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States-of-Mind

Inevitability of failure

Failure is an inevitable part of life. We all experience times when we fall short of expectations in some way, when we do not succeed in an endeavour or relationship. 

It is inevitable, and happens to everyone on a small or large scale at some point in life – and often more than once in a lifetime. However, just because failure is part of the universal human experience does not mean it isn’t painful. 

We’ve all felt the initial blow, the wounded pride, embarrassment and sadness that come immediately following a failure. The bigger the fall, the harder it can be to pick ourselves back up again.

For many, particularly those with low self-esteem, the pain can be crippling. Even recalling past failures can be emotionally difficult. Sometimes, the feelings of shame associated with previous failure can hinder a person’s willingness or ability to move on or try again. 

Research in the US has found that changing our perspective when we recall failures can affect our emotional response to them. 

According to research, we experience more negative feelings, such as shame, when we think about our failures from a third person perspective (through the eyes of an observer). If we recall the situation through our own eyes, we experience less shame.

When thinking about events in our lives (remembering the past or imagining the future), we often picture the events in our minds. Sometimes we see things from our own point of view, but not always. This study has shown how a subtle shift in perspective can make a big difference in our emotional response to those events – particularly to failures.

In the study, volunteers completed a self-esteem assessment and were then directed to recall a failure. Participants were randomly assigned to remember the event from the first or third person perspective, then rate how much they were experiencing various emotions. 

Those with low self-esteem were shielded from experiencing shame if they were recalling failure from a first person perspective. 

These results are heartening, and leave room for simple ways to lessen the negative emotional impact of difficult experiences. Without the need for extensive training, it is possible to give people some simple and effective techniques to maintain emotional well-being, as well as to improve self-insight. 

We all experience failures. With the right perspective and a healthy emotional response, we can allow those experiences to strengthen our character and teach us how to move on and avoid similar pitfalls in the future.

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Inheriting memory

The nature nurture question is more complex and interconnected than it sounds - one fascinating example of this is found in the idea that memory could be inherited. 

Research shows that traumatic experiences can change the DNA in sperm and affect the behaviour of subsequent generations. 

We have long known that traumatic experiences can change the way our brain develops and lead to a higher likelihood of experiencing mental health issues later in life, but it seems these experiences can actually affect the mental health of our children, and even our grandchildren.

Researchers at Emory University in the US studied this question in mice. They trained mice to fear a particular smell and then observed changes in sperm DNA. A section of DNA associated with sensitivity to the particular odour became more active in the sperm and was then passed on to the next generation of mice. The next two generations of mice were then very sensitive to the same smell even without being trained for it. 

It is believed these findings are very relevant to our understanding of phobias, anxiety disorders and PTSD in humans. Some experts believe this trans-generational response will also have implications in other areas of health such as obesity and diabetes. 

These results certainly do seem to further complicate our understanding of the way genetics factor in to mental health conditions such as anxiety disorders. Most psychiatric conditions are known to have at least some genetic component, and are usually more common in relatives. We often think of this as a straightforward passing on of a trait. If I have blonde hair, I am more likely to pass that on to my children.

In recent years, we have learned that our experience of mental health symptoms can change our own genes and brain structure on a physical level. This has been likened to switching genes on or off. 

This is the first indication that the genetic material of our future offspring can also be affected by our experiences. Not only will my own brain change as a result of my anxiety disorder, but the genetic material I pass on may also become more sensitized as a result. 

More research is needed to understand the extent of this effect in humans, but it certainly has the potential to be a game changer in our understanding of the underpinnings of some mental health conditions. 

In the meantime, there are effective treatments available for anxiety and depression. Regardless of the cause of the condition, if you are living with mental health symptoms that are affecting your ability to function or enjoy life, speak with your doctor to learn your options. Help is available.

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Feeling the rage

Intermittent explosive disorder

Over the years I have written columns about most of the commonly occurring psychiatric disorders. One disorder that hasn’t been covered so far, but which is now known to be much more common than once thought, is called intermittent explosive disorder. 

The name describes it pretty well. It is a condition involving impulsive aggression. Individuals experiencing intermittent explosive disorder tend to blow up from time to time in aggressive outbursts. 

Of course, many people have the occasional outburst when faced with particularly stressful situations or people – when we’re overly tired and the irritants of the day seem to be relentlessly pursuing us. 

To be diagnosed with this particular condition, though, the individual has to have periodic aggressive outbursts that are impulsive in nature and involve aggression (verbal or physical) that is grossly out of step with the provocation or stressor involved. 

Aggressive behaviour that is labeled intermittent explosive disorder must not be easily explained by another mental or physical illness or substance use. 

These are aggressive outbursts that clearly go beyond the scope of a normal snappy remark or shouting match. Think of extreme road rage scenarios as a good example. Stopping at an intersection and using a golf club to seriously smash up a stranger’s vehicle after being cut off – this goes well beyond a normal reaction to an admittedly infuriating experience.

People experiencing this condition often describe their outbursts as brief (lasting less than an hour), being accompanied by physical symptoms such as sweating or palpitations, and immediately followed by relief and later remorse.

Obviously, outbursts such as these are extremely destructive for the people having them, and everyone around them.

Until recently, this condition was thought to be quite rare. Research over the past decade now shows it is just as common as many other psychiatric conditions – affecting anywhere from three to seven percent of the population. It can begin in childhood, adolescence, or early adulthood, and is chronic in nature. Studies have found it can persist for as few as 12 years or for most of adult life. 

Although it is considered a unique disorder, intermittent explosive disorder often co-exists with other psychiatric conditions such as bipolar disorder, depression, or anxiety. 

Although there are some treatments that seem to help, much more research is needed. Cognitive behaviour therapy helps some people with impulsive aggression to recognize their behaviour, and learn to control it. Some antidepressant medications have also shown promise in treating intermittent explosive disorder. 

If you think you or a loved one may experience intermittent explosive disorder, speak with your doctor about it. You will likely need an assessment from a mental health professional to rule out other conditions, and determine the best option for moving forward. 





Borderline personality

Borderline Personality Disorder Recovery

Borderline personality disorder (BPD) is a very disruptive condition, and one of the most difficult to manage in a medical setting. 

Individuals with this condition typically have a long history of intense, unstable relationships, and an extreme fear of being abandoned by people. They almost always have a poor sense of identity that is highly influenced by surroundings and relationships. 

Other key symptoms in BPD include inappropriate anger that is difficult to control as well as a history of impulsive, reckless behaviour in sex, spending, drug use, stealing or eating. Chronic depression, anxiety, feelings of emptiness, and rapidly changing moods are also hallmarks of this condition. 

With the above symptoms, it is very common for those with this condition to have great difficulty in both relationships and employment. Until quite recently, the prognosis for BPD patients was pretty poor. We had very little in terms of treatment options to offer, and many physicians avoided dealing with these difficult patients.

In the past few years there has been progress in treatment with good outcomes, using dialectical behaviour therapy. 

A recently published study followed patients with BPD over the course of 16 years to learn what their lives were like as they recovered. The McLean Adult Development Study (MADS) found that adults who had recovered from BPD were more likely to marry and be parents than those who do not recover – they also tend to wait longer to do so and have lower rates of divorce.

The variables of stable relationship and parenting were chosen as they are some of the indicators of successful adult adaptation.

At the 16-year follow up, 60 percent of patients had achieved at least a two-year recovery. Almost everyone (99 percent) had experienced a remission of symptoms, but some remained unable to work full time, which was another factor in the definition of recovery.

Almost 80 percent of recovered patients were ever married, or lived with a partner for more than five years, compared with just under 40 percent of non-recovered patients. Those who recovered also tended to get married older (average age 29 vs 25 in non-recovered individuals). Divorce rates were significantly lower among recovered individuals (42 percent vs almost 75 percent of non-recovered patients).

Some of the factors associated with successful marriage and parenting included an absence of childhood sexual abuse and a higher IQ.

This is one of the first long-term studies looking at the life outcome for individuals recovering from BPD. The results are encouraging, and offer hope to those experiencing this very difficult condition.

If you suspect that you or a loved one may be experiencing a personality disorder such as BPD, speak with your doctor. Help is available, and recovery is possible.



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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

Like us on Facebook: facebook.com/oktrials

Follow us on Twitter: @OCT_ca



The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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