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How Important is Biology in Mental Health?

July 17, 2021

Biology Trumps Psychology

The myriad of mental health issues that exist are very real and have a profound impact on countless Americans. It is important to get an accurate diagnosis in order for the problem to be effectively treated. The vast majority of mental health issues are just that, mental health issues. However, there are dozens of medical, biological, chemical issues that can manifest as mental health issues. In these instances, treating the mental health symptoms, such as depression, may fail to address the true source of the symptoms. Before diagnosing a mental health disorder, it is critical to be on the lookout for possible medical conditions and rule them out. If there is an underlying medical condition, things will not improve or get better. This is an instance where biology trumps psychology.

Self-Advocacy and Thorough Assessment

Whether you are the patient or the provider, it is important that you be aware and on the lookout for biological and medical causes for mental health symptoms. It is important not to confuse symptoms for their causes. For example, don’t assume depressive symptoms automatically mean depression, or that psychotic symptoms automatically mean schizophrenia. If you are the patient presenting with mental health symptoms and you have no history of mental health problems and no obvious stressors (divorce, job loss, etc.) tha read more

June 16, 2021

In the last article in this series on emotional regulation, we talked about the natural order of emotions. Operating properly, children and adults alike, experience an emotion internally, and then we express the emotion outwardly. We also discussed a number of factors that cause many boys and men to avoid expressing their feelings. In this article, we will discuss how it is people hinder and interfere with the natural desire to express feelings. Given all the cultural influences on boys and men around emotional expression, many guys come to realize they are only socially allowed, or encouraged, the expression of two feelings: happy and angry. Guys are permitted to joke around and laugh, and they can express and display anger without any negative disapproval (unless the anger becomes violent). This is about it for socially sanctioned emotional expression. As a result, most guys begin overcontrolling and suppressing their other feelings like guilt, sadness, fear, hurt, etc. Unfortunately, for most guys they begin the act of suppression at a very young age; often between 6-10 years old when they start receiving negative messages for the expression of more vulnerable emotions. At this tender age this requires some active and conscious effort to keep these feelings from coming out. Over time, with enough time and practice, routine suppression of feelings becomes second nature and ev read more

May 22, 2021

For generations, women have complained about the men in their lives being stoic, flat, unemotional, and even like robots. Whether it is their father, boss, or significant other, many women find it nearly impossible to get an emotional response to the question, “How are you feeling?” Keep in mind this phenomenon is not exclusive to men, as we certainly see some women end up in this place, just as we know there are some men who are very capable of being emotional. In clinical practice, it seems about 80% of men struggle with emotions and about 10-15% of women struggle with expressing emotions. In this three-part series, we will discuss how so many men come to be so emotionally restrained. In the second article, we will discuss how it is that men are able to interfere and hamper their own emotional expression. In the final article, we will discuss the path back to emotionality for our men.

The Two Part Emotional Process

When it comes to feelings, there are broadly speaking, two main components to the process: the experience and the expression. We see many men who believe they are quite in touch with their internal experience of emotions in that they can label and identify what they are feeling on the inside. Some guys are confused about what they are experiencing, and others rarely feel anything on the inside. Where most guys fall down is on the expression side of the read more

May 8, 2021

Although most people believe depression is the number one mental health issue, it’s actually anxiety. There are many more cases of anxiety and it can manifest in a variety of forms such as: Generalized Anxiety Disorder, Panic Disorder, Social Phobia, and Obsessive-Compulsive Disorder (OCD) to name the more common ones. In most cases, the best treatment option depends on the diagnosis and the particular issues going on in a person’s life. Based on these variables’ healthcare professionals try to figure out the best treatment plan. Anti-anxiety medications are often part of the treatment plan when treating anxiety disorders. Broadly speaking most anxiety disorders are treated with antidepressants, benzodiazepines, or a few atypical anti-anxiety medications.

Generalized Anxiety Disorder

Generalized Anxiety Disorder is characterized by excessive worry, rumination, and preoccupation that is intrusive and affects concentration, sleep, and energy level to name just a few symptoms. In most cases, generalized anxiety disorder responds quite well to antidepressants. There are a wide variety of antidepressants that generally target the neurotransmitters for serotonin and norepinephrine. These medications need to be taken daily and generally take 3-6 weeks to build up in the bloodstream and provide some symptom relief. Most people notice improvements in sleep, appetite, ener read more

April 24, 2021

Bipolar Disorder is a very serious type of depression that was formerly known as Manic Depression. Treatment for bipolar disorder differs from treatment for more traditional forms of depression, often using a class of medications called mood stabilizers. In this article, we will talk about how bipolar disorder differs from regular depression and about the best treatment options for it.

Bipolar Disorder Symptoms

Bipolar disorder includes a depressive phase that is very similar to that of traditional depression and includes symptoms such as:

  1. Having a depressed (sad or empty) mood most of the day.
  2. Loss of interest or pleasure in usually enjoyable activities.
  3. Appetite/weight gain or loss.
  4. Disturbed sleep (insomnia or excess sleep).
  5. Lowered energy level/fatigue.
  6. Restlessness or feeling slowed down.
  7. Feelings of worthlessness or excessive guilt.
  8. Indecisiveness or lack of concentration.
  9. Suicidal thoughts or feelings.

With traditional depression, these symptoms are usually persisting for weeks, months, or years. With bipolar disorder, the depressed phase tends to last for a shorter period of time, typically 2-3 weeks on average. Additionally, with regular depression, there are often situational read more

March 14, 2021

Many people use the terms guilt and shame interchangeably and are not even really sure what makes them different. There are important differences; especially in terms of the impact they can have on you and how you address them. Let’s look at what makes guilt and shame differently. Guilt: Is an emotion that occurs as an automatic reaction to acting against one’s own morals and values. For example, if Bill values honesty, but he goes home and lies to his wife, he will suddenly feel guilty. Interestingly, the purpose of function of guilt is that it is designed to get you back in alignment with your values, i.e., to be a good person. In our example above, Bill’s guilt will hopefully propel him to get honest with his wife, or simply stop lying to her in the future. Shame: Is an emotion that occurs in reaction to a perception of self-defectiveness. For instance, Beth might believe there is something bad or wrong with her when a guy didn’t call her for a second date. In many instances shame causes people to hide parts of themselves that they believe are self-defective from others in an effort to avoid humiliation. Most people who do this only allow others to see and interact with the persona they portray, because of the fear that if they were genuine and real, they would be humiliated in front of others. The primary diff read more

January 3, 2021

Divorce Facts and Findings

Choosing to get a divorce is one of the biggest and most personal decisions a person can make. It’s a decision that has sweeping implications for everyone involved. It is almost always an upsetting event that leaves people feeling great disappointment and grieving the loss of hopes and dreams. Compounding these losses are people left trying to adjust and cope with the stressors that affect us legally, financially, emotionally, socially, as a parent, all the way down to logistically in terms of living space. For many this is perceived as the lesser of two evils as relationships have become too acrimonious, painful, and toxic. Most Americans believe that it is better to get a divorce than be in an unhappy and unproductive marriage. Overall, the divorce rate is declining, having gone from 50% of all marriages ending in divorce to only 39% recently. Millennials between the ages of 25-39, now comprise 60% of all divorces. Although age 30 is still the average age of divorce, the divorce rate in people over 50 has doubled since 1990 likely giving way to changes in former conservative beliefs in an era that has become more accepting of divorce. Next, let us look at the primary factors that cause divorce.

Causes of Divorce

There are countless reasons and cau read more

November 28, 2020

What is Self-Injury?

Self-injurious behavior (SIB) is self-harm, self-mutilation, or the deliberate act of causing pain or injury to your own body. Self-injurious behavior usually takes the form of cutting or burning, but can include scratching headbanging, or any other form of injury.

Who does Self-Injury?

Self-injurious behavior can occur at any age and any demographic; however, it is most common in teenagers and young adults. One recent study found that 6-14% of adolescent boys and 17-30% of adolescent girls engage in self-injury at some point. Most adults who engage in self-injury either have mental health issues or a history of self-injurious behavior.

Why People Injure Themselves?

Contrary to common perception, self-injurious behavior is rarely about suicidal ideation or intentions. Interestingly, it is typically about pent up and intense emotions that the person is struggling to deal with. Many people stumble upon this strategy to escape and avoid difficult emotions. When people engage in self-injury, pain receptors are activated and the brain goes into emergency mode to identify and alleviate the source of pain and injury. In the process, the brain prioritizes the physical pain from the self-injury and pushes all the emotions to the side in order to deal with the more immediate crisis at hand – the pain. In short, the infliction of physical read more

November 14, 2020

The experience of loss is an unfortunate reality that none of us can escape during our time here. Dealing with losses is one of the more difficult stressors that we all face at various times in our lives. Having an understanding of the process and ways to navigate this process can make it more tolerable. Grief and loss are not specific to the people we care about, nor does it mean the death of someone. Although someone passing away may be the most commonly associated with grief and loss, it also pertains to the break up of a relationship, loss of a job, end of a marriage, loss of abilities, loss of dreams, or treasured object to name just a few. The common denominator with loss is the attachment and strong feelings we possess about whatever it is we lost. Whether its familiarity, nostalgia, compassion, concern, or love, it is these feelings that bring about pain and sadness when we experience a loss.

Stages of Grief

Many people are familiar with the stages of grief which are denial, anger, bargaining, sadness, and acceptance. Many people experience these stages and it can be helpful to be familiar with them as it allows us to know what to anticipate and expect when dealing with grief and loss. It should be noted that not everyone goes through all of these stages and they often do not occur in a linear fashion. Often, we see people cycle through anger and sadness repeat read more

November 1, 2020

In the last article, we talked about the incredible impact and effect that suicide has on individuals, families, and the community. In this article we are going to talk about how to prevent suicide. With proper knowledge and awareness, there are things we can do to intervene and hopefully prevent unnecessary losses.

Predisposed Temperament

The greatest triad of factors that account for most suicides are a person’s predisposed temperament and genetic vulnerabilities, severe psychiatric illness, and acute psychological distress. A predisposed temperament can include things such as an impulsive nature, a tendency to be emotionally volatile and reactive, and genetic vulnerabilities can include a tendency to have mental health issues or even a family history of suicide. By severe psychiatric illness we are referring to severe depression, bipolar disorder, schizophrenia, and substance abuse. If one or more of these are going on, a person is it high risk for suicide. Acute psychological distress are often environmental factors such as loss of a job, divorce, or breakup of a relationship to name just a few. Whether it is yourself or a loved one, being alert and on the lookout for this perfect storm can let you know when you need to be aware and possibly intervene. Temperament may or may not change read more