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  1. March/April Psychiatry Drug Alerts Update

    From Psyciatry Drug Alerts Periodicity we will be updating our blog with information about Psychiatric drugs we feel will be useful to our current and future patients. These updates are not medical advice and as always you should make sure to contact your health care professional with any concerns about your symptoms and current medications. From the July 2012 Issue Olanzapine for PTSD. In a small manufacturer-sponsored study olanzapine (Zyprexa) monotherapy was superior to placebo in patients with non-combat-related posttraumatic stress disorder. -Up to 40% of all patients with PTSD do not respond to SSRIs and SNRIs, the recommended first-line treatments. Adjunctive Low-Dose Dextromethorphan in Schizophrenia Risperidone (Risperdal) with adjunctive dextromethorphan was more effective than risperdone alone in a group of patients with schizophrenia. This and other observations from the study are consistent with the hypothesis that inflammation is the underlying mechanism of schizophrenia. -Increasing evidence suggest abnormal peripheral and CNS cytokine levels, indicative of inflammatory activation, contribute to the neuronal damage and degeneration observed in patients with schizophrenia. Metformin for Antipsychotic Side Effects in Women Treatment with metformin reversed antipsychotic-induced amenorrhea and weight gain in a placebo-controlled trial of women with first-episode schizophrenia. Lurasidone: Acute Efficacy Lurasidone received FDA approval in 2010 for treatment of schizophrenia. Although similar to other second-generation antipsychotics, it has a somewhat different receptor profile and appears to cause fewer metabolic and OT effects as well as less weight gain. The approved starting dosage is 4mg/day, and the maximum recommended dosage at approval was 80mg/day. Oxytocin: Potential Schizophrenia Treatment The neurohormone oxytocin, synthesized in the hypothalamus,acts both centrally and peripherally, as both a neurotransmitter and as a homorne. Oxytocin receptors are located in a number of brain areas relevant to schizophrenia. The oxytocin sytem interacts with other hormonal systems important in schizophrenia: estrogen, serotonin, dopamine and glutamate. Several studies have demonstrated variations in central or peripheral levels of oxytocin or it’s carrier protein in patients with schizophrenia. ..preclinical and clinical evidence strongly supports the potential for oxytocin to ameliorate social cognitive deficits of schizophrenia, which are poorly address in other treatments.
  2. Greendale Against Bullying-What is bullying?

    Dr Jim and Gilbert Brown American Behavioral Clinics has partnered with Greendale Against Bullying. On March 22nd they had a rally to show the movie Bully, listen to former Packer Gilbert Brown and talk about how to defeat bullying. Dr. James Winston gave a speech to the 400 people who had come to take part, here is what he said. The most common definition is a repeated oppression, psychological or physical of a less powerful person by a more powerful person or group of persons. Bullying behavior occurs in schools, sports, youth groups work places, social groups, senior centers or online activities. It takes place between people of all ages and walks of life. Bullying can be physical which can include hitting, kicking or punching someone. It may involve stealing, hiding or ruining someone’s things. Sometimes it can be threats or making someone do things he or she doesn’t want to do. Verbal bullying includes teasing, insulting or name calling. Relationship bullying may include refusal to talk with someone or spreading rumors about someone. Roughly 25% of kids experience bullying, reasons may include: a different size child, smaller or bigger than other kids their age, if a child is a minority based on color, religion, or sex, if a child has a disability that makes him walk or talk differently, if a child gets anxious or upset easily, if a child is usually alone or doesn’t have many friends, if a child shows a lack of confidence and doesn’t seem like she’ll stand up for herself. Bullying isn’t new, but our attempts to respond to it are. Today, the challenges are complicated by kids access to new technologies which include cyberbullies and Facebook thugs. Cellphones and laptops spread gossip quickly. Emotional violence in the virtual world can inflict real psychological trauma. Kids who bully are often resentful or envious. Some bullies are arrogant or narcissistic. A bully may be having problems in other parts of their life. Something may be going on in their family or they are struggling with school. A bully may feel they aren’t getting enough attention from parents or teachers. A bully may have watched their parents or older siblings get their way by being angry or pushing other people around. The bully may be spoiled by their parents and hasn’t learned about not hurting others. The bully may be exposed to lots of violence in movies, tv or video games. The reason why one kid would want to bully another kid is this. When you make someone feel bad, you gain power over them. Power makes people feel like they’re better than another person. That makes them feel really good about themselves. Power makes you stand out from the crowd and get attention from other kids. So, what should children and teens do if someone bullies them? Ignore the bully. Pretend you didn’t hear them, don’t even look at him, walk right past him if you can. Don’t cry, get angry or show you’re upset, that’s the bully’s goal. Telling someone to stop firmly “NO that’s what you think”. Asking to join the game or conversation in a friendly, confident way. Learning and finding someone else to play with. Interrupting adults and being persistent asking for help. Turn and walk away or run if you have to remove yourself from the situation. Use your awareness to notice a problem situation and move out of reach. To prevent future bullying, don’t walk alone and travel with one other person if you can. Avoid places where bullying happens, i.e. take a different route to school or leave at a different time. Sit near the bus driver on a school bus. Don’t bring expensive things to school. Avoid being alone in a locker room or bathroom. Act confident, make eye contact, and stand up straight with your head held high. Practice bullying comebacks ahead of time. Make new friends and develop interest in social or physical activities. One in 10 students drop out of school because of repeated bullying. 90% of 4th to 8th graders report being victims of bullying. Harassment and bullying have been linked to 75% of school shooting episodes. In summary, people have the right to be treated with respect and the responsibility to act respectfully towards others. My 94 year old, living World War II Sergeant, father always told me to get a good education. It’s important that each child stays focused on what’s really important, like education, and not the negative energy of their peers who may try and suppress their spirits. American Behavioral Clinics is here to help when you feel lost, alone or sad. Doctors, teachers, police officers and lawyers come to American Behavioral Clinics. You shouldn’t feel shameful to get help if you need it. We need to be partners in fighting emotional and physical abuse together.
  3. Tips for Enjoying the Holiday Season

    Tired Holiday Shoppers Some may call this “the most wonderful time of the year”, but we know that the holiday season can actually be some of the most stressful months of the year. The busy nature of the season can lead to depression and overwhelming stress. Take some time to prepare for the next several weeks so you can enjoy the holidays rather than simply survive.

    Pressure for Perfect Holidays

    Holidays receive special attention in the media. The holiday scenes pictured on TV set extremely high standards and put pressure on Americans to live up to extravagant standards. These ads and commercials remind us of the things we “need”. Many people also feel stress as they anticipate the gatherings with extended family members and friends. It can be difficult to imagine spending time with certain people who press our buttons or let us down.

    How do you deal with added pressure and spending more time with others?

    Turn off the TV. Spend less time watching TV to avoid the extra pressure. Reflect. Take time during the holidays to stop and reflect on the blessings you have and the many reasons you should be thankful. Start new traditions. It is a great time to pick new traditions to start with family and loved ones. Traditions can be simple and often start spontaneously when you aren’t stressing over detailed plans.

    Food and Alcohol in Excess

    Many holiday celebrations center around tables of food and trays of alcoholic drinks. The added temptations can be a trigger for old habits or a trap for potential eating problems. Making a plan to handle food and alcohol temptation will help you avoid regret associated with overeating or drinking a little too much. Make a plan. Whether you stock up your pantry with healthy snacks, replace your holiday recipes with healthier versions, or add extra workouts, pick a plan that will work best for you. Set your priorities. Listing your priorities will remind you that the central focus of celebrations is spending time with others rather than tasting every treat.

    Demanding Schedule

    The holiday season often sneaks up on us and catches us unprepared. This leaves us feeling like we can’t quite catch up with the parties, baking, entertaining, shopping, and cleaning that needs to be done. Changing your attitude will help you stay relaxed even in the face of a full calendar. Stick to a budget.  Set limits for spending for each responsibility you have. Creating a budget ahead of time will help you keep things in perspective and avoid spending too much money. Reach out for help. Don’t be afraid to ask friends and family members for help. Most will be happy to help, and it may give you a chance to work together. Consider professional help. There is no shame in looking for help from professionals. If you feel consistently sad or anxious, consider talking to a doctor or mental health specialist. For more information, read a little about us or contact one of our locations.
  4. Holiday Eating Tips

    Holiday Eating Tips By Stacey Nye, PhD, FAED Thanksgiving is right around the corner and many of my clients have a similar concern: How to handle all the food usually present at large family holiday events. Hopefully these tips will help get you through with little stress and much enjoyment.     Tip # 1 Eat all of your typical meals and snacks the day of the event. People often make the mistake of skipping meals so that if they end up overeating they won’t feel as guilty. This is a big mistake. Showing up starving to a huge meal containing many of your favorite foods is a set up for overeating or binge eating. “But then I won’t have room in my stomach for everything that I want to eat” you might argue. The reality is that our stomachs have a limited capacity (approximately 1.5 liters of food) and empty approximately every 1-3 hours (depending on the person and food eaten). Eating lunch at 12 will still leave you with a relatively empty stomach for a 4pm dinner, and certainly no less room than you would have had if you had not eaten all day. Plus, walking into the room feeling deprived from fasting all day makes you more vulnerable to feeling out of control once dinner is served. Tip #2 Create structure One of the problems people run into at big holiday meals is that the food is plentiful, available and left out for long periods of time. Most of us eat our meals and snacks in discreet episodes- we take the food out, eat, and then clean up the remainders. So, for all day holiday meals one must create structure where structure may not already exist. • Designate a time in your mind to eat your meal so that it has a discreet beginning, middle and end • Avoid walking around and eating directly from serving platters. Fill a plate for yourself and use utensils. Try to sit at a table designated for eating. If you want seconds, fill your plate again. • When you’re done, clean up your plate and leave the table and dining room. You are making room for someone else to sit and enjoy their meal and doing yourself a favor by not lingering where the food is. There may still be finger food in other rooms. If you decide you want some of this, find a cup or a plate and repeat the process. Tip # 3 Eat mindfully Eat when you’re hungry. Food tastes better when you’re hungry. Stop when you’re full. Guilt aside, the physical sensations of being overly full, such as abdominal pain, bloating or heartburn, are unpleasant and unhealthy. Don’t have room for you favorite desert or enjoyed the turkey so much but you’re too full? Most hosts expect to send home doggy bags. Save the food for when you’re hungry again. Alternatively, make your own Thanksgiving dinner, any day of the year. Eat what you want. Really taste what you’re eating. Don’t like green bean casserole? Don’t eat it. Love squash? Make sure you get some. Tip # 4 Go easy on the alcohol. Alcohol lowers our inhibitions and makes us vulnerable to eating errors like overeating. Drink plenty of water to avoid dehydration. Tip # 5 Remember why you’re there While food can be a major component of many holiday celebrations, most of the time it’s not the main reason. Thanksgiving is a day of counting our blessings and being thankful for what we have. It is also a day when family and friends joins together, often after not having seen one another for a while. Once you have eaten your thanksgiving meal, if you feel tempted to eat more, remember why you are there. Take a look around the room and find a friend or family member that you haven’t seen for a while and go talk to them. Stacey Nye, PhD, FAED American Behavioral Clinics (262) 241-3231 – Stacey Nye is a clinical psychologist specializing in the individual and group treatment of eating disorders, body image and women’s issues.

  5. Domestic Violence in the Workplace

    From Milwaukee’s FEI Behavioral Health – The Workforce Resilience Experts – As recent events have proven, acts of domestic violence in the workplace not only pose a threat to the victim but also potentially to co-workers and customers. According to the Centers for Disease Control, more than 1 in 3 women and 1 in 4 men in the United States have experienced some form of domestic violence in their lifetime. In addition, the annual cost of lost productivity in the workplace due to domestic violence totals $727.8 million. In order to create an organizational culture that promotes employee safety, managers should be trained to recognize and respond to signs of domestic violence among employees. Domestic violence includes a pattern of repeated physical or psychological behavior used to coerce, intimidate, humiliate or force another person to think, feel or behave in a manner that the batterer dictates. It includes physical abuse, sexual abuse, isolation, economic reprisals, emotional put-downs, threats and intimidation. Typically, domestic violence follows a cycle of three stages: • The tension state is where stress between partners becomes intense. The victim will often try to ease the abuser’s stress in an attempt to avoid the violence. • The explosive stage involves the actual violence. Violence can take any form and is not exclusively physical. • The honeymoon stage is the time that the abuser is extremely remorseful and committed to “never doing it again.” The victim often chooses to believe the promises. Unfortunately, the cycle of violence usually continues. Identifying that the cycle is part of your life is often the first step toward help. While the cycle is not easy to break, the violence will continue unless help is secured. When signs of domestic violence enter the workplace managers must take swift action and understand how to appropriately address changes in behavior that affects employee performance. Managers should consider the following: • Develop workplace safety response plans and provide reasonable means to assist victimized employees in developing and implementing individualized workplace safety strategies. • Incorporate a specific intimate partner violence clause in your general policies on workplace safety. Make sure your policy addresses performance issues related to victims of domestic violence, provides accountability for employees who use company property (mail, e-mail, letters, phones) to harass a family or household member, and outlines the rights of domestic violence victims as they relate to the use of company time and resources to handle domestic violence and/or resulting legal issues. • Post information on domestic violence and available resources in the work site in places where employees can obtain it without having to request it or be seen removing it, such as employee rest rooms, lounge areas, as inserts in employee benefits packages and/or as part of new employee orientation. • Stay clear of common pitfalls, such as offering personal advice or attempting to counsel. Instead, employees should be referred to their EAP or a domestic violence help hotline. Read more from Milwaukee’s FEI Behavioral Health

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