 It’s been months since the first publicly confirmed case of COVID-19 hit Washington state at the end of February. Since then, we’ve all had to adjust to a new normal in order to move forward in health and safety. For many people, home has taken on a completely different meaning! It’s become a place to work, to learn, to exercise, and, most importantly, a place to stay safe from the dangers and risks of COVID-19. But for those affected by domestic violence, staying at home is anything but safe. In fact, new estimates from the United Nations Population Fund suggest that three months of quarantine will result in a 20 percent rise in IPV (“intimate partner violence”) throughout the world. Today’s lockdown measures appear to be fueling increased instances of domestic violence but the question still remains: why? The Dangers of IsolationIt’s well known that social isolation and loneliness can take a toll on your physical, mental and cognitive health. There’s a lot of discussion about the effects of isolation, loneliness, and depression, but we also need to put the spotlight on the impact isolation has on domestic violence. Unfortunately, social isolation is a common tactic abusers use to limit outside contact. By isolating someone from family, friends, and work, abusers are able to control their entire environment. This creates a cycle of abuse that can leave one feeling trapped with no way out. Increased StressStress isn't a psychiatric diagnosis, but it's closely linked to your mental health in a few ways. Increased stress can trigger for anger, irritability, and unhealthy outbursts which can all be contributing factors to increased reports of domestic abuse,” said Dr. Flatow, a Psychiatrist at Pacific Mind Health. Disease outbreaks can foster a type of stress due to fear of the unknown. Unlike natural disasters or catastrophes, it’s hard to look forward. There also economic anxiety and increased unemployment rates that can add to daily stress and trigger abuse. Substance AbuseMeanwhile, reports show that alcohol sales have skyrocketed as people continue to stay at home. We’ve seen liquor and wine stores remain open as “essential businesses” during the COVID-19 outbreak. Increased alcohol consumption coupled with the other factors listed above contribute to cases of domestic violence and abuse Help For Domestic AbuseIt’s important to know there are many resources for those affected by domestic abuse and violence even during the COVID-19 pandemic. Many women in abusive relationships find it difficult to trust others. Also, if and when they do reach out, they want reassurance and support knowing that something is available for their safety.
Reaching out isn’t always easy, but safety is essential during these challenging times. On a national level, the National Domestic Violence Hotline provides support through their hotline (1-800-799-7233) or online chat (thehotline.org). Locally, in the Long Beach area, the Women’s Shelter of Long Beach provides a 24/7 crisis hotline (562-437-4663). You can also find more information www.womenshelterlb.org.  Trying to find your way forward in life isn’t always easy. Sometimes it can feel like there’s no way forward, especially when you live with the heavy burden of depression day after day. It’s hard to even think about the future because depression breeds a continuous self-defeating cycle of sadness, stress, anxiety, and hopelessness making people feel stuck and misunderstood. When you live with depression, you spend your days trying to navigate through the fog hoping that maybe…just maybe…tomorrow will be different. Now, with Express TMS, there’s new hope in tomorrow. What To Do When Medications FailTreating disorders of the brain is just as important as treating disorders and conditions that affect your physical health. The goal of medication is to help people find healing and relief from symptoms. When people get sick, they go to the doctor looking for a cure. In some cases, routine treatments simply don’t work or cause unwanted side effects. And, in those cases, doctors move on to second-line treatments, alternative medicine, and off-label use of drugs to find healing and relief for patients. We see many examples of successful second-line treatments in life-threatening diseases such as cancer and diabetes. In fact, the advancement of modern medicine over the years has helped provide renewed hope and healing in many ways. Second-line and alternative treatments continue to help improve outcomes and quality of life for patients around the world and for that, we’re thankful. Major Depressive Disorder Affects Over 300 Million People Globally. In the field of psychiatry, we have successful second-line treatments that help our patients find relief when first-line treatments (like antidepressants) don’t work or cause unwanted side effects. We know that sometimes antidepressants and therapy aren’t enough. In fact, antidepressants don’t work for 30 percent of patients leaving them stuck in that self-defeating cycle of sadness, stress, and lingering hopelessness. So what do we do for the 30 percent of patients who fail to respond to first-line treatments such as antidepressants? Where can you turn if you’re sick of feeling sick… and tired… and generally miserable? Maybe you’ve tried medication after medication to no avail. You’ve increased doses and incorporated therapy but nothing seems like it can help lift the veil of depression. Now, Express TMS offers an alternative, non-invasive option with a high success rate. 3-Minute TMS Therapy - Come See Us On Your Lunch Break!We are very pleased to now be offering Theta Burst Stimulation (TBS) at Pacific Mind Health. This is a newly FDA- approved, 3-minute 'Express TMS' protocol which has been shown to have equal or better efficacy than traditional TMS protocols lasting 30+ minutes. This new treatment protocol minimizes time expenditure and discomfort and our state-of -the-art MagVenture TMS machine is one of the only TMS machines capable of delivering this type of treatment. “MagVenture is the only company to offer FDA cleared 3 minute TMS sessions and we’re happy to have this available for our patents at Pacific Mind Health,” said Dr. Mottsin Thomas. "This revolutionary TBS (theta burst) protocol is a faster TMS treatment that’s just as safe and effective for the treatment of major depressive disorder as standard TMS, only much faster. The ease and convenience of Express TMS works with busy schedules allowing our patients to come for treatment and get back to their day", said Thomas. Remission from depression is possible! If you’re one of the more than 4 million patients who does not receive adequate benefits from antidepressants and/or can’t tolerate the side effects caused by them, give our office a call today.
Our compassionate team is here to help you find a new way back to health and happiness through 3 Minute Express TMS Therapy. Give us a call today 562-279-0180 or fill out our form for a call back  Sometimes, when you live with depression, it’s not just one big thing. It's all of the little things that can really wear you down and make everyday life challenging. It’s the lingering sadness, anxiety, loss of interest, and general hopelessness that continue to build up and make it difficult to function. With depression, it can feel like life’s simply lost its flavor. Clinical depression is so much more than just having a bad day. In fact, depression is currently the leading cause of disability and poor health worldwide and it’s something that an estimated 1 in 6 Americans deal with each year. Luckily, many will find relief in medications and/or therapy. But what about the 30% of patients who still can’t find relief from their depression symptoms? TMS Therapy Can Offer Hope For ReliefFor that one-third of people, the symptoms continue to linger and build. They likely worsen over time and the heavy veil of depression makes it harder and harder to function. When patients don’t experience relief from medications, TMS Therapy offers new hope. TMS is a non-invasive therapy that involves no medication and has very few side effects”, said Dr. Mottsin Thomas . “When medications fail to proved relief for patents, TMS therapy might be more effective than trying yet another antidepressant medication.” TMS Therapy is an FDA cleared in 2008 and patients have been treated for major depression with TMS since the mid-1990s. This treatment uses MRI strength magnetic pulses that are delivered several times per second into the front part of the head.
The Results Can Be TransformativeIf you or a loved one suffers from depression, you might be wondering how anyone can really relate to what you’re going through. You want to get better, but it’s hard to see hope when you are living life in a fog. Maybe you’ve tried antidepressants without relief. Maybe the side effects from your current medications are weighing you down. Maybe the uncertainty, fear, and stress surrounding COVID-19 have taken a toll on your emotional wellness… We understand. Our team is here for you. Book A TMS Consultation TodayWhether it’s through medication, psychotherapy, or TMS Therapy, our team at Pacific Mind Health is dedicated to treating each individual with compassion while focusing on patient safety, comfort, and wellness. Untreated mental illnesses can cause frequent stress and affect your overall health and happiness in life.
You don’t have to walk through your struggles alone. At Pacific Mind Health, we’re committed to helping patients in our community find renewed hope and health through restorative state-of-the-art treatments like TMS Therapy. We’re here to provide the best in diagnosis and treatment to put you on the path to healing so can live your best life. Schedule your TMS Consultation today by connecting with our care coordinator 562-279-0180 or fill out our form  Welcome to May! We’ll be the first to admit that keeping track of time…or even what day it is…has proven to be somewhat challenging during the quarantine. But now it’s officially May and a great time to move forward in positivity. May is a well-known transitional month as we move from spring to summer. We get to celebrate Cinco de Mayo, Mother’s Day, and Memorial Day, but did you know that May is also Mental Health Month? That means we have the spotlight to help shed some light on the realities of mental and emotional wellbeing and the psychiatric conditions that threaten it. Mental Health Month: 'Tools 2 Thrive'More than just observing a month like this, let’s use the opportunity to learn what we can do to make a real difference in the life of someone who suffers from a mental health disorder. Mental Health America’s theme this year is “Tools 2 Thrive.” The goal is to help provide practical tools that everyone can use to improve their mental health and increase resiliency regardless of the situations they are dealing with (like COVID-19). “One in five people will experience mental illness during their lifetime, but all of us will have experiences that affect our mental health,” said Dr. Mottsin Thomas, a psychiatrist with Pacific Mind Health. “Destigmatizing mental illness is an important first step toward getting people the help that they need before they reach a point of crisis. This wonderful national campaign is something we fully support at Pacific Mind Health. The tools we use to help our patients thrive include everything from pharmacologic and therapy-based treatment to innovative treatments like IV Ketamine and TMS Therapy.”  As part of Mental Health Month, Mental Health America has put together a variety of screening tools that you can take individually or offer to a loved one who may be struggling. While these screenings do not take the place of a professional evaluation, they are useful in getting people to recognize symptoms in themselves and to spark dialogue about mental health care in general. We want to make it easy for you to get well and the right tools matter! Breaking The Burdens of ShameOne of the most important ways to #endthestigma surrounding mental health is to talk about mental health disorders openly just as we do with a physical illness like diabetes, cancer, or a heart condition to name a few. Depression is more than just having a bad day. It can be a crippling disorder that forces people to live under a veil of darkness… Anxiety Disorders can result in a debilitating cycle of persistent, excessive worry day after day… OCD is not a quirk, a preference for tidiness, or something that you can just ‘get over’ The more we make psychiatric disorders part of casual conversation, the further back we push the stigma associated with this suffering. Mental Health Awareness Helps Reduce The StigmaEven though we’ve come a long way over the past few decades when it comes to mental illnesses, we still have a long way to go in acceptance and normalization. The good news is mental health disorders like GAD, Major Depression, ADHD, and OCD are very treatable. The key is to get help as soon as possible. It is possible to lead a very happy and successful life, hold down a career, and have a strong social life despite having a mental illness. We’re thankful for celebrities who help us normalize mental illnesses by stepping out into the spotlight. Johnny Depp, David Beckham, Howie Mandel, Whoopi Goldberg, Jessica Alba, and Heather Locklear are just a few A-listers who’ve publicly shared their struggles. “It takes a lot of courage to say ‘My anxiety is flaring up and I need to take a break’ in the middle of a birthday party. Try it, though, and I suspect you’ll have a few other people who follow you to a quiet space,” said Dr. Joshua Flatow, a psychiatrist at Pacific Mind Health in Southern California. “More and more, as people are honest about their struggles, the stigma around mental illness fades. Mental Health Awareness month is intended to empower people to let go of any shame related to a diagnosis and to educate others about how they can openly and usefully support loved ones with mental health issues.”  Pacific Mind Health Can Help You ThriveMedication and therapy are often effective treatments for common mental illnesses. Our team also embraces Neuroscience breakthroughs by providing cutting-edge treatments like Ketamine and TMS Therapy for hard-to-treat cases of depression.
You can be free of depressive thoughts, despair, and that awful feeling that you don’t belong or fit in. You can live a full and rewarding life. Celebrate Mental Health Month by making your mental wellness a priority. It all starts with an evaluation - call today! It’s day - who knows what, of week - can anyone remember? and minute - at least 8 trillion of Quarantine 2020. Families are sequestered in homes that used to be places of comfort but now feel more like institutions of confinement. If you try to escape for a few minutes, don’t dare take a walk around the neighborhood without a mask or you’ll feel like Cersei on her “Shame” walk. Speaking of shame, has TikTok really become our best chance at modern human connection? All this time in isolation has given us lots of time to think. Normally we long for those quiet moments where our brains can have still reflection, but it is possible to get too much of a good thing. Especially for those with anxiety.  With anxiety, overthinking is a baseline. The brain spirals into thoughts that are often out of proportion with reality. No matter how hard you try, you can’t suppress them, and the frustration of being out of control feeds the anxiety even more. Sometimes it ultimately culminates in the near-death experience of a panic attack. You can’t breathe, your chest seizes up, your vision blurs, your arm goes numb, and your hands clench against your will. You’re convinced this is it -- you’re having a heart attack and a stroke at the same time. Except you’re not. You’re in the grips of anxiety, experiencing the very real symptoms it brings, and it’s just awful. “Anxiety is understandably on the rise with the Covid-19 pandemic, not just in patients with anxiety disorders but also in people who typically manage anxiety without issue,” said Joshua Flatow, a psychiatrist at Pacific Mind Health in Los Angeles, Calif. “The constant worry, the isolation, the actual threat of death -- these are legitimate concerns having a significant effect on all of us.”  For those new to anxiety thanks to Covid-19, it seems like this cycle of feeling out of control, worried, frustrated, and trapped will never end. We can’t escape to the gym or a spa to reset because our normal coping places are closed. No more heading to the pub for happy hour with friends to blow off some steam. We can’t get relief from our families because they’re likely contributing to our stress levels. This will not last forever, but what are we supposed to do in the meantime? Get professional help for your anxiety. Seriously. This is not a time to be coy about struggling. “Getting help early will not only prevent an escalation in symptoms, but it can also prevent a decline overall,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health specializing in anxiety management. “Stress and anxiety can lead to emotional instability, insomnia, abuse of alcohol or drugs, and even depression or suicide. Early intervention can spare patients from getting to the point of crisis.” To ensure all patients who need it can get timely comprehensive care, Pacific Mind Health is offering telepsychiatry and teletherapy, an easy-to-use service that allows providers to see patients through an encrypted, HIPPA compliant online video service. For those with known anxiety disorders or those with pandemic-induced anxiety, telepsychiatry provides continuity of care and a face-to-face interaction while respecting health-related mandates. Pacific Mind Health is offering Telepsychiatry and Teletherapy Several medications exist for the treatment of anxiety, the most common of which are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). SSRIs and SNRIs target neurotransmitters in the brain to increase a person’s threshold for stress and decrease the intensity anxiety responses. Other medications like buspirone may be indicated for panic attacks, as it provides a rapid calming effect. Benzodiazepines were historically used for management of anxiety, but as understanding of the underlying causes of anxiety and the long term effects of benzodiazepines increased, reliance on them has decreased. They still have value for short-term, immediate relief of anxiety symptoms, but they are no longer considered a first-line treatment for anxiety. One exciting new development in the treatment of anxiety associated with depression is transcranial magnetic stimulation (TMS). TMS stimulates brain cells associated with mood control and depression, however many studies indicate it may be useful in treating a range of psychiatric conditions, including anxiety and OCD. To that end, Pacific Mind Health is offering TMS therapy to qualified patients.  In addition to medications and TMS, therapy, particularly cognitive behavioral therapy, can help patients learn new tools for coping with anxiety, especially in times like these when our normal coping methods are unavailable to us. Cognitive behavioral therapy (CBT) is useful in teaching patients how to become aware of anxiety triggers, to explore stressful situations in less frightening ways, and to cultivate better coping and problem-solving skills. Pacific Mind Health offers CBT in person or through its convenient, easy-to-use telepsychiatry service. “CBT is based on the premise that thoughts dictate feelings,” said Dr. Flatow, who said he recommends therapy to the majority of the patients he treats for anxiety. “By challenging thoughts, you can reprogram negative thinking patterns and stave off anxious feelings.” The cognitive restructuring cultivated in CBT challenges patients with anxiety to:
“Anxiety is a heightened reaction to input from various areas of life, and this pandemic has essentially pushed most of us into a corner when it comes to managing anxiety. But there is no need to stay in that corner, trembling and worried. There are treatments available. This pandemic does not have to feel like the end of the world simply because anxiety is trying to make it so.” - Dr. Thomas of Pacific Mind Health.  Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions, including anxiety and depression. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment
 The gloom of depression and existential disruption of PTSD can be all consuming and unrelenting. For some patients, medications work beautifully. For others, lifestyle modifications and therapy help to lessen the effects. But for many, depression and PTSD symptoms persist despite treatment, and may even worsen over time. Thanks to ketamine, a drug historically used for pain, patients who suffer at this magnitude have new hope. “Ketamine works differently than other psychiatric medications historically available to patients,” said Joshua Flatow, a psychiatrist at Pacific Mind Health in Los Angeles, Calif. “We are excited to offer this innovative therapy to patients and optimize their mental health outcomes.” Research by the Canadian Agency for Drugs and Technologies in Health found that ketamine can boost mood, reduce fatigue and make inroads into helping depressed people who have tried prescription drugs and talk therapy with limited or no success. The study explored the efficacy, safety and clinical guidelines for the use of ketamine in the two focus areas of treatment-resistant depression and PTSD. However it also found that ketamine provided relief for a variety of other mental health problems and symptoms, including fatigue, anhedonia, and suicidal ideation. Low-Doses of IV Ketamine Delivered Improved Symptoms in Hours Not only did several studies note that ketamine provided significant improvement in depression versus the placebo used, but that the benefits manifested in a matter of hours or even minutes in some cases. “Ketamine produces a dissociative experience, which means that patients feel a peculiar disconnect from their body while their brain undergoes an intensely new sensation,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health. “The effects are instantly transformative for some and delayed for others, but are felt far sooner than the typical 4-week delay associated with more traditional antidepressants.” One study noted that ketamine had a more pronounced effect on patients with major depressive disorder (MDD) than those with bipolar depression. Varying dosages were also investigated, with a finding of greater efficacy for low-dose treatments. Ketamine, like opioids, has potential for abuse because of its dissociative effect, particularly for patients with substance abuse disorders. Providers evaluate each patient’s history in determining whether ketamine treatment is appropriate, and dosages indicated for psychiatric treatment are sub-dissociative and less likely to cause unwanted side effects. Patients No Longer Have to Feel Tired and ‘Numb’ All the Time In addition to improvement in depression, patients who undergo IV ketamine therapy report reduced fatigue and increased ability to feel pleasure. Patients endorse feeling the most pronounced effect for the first two days after treatment, with a gradual decline in the benefit over the following two weeks. For the results of ketamine treatment to last longer, it’s usually recommended that patients receive 2-3 infusions per week for a total of up to 8 infusions. After initial treatment some patients return as needed for ‘ketamine booster infusions. Pacific Mind Health offers IV Ketamine treatment to patients in Los Angeles and Long Beach. Learn more about Pacific Mind Health’s approach to ketamine treatment on our website. “As practitioners, we are pleased to bring ketamine to our practice because of its quick, positive results for patients,” said Dr. Flatow. “By making ketamine treatment readily available, we hope to give patients with depression and PTSD a new outlook on life.” Pacific Mind Health is currently offering consultations and accepting new patients for ketamine therapy. If you believe you may be suffering from a mental health condition that could benefit from ketamine, please contact us to schedule a consultation.
By now you’ve probably received an email from your employer, your airline, your phone company, your child’s school, your doctor’s office, and every other entity you’re connected to with some messaging about the coronavirus. We fully expected news coverage of it, and at least a press conference or two from the government, but coronavirus has gone so far as to email us -- repeatedly. It has made personal contact to a private address, bringing with it tips and tricks to avoid it. The awful truth is that we simply can’t.  The coronavirus, much like Zika virus and Ebola virus and Swine Flu and SARS and West Nile virus, is in the air. It’s already earned a new nickname, COVID-19, to distinguish it from the other coronavirus strains that most of us mistake for a bad cold. It is a real virus that causes a real health concern, especially for older adults and people who may have chronic heart, lung or kidney disease. It does require vigilance and behavior modifications to protect yourself, especially as it is easily spread. But does it require panic? Will our heightened anxiety about coronavirus translate into protection? Will waiting in line at Costco with a year’s worth of toilet paper spare us or expose us? What should we be doing to stay healthy?  “Intense, sustained anxiety can suppress the immune system, and given the amount of exposure to the coronavirus information being circulated around the clock, most people are experiencing more anxiety and for longer periods,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health in Los Angeles, Calif. “Of course, anxiety will not cause any illness, but the suppression of the immune system can increase susceptibility.” Consider how the run on supplies may be affecting you. Typically you may go buy bottled water and pick up some hand sanitizer while in the checkout lane. Now you can’t find hand sanitizer. Nor can you buy masks. Bottled water is scarce on shelves, and easy-to-find over-the-counter medications for things like fever and cough are suddenly impossible-to-find.  Last week Amazon had to crack down on people trying to profit off of fear by attaching misleading information about coronavirus to products, and this week it has removed more than half a million products for price gouging. How are we supposed to prepare when we can’t get what we need to be prepared? You Do Not Need to Buy Anything Special to Combat CoronavirusThe reality is you don’t need to buy anything special to combat coronavirus. You need to be disciplined at washing your hands thoroughly and often. You need to maintain a clean environment, including wiping down surfaces touched by multiple people, especially cell phones. You need to avoid crowds and provide some extra personal space when in lines or congested areas. You need to isolate yourself if you are sick or exposed to someone sick, and resist the temptation to find comfort in denial. And you need to manage your anxiety.  “As troubling as it is, coronavirus has united us around the world,” said Joshua Flatow, a psychiatrist at Pacific Mind Health in Los Angeles, Calif. “We felt for the whistleblowing doctors and nurses in Wuhan. We tried to imagine what it would be like to be stuck on a cruise ship with infected people and no ability to leave. We felt grief and relief as our calendars cleared with all the cancellations and postponements of events and commitments. The world is experiencing the same worry, and it’s this global concern and connection that has spread fear and spiked anxiety.” The uncertainty surrounding COVID-19 is going to persist until it stops spreading, and anxiety will continue spiraling as well. Many aspects of this outbreak are out of our control, but what we can do is protect our mental health. Tips for Staying Sane amidst COVID-19 Craziness
 Pacific Mind Health is Offering Telemedicine to Our PatientsPacific Mind Health in Los Angeles, Calif., is offering its patients the opportunity to obtain and continue their care through its easy, convenient telemedicine program. Telemedicine is a form of a secure video appointment that allows patients to connect with a provider from the comfort of home. Primary doctors and urgent care clinics are also encouraging phone and telemedicine visits for patients, especially those with fever and dry cough, symptoms of COVID-19 infection that arrive 2-14 days after exposure. If you are feeling sick and are unsure if it is due to allergies, flu, or another virus consider these appointment alternatives to contain exposure.  “Anyone feeling extra anxious over coronavirus should not feel hopeless or unsupported,” said Dr. Thomas. “Even people with optimal mental health are struggling with tolerating vulnerability and managing uncertainty associated with an outbreak like this. At Pacific Mind Health, we help patients not only develop effective strategies for coping with this event, but also with everyday life events that cause anxiety.” Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment.
Attention Deficit/Hyperactivity Disorder (ADHD), something kids of the 80s may have come to know as Attention Deficit Disorder (ADD), is a neurodevelopmental disorder that affects a person’s ability to pay attention and control impulses. Often, the symptoms of ADHD present in early childhood or adolescence, where fidgety kids are found to be disruptive in structured environments like school classrooms. According to a 2016 study by the Centers for Disease Control and Prevention (CDC), more than 6 million children ages 2-17 have been diagnosed with ADHD in the United States.  Patients with ADHD Are often Highly IntelligentBetter understanding of the disease has meant better treatment for kids known as “problem children” just a couple decades ago. But for those ADHD sufferers who came of age before the rise in understanding, the “bad kid” label may have earned them incorrect diagnoses of anxiety, bipolar, or personality disorders and may have cost them jobs, relationships, and self esteem. “A hallmark of ADHD is an individual’s inability to stay on task,” said Joshua Flatow, a psychiatrist treating ADHD at Pacific Mind Health in Los Angeles, Calif. “The trouble is, these patients fully recognize their shortcoming and its effect on those around them yet they are unable to do anything about it. They’re often highly intelligent with the attention span of a toddler, which heightens their internal frustration and sometimes spirals into other issues like anxiety and depression.”  Identifying the Underlying Condition is the First StepAt Pacific Mind Health, Dr. Flatow and his team are uniquely attuned to the entangling of ADHD with other psychiatric conditions. Identifying the true underlying condition, he says, is the first step in getting patients the treatment they really need. Of those 6 million children who have ADHD diagnoses, about 90% will still be dealing with it as adults. For those who made it to adulthood without a diagnosis, the frustration of not meeting goals and seeing peers attain success with less effort can be crippling, especially since they don’t understand that it’s not their fault. It’s their uniquely wired brain, and they were never given the training needed to wrangle it in a modern society. If only they were a nomad... The interaction of genes with environmental factors, including cigarette, alcohol and drug exposure during gestation, toxin exposure in youth, and brain injuries, are being explored by researchers across the country to pinpoint the cause of ADHD. One interesting find is that neurotransmitters, which is the brain’s way of communicating, are less active in the parts of the brain in charge of maintaining attention in people with ADHD.  PET scan comparing levels of brain activity between subjects. Left: brain activity in healthy subjects. Right: apparent decreased brain activity in people living with ADHD. Neuropsychological Tests are Helping Providers Treat ADHDIn the meantime, healthcare providers are becoming more adept at diagnosing it through a combination of neuropsychological tests, subjective evaluation that includes childhood history, and brain magnetic resonance imaging (MRI), which may help identify subtypes of ADHD: inattentive type, hyperactive/impulsive type, or combined type. Whatever the type, the treatment modalities are the same. Stimulants like amphetamine and dextroamphetamine (Adderall) have been found to help hyperactive ADHD patients concentrate better and resist distraction more easily. Antidepressants such as atomoextine (Strattera) can help stabilize moods and control impulsive behaviors. Counseling is as important as the medications, though, as it targets self esteem and provides behavioral training that enables ADHD patients to get organized, establish routines, and repair relationships.  Untreated ADHD Puts Patients and the Public at Risk“Going through life with untreated ADHD could be dangerous,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health in Los Angeles. “Studies show people with untreated ADHD are more likely to have serious car accidents, and the impulsivity of the disease can lead to substance abuse or risky behavior that may lead to incarceration or, in extreme cases, death. Life expectancy for adults with ADHD is 13 years less than the general population, but patients with ADHD shouldn’t despair. There are treatments available, and many people with ADHD are highly successful and lead full lives.”  ADHD Can be a Blessing in DisguiseJust look at Simone Biles, Olympic Gold Medal gymnast who’s doing stunts so dangerous they may be too much for the 2020 Olympics. Or Michael Phelps, undoubtedly one of the most extraordinary swimmers ever to get in a pool. Justin Timberlake and will.i.am actually credit ADHD for making them better musicians. Political Analyst James Carville wasn’t diagnosed until his 50s, when his wife noticed his fidgeting was so relentless she insisted he get evaluated. These celebrities are just a few of the 4.4% of adults in the United States with ADHD, but they are an example of the potential that comes with harnessing the disease through treatment. Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment.
 Even though we’ve had a few days for it to soak in, the death of Kobe Bryant, one of the world’s most beloved basketball stars, still feels like a bad dream. He was headed to his daughter’s basketball game and he is no more. How did something so mundane become so terminal? And why are we reeling from the loss of this man we only knew through our television screens? “Celebrities are often the subject of our affection, and though it’s an affection that is unrequited, it can foster a powerful sense of connection,” said Joshua Flatow, a psychiatrist at Pacific Mind Health in Los Angeles. “When that celebrity dies, especially in an unexpected way or at a young age, the grief that follows results from that connection. You may never have met the person or even been in the same room with them, yet you have shared their ups and downs with them. You have seen private details of their lives. You have memories with them. You miss them. And you mourn them.” With Kobe Bryant’s passing, the community of Los Angeles immediately flocked to the home of the LA Lakers, the Staples Center, in order to show their respects. But they also flocked there as a first response to grief. “Death has an interesting ability to unite people through grief,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health in Los Angeles. “When a loved one dies, families typically come together to console and support one another through the grieving period. When a celebrity dies, shared grief brings entire communities and, in some cases, the world together to grieve. Grief is real, it is powerful, and it can become complicated and debilitating.” “There’s no silver lining here, it’s just awful… It’s all bad. It’s all sad.” - Jimmy KimmelGrieving and Loss: Time Heals Most ThingsTime and retrospect are almost miraculous in their ability to help people focus on how human beings, particularly loved ones, lived and impacted their world - as opposed to how long they lived. Marilyn Monroe, James Dean, Jimmy Hendrix, Janis Joplin, Amy Winehouse, Kurt Cobain, Heath Ledger… they died before they were 40 years old but the love we have for them continues to this day. In some cases, their memory has lived longer than they did. Remembering those who have died is a healthy aspect of grief, one that can bring comfort during times of immense sadness. Connecting with others is also useful, especially others who are grieving, as they understand how you feel and share the same sense of loss. “It is important to remember that grief does not come in one simple form, nor does it progress in a linear fashion,” said Dr. Flatow. “Grief can cause sleep disturbances, appetite changes, stomach upset, and headaches. It can also cause feelings of anger, sadness, loneliness, despair and irritability.” Most people will experience bouts of sadness and anger that pass fairly quickly – they are likely experiencing a normal grieving pattern.  Understanding Grief and Managing Mental Health During Times of LossWith the onset of grief, many people fall into a sudden and acute state of pain. At first, it’s important to let yourself feel the pain of your loss. Knowing that it’s normal and many others who are grieving will also experience this symptom can help you through this phase. While you may be tempted to shift into isolation, this is where psychotherapy or talking to people close to you can help you validate your feelings. Some people find that chronicling their feelings in a journal is helpful as well, and even writing a note to someone who has passed away can be cathartic. Maintaining a normal routine can also be helpful in times of grief. Patterns provide comfort and restore a sense of predictability and security, especially after an unexpected or senseless death like Kobe Bryant’s. If you or a loved one believes that your cycles of grief are impairing your ability to function, treatments are available. Specialized psychotherapy targeting grief as well as Selective Serotonin Reuptake Inhibitor (SSRI) medications like Lexapro, Prozac, or Zoloft may also be a first-line approach to treat event-provoked or grief-induced depression. The practitioners at Pacific Mind Health are available to support you through grief whatever your treatment requires.  Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment.
Pessimism about Reality Can Impact Mental Health in a Serious WayThe 77th annual Golden Globes were just a couple days ago, but Ricky Gervais’ opening monologue is still echoing from coast to coast. And why not? In 8 minutes of dark humor, the comedian managed to gut Hollywood and we all laughed as its hypocrisy came spilling out. But if it was all about Hollywood, why are we still reeling from it? Because it was also about us. Note: **Viewer Discretion is advised** Hollywood is a fantastical version of our humanity. It bedazzles our best and our worst. And like the actors and film society members at the Golden Globes, we are also racist, “woke” hypocrites who empower pedophiles, send money to Chinese sweatshops, and pull out a camera when we see someone else’s trauma. First, the 24-hour news cycle brings us unrelenting coverage of the devastating fires in Australia, complete with the most pitiful koalas we’ve ever seen, followed by the horror of Hong Kong protestors being gassed and beaten by law enforcement. Then, when we turn on Netflix to relax, there’s the unreal-but-all-too-real tragedy of Don’t F*ck with Cats. How exactly are we supposed to escape this awful reality? Time Magazine honors Greta Thurnberg as Person of the Year for her efforts in raising awareness about climate change, and we try to buy compostable garbage bags or commit to carrying our water in a Hydroflask instead of buying single use bottles. Then we see that the Great Pacific Garbage Patch is now so big it makes Texas look small. What exactly can we do to make a positive change? The more we learn about the world, the worse we realize we are. The more we discover no matter what we do, we fail. The more we realize that we don’t matter, that there’s nothing we can do. Headline Stress Disorder and Its Counter-Productive Impact on Peace of MindBeing aware...can also leave us feeling totally out of control. “Being aware not only can create chronic feelings of hopelessness and anxiety, it can also leave us feeling totally out of control,” said Mottsin Thomas, a psychiatrist at Pacific Mind Health in Long Beach, California. “These negative feelings can affect our interpersonal relationships, our professional performance, our self esteem, our sleep patterns, and our overall health.” In 2016, a study by the American Psychological Association discovered that 66% of Americans felt stress about the future and identified the non-stop news cycle as a significant contributor to this feeling. In fact, this prompted therapist Steven Stosny to coin the term “headline stress disorder.” Increased stress can also prompt the release of hormones that cause inflammation found to be associated with heart disease, rheumatoid arthritis and other health problems. It can also cause heightened anxiety even in people without anxiety disorders.  When you reach into your pocket and ask your phone to google “what’s in chicken nuggets?” you’ll definitely gain knowledge, but what does that knowledge get you? Are you now conscience-bound to boycott McDonald’s even though that’s the only thing your toddler eats without a fit? Is it going to send you down a rabbit hole of chicken farming injustices that compels you to source locally raised cage-free animals that cost twice what you normally pay? When your picky eater refuses to eat the homemade chicken nuggets and you are forced with dumping them in the trash, are you going to get visions of starving children in Yemen? Are you ultimately going to discover that the very phone you used to learn about chicken nuggets was put together by someone being paid $1.78 an hour and now you can’t even ask it questions without guilt washing over you? Setting Boundaries for Your Consumption of Media is Good for Your Mental Health“While it is important to stay informed, it’s also important to stay healthy. “Knowledge is power, and it has the power to do good or do bad, depending on the individual,” said Joshua Flatow, a psychiatrist at Pacific Mind Health in Long Beach, California. “While it is important to stay informed, it’s also important to stay healthy. Setting time limits for taking in news, balancing bad news with good news, taking social media breaks, being selective with news sources, and directing helping impulses locally instead of globally can help give the power of knowledge back to people instead of having a reducing effect on their sense of individual value.” If You’re Experiencing Heightened Anxiety for Any Reason There is Hope at Pacific Mind HealthPacific Mind Health offers help to patients with news-induced anxiety through cognitive behavioral therapy. Medication may be indicated depending on the presentation and precursor, but learning coping techniques is a central part of Pacific Mind Health’s comprehensive approach to managing anxiety in our modern society. Anxiety is certainly a part of life, but it does not have to be the center of it.
Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment.  Your eyelids get heavy and your breathing slows down. The house gets quiet. Your body recognizes it’s time for bed. You’re exhausted from the fullness of the day… work, school, family, friends, the basics of feeding yourself and doing daily chores. You lay down in bed, desperate for sleep, only to realize there’s no sandman coming to sprinkle dream dust on you. Instead your brain speeds up to a mile a minute, your legs start twitching, you can’t get comfortable, you toss and turn. FOR HOURS. What is going on?  According to polls and census data on Long Beach, roughly 40% of our community has trouble with sleep, whether that’s difficulty falling asleep, staying asleep or, conversely, oversleeping. It’s no surprise, then, that fifty-one percent of people report feeling tired or having little energy. Sleep disorders are shockingly common, yet most people suffer in silence, laying in bed watching the minutes tick by. The most common sleep disorders include:
The study of sleep is ongoing, but a study by Harvard found that sleep disruptions from sleep disorders affect levels of neurotransmitters and sleep hormones, impairing a person’s ability to think and regulate emotions. Sleep problems may actually increase the risk for developing certain mental illnesses, including anxiety, depression, and mania. For people with psychiatric disorders, sleep problems are 50-80% more likely than in the general population. By treating sleep disorders, patients may see improvement in their psychiatric symptoms. We get it. Sleep is important. We recognize its importance in our children, scheduling nap times and setting bedtimes. But adults do not prioritize sleep, and the fallout is huge. “Poor sleep is making us sick,” said Joshua Flatow, psychiatrist at Pacific Mind Health. “Our societal demands make it almost impossible to get proper rest. Shift work can lead to or compound sleep problems, as can our dependency on electronics, whose blue light emissions dysregulate our circadian rhythms. The band-aid of energy drinks are only making things worse, as they are causing heart problems, high blood pressure, and digestive problems.”  Pacific Mind Health Has a Comprehensive Approach to Treating Sleep DisordersAt Pacific Mind Health, the approach to treating sleep disorders is comprehensive. Mottsin Thomas, a psychiatrist at Pacific Mind Health, said the first step is to fully evaluate patients, including lab studies to identify metabolic or hormonal causes of sleep disturbances and psychiatric evaluations to identify mental health contributors. “Because psychiatric issues and sleep disorders are so entangled, it’s important that we find the root cause and construct a treatment approach from there,” said Dr. Thomas. “Too often doctors prescribe a sedative, which may lead to more sleep but not quality sleep. At Pacific Mind Health, our team of qualified professionals may use medications, cognitive behavioral therapy, medical devices, or some combination to provide optimal treatments to our patients.” Poor Sleep Can Impact Your Overall HealthIn the same way that exercise and good nutrition are important to your body, sleep is important to your brain. Mental and emotional resilience are directly linked to proper sleep, and chronic sleep deprivation can make you vulnerable to medical and psychiatric conditions. Rest assured, though, there is help available. Pacific Mind Health offers comprehensive mental health care for a range of psychiatric conditions. If you are looking for a psychiatrist in Los Angeles or Long Beach, California, or telepsychiatry in California, please contact us to schedule an appointment.
Individuals with bipolar disorder (BD) have a higher incidence of Parkinson disease (PD), according to the results of a study published in Neurology. In addition, more frequent manic/mixed and depressive episodes increase this risk... Read the entire article from Psychiatry Advisor here.
Sleep-disordered breathing (SDB) is an umbrella term used to describe various conditions that cause atypical respiratory patterns (e.g., sleep apnea) and result in the partial or complete cessation of regular breathing cycles throughout the night. Sleep-disordered breathing, and the sleep disruption caused by SDB, are associated with epigenetic age acceleration, according to a new study (Li et al., 2019) from Harvard Medical School... Read the entire article from Psychology Today here.
The latest research by scientists tracking the neurological development of these children, published in the journal Developmental Science online in advance of print, shows that disruptions in caregiving produce detrimental effects on a child’s brain function, evident by EEG (electroencephalogram) analysis after children reached teen age (16-17 years old)... Click here to read the entire article on Psychology Today.
Personality disorders, as described in the DSM-5,1 are characterized by inflexible and maladaptive patterns of behavior, thoughts, and feelings. Furthermore, personality disorders are associated with distress or impairment. But personality disorders differ from each other in a number of important ways. In a paper published in the March issue of Journal of Clinical Psychology, researchers Stanton and Zimmerman examine shared and unique features of two of these disorders: narcissistic personality disorder and antisocial personality disorder... To read the entire article on Psychology Today, click here.
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