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Stress And Depression


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Stress And Depression

  1. 1. <ul><li>Severe Persistent Stress, Depression </li></ul><ul><li>& Addiction </li></ul>
  2. 2. Stress A Challenge or Condition Which Forces Physiological and Neurological Systems to Move Outside of the Norm. Moderate and Controllable Stress is Vital to Development.
  3. 3. The Brain is Designed to Change in Response to Pattered Repetitive Stimulation . <ul><li>Neurosystems Activated Repeatedly can Change in Permanent Ways. </li></ul><ul><li>The More the Systems are Activated the More it Evolves – Becomes Engrained. </li></ul>
  4. 4. Severe, Unpredictable, Prolonged or Chronic Stress <ul><li>Compensatory Mechanisms are Over Activated or Fatigued </li></ul><ul><ul><li>The Brain learns to function in a constant state of ‘fight or flight’. </li></ul></ul><ul><li>Can Not Restore Normal Equilibrium </li></ul><ul><li>The New ‘Forced’ Homeostasis Requires more Energy to Maintain </li></ul>
  5. 5. <ul><li>Neural Systems Respond to Sustained </li></ul><ul><li>or Chronic Stress by Altering Neurochemical and Synaptic Organizations . </li></ul><ul><li>Stress Changes the way the Brain Functions. </li></ul><ul><li>With severe, prolonged or unpredictable stress the changes can be permanent. </li></ul>
  6. 6. Norepinephrine <ul><li>As a neurotransmitter, norepinephrine helps to regulate arousal, dreaming, and moods. </li></ul><ul><li>As a hormone, norepinephrine acts to increase blood pressure, constrict blood vessels, and increase heart rate - responses that occur when we feel stress. </li></ul>
  7. 7. Amygdala <ul><li>Center for processing, interpreting and integrating emotions </li></ul><ul><li>Plays central role in determining how much emotional value to place on Sensory inputs </li></ul><ul><li>Stores memories of Fear </li></ul><ul><li>Amygdala does not have a sense of time. </li></ul><ul><ul><li>Can’t distinguish between old fear & current fear. </li></ul></ul>
  8. 8. Endorphins <ul><li>Endogenous Opioids – Responsible for Numbing Pain During Trauma </li></ul><ul><li>Creates a Rebound Effect when Numbing Effects Begin to Wear Off. </li></ul><ul><li>Numbing Effect can be Recreated with Alcohol or Opiate use. </li></ul><ul><li>Once the Brain Creates a Connection Between AOD use and the Numbing Effect Cravings Start. </li></ul>
  9. 9. <ul><li>Brain will often experience ‘numbness’ in response to little reminders of trauma – the brain releases endorphins. </li></ul><ul><li>Eventually the Brain over compensates for the increased levels of endorphins by releasing suppressants. </li></ul><ul><li>As the suppressant system becomes stronger a Deficit is created – resulting in endorphin withdrawal. </li></ul>
  10. 10. Alcohol Increases Endorphin Activity <ul><li>Thus Alcohol aids in fighting the withdrawal. </li></ul><ul><li>As would Heroin and Cocaine. </li></ul><ul><li>AOD use reproduces the ‘numbing effect’. </li></ul>
  11. 11. Therapy <ul><li>Memories brought up in therapy can increase endorphins. </li></ul><ul><li>The Numbing effect can interfere with a persons ability to engage in therapy. </li></ul><ul><li>May also increase or restart cravings. </li></ul>
  12. 12. Stress Alters the Arousal Baseline <ul><li>Internal calm is rarely achieved </li></ul><ul><li>More sensitive to similar stressors. </li></ul><ul><li>Will have sensitized alarm response </li></ul><ul><ul><li>Over reading verbal & nonverbal cues as threatening. </li></ul></ul><ul><ul><li>Often leads to violent behaviors as a defense mechanism. </li></ul></ul>
  13. 13. Stress Sensitization <ul><li>Hyper vigilance – waiting for the other shoe to fall. </li></ul><ul><li>Increase Startle Response </li></ul><ul><li>Affective Labiality – mood swings </li></ul><ul><li>Anxiety </li></ul><ul><li>Dysphoria – depression </li></ul><ul><li>Difficulty Concentrating </li></ul>
  14. 14. Lasting changes to: <ul><li>Hypothalamus – controlling memory </li></ul><ul><li>Amigdala – interpretation of threat </li></ul><ul><li>Pituitary and Adrenal Systems – stress and mood regulation </li></ul><ul><li>Nuerotransmitters – mood regulation </li></ul><ul><ul><li>Epinephrine </li></ul></ul><ul><ul><li>Norepinephrin </li></ul></ul><ul><ul><li>Dopamine </li></ul></ul><ul><ul><li>Serotonergic </li></ul></ul>
  15. 15. Neurological Changes are often Unnoticed or Misdiagnosed <ul><li>Often looks like: </li></ul><ul><li>ADHD </li></ul><ul><li>Depression </li></ul><ul><li>Bipolar Disorder </li></ul>
  16. 16. PTSD Symptoms in Children <ul><li>Impulsivity </li></ul><ul><li>Distractibility </li></ul><ul><li>Attention Problems </li></ul><ul><li>Hypervigilance </li></ul><ul><li>Dysphoria, </li></ul><ul><li>Numbing </li></ul><ul><li>Social Avoidance </li></ul><ul><li>Dissociation </li></ul><ul><li>Chemical Dissociation </li></ul><ul><li>Sleep Problems </li></ul><ul><li>Aggression </li></ul><ul><li>Regressed or Delayed Development </li></ul>
  17. 17. <ul><li>Females </li></ul><ul><li>tend to present more internal symptoms: </li></ul><ul><li>Anxiety </li></ul><ul><li>Dysphoria </li></ul><ul><li>Dissociation </li></ul><ul><li>Avoidance </li></ul><ul><li>Males </li></ul><ul><li>tend to present more external symptoms: </li></ul><ul><li>Impulsivity </li></ul><ul><li>Aggression </li></ul><ul><li>Inattention </li></ul><ul><li>Hyperactivity </li></ul>
  18. 18. Alcohol and Other Drug Use <ul><li>Often an attempt to self-medicate </li></ul><ul><li>Chemical Dissociation </li></ul><ul><li>Attempts to cope with Affect Disregulation </li></ul><ul><ul><li>difficulty regulating emotional distress usually due to a lack of coping skills. </li></ul></ul><ul><li>There is an extremely high correlation between abuse, affective disorders and addiction, especially in women. </li></ul>
  19. 19. Trauma, Addiction and Women <ul><li>Women substance abusers are 39 – 52% more likely to have a Dual Diagnosis of Addiction and PTSD </li></ul><ul><ul><li>commonly originating from repetitive childhood physical or sexual assault. </li></ul></ul><ul><li>Women who have been traumatized have an quicker onset of addiction than do women who have not experienced trauma. </li></ul>
  20. 20. Addiction and Trauma Among Men <ul><li>Studies suggest that the correlation between PTSD and Addiction is higher in men that: </li></ul><ul><ul><li>Witnessed Domestic Violence </li></ul></ul><ul><ul><li>Experienced Covert sexual abuse </li></ul></ul><ul><ul><li>Witnessed the abuse of siblings </li></ul></ul><ul><ul><ul><li>These rates are higher than men who were the victim of abuse </li></ul></ul></ul><ul><ul><li>Were victims of violent crimes or combat veterans </li></ul></ul><ul><ul><li>Related to the inability to create any change in these types of situations </li></ul></ul>
  21. 21. <ul><li>Adolescent males are commonly misdiagnosed as having a conduct disordered or ADHD. </li></ul><ul><li>Men often labeled Antisocial or Bipolar </li></ul><ul><ul><li>The symptoms of addiction and PTSD are very similar to all of the above. </li></ul></ul><ul><li>Violence, Anger or Disregard for others are often a ‘mask’ to defend against further victimization. </li></ul><ul><ul><li>Misdiagnosis easily done without sufficient information/history </li></ul></ul>
  22. 22. <ul><li>Some of the social maladjustments arising from abuse are: </li></ul><ul><ul><li>Alcoholism & drug addiction </li></ul></ul><ul><ul><li>Self-injury, prostitution, promiscuity </li></ul></ul><ul><ul><li>Eating or sleeping disorders </li></ul></ul><ul><ul><li>Inability to trust, perfectionism, phobias, avoidance of both intimacy and emotional bonding </li></ul></ul><ul><ul><li>Anxiety / depression </li></ul></ul><ul><ul><li>Distrust of perceptions or feelings </li></ul></ul><ul><ul><li>Negative personal beliefs / Low self esteem </li></ul></ul>
  23. 23. The Cycle of Depression and Negative Cognitions <ul><li>Victims of Abuse often have extremely negative thoughts about themselves and others. </li></ul><ul><li>These thought process become engrained. </li></ul><ul><ul><li>Similar to a path through the woods </li></ul></ul><ul><li>These engrained negative thoughts feed the depression just as the depression feeds negative thoughts. </li></ul><ul><li>Must Retrain the brain to think differently – ‘fake it till you make it’ </li></ul>
  24. 24. Therapy Options <ul><li>Group or Individual Psychotherapy </li></ul><ul><li>EMDR – Eye Movement Desensitization and Reprocessing </li></ul><ul><li>Medication </li></ul><ul><li>Cognitive Behavioral therapy </li></ul>
  25. 25. Research shows: <ul><li>Medication and Therapy together have higher rates of success than either do alone. </li></ul><ul><li>Relapse rates decrease when depression, PTSD and addiction are treated simultaneously. </li></ul><ul><li>Untreated PTSD significantly increases relapse rates. </li></ul>
  26. 26. Research also shows <ul><li>The effectiveness of therapy is determined as much or more by the therapist than by theoretical orientation. </li></ul><ul><ul><li>How does the therapist or counselor make you feel? </li></ul></ul><ul><li>This is vital to successful therapeutic experience. </li></ul>
  27. 27. <ul><li>A Place Called ‘ There ’ Counseling </li></ul><ul><li>Autumn Austin, MA, LPC, CGP, CSAC </li></ul><ul><li>1135 Four Lakes Dr. Suite A </li></ul><ul><li>Matthews, NC 28105 </li></ul><ul><li>704-651-0668 </li></ul><ul><li> </li></ul>