Over the last several decades, psychiatry has prided itself on becoming a true medical specialty. Hundreds of medications for anxiety and insomnia and depression were added to our therapeutic armamentarium. The Diagnostic and Statistical Manual of Mental Disorders swelled with conditions defined by increasingly specific lists of signs and symptoms.  Technological innovations like Positron Emission Tomography offered the promise of meaningful testing to confirm or refute a psychiatrist’s particular diagnosis.
The excitement of making psychiatry conform to the medical model, just like internal medicine or surgery, led to turning out a generation of psychiatrists many of whom have never been in psychotherapy themselves and are mostly comfortable prescribing medicine and much less comfortable exploring the life stories and stresses and hopes and dreams of their patients.  The idea that problems of meaning, problems of the soul, were the roots of our patients’ suffering, not just problems of brain chemistry, seemed to fall out of fashion.
However, it took more than a tide of technology to nearly sweep away the most powerful way psychiatrists can heal patients—namely by using human empathy to find and change their self-defeating patterns of thinking, feeling and behavior.  I believe it took an underlying fear of the immeasurable power of the human spirit.
The truth is that healing patients suffering with anxiety and depression and psychosis and attention deficit problems requires bringing oneself to the task of intuiting when in life their self-confidence or self-esteem or sense of safety was shaken.  It requires listening with one’s heart to find those moments in childhood or youth or young adulthood that disheartened one’s patients.  It requires taking down the interpersonal walls that leave so many of us strangers to one another and becoming intimate with the conscious and unconscious emotions of those who seek comfort and compassion and, yes, curative therapies from us.
If none of that sounds like something that can be found on a CT scan, that’s because it can’t.  No brain scan or blood test will ever show the way the human spirit, properly harnessed, can heal.  No EEG will explain the power of a moment of epiphany to change the course of a person’s life, nor the potential for a sustained increase in mood or decrease in anxiety or disappearance of psychosis brought about by one human being understanding another’s suffering at the deepest level.
The most powerful healing in psychiatry might be accepted as mystical and immeasurable were it not for a relatively recent historical prejudice in favor of tiny molecules rather than small miracles.  
I have no such prejudice left.
From my perspective as a doctor, I worry not at all whether the medicines I sometimes prescribe or the moments of connection I always attempt to achieve with my patients are the more powerful remedy.  I want only to wrestle their suffering to the ground and I welcome the help of every force I can bring to the battle—whether I can understand it as a scientist or not.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Jealousy has a bad reputation. After all, jealousy can end friendships. Jealousy can lead people to brood over feeling short-changed by life and distract them from precious gifts they should be enjoying. Intense jealousy can interfere with romance and marriage and destroy the very bond that sparks the jealousy to being with. Jealousy taken to psychotic levels is, of course, paranoia-a true psychiatric disorder.

Yet in romance, mild and even moderate jealousy may not only have its benefits, but be a critical ingredient to maintaining passion.

We all want to feel chosen by our romantic partners. We want to feel special. In love, there is a dimension of conquest, of overcoming the resistance of the other person to intimacy and defeating all the other potential suitors who might have won the heart of the person who smiles upon us. This “favored nation status” in love is very closely linked to jealousy. Early on in a relationship, when the romantic energy is most intense, it would be unusual not to feel jealous if a romantic partner were to dote on another.

As romantic relationships continue on, for months and years, we can easily take the love and attraction of our partners for granted. We can tip past confidence about the commitment of our partners, into complacency. And the trouble with complacency is that it is the antidote of passion. It kills any desire to compete for the special place occupied in the life of another. We too often stop earning love and stop appreciating it.

Good jealousy is the kind that keeps us awake and alert in our love lives. And we should welcome it. We should luxuriate in the harmless flirtations of our partners, give one another license to play a bit with passion and never fail to note the miraculous and much-maligned feeling of wanting and needing to be the winner in an eternal quest for the heart of another.

Anyone can safely take a small dose of jealousy right now. Just close you eyes and imagine your husband or wife or girlfriend or boyfriend sitting down to tell you that he or she is leaving you for someone else. Imagine that other person in your mind. Then resolve to tell your partner one thing or go on one adventure that would win her back. Now, open your eyes-and do it.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

The tragedy in Haiti has already shown us a great deal about the human spirit.

Nowhere in that country, here in America or elsewhere in civilized nations is there any event or image that speaks to complacency or helplessness. The reports and pictures coming out of Port-Au-Prince are all about courage and compassion and survival. Even traumas of immense proportion, including natural disasters and wars, do not paralyze the efforts of human beings to help one another resurrect that which has been lost. Compassion and hope are two of the most laudable and indomitable characteristics of our species. We want to see resilience where there is devastation.

And so we look for it amidst the rubble. And, of course, we find it. Survivors are pulled from collapsed buildings. Single doctors treat thousands in makeshift, open-air clinics. Orphans sing praises to the Lord while waiting patiently to be rescued. The resilience of human beings, however, should not lead us to underestimate the ultimate psychological toll of the earthquake on the strong and good people of Haiti. Just as many strong men and women go to war and return struggling with post-traumatic stress disorder and depression and other challenges to their mental well-being, so it will be for millions of Haitians and their descendants.

A tragedy of the proportion of this 7.0 earthquake rumbles through more than one generation, as the loss of fathers and mothers and sons and daughters sparks disorders of mood and anxiety months, years, even decades, later. Human beings are resilient, but they are also sensitive. The compassion that fuels needed efforts in a crisis is actually linked in a very real way to our vulnerability. We care and, therefore, respond. We care and, therefore, suffer.

If the soul were an automobile, it would be a Ferrari, capable of extraordinary performance, but fragile. Trauma—our own and that of others—can motivate us to do God’s work, even as it shakes us with questions about the unpredictable nature of life and death, the lack of control we all have over when we will hurt and whether we can heal. Any plan for the rebuilding of Haiti will harness the incredible human capacity to rebound after tragedy. But any practical plan to rebuild the people of Haiti must take into account the fact that psychiatric disorders will likely be soaring in that nation for the next five or ten decades.

We humans are wired for empathy and intellect. That comes at a price.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

A recent study spearheaded by author and researcher Jean Twenge reveals that we have a Tsunami of psychiatric illness headed our way.

Compared to 1938, when the Great Depression gripped the nation, 600 percent more young people now struggle with mood disorders. Six times as many. Anxiety disorders and personality disorders are skyrocketing, too.

The study, conducted at five universities, analyzed data from more than 77,500 high school and college students. Each of them was given the MMPI, or Minnesota Multiphasic Personality Inventory. That’s a test that measures personality traits and detects signs of psychiatric disorders. The test is made up of 567 test items and takes between 60 and 90 minutes to complete. The results only confirm what I’ve observed in my practice and what other clinicians have been telling me for years: The impact of popular culture and technology on teenagers and young adults is literally making them psychiatrically ill.

There’s a simple way to translate this: Our young people are drugging themselves by the tens of millions every single day with a combination of celebrity worship, dreams of unlimited wealth and handy ways to stay away from anything like reality. They’re losing their ability to process genuine emotion, diving into in a Web of Facebook, YouTube, trophies for everything, iPhones, e-mail and Twitter.

When human beings use any drug to avoid mastering the swings of emotion that are normal during childhood, youth and young adulthood, they open themselves up to being overwhelmed by life’s inevitable challenges. They are like untrained athletes trying to lift the weight of the world. They end up psychiatrically injured. It’s happening. And it will be devastating to the American health care system as these young people emerge into adulthood, requiring a massive deployment of mental health care services, not to mention the costs of lost productivity at work, shattered marriages and crime.

Maybe it would be different if psychiatry as a profession were prepared to deal with what’s coming. But my profession has been eviscerated by a combination of discriminatory insurance company policies and blunders by organized medicine that have turned too many psychiatrists into experts at dispensing medicines and nothing more. In order to safeguard the psychological health of a nation about to be hit by a crushing tidal wave of psychiatric illness, we need an army of true healers who actually listen to patients and reconnect them with their core thoughts and their feelings and make them masters again of their own emotions.

I’ve asked for it before, but I will here again. The President needs to create a Commission to address this public health nightmare. We are very late to the game and losing will devastate more than one generation and cost us trillions.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Autism is, as most everyone knows, a developmental disorder that begins by age 3 and includes major disturbances in a child’s social skills and ability to communicate.  It strikes 1 in 100 babies born in America.
Recently, data emerged showing that a comprehensive program to identify autistic children as toddlers and deliver an integrated behavioral treatment plan including lots of play and human interaction improves the IQs of autistic children.  This is good news and a very good reason to increase our efforts to identify autistic children as early as possible and provide them the care they need.
As a psychiatrist who has worked with both adults and children with developmental disorders, I also believe that it is important to treat most or all autistic children very early for what I think are very clear symptoms of unwieldy anxiety. After all, autistic children can shun human interaction, stiffen at human touch, often gravitate toward repetitive and soothing movements, seem drawn to objects or machines that generate predictable rhythms (like fans) and can act out angrily when their routines are altered.  All of these signs are also consistent with those of an anxiety disorder.
It is possible that, in the end, autism will be understood as a severe anxiety disorder starting in early childhood.
Remember, OCD (obsessive-compulsive disorder) is classified as an anxiety condition.  Anxiety is the core driving force for the repetitive thoughts or actions that plague so many.  Obviously, the desire of an autistic child to maintain a specific routine or repeat a specific behavior or watch a spinning plate seems very similar to the actions of those with obsessions and compulsions.
For this reason, not only behavioral techniques, but also medicinal remedies have to be considered front line therapies to interrupt the progression of autism once it is identified.  I advise parents of autistic children, therefore, to strongly consider judiciously using medications like serotonin reuptake inhibitors (Paxil, Zoloft, Lexapro and others) immediately when autism is diagnosed.  The possibility should at least receive very vigorous consideration from the doctors involved in caring for these children.
I also believe that the new treatment already approved for depression called rTMS or repetitive transcranial magnetic stimulation may have benefits for autistic children.  It has almost no side effects and reduces anxiety very significantly.
Bottom line: The most vigorous treatment for autism as soon as possible is probably the best way to limit its long-term consequences.  If my child were stricken with the disorder, I would include the early use of anti-anxiety medication as part of that strategy.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.
 

Holidays bring joy, but they often bring stress, too.  Economic stress and stress related to travel make the Christmas list, but my patients tell me that the greatest stress that comes with Christmas and the New Year is relationship stress.  Holidays bring us into closer contact with relatives and friends with whom we might otherwise choose to have very limited interactions.  Unresolved conflicts with brothers and sisters can play in the background of handshakes and toasts. That constantly critical step-parent might be around you the whole day.  A gift is unwrapped that reminds you again that a friend just “doesn’t get you” or has never been nearly as generous as you are.
 
What’s the best way to cope?  The key can be uncovered in the very spirit of Christmas itself.  Christmas is about God’s love for mankind.  And it is, therefore, about our love and generosity. It is about giving to others.
 
So I recommend that you let yourself take a holiday from hurt.  Tell yourself that this Christmas through New Year’s Eve is your vacation from trying to right the wrongs of the past or dwelling on injuries you suffered due to the shortcomings of others.  We all have these injuries in greater or (blessedly) lesser measure, and they have to be recognized at some point in order to heal them, but for nine days from December 24 through January 1, I prescribe being the healer.
 
What does being the healer mean?  It means extending yourself to others in a way that makes them feel comforted and valued.  It means giving them the benefit of the doubt by seeing them as doing the best they can in relationships, even if they don’t do very well.  It means listening to what is going on in their lives and offering support and encouragement, rather than pointed advice or any judgment.  It means being focused almost entirely on improving their holidays than on proving anything about yourself during the holidays.
 
Here are a few pointers about being what I call a holiday healer:

1)   Being a holiday healer only happens when you decide to be one. Human beings want to be heard, so being a therapeutic listener is actually work.  It requires intention.
 
2)   Being a holiday healer can be a little lonely.  This is because healing takes place from a bit of a distance.  It’s less about an exchange of feelings than it is about letting yourself feel the happiness or stress or hypocrisy of others and gently nudging others in the direction of the best inside them.  
 
3)   Being a holiday healer is worth it.  The gifts people actually remember are little gifts of time or kindness or forgiveness.  You can give these very powerful gifts, and they will empower you ten-fold.
 
4)   Being a holiday healer is contagious.  You may not believe me, but people respond to healing by becoming healers themselves.  It’s a miracle called human empathy, and it’s the best evidence for the existence of God that I’ve seen in the world.
 
 
If you decide to be a holiday healer, be very aware of the reactions of those around you.  You’ll notice that people gravitate toward you and that you feel just a little lighter on your feet, a little freer to see the best in people and a little more likely to see the best in yourself.
 

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

We are raising a generation of addicts, and we’d better do something about it, starting now.
 
A new federal survey has found that more and more teens are smoking pot, abusing pain pills and using illicitly-obtained stimulants used to treat attention deficit disorder. 15.9 percent of tenth graders reported using marijuana in the last month.  The percentage of eighth graders who considered using ecstasy once or twice a dangerous activity decreased from 42.5 percent in 2004 to 26 percent in 2009.
 
It isn’t just drugs our kids are addicted to.  Kids now play what’s called “the choking game” with greater frequency, too.  This “game” (which it isn’t) involves them choking one another or using improvised nooses to cut off oxygen to the brain and feel “high.”
 
Teens are also using food as a drug, with obesity rates soaring.  It seems as though they are saying in large numbers that anything will do to get them away from reality.
 
But I don’t think marijuana or pain medication or stimulants or the choking game or fast food are the biggest “drugs” to which kids are addicted.  They are using their iPods, DSIs, YouTube, reality TV and celebrity escapism in order to shut down their minds, avoid their feelings and substitute the “high” of technology and entertainment.
 
The price of a generation of addicts is incalculable.  We have to expect that teenagers using pot and Adderall and Percocet and choking and 21st century versions like Facebook will face an increased rate not only of substance dependence, but of depression and anxiety and their physiological brethren—from hypertension to cardiac disease to malignancy.  We have to expect higher rates of sexually transmitted diseases, as young people turn to sex to feel better, too.  We have to anticipate more violence, as young people evolve into adults with little experience managing their anger and a higher likelihood of turning to street drugs to try to contain that and every other uncomfortable feeling.
 
More than one of my young patients tell me they participate regularly in “Live Action Role Play,” in which a group of teenagers conspire to pretend to be people other than who they really are—nearly full-time.  So a cashier at a grocery store can be treated by his friends like a rock star, complete with text messages asking where he’s headed on tour.
 
It isn’t just teens, either.  Kids are getting into the “act.”  Club Penguin gets them ready to treat animated creatures like real pets—as in, to not care about real life any more than bright images on a screen.  Cell phones put instant messaging in the hands of 9-year-olds and remove them from face-to-face or even voice-to-voice communication.
 
All of this activity can be reduced to one basic behavior:  Getting high, as in, intoxicated.  We may not see it that way today, but we surely will, looking back, from some very complicated and painful tomorrow.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

As mistress after mistress comes forward, admitting to a sexual liaison with Tiger Woods, it would be easy to focus on his voracious appetite for sex and his fall from grace in the eyes of his fans and miss some very important lessons about the rest of us in 21st century America.

Marriage in America is under siege, in a big way.  At least 40 percent of American marriages end in divorce and a very large percentage of those that survive are desperately unhappy ones in which the partners feel estranged from one another or even spiritually suffocated by one another.  In my practice of psychiatry (and in the practices of the counselors and psychologists and psychiatrists with whom I routinely speak), I would estimate that as many as 90 percent of married individuals would rank their unions as the source of very significant stress or would say that their marriages are a source of low mood or anxiety.

We marry in the throes of romance, and a conspiracy of silence prevents us from a society-wide, in-depth, healing discussion of how to maintain it after more than a few years of cohabitation. Isn’t one of the sustaining beams of our culture worth the attention of leading scholars? Shouldn’t the Surgeon General consider the marriage crisis in this country worthy of understanding and healing? Why do we teach sex education in school, to the exclusion of teaching techniques of emotional intimacy?   Why do we pretend that marriages can be effortlessly passionate forever, rather than advising couples to routinely take space from one another as a way to recharge their levels of attraction? Why don’t we look deeply at the fact that a husband or wife might be willing to donate a kidney to his or her spouse, yet unable or unwilling to remain sexually “faithful?”  

What does that mean about the real glue of long-term attachment—that it is actually nine parts emotion and only one part physical? Why haven’t we talked about what marriage means in a culture in which each partner may have had a dozen or more sexual relationships prior to marriage and is very possibly going to have more than one marriage in his or her life? Why is it that American men still have been given very little insight into just what women feel after infidelity (and vice-versa)?  

We know that Elin Woods is angry, but we don’t know the real depth of her pain.  Isn’t it possible that if teenagers learned how betrayal sparks jealousy, resentment, fear of abandonment and worries about being unloved and unlovable that they might remember those lessons in their adult, married years? If more men understood the psychological risks to their adolescent daughters and sons of intuiting that their fathers or mothers are unfaithful, would that give parents more reason to invest in their marriages? The fact that Tiger’s sexual escapades have pushed Afghanistan off the front page is evidence enough that sex is a dominant force in American society.  As technology more and more defines our existence, the lure of sex will only intensify, if only to remind people they are human.  

If we pretend that the institution of marriage can withstand that kind of energy without a plan, we’re going to become—even more than now—a nation married to hypocrisy in our private lives.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

If Michaele and Tareq Salahi faked their way into President Obama’s first state dinner at the White House, they join Richard and Mayumi Heene (Balloon Boy’s parents) and Nadya Suleman (Octomom) as massive examples of the vulnerability of our shared reality to manipulation by “reality terrorists.”

“Reality terrorists” are those who seek to explode real news, real-life events, real politicians, real law enforcement officials and real feelings of admiration or panic or disgust and turn them into fabricated, staged entertainment events to pump up their egos or their wallets by becoming TV stars.
 
This is more than a game or a gaffe.  This is a kind of psychological terrorism that assaults our collective ability to trust that dramatic events unfolding around us are serious ones that should indeed command our attention and elicit our genuine concern.  If a state dinner is no more than a dry run for The Real Housewives of D.C.—in which Michaele Salahi hopes to star—then the White House is no better than the set of a sitcom and deserves no special respect or awe.  

If a boy drifting away in a helium balloon, followed by the Colorado Army National Guard, is no more than a family’s pathetic ruse to net a third appearance on Wife Swap, then the Guard is no better than a troop of circus clowns running after a beach ball.  If a sick woman and her reprehensible fertility “doctor” are allowed to turn childbirth and children into a freak show and get paid for it, then our real efforts to cure infertility and love our sons and daughters is just so much filler between commercial interruptions.
 
Make no mistake about it, the convergence of television and the Internet can end up providing devastating weapons to a new breed of homegrown terrorists who value only their own causes (fame and fortune) and hijack our media, our empathy and our cultural/political symbols and icons, turning them upside down and inside out, leaving them as meaningless carcasses for camera crews to step over—like so many crushed Coke cups on the floor of a movie cinema.
 
One inherent problem with this kind of piracy is that it works even better than Somalis grabbing tankers.  The White House Party Crashers, Balloon Boy and Octomom did hit the fame jackpot and may all end up profiting in one way or another, despite their truly despicable acts.  Reality terrorists know that we will fall all over ourselves as a society to watch titillating events, in preference to complex, important ones.  It’s our psychological Achilles’ heel.  We’ll take drama over substance, every time—and pay up for it.
 
Notice the amount of newspaper ink wasted on Tiger Woods lately, when we’re sending 30,000 more American troops to Afghanistan.  Did he have sex with another woman?  Was he drinking when he crashed his car?  Did he have a spat with his wife?  Who cares?  Well . . . America does.
 
In a world that worships the lens of a camera and cares not for fact over fiction, in which the President of the United States is happy to joke with any late night TV host who’ll have him and grace the cover of any men’s magazine that can disseminate his image, is it any surprise that an Iranian dictator who might just blow up an entire nation one day is perceived as a petty prankster puffing out his chest?  A silly clown?
 
We’re confused now about what is real and what is fake, and we’re going to pay very, very dearly for it.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Recently, I treated a patient struggling with depression and substance abuse who had found a legal way to get high.  He had ordered Kratom capsules on the Internet.  Lots of his friends have ordered up supplies, too. I hadn’t heard of Kratom, and you probably haven’t, either, but I think you will.  

It mimics some of the effects of opiates (like morphine and opium) and can relieve physical pain and produce a sense of increased well-being and increased energy. Depending on the dose taken and the way it is used (smoking versus chewing leaves versus drinking Kratom tea), it can cause anything from euphoria to sedation.

Kratom trees are native to Southeast Asia, including Thailand and Malaysia, but plants can be and are being grown in this country, as well. While Kratom may turn out to have medicinal uses in treating chronic pain, helping people detox from heroin and even in controlling anxiety and depression, very little is known about its real risks and benefits. It can certainly be addictive, especially for those who end up using Kratom on a daily basis.  Abruptly stopping it can lead to severe depression and severe anxiety.

With marijuana decriminalization potentially on the horizon across the country, I expect to see even more of the long-term effects of daily marijuana use in my psychiatric practice.  I have treated many patients who have lost motivation, succumbed to chronic depression and found it difficult to focus their attention after months or years of smoking marijuana. Kratom could be another “quick fix” that young people flock to in order to avoid their complicated emotions and the complex realities of the world in which we live.  

Only time will tell, but I can tell you this:  My patient didn’t limit his substance abuse to Kratom. He ended up using cocaine, too.  And Oxycontin.   Underneath it all, there’s an epidemic of anxiety and depression in our population. Ultimately, that epidemic will only be addressed through introspection, counseling and the judicious use of approved medications. Kratom, alcohol, marijuana and the rest of the quick fixes for unwieldy feelings are really only roads to my office and those of my colleagues.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.