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Home » Blogs » Archive by category '憂鬱症' (網誌分頁 3)

愛吃甜食基本上是一種"癮"

五月 21st, 2014 Posted in 其他資訊, 失眠, 憂鬱症, 藥物戒治

愛吃甜食基本上是一種"癮"
不吃很難受跟藥酒癮一樣,基本上糖類的危害在人類越來越大他造成的不只是肥胖和糖尿病
他還跟睡眠以及情緒,憤怒安全感有關係
基本上現在很多人需要"夜食"或是 "情緒食"
這與精緻醣類的血液中糖分快速上升有關係,也與血清素和色胺酸有關
這會影響到心情,當這些東西下降時,我們的的大腦會"想要"那些東西
不過這可以用喝水,運動,大量纖維質以及藥物控制接本上不難治療
東方女生少一點,治療簡單,約35歲之後也機會不會復發了(當然不一定會復發,不用擔心)

偏頭痛了嗎?小心! 憂鬱症也一起找上你

十一月 27th, 2013 Posted in Blogs, News, 憂鬱症, 自律神經失調, 躁鬱症

加拿大最新研究發現:深陷頭痛之苦的人更容易有憂鬱和自殺的傾向

此項發現是由多倫多大學研究員從2005年加拿大社區健康調查67,000位名眾樣本資料中分析獲得,其中超過6,000名參與者曾被診斷出患有偏頭痛症狀,與先前研究相符合的是,相較男性之下(每16名男性中有1位),頭痛症狀更好發於女性(每7名女性當中有1位)

分析指出偏頭痛之患者罹患憂鬱症的機率是平常人的2倍之多(男性:8.4%比3.4%;女性:12.4% 比5.7%)

多倫多大學研究員將此項新發現刊載於網路出刊的Depression Research and Treatment. Esme Fuller-Thomson教授、Sandra Rotman教授、Endowed Chair教授和其他研究員於文章中寫出“年輕”偏頭痛患者,是罹患憂鬱症的最大危險族群。Fuller-Thomson教授表示:30歲以下女性頭痛患者罹患憂鬱症的機率是65歲頭痛患者的6倍

在詳查頭痛與憂鬱症之關聯性的同時,研究員也分析了頭痛與自殺傾向的相關性。他們發現不論是男性女性,曾經“認真考慮過採取自殺行為”的頭痛患者是非頭痛者的2倍,男性為15.6%比7.9%;女性為17.6%比9.1%

作者之一Meghan Schrumm說明:我們不是很確切知道為什麼年輕頭痛患者與憂鬱症和自殺傾向有這麼高的關聯性,也須是因為年輕患者還未找到合適的治療方式與生理機制去減輕疼痛及其所帶來的影響。

Fuller-Thomson教授表示對於憂鬱症和自殺傾向,他們的新發現突顯出例行性的檢查和介入鎖定對象的重要性,尤其是最脆弱的頭痛患者們。

最近在Neurology期刊發表的另一研究也發現頭痛可能會改變腦部組織和增加腦部損傷的風險。本文由Catharine Paddock 博士撰寫

本文由松德身心科診所摘譯自:http://www.medicalnewstoday.com/articles/267610.php

~original text~

Migraine sufferers more likely to have depression

Friday 18 October 2013 – 3am PST

A large new study from Canada finds that people who suffer from migraines are also more likely to have depression and think about suicide than counterparts who do not have them.

Researchers from the University of Toronto analyzed data from a representative sample of more than 67,000 people who took part in the 2005 Canadian Community Health Survey.

Over 6,000 of the participants reported having been diagnosed with migraine, and in line with previous studies, migraine was found to be much more common in women (1 in every 7) than men (1 in every 16).

The analysis shows that depression among people with migraine was about twice as common as in people without migraine (8.4% versus 3.4% for men and 12.4% versus 5.7% for women).

The researchers write about their findings in a paper published online this week in the journal Depression Research and Treatment.

Lead author Professor Esme Fuller-Thomson, Sandra Rotman, Endowed Chair, and colleagues write that younger migraine sufferers were the group at highest risk for depression.

Female migraine sufferers under 30 years of age were more than six times as likely to have depression as sufferers aged 65 and over, Prof. Fuller-Thomson says.

As well as examining links between migraine and depression, the researchers analyzed links between migraine and thoughts about suicide.

They found, for both men and women, those with migraines were twice as likely to have "ever seriously considered suicide or taking (their) own life" than those without migraines. For men, the figures were 15.6% versus 7.9%, and for women they were 17.6% versus 9.1%.

Co-author Meghan Schrumm says:

"We are not sure why younger migraineurs have such a high likelihood of depression and suicidal ideation. It may be that younger people with migraines have not yet managed to find adequate treatment or develop coping mechanisms to minimize pain and the impact of this chronic illness on the rest of their lives."

Prof. Fuller-Thomson says their findings underline the need for routine screening and targeted interventions for depression and suicidality, particularly for the the most vulnerable migraine sufferers.

Another study recently published in the journal Neurology found that migraines can alter brain structure permanently and increase the risk of brain lesions.

Written by Catharine Paddock PhD

Reference:http://www.medicalnewstoday.com/articles/267610.php

重視"厭食症"病人

林耿立醫生呼籲~~重視"厭食症"病人
今日新聞提及~國3女罹厭食症 40公斤餓到剩26公斤猝死
林耿立醫生表示"厭食症"為各類精神疾病死亡率最高的類別
家屬務必更加重視厭食症病人的日常飲食表現

松德身心科診所 關心您
htthttp://www.hwc.com.tw/news/index.php?mode=data&id=266

門診時間表

http://www.hwc.com.tw/outpatient_services/

林醫生~美商北京明德醫院駐診

林耿立醫生應美商北京明德醫院之邀
預計至北京開設特別門診提供中英台語服務
初期規劃
自2013年11或12月起每月將有一週於美商北京明德醫院看診

林醫生北京駐診期間
大陸華北地區台商可就近至北京看診(明德醫院設施/服務皆很完善)
同時段林醫生亦可接受遠距諮商(需事先預約)

松德身心科診所

可以點選下面連結(中文在右上角落)

提高生命品質,陪伴親人無痛苦走最後一段旅程

十月 1st, 2013 Posted in Blogs, EAP, 失眠, 憂鬱症, 焦慮症, 躁鬱症

提高生命品質,陪伴親人無痛苦走最後一段旅程

林萃芬諮商心理師

面對親人生命交關的時刻,大部分家屬都會竭盡所能挽救親人生命,但是在一次又一次急救的過程中,往往也讓親人受盡苦痛,毫無生命品質可言,雖然家屬於心不忍,但也很難放手,病人與家屬內心的煎熬折磨可想而知。
中華民國諮商心理師公會全國聯合會理事長徐西森表示,生老病死是人生大事,也是無可避免的宿命歷程,近日「台灣醫療品質促進聯盟」結合十九個醫事團體發起「拒絕無效醫療」社會運動,期盼臨終關懷的病患家屬能放手、醫師能放下,鼓勵社會大眾能預先簽署放棄無效醫療的意願書,預約善終權。諮商心理師身為心理健康的助人工作者,有必要發揮助人角色與專業功能,讓臨終關懷病患安心、病患的家屬及其醫療人員心安。
長期投入諮商心理與復健諮商研究的徐西森教授說明,臨終關懷是指,協助照顧疾病無法治癒之癌症末期病人疏緩病痛、得以有尊嚴的走完人生旅程,以及減輕其家屬傷痛、度過失親悲傷時期的一種照護歷程。在此照護歷程中,諮商心理師最重要的職責與功能為「陪伴(being present)」與專業介入,對病人及其家屬宜多關注、多主動、多盡責、多開放、多傾聽、多敏感其身心需求、幫助家人與其相互道別、處理雙方的分離焦慮、協助其完成未竟事件(心願)等等。
馬偕醫院諮商心理師呂奕熹指出,大部分來到安寧病房的病人,在病情發展上大多不樂觀,因此希望藉著緩和治療來減低疼痛。不過,由於國人對於安寧緩和的瞭解並不深,且在傳統文化的概念中,若未能盡力救治,病人是長輩,決定者就要承受不孝之名;病人若是平輩或子女,則會被指責不仁。
呂奕熹認為,在安寧照顧的團隊中,非常強調團隊的合作。醫師主責病情與藥物上的控制,護理人員協助住院歷程的照顧,社工師則協助尋求相關資源的協助,而諮商心理師一方面可以照顧病人,通常病人在臨終前常有未竟事務,或充滿著各種情緒,或是憤怒上天的不公平,或是懊悔未能多給家人時間,情緒的不穩定也影響著病情。心理師在病床旁邊,對於不想說的病人給予陪伴,對於沮喪失志的病人給予支持,對於憤怒不平的病人給予情緒的宣洩,有助於讓病人的情緒穩定,進而可以放心地面對生死的問題。另方面亦可照顧病人家屬,家屬在長期照顧病人的歷程中,除了經歷生理上的疲累,也承受著心理上的壓力與挫折,也需要得到好的心理支持。
諮商心理師公會全聯會發言人林萃芬以為,很多家屬因為怕臨終的親人難過,常會強顏歡笑,忍隱滿腹悲傷情緒,或是在照顧臨終親人的過程中身心具疲,往往不堪負荷。最常見的狀況是,病人身體飽受折磨,家屬心靈備感矛盾,久而久之,很多家屬都出現憂鬱焦慮的身心症狀。此外,遭逢意外事故的病人家屬更是既震驚又難以接受突如其來的打擊,既混亂又不知道該如何是好。這個時候如果有心理專業人員協助家屬舒緩情緒,降低無力感,整理混亂的思緒,同時跟家屬討論後續的心理準備,可以讓家屬更有能量面對臨終的親人。
政治大學心理系兼任副教授及諮商心理師公會全聯會秘書長修慧蘭表示,每個人在生命末期均希望能統整自己生命,找到自己生命意義的答案,因此如何協助病人及病人家屬面對此人生重大課題,是醫事人員可以協助的部分。諮商心理師加入安寧團隊,不僅可以達到全人關懷的醫療目標,除了病患、家屬能夠獲益,亦能讓醫療團隊的功能發揮到極致,在推動避免「無效醫療」的歷程中,諮商心理師亦能達到讓人「安心」的效果。

分析不同失眠類型 透過心理諮商技巧找出失眠根源 才能安穩睡個好覺

分析不同失眠類型 透過心理諮商技巧找出失眠根源 才能安穩睡個好覺

林萃芬諮商心理師

案例:
32歲的李小姐婚前開朗活潑,每天上床倒頭就睡,很少嚐到失眠的滋味。然而,結婚以後,由於嫁入大家庭又進入家族事業工作,李小姐一方面要面對錯綜複雜的人際關係,另方面要求完美的個性讓她事必躬親,以致開始睡不好。還沒完全適應新婚生活,緊接著她又忙於迎接新生命的到來,初為人母的她極度緊張焦慮深怕沒把孩子照顧好,常常夜裡不斷驚醒查看孩子的狀況。老二出生後因體弱多病,李小姐更是提心吊膽,時刻注意孩子有沒有發生什麼意外。當媽媽後她便為失眠所苦,長期睡不好讓她變得暴躁易怒、缺乏耐心,常常莫名想哭,雖然有求助醫師的協助,現在孩子長大了,但仍無法擺脫失眠的折磨。
3月21日是世界睡眠日,根據最新的調查數據顯示,台灣目前大約每五個人就有一人為失眠所苦。令人關心的是,何以台灣失眠人數與日俱增?
中華民國諮商心理師公會全聯會發言人林萃芬諮商心理師表示,失眠議題除了生理的因素外,也跟社會變遷、工作壓力、生活型態、感情問題息息相關。特別是女性失眠的人數比男性高出很多,一般女性失眠的類型有下面幾種:一是當了媽媽之後警覺性提高,隨時注意孩子的狀況,深怕自己睡得太熟會忽略孩子的動靜。二是人際關係衝突緊繃,例如先生外遇出軌,或與家人爭吵不合,都會嚴重影響睡眠品質。三是另一伴有打呼症狀,被吵到無法入睡的亦大有人在。四是個性過度憂慮或是太要求完美,躺在床上反覆自我檢討,越想越難入睡。
林萃芬諮商心理師說明,失眠有長期與短期之分,長期失眠的狀況包括,夜晚從事耗費腦力的工作,例如設計或創作,久而久之變成夜貓子。或是在24小時的機構工作,或是上夜班,長期以往睡眠品質跟著下降。還有在外租屋或受限於空間太過狹小,習慣在床上打電腦、看電視、吃東西,導致睡眠時間越拖越晚。
至於短期性失眠,林萃芬諮商心理師舉例,像是處在不熟悉的環境中,如出差住旅館有些人會因恐懼不安而無法成眠。也有些人是因為考試、工作、業績壓力太大而引發焦慮性失眠。
長時間投入睡眠紓壓的林萃芬諮商心理師指出,短期失眠如果置之不理,有時候也會演變成長期失眠,很多長期失眠的人只要一想到睡覺,就會擔心自己睡不著,結果形成惡性循環,睡眠本身就是最大的壓力源。
林萃芬建議,想要安穩睡個好覺,不妨多管齊下,一方面檢查是否為生理因素造成,另方面可以求助身心科醫師開立適合的藥物。同時也可以透過心理諮商的技巧找出失眠的根源,舉例來說,要讓警覺性太高的媽媽在睡眠時稍微解除警報,首先要降低媽媽的擔心,再帶領媽媽從頭到腳練習睡眠放鬆的技巧。而為感情所苦的女性,可以藉由感情諮商重新探索經營親密關係,當心靈安定了,睡眠自然也安穩了。
至於過度憂慮的失眠者,則可運用心律呼吸法讓混亂的思緒暫停,才能夠進入夢鄉。林萃芬建議,倘若失眠是肇因於過往的創傷或遺憾,很多失眠者會做反覆的惡夢,這個時候亦可透過「夢工作隱喻治療」,進入失眠者的潛意識找出深藏的傷痛進行治療,當心靈創傷修復了,失眠的症狀可能亦隨之改善。如果是因焦慮壓力引發的失眠,可使用HRV情緒儀了解身心狀況、掌握焦慮的來源,進而採取有效放鬆的方式提高睡眠品質。睡眠好壞可說是心理健康的重要指標,睡得好自然遠離憂鬱焦慮,更有能能量面對生活。

2013臨床心理學會(年刊發表)

Influence of interpersonal problems on the relationship between attachment styles and social skills in Borderline Personality disorder

Jin-Jia Pan1(潘金嘉), Geng-Li Lin2 M.D. (林耿立醫師)
Institute of Psychology, Heidelberg University, Germany1
Song De Psychiatry Clinic, Taipei2

Background:
The literature on the relationship between attachment style and patients with borderline personality disorder (BPD) has been the subject of controversy and few attempts have so far been made at exploring the role of interpersonal problems between the causality of attachment styles and social skills in patients with BPD. The objective of this research was to examine whether interpersonal problems mediated links between attachment styles and social skills in BPD. Furthermore, this research also was to explore if the bias of interpersonal problems in BPD could predict inadequate social skills.

Methods:
29 BPD outpatients (19female, 10male) and 65 control subjects completed Relationship Questionnaire, Structured Clinical Interview for DSM-IV Axis II Disorders, Symptom Checklist-90-Revised, Social Skills Inventory, and Inventory of Interpersonal Problems Circumplex Scales. Moreover, a total of 94 significant others (29 from outpatients, and 65 from healthy subjects) were also recruited in this study to assess subject’s interpersonal problems. Independent samples t-test was conducted to compare all variables in two groups and examine the difference between self-report and other-report interpersonal problems. Hierarchical multiple regression analysis was performed to test (a) the relationship between the difference of interpersonal problems and social skills, and (b) the mediation effect of interpersonal problems between attachment styles and social skills in BPD.

Results:
Three important findings were found in this study. Finding 1: The majority of control people had secure attachment styles, while many borderline patients ’attachment styles were insecure. Patients’ scores on social sensibility (SS) were significantly higher than controls and scores on emotional awareness and emotional expression (EAEE) were lower than controls. In terms of interpersonal problems, borderline people described themselves more domineering, vindictive, cold, exploitable, intrusive and nonassertive than normal people. Compared to other-report interpersonal problems in controls, significant others appraised borderline people more vindictive and more socially avoidant. Finding 2: The result of the relationship between the difference of interpersonal problems and social skills indicated that domineering, vindictive, and nonassertive as predictors could significantly negatively predict social awareness and social expression (SASE) respectively; moreover, exploitable as predictor significantly positively predicted SS. Finding3: (1)Preoccupied attachment style had significant predicting power over social sensibility in BPD. (2) Intrusive had full mediation effect between preoccupied attachment style and social sensibility in BPD.

Conclusions:
The results suggest evidence for potential interpersonal mechanism of development of BPD, which was meaningful for understanding the psychopathology of BPD and helpful for application of psychological intervention. Furthermore, several limitations have to be considered in interpreting results, for example, small sample size, borderline outpatients without considering the comorbidity of other personality disorders, the limit of cross sectional study, etc.

Key words: Borderline personality disorder, attachment styles, interpersonal problems, social skills