Drs. Oz & Roizen: Mental Illness Is More Than a Feeling

As a society, we have a long way to go in our understanding of mental illness. The conversation continues here, as the doctors shed light on how to deal with depression, post-traumatic stress disorder (PTSD) and even pathological lying.

Q: My brother returned from Afghanistan a year ago and has been battling PTSD. He’s seen doctors but still has occasional breakdowns. What role can I play in supporting him?

A: PTSD changes how certain hormones and neurotransmitters respond to stress. The best way to treat it is with medications such as Zoloft and Paxil, talk therapy, and by providing a supportive environment. This is where YOU come in!

Communicate your support. Learn as much as you can about PTSD to get a sense of what your brother is going through. Then let him know that you’re ready to help in any way, whether it’s keeping track of meds, attending doctor appointments with him, or just providing companionship. You might suggest he join a support group of other veterans with PTSD, which is shown to help.

Listen. Don’t argue with your brother, which can agitate him. Be positive—your loved one’s mood will fluctuate dramatically and is susceptible to the attitude of his closest family members.

Be patient. Progress won’t be instant, so give him space and let him know you’ll be there when he’s ready to reconnect. Try to learn what triggers symptoms, which can include, among other things, self-destructive behavior, intense anger or guilt, and even flashbacks. Plan outings and activities that steer clear of his triggers.

Take time for YOU. Dealing with someone who has PTSD isn’t easy. Taking care of your own needs will help you have the mental and physical energy to be there for him. Haven’t had the time to eat right, exercise and get a good night’s sleep? Make those things a priority.

Q: A longtime friend is a pathological liar. How am I supposed to react when I know she’s not telling the truth?

A: You’ve probably been exercising patience for a while, because this didn’t start overnight. Pathologic lying—telling lies repeatedly and impulsively—tends to develop early in life as a response to a tough situation that seemed to resolve itself when the child lied. It becomes a way of life, and making up things is more comfortable than telling the truth.

Pathological liars may also fib to get attention. They discover that the spotlight makes them feel good, and the whoppers grow bigger each time. The lying is not meant to manipulate—it’s more like a very bad habit your friend can’t break on her own.

Next time she lies, kindly present proof of the truth. Do not shout or accuse her of being a liar, which could cause her to go on the defensive. Simply provide the facts. If she vehemently denies it, leave the situation alone. But if she softens, ask whether she is seeking help from a mental health professional. If she is not, gently encourage her to do so.

Tell her you know it’s not her fault and you will be there for her, but it’s difficult to have a relationship without honesty. If all else fails, you may have to give your friendship a break. Change can only come in time and from within her.

Q: Are there any foods that have a specific mood-boosting effect—well, other than cheeseburgers?

A: Yes! Certain foods boost levels of serotonin, a brain chemical that can help you feel more content and calm. When you’re feeling blah, reach for these “happy meal” picks:

Turkey: This sandwich staple contains tryptophan, which your body needs to make serotonin—it’s partly why people feel so satisfied after Thanksgiving dinner.

Dark chocolate and bananas: For a feel-good dessert, mash these two serotonin-enhancing foods together (opt for chocolate with at least 70 percent cacao—the higher the percentage, the greater the surge of serotonin), freeze the mixture, then enjoy!

Carbohydrates: They get a bad rap, but carbs are essential for the production of serotonin. The healthiest way to get your fix is from whole grains, fruits, dairy and vegetables. One warning: Too many refined carbs, such as crackers and white bread, can cause weight gain.

DHA: This is a type of omega-3 fatty acid found in some cold-water fish (salmon, ocean trout) and also in supplement form. DHA increases serotonin and dopamine, another feel-good brain chemical. Taking 600 to 900 milligrams a day can help ease anxiety and depression without side effects. A bonus: It improves your thinking, so taking it is a no-brainer.

Q: Maybe it’s just the news, but I’m worrying more about the mental health of people around me. What are some signs a person at work may have violent tendencies?

A: There’s no way to tell with 100 percent accuracy whether someone will commit a violent act, but here are some red flags that a person might be more likely to lash out:

➸ A history of violent behavior. The top predictors for future violent acts are past violent acts.

➸ Alcohol or drug abuse.

➸ Intolerance. Some offenders are motivated by hatred.

➸ Affiliation with gangs.

➸ Inappropriate access to, possession of and use of firearms. An unhealthy fixation with firearms can lead to a violent crime.

➸ Extreme social isolation. Not everyone is a people-person, which is normal, but extreme isolation has been linked with a higher risk of aggression.

It’s impossible to diagnose sociopathic personality disorder on sight, but people with this condition may have uncontrolled anger or show a repeated disregard for right and wrong and the safety of others. Know that mental illness doesn’t automatically make someone dangerous—these people rarely commit violent crimes.

If you ever feel unsafe, report your concerns immediately and in writing to your manager or the human resources department. Any threat of violence from a co-worker, however slight, should be taken seriously. In most cases, it’s probably a false alarm, but it’s best to be cautious.

Q: My husband has been angry and irritable since his job loss months ago. The kids and I walk on eggshells around him. What can I do?

A: It’s not surprising that your husband is on edge after losing his job. It’s a huge blow, and he might even have become depressed as a result—irritability and anger are common symptoms of depression in men.

To help him out of the rut, encourage a family hike or bike ride. Exercise is proven to relieve depression symptoms by boosting endorphins.

If your husband is depressed, he will benefit greatly from talk therapy and possibly antidepressants. Depression is not a momentary sadness but a persistent feeling of despair triggered by an imbalance of chemicals in the brain. It’s important to treat depression as a disease—just like heart disease or diabetes—not something he can just will himself out of. 

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