Author Archive

Listen to an enlightening, inspiring interview with Gretchen Rubin, author of The Happiness Project:

“The Happiness Project is the memoir of the year I spent test-driving the wisdom of the ages, current scientific studies, and lessons from popular culture about how to be happier – happily, it was a #1 New York Times bestseller. As one of the hundreds of experiments I’ve conducted, I started this blog. Here, I recount my daily adventures in pursuit of happiness.” – Gretchen Rubin

War is hell. And it doesn’t end on the battlefield.

The military’s response to what was once called “shellshock,” “battle fatigue,” and now PTSD, has changed dramatically, largely due to the astonishingly high numbers of veteran suicides during the Iraq war: between 2005 and 2007, suicide rates among veterans soared to 20% of the national total.

This number drops significantly among veterans receiving treatment at the VA. “[P]eople who have PTSD have suffered a wound, just like they’ve been shot, and need to be treated,” said Defense Secretary Robert Gates in a Pentagon Channel interview.

Online therapy, through sites like Breakthrough.com, has emerged as an alternative to reduce the effects of stigma. Veterans can access therapists confidentially, from any location, and with the option of maintaining their anonymity.

“Online counseling lets people get help where they are, physically and psychologically,” says Mark Goldenson, CEO of Breakthrough.com. “They don’t have to sit in a waiting room, explain why they are leaving home or work, or pay for gas or childcare. It lets people focus on getting better.”

Online counseling also helps people find the best provider for them, which research shows is an essential factor in getting better. Users can briefly talk online with potential counselors before committing to an entire session.

Online therapy also reduces costs for both clients and providers. It can eliminate travel costs, reduce administrative and overhead fees, and is increasingly covered by insurance (including Medicare and AMA).

While teletherapy is still a new practice, studies have shown that it can be as effective as in-person treatment. For example, a Lancet study found that online counseling more than doubled the likelihood of recovery for certain conditions.

With the military now encouraging soldiers and veterans to get help, perhaps fewer of our nation’s heroes will suffer in silence.

Many people who could benefit from psychotherapy don’t begin or stay in treatment because they think it’s too expensive. However, recent changes in the healthcare spectrum mean there are more options than ever before; insurance reimbursement for telecounseling makes it so that almost anyone can afford therapy.

Beyond its current affordability, a UK study found that psychotherapy is actually 32 times more effective at making you happy than money: a $1600 course of therapy had a happiness-equivalent of receiving a $50,000 raise. Based on their findings, it could be inferred that compared to therapy, money is a relatively inefficient way of achieving happiness.

The WHO estimates that depression is the leading cause of disability worldwide;  even nations which have experienced enormous economic growth have not seen concurrent increases in national happiness. This recent research suggests that in order to improve the national mood, nations would do better by expanding access to mental health care than concentrating on economic gains.

A penny saved is a penny earned — unless you spend it on therapy, in which case it is the happiness-equivalent of 32 cents.

Psychotherapy has been shown to help 90% of people who receive it, yet most who would benefit from it don’t go, largely because of the perceived costs.

With these new regulations, it is hoped that more of the 57 million Americans who would benefit from mental health services will be able to access them.

Everyone knows that an online session with a doctor or therapist can’t possibly be as effective as an in-person visit. Right?

It turns out, this is not necessarily true. A recent Lancet study found that for depression, online therapy (counseling sessions conducted via live video, chat, or email) was 2.4 times as effective as in-person sessions with a GP (the general go-to for depression within the UK health system). Depression is experienced by 1 in 6 people at some point in their lives; the associated labor-loss cost is estimated at $44 billion per year in the US.

“Online therapy lets people get help where they are,” says Mark Goldenson, CEO of Breakthrough.com, the online platform which connects mental health providers with clients through secure video, chat and email. “They don’t have to sit in a waiting room, they don’t have to explain why they’re leaving home or work, they don’t have to arrange childcare. It lets people focus on getting better.”

“Once the conversation starts, [they] forget there’s a screen between us,” says Dr. Kristopher Kaliebe, an assistant professor at Louisiana State University, who has telemed equipment set up in his home.

1 in 4 adults has a diagnosed mental illness. These 57 million Americans are nonetheless significantly underserved due to cost, inconvenience, low access in certain areas, and the effects of the stigma surrounding receiving mental health help.

With the establishment of Health Care Reforms, the Mental Health Parity Act, and the spread of technology, telecounseling may become a key part of the emerging healthcare spectrum. As 40 million newly-insured patients enter the health care system, and telecounseling is increasingly covered by insurance, big shifts may be expected. The most important tool in a doctor’s bag may soon become her laptop.

“In some ways, it’s a throwback to the housecall of the past,” says Goldenson. “Only in this case, the practitioner can be available at more times and from almost anywhere.”

About Breakthrough.com: Breakthrough.com connects mental health providers with clients through secure video, email and chat. Breakthrough.com is a startup in Menlo Park, CA, and has been covered in Forbes, Wired, and TechCrunch, and was recently named by Business Insider listed them as one of “The 15 Startups I Would Invest In If I Had The Cash” alongside Twitter, Foursquare and Zynga.

I get a chance to speak with the Drs Bill and Ginger Bercaw, sex therapists and authors of the upcoming “From The Living Room To The Bedroom.” We discuss sexual abundance, and how to nurture it in any relationship.

1. Escalation of intensity of romantic and sexual behavior – more time or money spent, more intense sexual experiences etc.

2. Lying, hiding or keeping Secrets about your sexual behavior – living a double life.

3. Looking for relationships and sex has become your primary life priority.

4. Failed Previous Attempts to stop problem sexual or romantic behavior.

5. Sexual behaviors continue despite clear and obvious potential or actual consequences (legal, family, work, health etc.)

Rob Weiss is the founding director of the Sexual Recovery Institute in Los Angeles, which has experienced a 50% increase in business in the wake of Tiger Woods. We discuss sex addiction, the modern sex-scape, and “the process.”

This week we’ll be taking a look at sex, addiction and the psyche with sex therapists Drs. Bill and Ginger Bercaw, who run the California Center for Healing, and have just come out with a new book: From the Living Room to the Bedroom: Six Steps To True Intimacy And Sexual Abundance . We’ll also be speaking with Rob Weiss, founder and director of the Sexual Recovery Institute, which has experienced a 50% increase in clients in the wake of Tiger Woods news.

Join us live on Twitter to participate in the discussion.

We welcome your questions and comments. Let us know what’s on your mind, and what you’d like us to undress — er, address!

Charlie Sheen: Winning Meme-Machine, or Accelerating Downward Spiral?

“Is Charlie Sheen awesome or seriously disturbed?” asked the Washington Post yesterday in an online poll; as of today, 46% voted “awesome.”  News networks have granted him hour-long interviews, his quotations have been adapted into a list of dating advice, and his twitter account has gained nearly 1 million followers in less than 24 hours. Already, conversations across the country are sprinkled with phrases like “winning,” “tiger’s blood,” and “rockstar from Mars.”

But experts, and those who have experienced mood disorders caution against humoring — and directing humor at — his behavior.

“It’s not a joke. And it’s nothing to make fun of,” says blogger Tod Maffin, who lectures on mental health and work life balance, and his road back from two very severe substance addictions. “If you wouldn’t make fun of someone with cancer, you shouldn’t be poking fun at Charlie Sheen.”

“We need to be mindful that Mr. Sheen is a human being first, and should not be used as an object for mocking, moral outrage or stigma,” concurs Deborah Serani, Psy.D, author of Living with Depression: Why Biology and Biography Matter Along the Path to Hope and Healing. “It is also important that mainstream media understand that the way it chooses to report about Charlie Sheen can do one of two things: it can unwittingly create a contagious trend of demeaning mental illness or it can educate and help others receive treatment.”

Maffin says that Sheen’s  grandiose phrases are signifiers of a serious problem.

“These aren’t harmless, everyday ‘metaphors,’ as some have claimed. These are pathological statements,” says Maffin. “If you know someone who lives with bi-polar disorder and you hear phrases like [Sheen's]… they are in trouble. Find a way to get them to medical attention immediately.”

Dr. Drew Pinsky, who tweeted about Maffin’s blogpost, said similar things on HLN about Sheen’s recent rash of extreme statements.

“It is bizarre, but I would caution you not to use your healthy brain to make assessments about what’s going on with him. This is  not somebody whose brain is working normally,” said Dr. Drew, who is famous for helping celebrities deal with addiction on his reality show, Celebrity Rehab.

“We call this a manic episode, or a hypo-manic episode. That’s clearly the condition he’s in, where there’s perseveration (repeating things), there’s loosening of associations where thoughts don’t connect, there’s pressure in his speech, there’s irritability and rages, and then again, these sort of peculiar, grandiose gestures,” explained Dr. Drew.

“This is an uncomfortable state, make no mistake about it. People who are in this state are not feeling good, and when they look back at it, they’re very unhappy, typically that somebody didn’t step up and do something on their behalf.”

Robin Mohilner, MFTi, defends Sheen’s humanity on her blog, Thrive With Bipolar Disorder. She interprets his words and actions as the voice of mania and years of self-medicating drug use, not his true character. Mohilner feels that Sheen’s behavior, though outlandish to outsiders, is normal for someone living with untreated bipolar disorder — and that his lifestyle itself is normal for someone with this condition who is also rich and famous. She suggests that when a person has money and status, the others in their life are often more likely to be indulgent and accepting of them, and thus may not label their behavior with a diagnosis or insist that they seek help. Mohilner empathizes with Sheen’s unique situation, saying she feels lucky that she was not in the public eye during her own experience with bipolar disorder.

“I am so thankful that I was not famous and incredibly wealthy when I had my worst full-blown out of control manic episode. I am so grateful that there was no one to document my actions and words besides my mother.”

Mohilner believes that Sheen is currently experiencing “the best part of mania.”

“Who wouldn’t want to truly feel omnipotent, divinely chosen and special and invincible?” she says. “Right now, to everyone else, Charlie looks out of control. However, my experience knows that he feels more in control of his life than ever before.”

Serani describes being in the depths of a mood disorder as “swirl[ing] in an ocean of mental, physical, and spiritual chaos,” and says that “it’s only when you reach the safety of the shore that you realize just how dangerously ill you were.”

Mohilner and Dr. Drew agree: someone in the throes of mania is headed for a very dark, painful collapse. Dr. Drew mentions the inevitability of a 72-hour lockdown, and Mohilner offers her own grave take on what comes after the “best part of mania”:

“Every emotion I’ve ever had came exploding out of me. All of my pain, rage and sadness exploded out of me uncontrollably.  I was haunted by delusions disguised as memories and obsessive paranoia that my family was trying to hurt me.  I used my words as knives to hurt people. Everything that was good in me, was gone.  All I could do was destroy my life. This is why I take my medication everyday and do everything that it takes to remain stable with bipolar disorder.”