Bitterness as a mental disorder?

Have you, or someone you know, fallen into an enduring feeling of bitterness toward someone?  I don’t mean feeling somewhat “wronged” and so distancing from the person, but rather having a more pervasive and overwhelming feeling of deep resentment toward the other person and perhaps self- recrimination for having been vulnerable to them.

There are reports that the group of mental health experts who debate and construct the contents of the Diagnostics and Statistics Manual of Mental Disorders (used by all behavioral health providers and health plans) are recommending the inclusion of a new diagnosis: Post-traumatic Embitterment Disorder.  It would be described as a problematic (“pathological” in the lexicon of psychiatry) reaction to one negative life event.  Such events include having been deeply humiliated by someone resulting an emotional mixture is of depression, helplessness and hopelessness.

Dr. Michael Linden, who first proposed the new diagnosis, states that he also believes people may have increased possibilities for this experience during times of significant social change, including times of economic turmoil when people are “let go” from jobs they need and want, and lose important relationships (see my post dated 11/12/08: Grief-A Common Experience).  

There are both intensely personal and broadly impersonal experiences that can result in feelings of humiliation.  Humiliation, particularly if it is willfully inflicted by someone significant in the person’s work or social circle or by someone who is personally important is a particularly painful and enduring experience, and can result lasting emotional scars.  The traumatic effect is intensified considerably if the humiliation is witnessed by others, thus making it “public” and possible a source of shame.  Bitterness, itself enduring, might well be the predominant outcome.   While I strongly believe that care should be taken to not classify all or most difficult human emotional reactions as possible mental illnesses, any emotion that is both enduring and debilitating merits the full range of behavioral health activity:  investigation, identification, and treatment.  I will follow the development of this newly classified clinical problem with interest.

And above all,  let’s also work to create a world where there are fewer instances of such deep and lasting humiliation in the first place.  That would be so much better than having a new name for what it does to us.

Health Education at Kaiser

Are you being challenged by general health concerns, such as the need to improve your mobility or to stop smoking?  You may not know that your  local Kaiser Medical Center offers Health Education classes and that many on these classes are open to people who do not have Kaiser Healthplan insurance.   Some classes are free, while others have a minimal fee, such as $80 for 8 classes ($10 per class).  Examples of what is available include:

• Pilates: An Introduction (with a follow-up class also available)
• Awareness Through Movement: The Feldenkrais Method
• Grief and Bereavement Support Group
• T’ai Chi for Health
• Yoga for Health
• Quit Tobacco Workshop
• Sleep Better:  Master Insomnia

I tried locating the classes, and other resources on the Kaiser website at www.kp.org/healthyliving  .  They are there, but I had some difficulty finding them.  You can also call these phone numbers for  information, and perhaps have a resource guide mailed to you:

• Oakland Kaiser Health Education Center- (510) 752-6204
• Richmond Kaiser Health Education Center- (510) 307-2210

Most Kaiser Health Centers, such as in San Francisco, Pinole and Walnut Creek, also have very active health education programs.  Find the Kaiser near you can call for more information about these free and low-cost health education resources.   Remember, Wellness is most often a total experience:  mind, body and spirit.  These classes are low-cost, and sometimes joining others, such as in a Quit Smoking class, can provide that extra bit of inspiration and motivation you may need to help you make the change.

Revenge: is it really sweet?

Recent research reported in the June 2009 issue of Monitor On Psychology (published by the
American Psychological Association) looked at the experience of exacting revenge, or being prohibited from doing so.  The results may surprise you.

Many people believe they have been maliciously wronged by someone at some time in their lives.  And, most people believe that revenge will help them find a kind of “closure” with the distressing event. 

Kevin Carlsmith found what might be surprising results:

“The results suggest that, despite conventional wisdom, people – at least those with Westernized notions of revenge – are bad at predicting their emotional states following revenge, Carlsmith says. The reason revenge may stoke anger’s flames may lie in our ruminations.  When we don’t get revenge, we’re able to trivialize the events, he says.  We tell ourselves that because we didn’t act on our vengeful feelings, it wasn’t a big deal, so it’s easier to forget it and move on.  But when we do get revenge, we can no longer trivialize the situation.  Instead we think about it.  A lot.  Rather than providing closure, it does the opposite:  It keeps the wound open and fresh.”

If you harbor your own vengeful thoughts for wrongs done to you, perhaps you will re-think them, and find a way to let go, and move on, and save yourself the continuing turmoil and trauma that comes from dwelling on the ways to “get even.”  Just think of all of the positive, fun and self-affirming ways you could use your imagination!  Turn to the future, and live your life with an intention to fill your moments with better experiences, happier times, and people who care enough not to hurt you in the first place.

And that may be the best revenge of all.

Men and Mental Health

Popular wisdom holds that men are more stoic, or perhaps less in touch with their feelings, then are women.  Now a recent study done in Great Britain reveals that the popular wisdom is true.  For you the popular wisdom may not have needed validation, but the numbers are still interesting, and also concerning.

Researchers found that 37% of men surveyed report feeling of anxiety and depression.  The primary factors causing distress in their lives were job security, work and money.  This appears to be a direct result of the global economic free-fall, and so can be presumed to be valid in most countries that trade beyond their borders.

The study continues to provide illuminating statistics.  At least 31% of the men surveyed  report they would feel embarrassed to seek mental health help, and only 14% would seek any kind of medical attention for symptoms of anxiety or depression, compared with 37% of women who would do so.   Just as concerning, only 29% of men would talk to friends about their inner struggle, compared to 53% of women who would do so.

With more and more job loss in our community, and the overwhelming feelings of loss and fears that happen when one faces the collapse of a hard-earned lifestyle, we can expect that we ourselves and many people around us will experience increased stress and anxiety.   This is an appeal to the men, and those who love and care about them, to seek the support and guidance of a qualified mental health professional when occasional worry turns into more persistent anxiety, or more.  Encourage the men that you think may be suffering in silence, or not so silently with alcohol or drugs,  to make an appointment.   Doing so is a sign of courage and strength. 

Are you feeling anxious, sad or worrying more than usual?  Beat the odds the researchers report… reach out for support today.

Stats for therapy are interesting and concerning.

The Substance Abuse and Mental Health Services Administration recently release a report with some concerning statistics.  While they estimate that over 24 million people age 18 and older experienced a serious psychological challenge during 2008, less than 50%  of received any kind of mental health service.  Included in the review were issues such as anxiety.  Rates for those experiencing mental distress were highest for young adults (18 to 25 years old) and lowest for people over the age of 50.  Alarmingly, those same young adults were least likely to received services 29%) versus over 50%  of people over age 50.

The disparity by age group could be partially result of both recognition (younger people may be less likely to recognize mental distress as a serious condition) as well as resources (older people may have better insurance coverage and more expendable income).  The numbers are nevertheless concerning.  Untreated mental distress can deepen and become a more significant or debilitating challenge, and the prevalence among young people of having untreated mental distress hints at future challenges in the mental health profession.

Anyone experiencing mental distress would be well advised to seek treatment early, as you would with any other condition affecting your well-being. 

Further is must be noted that nearly all public media messages about mental and emotional distress are produced by pharmaceutical companies as they market their drugs.  I have yet to see one of these ads recommend psychotherapy as either an alternative or an adjunct therapy.    These stats indicate that we must do a better job of publicly talking about mental health issues and the array of interventions that are available.