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Digital health smartphone apps have shown unprecedented growth in the medical field along with the development of mHealth (mobile health) technology. Psychiatry and mental health services are enjoying the potential of mHealth technology with Mobile mental health apps that put personal health information into easily accessible smartphones, smart watches, and personal health monitoring sensors.

Mobile Mental Health Apps Risk

With the explosion of smart apps that can be found and downloaded from the App Store or Google Play for example, come the question of the usefulness and risk of these mobile mental health apps. The majority of apps for mental health have been developed without research, lack of scientific evidence that shows proof of effectiveness, or may have poor protection of your personal data.

Mobile Mental Health Apps Evaluation

Digital health technology is still fairly new; however, the American Psychiatric Association has taken a proactive step by developing an App Evaluation Model to help guide clinicians and patients in the quality of a mobile mental health app or mHealth tool being considered.

Five Steps in App Evaluation Model

The APA’s App Evaluation Model has five steps where each step is a foundation for the next level. It is important to evaluate each app to make an informed decision before “trying it out.” Apps that make it through the fourth and fifth step are worth your consideration and review by you and your therapist for functional use in your treatment program.

Five Steps of Review in App Evaluation Model

1. Background Information: Is there a fee for the app or is it free? If free how does it support its development? Who is the developer? Is there advertising within the app? What platforms does it work with? When it was last updated and what were the updates (security, glitches, added services, etc.)? Are there in-app purchases or upgrades?
2. Risk, Security, and Privacy: Is there a privacy policy? What data is being collected? Is personal data de-identified? Can you opt-out of data collection? Are cookies placed on your device? What data is shared? Who is it shared with? Can your information be sold to third parties? Is data kept on the device or uploaded to the web or cloud? What are the security measures? Is data encrypted? Is the app HIPAA compliant?
3. Evidence: If your app review has proven acceptable for the first two levels, then it is time to evaluate evidence for potential benefits. What does the app claim to do versus what it actually will do? Are there any peer reviews or published evidence about the tool or science behind the app? Is there any feedback from users available? Does the app appear to be of value for your needs?
4. Ease of Use: Is it easy to access? Can it be used on a long-term basis? Can you customize the features? Do you need an active internet connection to use? Does it work on the platforms that you have? Is it appealing and simple to use? Apps that are difficult to understand or manage will most likely fail to be used.
5. Interoperability: Can it work with other electronic tools and devices? Can you export or print the data from the app? Can you upload the data to an electronic health record that your psychiatrist or medical professional can use?

mHealth Psychiatric Treatment

Dr. Hege is a leader in offering convenient options such as video psychiatry, evening or weekend treatment scheduling, and use of new technology in providing the best psychiatric treatment available to you. Call the office today for a comprehensive evaluation of your needs. You may qualify for video sessions, so if that interests you please be sure to ask about it.

Addiction to nicotine is a difficult dependence to give up, and many smokers find themselves trying to quit smoking and kick the habit over and over again. Working with a knowledgeable mental health professional who can prescribe medication to not only help you quit, but help you manage withdrawal symptoms may be the only way you can finally succeed and break the hold nicotine has on your life.

Quit Smoking Statistics

If you are a smoker who wants desperately to quit smoking but have been unable to succeed on your own, you are not alone:

• 70% of smokers want to quit
• 40% of smokers will try to quit this year
• 7% of those who try to quit will actually succeed on their first try; 93% will not
• 50% of those who quit will relapse after drinking alcohol
• 5% of smokers are able to quit cold turkey

If you are one of the 93% who are unable to quit the first time, second time, or successive times, it is time to seek the professional help you need in order to become an ex-smoker.

• 90% of those who quit smoking before the age of 30 reduce their rate of death related to smoking
• 50% of those who quit before the age of 50 reduce their rate of death from smoking

Signs of Severe Smoking Dependence

Smokers who are seriously dependent on nicotine may exhibit one or more of the following signs:

• Smoking more than 1 pack of cigarettes a day
• Smoking within 5 minutes of waking up in morning or from a nap
• Continuing to smoke even when sick
• Waking up at night to have a smoke
• Smoking to help with symptoms of nicotine withdrawal

If you have even a couple of these signs of smoking dependence enlisting the aid of an addiction psychiatrist is thebest plan for success in smoking cessation.

Prescription Medications to Stop Smoking

Your psychiatrist has numerous medications available to prescribe and can provide referrals to support and adjunct services when developing your treatment plan to stop smoking, end nicotine addiction, and reduce any unpleasant withdrawal symptoms.

The medications that may be prescribed include:

• Chantix (varenicline) – this medication not only lessens the pleasure one gets from smoking by interfering with nicotine receptors in the brain; it also reduces the symptoms of nicotine withdrawal. Chantix helps you lose your craving for smoking and nicotine.

• Zyban, Wellbutrin or Aplenzin (bupropion) – the medication bupropion is known under three different brand names. It is an extended release anti-depressant that helps reduce cravings and symptoms of nicotine withdrawal.

• Nortriptyline – this is an older anti-depressant drug that helps reduce tobacco withdrawal symptoms

• Clonidine – this medication, used to treat high blood pressure has also been shown to help people quit smoking. When used as part of a smoking cessation plan it is often given in pill or skin patch form.

• Other medications and even anti-smoking vaccines are being tested in Europe and the United States but are not yet FDA approved. Your psychiatrist has access to the most effective medications and strategies for a successful program to quit smoking with the least interference from withdrawal symptoms.

Nicotine Addiction Psychiatrist

If you want to successfully quit smoking call Dr. Hege for a convenient evening or weekend appointment and begin a new life as an ex-smoker.

Reporting a sexual side effect while using psychiatric medications is a common complaint for both men and women. The severity of sexual side effects vary widely depending on the person, how they react to their medication, the specific medication prescribed, the dosage taken, and any co-existing medical disorders such as heart disease, cancer, and diabetes.

Sexual Side Effects

Psychiatric medication may effect sexual function in a number of ways. The severity of sexual side effects may be minor, may ease up as your body adjusts or become a continuing issue that impacts life enjoyment. Sexual side effects include:

• Erectile problems
• Orgasm difficulties
• Problems with arousal and satisfaction
• A change in the desire for sex

Statistics of Sexual Dysfunction

Most of the research available on impaired sexual function and psychiatric medication focus primarily on depression and antidepressants. Sexual dysfunction however is also a concern for those diagnosed with anxiety disorders, mood disorders, bipolar disorder, and schizophrenia to name a few. While 35% to 50% of those with untreated major depression report some type of sexual issue, those taking SSRIs (anti-depressant medication) report 30% to 40% delayed orgasm, 20% report decreased libido, and 10% of men complain of erectile function.

Impact of Psychiatric Medications on Sexual Function

The following classes of medication listed indicate some common drugs within each class that have more reported sexual side effects versus those with fewer reported sexual side effects:

Antidepressants:

• More reported side effects: Celexa (citalopram), Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline)
• Fewer reported sexual side effects: Wellbutrin, Aplenzin, Forfivo XL (bupropion), Cymbalta (duloxetine), Remeron (mirtazapine), Viibryd (vilazodone)

Antipsychotics:

• Increased side effects: Cozaril (clozapine), Risperdal (risperidone)
• Fewer reported effects: Abilify (aripiprazole), Zyprexa (olanzapine), Seroquel (quetiapine)

Sedatives:

• Increased sexual side effects: Valium (diazepam), Mellaril (thioridazine)
• Less reported effects: BuSpar (buspirone)

Reduce Psychiatric Sexual Side Effects

The solution is not to stop the medication you need for your mental health issues but rather to work with your psychiatrist to find an effective medication or combination of medications that work for you and reduce any sexual dysfunction that you have been experiencing.

Call Dr. Hege for a confidential appointment – there are many avenues of treatment available to help you live a full and satisfying life. Let Dr. Hege help.

Cocaine withdrawal is a difficult feat to accomplish with the intense cravings and withdrawal symptoms that can torment a person for weeks and weeks. The odds for beating cocaine addiction dramatically increase with proper psychiatric care and cocaine withdrawal medication management. Working with an experienced psychiatrist trained in addiction and recovery can help you reach and maintain recovery from a life controlled by cocaine cravings.

Cocaine Withdrawal Medication Antabuse Effective

Working with a specialist with decades of experience treating patients with primary and secondary substance abuse and addiction issues is paramount to a recovery plan that is successful. One of the medications that may be prescribed to help manage cocaine addiction withdrawal symptoms is:

• Antabuse / Disulfiram: This medication will help to minimize cocaine cravings and has been shown to improve abstinence and the recovery rates during the first three months of recovery. While Antabuse is generally used in the treatment of alcohol abuse it has shown positive results in the treatment of cocaine addiction as well.

Antabuse Effects on Cocaine Withdrawal

Cocaine primarily affects the neurotransmitter dopamine which directly affects the reward center of the brain – cocaine dramatically increases the level of dopamine in the brain which in turn causes feelings of euphoria that is commonly associated with the drug. In addition to increasing dopamine levels, cocaine increases norepinephrine which makes one feel they are full of energy. Euphoria combined with high energy makes cocaine addiction doubly difficult to recover from.

Use of Antabuse / Disulfiram blocks a specific form of dopamine which is an essential component in the body’s production of norepinephrine; Antabuse has a dual effect on the effects of cocaine use attacking the two main effects it has one the brain and body. Use of Antabuse makes using cocaine an unpleasant experience. While research data is bringing better understanding to the use of Antabuse with cocaine withdrawal, use of this medication is proving to be an effective part of a cocaine recovery treatment plan.

Cocaine Withdrawal Treatment Locally

Dr. Hege, a specialist in addiction and recovery, is a psychiatrist with over 25 years of successful treatment experience. The time has come to start on the road to your recovery. Call the office for a confidential appointment and comprehensive evaluation.

There are numerous choices to make when looking to find mental health professionals that can meet your needs in developing a successful treatment plan. There are over six different mental health professions with dozens of variations on the type or types of services they offer. It can be a confusing time deciding who to call, who is the right therapist for your needs, or figuring out just what type of mental health provider you do need.

Similarities and Differences among Mental Health Professionals

All mental health professionals who work with or treat individuals or groups, whether in a hospital, out-patient setting, group practice, or in private practice must hold a license to practice. Each state has its own specific rules and regulations for licensure for each type of profession that works directly with patients. The biggest difference found between the different types of mental health professionals can be found in the specialty or focus area and their educational background or degree held.

Mental Health Professionals

There are several different types of mental health providers to choose from when looking to find the right therapist or counselor for you. Some of the different types of professionals available in your community are:

• Psychiatrist – A psychiatrist is a medical doctor and the only mental health professional that is not only a specialist in mental health care, but one which can prescribe medications. While your family doctor can also prescribe mental health medications they do not hold the background or specialized training and degree for the treatment of mental health disorders. A psychiatrist may also include adjunct services such as cognitive behavioral therapy, group therapy or support groups as part of your individual plan.
• Psychologist – A psychologist may practice psychotherapy and usually has a doctorate degree, but not a medical degree. Their training may require thousands of hours of training and clinical experience that can include the diagnosis, psychological assessment, psychotherapy, individual, marriage and family counseling. In some states and settings a psychologist may hold a master’s degree and practice under specific guidelines.
• Clinical Social Worker – A clinical social worker generally have a master’s degree in social work for a M.S.W. and will show L.C.S.W. if they are practiced in providing psychotherapy services. While a clinical social worker may work in private practice they are often found working in a hospital, mental health agency, or in conjunction with a psychiatrist.
• Psychiatric Nurses – These nurses are registered nurses (RN) who have received specialized psychiatric training where they may provide some forms of psychotherapy. Psychiatric nurses are most typically found in a mental health facility or agency or working with psychiatrists or psychologists.
• Marriage and Family Therapist – These therapists may hold a master’s degree but rules and regulations vary from state to state, where they may be practicing with a more limited degree and experience. In choosing a marriage and family therapist it is important to check on their educational background as well as experience and training received with mental health disorders.

Psychiatry and Psychotherapy

In addition to medication, psychiatrists may also choose to engage you in psychotherapy, whether in a group or through adjunct services connected to their practice. Some common types of psychotherapy offered include cognitive behavioral therapy, group therapy, family therapy, and psychodynamic therapy to name a few. Your psychiatrist will make the determination as to what your treatment program will include following a comprehensive assessment of your concerns and issues.

Choose the mental health professional who can meet all of your needs. Call Dr. Hege for a confidential appointment – evening and weekend appointments available.

Many people who have never seen a psychiatrist or mental health professional often have misguided perceptions or believe a myth about what to expect. If your idea of what goes on in a psychiatrist’s office comes from what you have seen on soap operas or in the movies you may have a set of expectations that could actually limit the ability of the therapist to do their best for you.

Pre-Appointment Mind Set

While it is important to make that appointment for help with any emotional, psychological or behavioral issues you or a loved one may be having, it is equally important to have an accurate idea of what to expect during your psychiatric session times. Having accurate perceptions in place will allow you to get the most out of each session and facilitate an active one-on-one working relationship where your therapist can develop and implement a successful individualized plan of treatment.

Common Myths about Therapy

Understanding what reality versus a myth is can let you take full benefit from your mental health services. Some of the most common misconceptions are:

• “Therapy is supposed to make me happy.” While you may feel that you are happier with life and more comfortable overall, the intent of therapy is to assist you in becoming fully functional and connected with family, friends, work situations, school.
• “I want to be cured in one session.” The entire process of therapy takes time with no quick fixes. Each person is unique with their own needs, perceptions, and motivation for change. The therapist needs to develop an individualized plan, making changes as progress evolves. Many people have more than one issue or concern which may require a higher level of coordination of services, or use of more than one type of medication.
• “I want to be told what I need to do.” Many people go into a therapy session expecting to be told what to do to change their life or solve their problems. While a mental health professional will explore options, outcomes, or may refer for adjunct or group services, a therapist will guide rather than tell you what you need to do.
• “Talking to friends and family is just as good as seeing a psychiatrist.” Having a good support base is important when you are going through a rough time, but mental health professionals have the training and experience to understand and treat basic to complex problems. A therapeutic relationship is also confidential, where you can feel free to discuss things you have never been able to talk about before.
• “Only people that are crazy go see a psychiatrist.” Life is often stressful and full of challenging events and changes. In today’s world, getting help for psychological or behavioral issues is seen as part of keeping oneself healthy in both mind and body.
• “If I try harder I should be able to get better on my own.” Sometimes people struggle for months and years before seeing psychological help. A medical, biological or behavioral component to some disorders require more than just trying harder to get better.

Having the courage to know you need professional assistance and seek out a psychiatrist to help you lead a full functional life is a sign of strength. Take the first step toward feeling better and making a positive change in your life – call the office for an appointment.

Binge Eating Disorder, B.E.D., is the most common eating disorder affecting 1% to 5% of adults in the America. According to the National Eating Disorders Association about 50% of those with B.E.D. are either overweight or obese, however being diagnosed with B.E.D. involves more than just overeating. Only a trained and qualified health care professional can make the appropriate diagnosis and then develop the correct treatment plan that will be successful.

Cause of Binge Eating Disorder

With research and recent medical advances the exact cause of B.E.D. remains uncertain. There is some evidence that Binge Eating Disorder may be hereditary with the disorder linked to family genetics. There are some hypotheses that B.E.D. is caused by certain brain chemicals, or even certain life experiences such as life-threatening accidents or natural disasters.

Diagnosis of Binge Eating Disorder

The diagnosis of B.E.D. is very specific and all of the following symptoms must be present for a true and accurate diagnosis:

• Regularly eating far more amounts of food than an average person would be able to eat in a similar time period
• Feeling that the amount of food eaten is out of control during a binge
• Becoming very upset by the episode(s) of binge eating
• Binge eating typically occurs at least 1x/week over a 3-month period
• Those with Binge Eating Disorder do not try to correct their excessive eating habits by throwing up or by over-exercising; B.E.D. is not part of another type of eating disorder.

In addition to meeting all of the criteria above, at least three or more of the following symptoms must also be present for an appropriate diagnosis:

• Eating extremely fast
• Eating beyond the feeling of being full
• Eating large amounts of food when not hungry
• Eating alone to hide how much is being eaten
• Feeling bad about oneself after a binge has occurred

Degree of Binge Eating Disorder Exhibited

Along with an accurate diagnosis is the determination of the severity of the B.E.D. which your doctor will utilize in the development of an effective treatment program.  There are four levels of this disorder:

• Mild degree with 1 to 3 binge eating episodes exhibited a week
• Moderate degree with from 4 to 7 binge eating episodes a week
• Severe degree where 8 to 13 episodes are reported each week
• Extreme degree with 14 or more binge eating episodes every week

Treatment for B.E.D.

Vyvanse is the first and only medication approved to treat moderate to severe adult Binge Eating Disorder. Vyvanse (lisdexametamine dimesylate) is a prescription medication that your psychiatrist may choose to utilize in the treatment of your eating disorder. Following a comprehensive evaluation, an individualized treatment plan will be developed that may include Vyvanse, cognitive behavioral therapy, adjunct therapy, or support groups.

Binge Eating Disorder Psychiatrist

For qualified experienced care in the diagnosis and treatment of B.E.D., call the office of Dr. Hege to get your eating under control. It is time to enjoy life without the hidden struggle of binge eating.

The American Cancer Society reports that 20%, or over 40 million American adults currently smoke. With public education efforts it is well known that smoking has a multitude of damaging effects on the body including heart disease, stroke, oral cancer, colon cancer, or emphysema. In addition 90% of lung cancers can be linked to smoking. The difficulty with quitting is that smoking is both a physical and mental process; the addictive qualities of nicotine compare to heroin addiction.

Quitting Without Medication

Research data show that only 4 to 6 percent of adults who try to quit by themselves succeed. Use of nicotine replacement therapy, support groups or quit-smoking aids brings the success rate up to 16 to 24 percent. That number increases to between 25 and 33 percent when medications like Zyban or Chantix are added into a medically monitored treatment plan. Being able to quit smoking is a difficult task best tackled with a physician or psychiatrist who understands the addiction and the medications that work.

The Addiction of Nicotine

Two recent prominent studies have reported results that pinpoint specific regions of the brain that make it difficult for some people to be successful at quitting smoking. The one region, interpeduncular nucleus, is packed with nicotine receptors, with this area triggering anxiety responses during nicotine withdrawal. The other region of the brain, the insula, a large region that is viewed as the seat of addictive urges and cravings.  The insula becomes active when a smoker not only craves a cigarette, but when they are just thinking about smoking — a double-edged sword of anxiety and cravings to face when trying to quit smoking.

Quit Smoking with Nicotine Withdrawal Doctor

Call Dr. Darvin Hege to break the physical and psychological addiction that nicotine has on you. He may prescribe medications, nicotine replacement treatments, cognitive behavioral therapy, psychological support adjunct groups or other individualized treatment options to help you succeed and break the nicotine habit. Call the office today.

Opioid addiction has a powerful pull on those who use them, whether legally through prescription drug use or through illegal drugs such as heroin. Once addicted to opioids, a person typically requires professional intervention with medications such as Suboxone, as well as family and community support systems to beat the addiction. While the general public may not understand the intense addictive qualities of opioids, new research documentation may lead to greater awareness of the growing problem of opioid addiction in our society.

Addictive Cravings Detectable After Death

The Medical University of Vienna, Department of Forensic Medicine, published results in December 2016 that demonstrated addictive craving for opioid stimulation continues to exist up to nine days after a person has died. A protein in the brain’s reward center is altered with opioid use, making it more stable and able to react to an opioid stimulus in a type of memory function – this addictive craving can still be detected after death, indicating not only the power opioid addiction has, but the difficulty an addict has in trying to withdrawal from and quit opioids.

Post-Mortem Dependence Memory

The Journal of Addiction Research & Therapy reports on a study showing that the effects of chronic opioid stimulus can be identified post-mortem. The brain protein FosB that has been altered by opioid use, turns into DeltaFosB which becomes increasingly stimulated with chronic use and opioid addiction. DeltaFosB is found in the region where memory is formed which may make addiction and withdrawal all the more harder to achieve. DeltaFosB shows stimulation continues to exist nine days after the person has died – researchers believe that in living addicts the effect may last for months, making professional help all the more critical.

Psychiatric Opioid Addiction Treatment

When addictive cravings persist in the brain for months during and following withdrawal it is imperative to seek psychiatric opioid addiction treatment options. Call the office for a confidential appointment and expert care.

While the medications used to treat mental illness typically promote weight gain, there are also other factors that come into play. The National Institute of Mental Health reports that over 80% of adults diagnosed with mental illness also face the battle of keeping to a healthy weight. Medications do cause weight gain by changing the body’s metabolic processes as well as the perception of being hungry or full. Weight gain is such a serious concern for those taking psychiatric medication that it is often the major reason for patients to stop taking their prescribed medicine, ending an otherwise effective treatment plan.

Obesity and Mental Health Bring Health Issues

Weight gain related to mental health prescription drugs brings more than obesity as a health issue to the table. Obesity among those with mental illness surprisingly contribute to a mortality rate that is almost 3x that of the general adult population. Weight gain and obesity can also lead to high blood pressure, cancer, diabetes, heart failure and a multitude of other ailments and complaints.

Mental Health Illness’ Contribution to Weight Gain

Many of the complex symptoms related to mental illness can directly or indirectly contribute to the process of gaining weight. For example, some symptoms of depression include fatigue, lack of interest or motivation; these affect their desire to exercise which promotes a slowed metabolism turning those unused calories into fat. Patients with impulse control tend to eat and drink large amounts where the extra calories are not burned off on a regular basis. Patients with social anxiety disorder may avoid exercise around others, or avoid eating nutritious foods in favor of the anonymous fast food drive through line. Others may eat to help themselves through painful thoughts and emotions.

Which Came First? Weight Gain or Mental Illness

Research studies by University College in London, England on weight gain and mental illness report that those people who had symptoms of mental illness at the start of the study were more likely than those without a mental illness to become overweight and obese over time. Obesity however did not significantly increase the risk for developing a mental health disorder.

Psychiatric Medications and Gaining Weight

The following medications with the highest potential for gaining weight with use:

• Clozaril, Seroquel, and Zyprexa – antipsychotic medications that increase insulin resistance and lead to weight gain
• Remeron – an antidepressant that is also used to help those who need to gain weight
• Depakote – used in the treatment of bipolar disorder
• Paxil – 25% of users may put on considerable weight especially when used for a year or more
• Sinequan, Tofranil, Pamelor – older antidepressant medications which can cause short and long term weight gain
• Nardil, Parnate, Marplan – MAOI’s which also can cause considerable gain in weight over time

Medication Specialist

Mental health disorders and weight gain may seem to go hand in hand, especially when certain psychiatric medications are prescribed. Working with a psychiatrist with decades of experience can help you live a full, satisfying and healthy life. Call the office today.