Archive for July 23rd, 2012

Hallucinations Tell Me To Do Things That Hurt


I feel like I am being controlled by the man in my head named Simon. He is new. The other ones aren’t here now, he just came. I intended on it anyways, but yesterday when I put a razor inside my private area, I was fine you know, it felt good. The. It felt like Simon took over my hand and he cut and cut, and I only saw blood. And he told me he’d do it every night until he stopped. I’m ging to tell my therapist, I just dunno what to do till then. I’m on my medicines right. I don’t like being I trouble so I can’t tell anyone, they might send me away again. I just need some advice please. I cry and he keeps yelling and if I do anything he yells more and says bad thing and it’s gonna be worse next time. I’m scared, and I hope you’ll answer this, thanx.

A. I would recommend calling your therapist or your psychiatrist immediately. They may be able to assist you before your next appointment. This is a serious problem that should not be ignored. You feel compelled to cut yourself and have done so already. You have lost your ability to control your behavior. This is a situation where you need to be safe and you should not fear the hospitalization, if necessary, that will protect you.

You should consider going to the hospital. You may not require inpatient hospitalization. The hospital staff can keep you safe until you feel as though you can control your behavior. The staff at the hospital may also be able to adjust your medication which could significantly reduce your hallucinations and desire to cut. Perhaps they can even contact your psychiatrist or therapist who could guide them in adjusting your medication. Please don’t ignore this problem and make an effort to receive emergency assistance. I hope you’re able to receive the help that will make you safe.

Dr. Kristina Randle

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Commitment-Phobic?


I’ve been with my boyfriend for 7 months…One month of which was when he broke up with me in late March and we got back together in late April.
When I first met him, he said something along the lines of “Girls are LUCKY if they ever meet my friends and family.” I didn’t give much thought to it, because I thought, well, maybe he’s just saying that.
When we broke up in March, he dumped me saying I had too many demands and he couldn’t provide the love that I needed. When we got back together in late April, it turned out that he said he did a lot of thinking and couldn’t let me go because he “saw me in his future.” Still in love with him, I got back together with him.
Well, one day, I was cleaning his room (which I HAVE NEVER done for another man in my life ever before–I wanted to show him how special he is) and I noticed two hairpins on his end table that were not mine. I also noticed that the condoms he said “he ran out and bought because he was afraid of getting me pregnant while I started the birth control pills” were suddenly gone from the windowsill where they were a week ago…..I hate to say it, but 2 months into our relationship, we weren’t using condoms, and we still aren’t. (I got tested last week and am clear…but now I’m rethinking the non condom thing…stupid..I know).
So, my suspicions started. The next week, alone in his room (He lets me stay alone and sleep in in his apartment when we go out sun night, or a week night while he works–I have a weird not-too-typical schedule). So, I snooped. Yes. I did:( And, in a suitcase he uses as extra storage for his clothes, I found the clinic condoms that had been taken from the windowsill along with a box of Trojans (a ten count box) with only 4 condoms left. There was also an empty Trojan wrapper in with the rest of the condoms. Along with that, were my earrings and panties I had left a week before. Keep in mind, we have not used a condom since March, and before we got back together in April he moved from one apartment to a new one. Next, yes, snooped again:(, I checked his wallet (He didn’t bring it to work with him–just cash in his pocket). In his wallet was a condom and a card to an escort in the area he lives.
The following week when he got up to use the bathroom, I looked back in the wallet, and I noticed an additional condom put into the wallet (one was missing from the pocket in the suitcase) and the escort card was gone. I confronted him about all the condoms, and the wrapper, but I never mentioned the escort card–I still don’t know why I didn’t.
His explanations were: “Those were old clinic condoms I put back in there that we were gonna use.” Then he said the box was old and he just found it recently. When I pressed him about the condom wrapper, he said it was old. I said “Then why is the lube wet in it?” He finally said, in April, before we got back together, that he slept with a one night stand from a bar, and that must be the wrapper from the one night stand. He said silicone lube can stay wet if enclosed in a dark suitcase. True. I called the condom company, and they confirmed it can happen if its in a dark place:( yes, I know, already, sounds like I don’t trust him. When I asked about the wallet, he said that he carries condoms in his wallet because his brother who suffers from schizophrenia (paranoid type) checks his wallet to see if he has condoms every time he visits him to make sure that he is protected during sex because if he doesn’t he’ll tell the mother and the mother will get angry because he already got a girl pregnant. (I also know about his son and his sons mom–he visits every Friday, sometimes fri and sat). I said, “well doesn’t your brother know we do it at your place, and you’re with me?” He said, “He doesn’t believe things he cannot see.”
Okay, so that’s that part of it. Now, he won’t introduce me to his family because he says that it has to be over a year until I meet them. he says he won’t introduce me to his friends because, well, before we got back together in April, he said I needed “tweaking” I told him to accept me like I am or not, and then he stopped saying that when we got back together. Then he said his friends are busy all the time, and now he says I can’t meet them, because his friends are “stupid.” Okay, so we go on dates, but since we’ve been arguing about these issues, he rarely initiates calling me/texting me–unless I ask repeatedly. He says its because, every time I have seen him in the past two months, we have had a disagreement.
When I have confronted him, he says he does this with every girlfriend he has been with–it takes a while to meet ppl he knows.
I feel confused. The not calling, texting, and the random circumstantial evidence in his room–is it cheating? Or is it just typical guy forgetfulness sloppiness and distance from fighting too much?
And not introducing….does he really do this with everyone, or is it just with me? because I’m embarrassing, or a dirty little secret on the side? Please help! My last long term relationship was highly physically abusive (he knows this) and I just want a loving fulfilled one. Although, I still have extreme anxiety–I’m not perfect at all, either.

A: Hmmm – Let’s review: Hairpins that are not yours, condoms you aren’t using are missing, new condoms have been used and the wrapper for one is there, he is with his ex every Friday when he visits his son, and keeps a rubber in his wallet to keep his brother happy. Won’t introduce you to his friends or family and rarely calls or texts you.

What is it you love about this guy?

The bottom line is you just want a loving, fulfilled relationship. Without assuming he will change one bit — can you tolerate everything the way it is? If not, it is time to give him his walking papers.

But if you can tolerate it, a couples counselor may be necessary to help with the issues. The find help tab at the top of this page can help you find one in your area.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

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Press release for Biological Psychiatry – Neuroeconomics to Study Decision-Making in Anxious Individuals


Philadelphia, PA, July 23, 2012 – Anxiety disorders affect approximately 40 million American adults each year, and although they are treatable, they often cause significant distress.   

The excessive fear and dread that accompanies anxiety disorders clearly influences the everyday decision-making processes of anxious individuals. Despite its importance, “there is surprisingly little research on how anxiety disorders influence decisions,” commented neuroscientist Dr. Elizabeth Phelps, who co-authored this new review with Dr. Catherine Hartley, both of New York University.

Their review highlights that science is “starting to gain some traction by combining emerging decision science with the study of anxiety. The overlap in the neural systems underlying anxiety and decision-making provides some insight into how fear and anxiety alters choices,” explained Dr. Phelps.

Dr. Hartley added, “Historically, research has focused on the influence of anxiety on how we attend to and interpret events. These same processes should shape how anxious individuals make decisions.”

Their review explores the role of anxiety in decision-making using a neuroeconomic approach. Neuroeconomics is an interdisciplinary field that combines tools from the fields of economics, neuroscience, and psychology to study the brain’s decision-making processes.

The authors discuss the overlap between the neural systems mediating fear and anxiety and those implicated in studies of economic decision-making. Neuroeconomics research has revealed that circuits involving the amygdala, insular cortex, and prefrontal cortex are involved in tasks with uncertainty or loss. The amygdala is a key brain region that helps regulate fear and anxiety, while the prefrontal cortex is critically involved in the control of fear.

The authors also review a set of decision-making biases exhibited by anxious individuals and propose that the neural circuitry supporting fear learning and regulation may mediate anxiety’s influence upon their choices.

“Hartley and Phelps provide an elegant example of how reward-related decision making may be affected by other neural circuitries, in this case the emotional processing system,” commented neuroeconomics experts Drs. Carla Sharp and P. Read Montague. “This is without a doubt part of the future of the application of neuroeconomics to psychiatric disorder, as no example of psychiatric disorder can be reduced simply to reward-related decision making.”

The article is “Anxiety and Decision-Making” by Catherine A. Hartley and Elizabeth A. Phelps (doi: 10.1016/j.biopsych.2011.12.027). The article appears in Biological Psychiatry, Volume 72, Issue 2 (July 15, 2012), published by Elsevier.
 

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Notes for editors
Full text of the article is available to credentialed journalists upon request; contact Rhiannon Bugno at +1 214 648 0880 or Biol.Psych@utsouthwestern.edu. Journalists wishing to interview the authors may contact Elizabeth Phelps at +1 212 998 8337or liz.phelps@nyu.edu.

The authors’ affiliations, and disclosures of financial and conflicts of interests are available in the article.

About Biological Psychiatry
External link  Biological Psychiatry is the official journal of the External link  Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.

The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.

Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric neuroscience. It is ranked 5th out of 129 Psychiatry titles and 16th out of 243 Neurosciences titles in the Journal Citations Reports® published by Thomson Reuters. The 2011 Impact Factor score for Biological Psychiatry is 8.283.

About Elsevier
Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including External link  The Lancet and External link  Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include External link  ScienceDirect, External link  Scopus, External link  Reaxys, External link  MD Consult and External link  Mosby’s Nursing Suite, which enhance the productivity of science and health professionals, and the External link  SciVal suite and External link  MEDai’s Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, External link  Elsevier employs 7,000 people worldwide. The company is part of External link  Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Rhiannon Bugno
Editorial Office
Biological Psychiatry
+1 214 648 0880
biol.psych@utsouthwestern.edu

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