional state of mental health and the body’s physiological state, and can develop into PTSD (post traumatic stress disorder).

Common Reasons We Bring Stress into Our Lives

Stress and stressors can be found in some degree in most everyone’s life. Stress can occur at home, at work, school, while driving, while witnessing a crime, for financial reasons, for those going through a relationship breakup, for those trying to manage 2 or 3 jobs, for those dealing with unemployment and the reality of becoming homeless, or even due to over-commitment where you “cannot say no.” While it may be impossible to remove some stressors, seeking professional mental health services is a good choice – working with a qualified mental health practitioner has a high success rate in treating chronic stress.

Atlanta Chronic Stress Psychiatrist

Call Dr. Hege Atlanta chronic stress psychiatrist for a successful individualized treatment plan that will bring calm back into your life.

Psychiatric Misdiagnosis Delays Proper Treatment

Seeking help for mental illness or instability is a hard yet courageous step to take. Finding out that you have a psychiatric disorder or chronic mental illness is a scary time for most people, yet finding out years later that you were wrongly diagnosed in the first place can be even more frightening.

Misdiagnosis Occurs 69% of Time

Health Line reports wrongly diagnosing personality disorders as a bipolar disorder occurs 69% of the time. In addition to this erroneous diagnosis, more than 33% remain misdiagnosed for a decade or more; the remainder live with the incorrect treatment for a period of between 6 and 7 ½ years. Because some psychiatric or mental health issues may be hard to pinpoint depending on the phase or cycle of the disorder, it is critically important to find a qualified and experienced mental health practitioner.

Misdiagnosis Brings Serious Consequences

Brown University reported on a 4 year study showing 40% of patients diagnosed with bipolar disorder were later correctly identified as having a borderline personality disorder, major depressive disorder, antisocial personality disorder, post-traumatic stress disorder or with having an eating and impulse disorder. One major consequence of having a wrong diagnosis means that it is followed by the wrong treatment. Bipolar disorder may be treated with a mood stabilizer, yet treatment for borderline personality disorder follows a different path. Prescribing bipolar medications to someone without bipolar disorder needlessly exposes the patient to serious medication side effects that include a medical impact to renal, hepatic, immunologic and metabolic functions that can have life threatening consequences.

True Bipolar Disorder Also Misdiagnosed

Bipolar disorder is a biological illness where specific medications are essential for treatment. It is a chronic illness that requires life-long treatment and monitoring. Health Line reports that while many patients are misdiagnosed with bipolar disease, it is not uncommon for a bipolar diagnosis to be missed as most patients will seek out treatment during the depressed phase of their bipolar cycle. Mental health professionals may see the depressed state as just that and give a misdiagnosis of unipolar depression, or some other form of depression. Finding a qualified psychiatrist or mental health professional who is capable of making the correct diagnosis is important in that it will point the way to the right effective treatment – not to years of suffering through an incorrect treatment plan.

Atlanta Diagnostic Psychiatrist

Misdiagnosis is a common problem that can impact not only the patient’s life, but their family’s lives for 5 to 10 years before the correct diagnosis and treatment is discovered. Dr. Darvin Hege is a highly regarded Atlanta psychiatric doctor with decades of experience and decades of developing a successful treatment plan for his patients. Call for an appointment today – help really is only a phone call away.