After having recently listented to a RadioLab Podcast entitled "Invisibilia", I was struck by the important role that classifications play in our lives. This episodes follows a genderfluid individual who randomly vacillates between feeling psychologically male and female. While these unpredictable psychological shifts are undeniably stressful, the protagonist of this podcast asserts that the most difficult aspect of this condition is having no clear classification, precedent or diagnosis by which to measure this experience. 

It is not surprising that as social creatures, human beings have an intrinsic need to fit in and belong. However, most people would be surprised to realize just how often they rely on various internalized role-models, whether professional, racial, gender, ethnic, or other, to steer and anchor the various experiences of their lives. In fact, some would argue that this social comparison is, in part, what gives life context, if not meaning. 

But what if there was no prototype, no role-model and no guidelines to help guide one's experiences? While some may feel that this type of uncharted existence allows for a more natural, unanchored experience of life that is free from expectations, few would disagree that having a set of guidelines makes the inherent uncertainty of life much more manageable.

Over the last decade, postpartum depression has received a lot of attention in the media, making women fear that this form of depression is something that naturally happens to many women after they deliver their children. In this recent NYTimes article, David Bornstein dispels some of the myths surrounding postpartum depression, and underlines the importance of treating the symptoms of depression during, and preferably even before pregnancy. 

One of the most important points that Bornstein makes in this article is that only a small percentage of postpartum depressions have something to do with "natural" hormonal changes. In fact, this article states that most postpartum depressions are not isolated forms of depression, and at least some of the symptoms may be present during the life span years before and/or after pregnancy, indicating that delivering a baby may not be the underlying cause of the depression. Furthermore, the risk factors for postpartum depression are the very same as for any type of depression, namely a history of depressive episodes, past and current life stresses, a history of trauma and abuse, interpersonal conflict with primary support group, lack of social support and poverty.

Because only a small number of women get treatment for their depressive symptoms before their baby is born, even when the symptoms are present during the pregnancy, it is important for people to understand that treating depressive symptoms early can mitigate, and hopefully prevent subsequent suffering. The good news is that there are a number of ways to treat the various symptoms of depression during and before pregnancy, and not all of them mean having to take a pill. Studies show that non-pharmacological treatments such as exercise, mindfulness practices, increasing one's support network, and psychotherapy can all decrease depressive symptoms. It is also important to keep in mind that if one's depressive symptoms are such that pharmacological interventions are indicated, there are currently a number of medications that have been approved for use in pregnancy.

Currently offering relationship-based social skills psychotherapy groups for TEENS and YOUNG ADULTS with Asperger's Syndrome and High Functioning Autism and Social Anxiety! 

*         Learn, Practice and Implement Valuable Social Skills.

*         Form Enjoyable Lasting Relationships with Your Peers.

*         Get Professional and Peer Support with Organizational/Practical Life Skills.

*         Talk About Your Particular Experiences and Interests with Peers.

Members:                 Teens and Young adults with ASD's and Social Anxiety

Fee:                            $85.00 per one hour groups session 
                                   * (services may be reimbursable by your insurance)

Where:                      1150 Yale St, Suite 2, Santa Monica, CA 90403

If interested in joining or learning more about this group, please contact Dr. Inessa Manevich at 310.804.6339 or at dr.imanevich@gmail.com to set up an initial assessment 

The recent news that Facebook had conducted a psychological experiment on unsuspecting users in order to see if it was possible to alter the emotional reactions of users by manipulating content, has undoubtedly sparked people to think about what role, if any, social media plays on people's emotions. Yet perhaps it is the very hope that social media might influence one's emotional state, and perhaps even one's sense of self, that drives so many people to be so invested in it's use, and others, to opt-out.

If one is to assume that friendships are, at least in part, utilitarian in nature, and that each party gets what they need or want from the other, it makes sense to assume that one's on-line connections are also serving some sort of inter-psychic need. While most people certainly use social media in order to get information, stay in touch with friends and for professional networking, it seems to reason that we are also using our on-line selves in order to attain peer validation, support, as well as project the exact version of ourselves that we want to be at the moment.

Take the profile picture for example--is it not exactly the visual that we would like for others to associate with the idea of who we are? Is it not a highly-produced version of our idealized selves, or at the very least, some version of the person that we would like to be? And as we continually update our profile pictures and updates, are we not asking our network whether or not they "like" us, thereby seeking the approval from those who typically have limited real-time knowledge of our "real" lives, and are not necessarily in the best position to provide that validation? It certainly appears that by happily sharing our lives on-line we are also choosing to put some version of ourselves in front of a large number of people who we may or may not really know, in order to see whether or not they like us. Or, more accurately, if they like who we are trying to be. 

Perhaps not wanting to put oneself in the position of being judged by others has something to do with why some folks are so staunchly opposed to social networking. Or it may have something to do with simply wanting to avoid the myriad of feelings, ranging from joy and sympathy to jealously, competition, and even contempt that being privy to the accomplishments and failures of the "produced" lives of one's friends and acquaintances may engender.

It is important for mental health professional treating diverse populations to understand that open self-disclosure in psychotherapy is very much dependent on one's culture. For example, when working with Russian immigrants, the clinician may find some initial distrust and reluctance to "open-up" and to "trust" the psychotherapy process. Instead of acknowledging their psychological stressors and subsequent problems and disorders, research and practice show that both Russians and Russian immigrants are more likely to express their psychological distress in somatic concerns (Brod & Heurtin-Roberts, 1992; Kohn, Flaherty, & Levav, 1989).

Newhouse (2005) explained that “historically, the traumas that befell Russians and Russian Jews were so overwhelming, and strictures on personal expression so unrelenting, that people kept their emotional and psychological pain to themselves and presented a stoic front” (p. 705). He goes on to explain that disclosing personal pain and family problems was often seen as a betrayal to the family system, even if the disclosure is made to a mental health professional. Additionally, although emotional pain and difficulties in adjusting to life in the Former Soviet Union were so prevalent among its citizens (Smith, 1990), talking about this pain was regarded as a sign of weakness, as well as a dangerous statement against the political system. Clearly then, the Former Soviet Union was not a place where psychotherapy was often utilized and valued (Leipzig, 2006), a belief system that may be difficult to disown even after immigration.

Yet studies indicate that immigration, particularly from a totalitarian, repressive society such as the Former Soviet Union, can be a traumatic process, frequently leading to family dissolution, problems with separation and individuation, and mental illness of various kinds (Beckerman & Corbett, 2008; Hsu, Davies & Hansen, 2004; Markowitz, 2003). Likewise, epidemiological studies have documented relatively high levels of depression in different primary care settings in this immigrant group, as compared to the community samples (Hoeper et al., 1979; Katon, 1987). Yet when these immigrants do find themselves in a crisis, usually having to do with a family member’s illness or a child’s problems or a somatic manifestation of their psychiatric distress, they will, though reluctantly, seek the help of a therapist (Newhouse, 2005). It may be crucial then for mental health professional treating this population to understand their historical reluctance to disclose personal information, and be able to provide the patient with “a combination of solid credentials, personal warmth, and a proactive approach” (Newhouse, p. 701). 

*A portion of this blog post was taken from Manevich, I. (2010). The Changing Patterns of Self-Disclosure in Soviet Immigrants.

After recently reading this NYT magazine article about the over-prescription of antidepressant medications in the U.S., I thought it might be helpful to expand on this often-debated issue. Being a psychologist, it is not my job, nor my wish, to prescribe medication. However, it is very much my responsibility to notice when an appropriate medication consultation may be necessary. For example, if a client's presenting symptoms are significantly interfering with their daily life, making it nearly impossible for them to initiate change, it may be a good idea to obtain a medication consultation.

I often hear the fear that once begun, one will have to remain on the given medication indefinitely. While people with certain diagnoses, such as bipolar and psychotic disorders, are proven to fare much better if continually medicated, others may have a different course. For example, some individuals, particularly those with presenting symptoms of anxiety, adjustment disorders and mild depression, may initially need a little extra pharmaceutical help in alleviating the severity of their symptoms in order to be able to make the necessary changes in their lives. However, once these folks are able to make and maintain certain behavioral, cognitive and even affective changes, they may be able to lower the dose of their medication or even discontinue its use, advisably, with the consent of the prescribing medical doctor.

As mentioned above, in addition to treating the primary symptoms of depression, anti-depressant medications are often used to help manage symptoms of anxiety as well, and are often prescribed for people who experience frequent panic attacks, persistent worry and nervousness, as well as obsessive thoughts. While these medications do not cure the underlying anxiety, they can certainly alleviate some of the bothersome symptoms and can help patients be calm enough to effectively work thought their worries.

It is important to keep in mind that there are a number of highly effective and non-invasive options to treat symptoms of depression, adjustment and anxiety that have nothing to do with pharmaceutical intervention. For example, while exercise certainly has not received as much press and endorsements as psychopharmacological treatments for depression and anxiety, studies show that regular exercise may be a viable medicine against certain psychological problems. Likewise, regular meditation, yoga and mindfulness approaches may be extremely helpful in reducing symptoms of anxiety and  depression. Finally, while talk therapy can sometimes be a difficult and time-intensive process, it often results in lasting, sustainable change that rarely has the kinds of side effects that are unfortunately all too common with pharmaceutical interventions.

In addition to offering Relationship-Based Social Skills groups for teens and young adults with Asperger's Syndrome, I am now also offering social skills groups for teens and adults with Social Anxiety.

* Learn, Practice and Implement Valuable Social Skills.

* Form Enjoyable Lasting Relationships with Your Peers.

* Get Professional and Peer Support for Overcoming your Anxiety and Enjoying Social Activities.

Members: Teens and young adults with Social Anxiety and Asperger's Syndrome

Fee: $80.00 per one hour groups session 
* (services may be reimbursable by your insurance)

Where:  Groups offered weekly in Santa Monica.