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PMDD is characterized by severe, cyclical mood changes prior to menstruation, typically the worst 3-4 days before to the first day of menstruation and can last up to a week. In addition to the mood changes there are cognitive and physical symptoms as well.  This disorder affects millions of women. Mood/behavioral symptoms include but are not limited to mood swings, irritability, crying spells, depressed mood, negative thinking, or anxiety. There may be loss of interest, low energy, changes in sleep and appetite. Physical symptoms include breast tenderness, bloating etc.

Women with PMDD notice that it affects their functioning at work, in social settings and in relationships. Because of the timing of these symptoms, it is thought that PMDD is associated with hormonal fluctuations among other things. There is ongoing research to determine the exact pathways through which hormonal fluctuations bring about these symptoms.

If these are some symptoms you are struggling with- there are effective treatments available for PMDD. Medications and psychotherapy both are effective treatments. In some situations intermittent dosing of medications during the symptomatic days is sufficient to get symptom relief. Some hormonal treatments have been shown to be effective as well.  You don’t have to suffer through PMDD, ask your doctor for help.

Need help? Contact us at 919-636-5240 or email office@cognitive-psychiatry.com.

Dr Sayanti Bhattacharya

The post PMDD – Premenstrual Dysphoric Disorder – What you need to know appeared first on Cognitive Psychiatry of Chapel Hill.

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There is nothing permanent except change- wise words from a Greek philosopher. We all know this to be true yet we struggle with change and transitions just the same. What is it about change that is so hard?

We happen to like familiarity. It brings us comfort. Breaking away from familiar patterns, places, and people is difficult. Even if the change is a positive one, one you desperately wanted and were looking forward to- it can be difficult. Think about the times you moved in with your partner, your first semester in college, when you started a job that you wanted for a long time, moved into your dream home, or the birth of your child. All of these are likely positive life changes, ones that you had hoped and wished for. Yet these are difficult transitions and some of the more stressful times in your life.

It can be even harder when life changes in ways that are completely beyond your control and you are caught by surprise. Unfortunate events like loss of loved ones, loss of financial assets, missed work opportunities, academic setbacks happen in life. Change can be disorienting and unsettling. Expect to feel somewhat anxious and blue at times when going through a transition. Whether you want it or not, change will be a part of your life.  Transitions are great opportunities for new beginnings.

-“The best thing one can do when it’s raining is to let it rain.”

All the best,

Dr Sayanti Bhattacharya

The post Transitions appeared first on Cognitive Psychiatry of Chapel Hill.

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Do you struggle to say no to people? You are not alone in this.  Some people find themselves stretched thin and hard-pressed for time, yet are unable to decline more demands on their time from others. These demands happen at work, within the family and from social networks. Feeling stressed and over extended can lead to burnout at work and otherwise.  So how do you say no?

Remind yourself you have a choice

After all it is your time and your life- hence the decision to commit to an activity, to volunteer, to do an extra shift, or to help a friend is yours too. You know best what other commitments, chores and events you have on your schedule. Declining a request for more of those is a conscious choice that you can make.

Prioritize yourself

You are the best person to take care of yourself. Everyone needs time to unwind and recharge.  You need time to think about your ever-changing priorities and goals in life. It’s easy to get lost in the humdrum of life and not take care of yourself. Make some time for yourself- to do what you love and what brings you joy. Say no to things that don’t.

Be gentle, but firm

You can be assertive without being rude or offensive. You can say no without hurting other people’s feelings. When you start prioritizing yourself, this gets easier. ‘I wish I could, I don’t have the time right now’, ‘Maybe we can try another time?’ or ‘ I would have loved to, if it were possible’.

Be direct

You do not need to make excuses. You get to make the choices for yourself. If a brunch, or an activity in your child’s life seems too much to squeeze in to your already packed schedule, politely decline. You are busy is reason enough.

Good luck!

Dr Sayanti Bhattacharya

Need help saying no? Please call us at 919-636-5240 or email office@cognitive-psychiatry.com.

The post How To Say No appeared first on Cognitive Psychiatry of Chapel Hill.

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Dialectical Behavior Therapy, or DBT, has become a popular psychotherapy treatment model over the last few years as more people are becoming aware of it’s benefits. However, that increase in popularity has also led to some confusion and misconceptions about what DBT is and who it can help. Below are some of the most common myths about participating in DBT:

MYTH: DBT is only for individuals with Borderline Personality Disorder.

FACT: DBT has a significant amount of research behind it for not only Borderline Personality Disorder, but multiple disorders. DBT has been shown to be effective for bulimia, binge-eating, depression, bipolar disorder, post-traumaticstress disorder, and substance abuse. DBT can be helpful for individuals who wish to learn new skills for managing painful emotions and decreasing conflict in relationships.

MYTH: DBT takes too much time.

FACT: While it’s true that DBT may take more time than traditional psychotherapy, it is a lot less time than other more intense treatment options such as day treatment or inpatient stays. Additionally, the time in treatment is likely less than the time each week spent dealing with emotional problems, chaotic relationships, or difficult behaviors.

MYTH: DBT is a suicide prevention program.

FACT: DBT is not a suicide prevention program, but rather a life enhancement program. For many people who have considered it, suicide seems one way out of intense misery and suffering. DBT emphasizes the alternative is to make a life worth living. Although suicide and self-harm are always targeted as part of treatment, the goal of DBT is not to stop behaviors that bother others, but to help the individual build a life that is meaningful to them.

MYTH: DBT can’t help me because nothing else has.

FACT: Many clients who come to DBT have had limited success in other therapies. This is usually because the other therapies did not effectively treat the skills deficits that lead to their difficulties. DBT posits that “insight” alone does not sufficiently address reasons for the individual’s distress and problem behaviors . DBT combines insight with new skills, structured sessions to learn how to implement those skills, and phone coaching to help generalize those skills to all relevant areas in the person’s life.

MYTH: I will have to be in DBT forever.

FACT: DBT is a recovery based treatment. This means that a DBT therapist will work with the individual on building a life that doesn’t require you to be in DBT or any other treatment. The skills and strategies taught in DBT are designed to help people cope with multiple and varied life problems. Most clients who graduate from DBT go on to live very meaningful lives with much reduced suffering.

Want to learn more? Contact us at 919-636-5240 or office@cognitive-psychiatry.com.

Becca Edwards-Powell, MSW, LCSW

The post 5 Myths about Dialectical Behavior Therapy (DBT) appeared first on Cognitive Psychiatry of Chapel Hill.

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Stress can be a part of everyday life. We often deal with stress at home, at work, with friends, when we travel, at school, etc. and we often get worried about our past and out future. Here are 5 techniques to reduce stress with the help of your five senses.

See

Most of us are nature lovers. Just think about what helps you to relax most when you spend your time out doors. Take a hike; absorb th

e beauty of nature around you. Walk by a lake or a stream; look at the water as it flows. Imagine your problems flowing away from you and take a deep breath and relax. Look at the flowers as they bloom in your garden. Look at the colors. What is your favorite color? Find how many things you can see in nature th

at has that color. Look at them and feel the joy it brings to your heart. Take a walk in the nearest park. Find a window in your house or apartment that gives you a view of the nature outside. Sit by it and look at the skies. What color is the sky today? Observe how the clouds change their shapes. Look at the sun set; enjoy the colors in the sky as the sun sets in the evening. Take a walk to the beach. Look at the vast ocean, the waves, the sand, and the birds. What is it that you love the most in nature? Collect pictures or plants that make you happy and decorate your space at home or office. Use soothing colors and positive pictures in your room.

Smell

When was the last time you were able to stop and smell that flower that just bloomed in your garden? Take a few minutes each day to stop, take a deep breath and enjoy the air around you. What are the different smells around you? The smell of rain, flowers as they bloom, grass, leaves, scented candles, your shampoo, coffee, chocolates, cakes. Take few minutes every hour to pause and breathe. Set reminders or downloads apps on your phone or watch to do so. Carry your favorite fragrance in your pocket and take it out and smell it several times during the day.

Listen

Stop and listen to the world around you. The sound of the wind , the sound of rain, your partners voice , your child’s laughter ,music , the sound of water fall, birds chirping . There are lots and lots of sounds all around you. Find your favorite. Do it several times a day. If you have no access to nature sounds, use recordings.

Feel

Do you remember how much it helped you to relax when you held your friend’s or partner’s hands when you were afraid? Hold hands with your spouse, hug your child, and hold your pet close to you. Feel the leaves and flowers with your fingers when you go for a walk. Remove your shoes and walk bare foot on the grass or at the beach. Feel the texture of an orange before you eat it. Get a massage.

Taste

Notice the different flavors in your mouth as you eat a piece of chocolate or your favorite dish next time. Is it sweet, salty, sour or spicy? When you eat or drink, go at a slower pace and see how calming it can be. Next time you feel stressed, try cooking something that you like. Share it with a friend – see how much it helps you to relax.

Questions? Please call 919-646-5240 or email us at office@cognitive-psychiatry.com.

Dr Saramma Eappen

The post 5 Non-medication Ways to Manage Stress appeared first on Cognitive Psychiatry of Chapel Hill.

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Focus on Bedtime

Transitioning back in to a good sleep routine can be hard after your summer break! To get back in to a good sleep pattern:

  • set up a time to sleep and follow it!
  • close to your bedtime, try to wind down with a good book
  • keep the light in your room dim
  • try listening to soft music or taking a warm shower
  • switch off iphones, laptops, and TV prior to bedtime to reduce stimulation

Morning Routines

Getting back to waking up early, getting ready for school, commuting to school etc. can be hard! Set up an alarm that will help you to wake up on time. If you are in the habit of pushing the snooze button on your phone or alarm several times, then keep the alarm clock away from your arm’s reach. Try to follow a morning routine each day. For example:

  1. brush teeth
  2. shower
  3. dress up
  4. have breakfast

If you are in the habit of packing a lunch try to get it ready the previous night. Doing your grocery for a week at a time and having snacks and meal prep items handy also helps.

Home works/Assignments

Having a dedicated time to do your homework and assignments each day and following this on a regular basis helps. Turn off any kind of distractions like cellphones, TV etc. while you do your homework. Find a good spot where you can do your work and having materials handy like paper, pen, calculator etc. helps. Follow this routine and try to use this dedicated time each day to improve learning even when you do not have any assignments or deadlines that you need to keep.

Happy Back to School!

Dr Saramma Eappen

The post 3 Tips to Getting Back Into the School Routine appeared first on Cognitive Psychiatry of Chapel Hill.

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If you struggle with sleep issues, you may need to pay attention to your ‘sleep hygiene’. Here are a few simple ways to improve the quality of your sleep.

Wake up at the same time every morning 

Even if you go to bed later than you planned, try to wake up at the same time every morning. Eventually your body will fall into a rhythm. Your sleep will get consolidated and you will be able to go to bed at the same time every night. This will help regulate your Circadian rhythm (day-night body clock). Having a set schedule every day including holidays and weekends helps to set this rhythm and improve sleep.

Go to bed only to sleep

When you are tired and ready to sleep, head to your bed. Lying awake in bed worrying and waiting to fall asleep can be frustrating. If you find yourself doing just that, get out of bed and rest somewhere else. Reading, eating or watching the TV in bed are not recommended. If you are unable to sleep try to read a book, listen to music or engage in other relaxing activities. Try to avoid bright lights, including those from screens. When you are ready to doze off, return to bed.

Make your bedroom comfortable

Cooler temperatures are better for sleep, set the thermostat between 60-75 Fahrenheit based on your comfort level.  Darkness induces sleep, so consider blackout curtains, drawing the blinds or other ways to reduce light when you go to bed. Needless to say your bed and mattress being comfortable are important for a good night’s sleep. Reduce loud noise as much as possible, although white noise like nature and water sounds can be relaxing and helpful for sleep. Keep your televisions in other living spaces.

Get ready for bed

Bedtime routines and rituals are not just for babies. A relaxing bath, a good book and some gentle music will help you relax and fall asleep.  Stay away from stressful activities up to 2 hours before bedtime including checking work emails, watching the news, having a difficult conversation or working out.

Be active 

Physical exercise, even in moderate amounts improves sleep. Try to include some physical activity in your calendar. Be mindful of the timing and amount of exercise. Strenuous activity right before bed can increase stress hormone (cortisol) levels, which will get in the way of good sleep.

Sleep well!

Dr Sayanti Bhattacharya

The post 5 Ways to Improve Your Sleep Without Medications appeared first on Cognitive Psychiatry of Chapel Hill.

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Circadian Rhythm is your body clock that maintains your day-night rhythm. It is this clock that tells your body when it is time to rest and when its time to be alert and active. Typically this rhythm is maintained by the hypothalamus. The hypothalamus mainly regulates this clock by receiving inputs from the environment- like light, physical and social activities. When it is dark, the pineal gland in your brain secretes melatonin-which sends a signal to your brain and body to get ready for sleep. Light has the opposite effect on the brain.

Historically the sun was our primary source of light, and humans like many other animal species regulated their body clock based on sunlight, and the absence thereof. We have come a long way from those times. Now light from many different sources regulates and sometimes interferes with this rhythm including indoor lights, televisions, cell phones and tablets.

Circadian rhythm sleep disorders are problems with sleep that occur when the circadian clock does not function well. This may happen when the external stimuli are in contradiction to the internal body rhythm. Modern day social and work activities often cause this problem, as does travel. When you travel internationally or across time zones, you may have noticed problems with sleep and wakefulness. Again, this is your circadian rhythm at work. Jet lag happens when you travel to a different time zone and your body struggles to keep up with the change in time. You may feel sleepy and tired or be wide-awake at inconvenient times. Similarly people who work evening and night shifts may experience chronic problems with their sleep. Melatonin can help in both these situations by shifting the circadian clock.

Some people are ‘night owls’, which means they have a different circadian rhythm than most and typically function best and get the most restful sleep when they stay up late and sleep until late in the day. Similarly some people are ‘early larks’ and like to go to get early and are up at the crack of dawn. If you are one of these, you probably already know!

Live Mentally Healthy,
Dr. Bhattacharya

The post Learn About Your Circadian Rhythm appeared first on Cognitive Psychiatry of Chapel Hill.

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Do you struggle to find the time to take care of yourself? If you are in the habit of prioritizing work, chores and others over yourself you may find you are overextended and exhausted.

What is ‘self care’ and how to go about it?

It is quite simple- it is taking care of yourself the best way you can. Just like you take care of your loved ones. There is no rigid mantra or one size fits all strategy for self care. I firmly believe being able to prioritize self-care in your busy life is a big win. Anything that helps you relax and have fun qualifies as a self-care activity. It may involve listening to your favorite playlist, taking time to enjoy your cup of coffee/tea, taking a leisurely walk, or even taking a nap. There are many ways you can care for your body- exercise, yoga, massages, sports or just more rest and sleep.

Self-care is important for your mental health as well. Take the time to be with friends, to talk on the phone, to indulge in a midday walk, or an unplanned coffee stop in the middle of a busy day. When you are feeling low or stressed- reach out to a friend, a loved one or a professional.

Being able to take care of yourself is a learned skill; so don’t be disheartened if this something you don’t do yet or if this does not come naturally to you. You can start by being kind to yourself, and self-care will follow.

Live Mentally Healthy
Dr. Bhattacharya

The post Tips on Self Care appeared first on Cognitive Psychiatry of Chapel Hill.

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Physical activity and exercise are good for your mental health. Vigorous physical activity can help with self-confidence, a sense of well-being and better sexual health. Symptoms of mild to moderate depression and anxiety have improved with physical activity and exercise, as shown in some studies. Benefits of exercise have been noted in treatment of addiction disorders as well.

Similarly, being in a natural environment has a positive effect on psychological health and well-being. Feeling connected to nature can improve a sense of satisfaction with oneself, with life and lead to better self-esteem. Connection to nature is often referred to as ‘Nature Relatedness’. Anxiety levels are lower when there is a higher degree of ‘Nature Relatedness’. Even a view of plants and trees from your window can have a positive effect on mental health.

Studies have shown that physical activity and being in nature are both independently good for your mental health. When physical activity happens in natural environments, these positive effects are impressive. Improvements in mood, attention and cognition have been documented with physical activity in a natural environment. People who walked in the presence of nature had greater benefits in mood and cognition than those who took walks in urban areas. Not only does activity in the presence of nature improve mood and cognitive ability, such activity can reduce negative outcomes like stress and anxiety.

Next time you plan to take a walk, try to go to a nearby park. And liven up your living spaces with some indoor plants.

Live Mentally Healthy,
Dr. Bhattacharya

The post Take a Walk for Your Mental Health appeared first on Cognitive Psychiatry of Chapel Hill.

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