Mental Health

What does neuropsychological testing involve?

DEAR DOCTOR K: My husband's doctor suspects that he has Alzheimer's disease and wants him to have neuropsychological testing. What will these tests involve?

DEAR READER: There is no single test that can diagnose Alzheimer's disease. In fact, a doctor cannot make the diagnosis with absolute confidence without studying the brain under the microscope, which is rarely done except in an autopsy. Alzheimer's disease is diagnosed presumptively by a combination of different types of evidence. The disease typically has a slowly progressive onset. Sudden confusion or speech problems, for example, are not caused by Alzheimer's.

Is there an effective treatment for OCD?

DEAR DOCTOR K: I've been struggling with obsessive- compulsive disorder for years. Is there any effective treatment for it?

DEAR READER: There are better treatments today than there were when I went to medical school. As you know, in obsessive-compulsive disorder (OCD), a person is troubled by persistent, intrusive, anxiety-provoking or distressing thoughts (obsessions). He or she feels pressure to carry out excessive, repetitive behaviors (compulsions).

Can writing in a journal help ease stress?

DEAR DOCTOR K: My therapist told me that regularly writing in a journal might help ease my stress and improve my mood. Is there any evidence to back this up?

DEAR READER: Yes, there is, if you are disciplined about it and do it the right way. Some of my patients and friends have kept a journal following a major and unexpected life stress -- say, a cancer diagnosis, a car accident or a layoff.

How can I change my pessimistic outlook?

DEAR DOCTOR K: I'm a "glass half-empty" type of person. I know that way of thinking adds to my stress and unhappiness. Is it possible to change the way I see things?

DEAR READER: Yes, there is. Through a type of "talk therapy" called cognitive behavioral therapy (CBT), you can learn to reframe negative thoughts. That, in turn, can help change how you feel. CBT can help you challenge overly simplistic, irrational, negative thoughts. It's easiest when the thoughts are patently untrue: "I never do anything right," for example. It's harder when there's an element of truth mixed in: "At my age, I'll never reach my goals." If your dream was to be a famous opera singer, that statement may apply. Most likely, though, there are other goals you did reach. And other goals you can still reach.

How can I calm myself when I’m angry?

DEAR DOCTOR K: What can I do to calm myself when I'm angry?

DEAR READER: Anger is often called "the fire inside." It is one of our most powerful and primal human emotions. But in the modern world, anger can get in the way of our work, relationships and social interactions. In his thoughtful, instructive and award-winning book, "Outsmarting Anger," my Harvard Medical School colleague, Dr. Joseph Shrand, and Leigh Devine explain how to recognize and manage your anger.

What is Tourette syndrome?

DEAR DOCTOR K: My grandson was recently diagnosed with Tourette syndrome. Could you explain what this is? What can I do to help him?

DEAR READER: Twenty years ago, I got into a cab at the hospital, heading for the airport. The driver was a man in his 30s who liked to talk. About every 30 seconds as he talked, he would clear his throat. It was not a gentle sound -- you could have heard it several hundred yards away.

What are some suicidal signs to watch for in someone severely depressed?

DEAR DOCTOR K: My husband suffers from severe depression, and I'm worried he might take his own life. How do I know if my fears are warranted?

DEAR READER: Most people who commit suicide are depressed. But most people who are depressed do not commit suicide. We can't predict who will commit suicide, but experts observe that certain factors increase a person's risk of suicide.

How can I tell if my son has a learning disability?

DEAR DOCTOR K: I think my son may have a learning disability. How can I tell if there really is a problem?

DEAR READER: Most kids have some difficulty in school at one time or another, and usually it's nothing to worry about. Sometimes, though, it can be a sign of a learning disability. "Learning disability" is a broad term that can cover different types of problems. A child with a learning disability may have a hard time receiving, organizing, remembering or using information.

What are symptoms of a panic attack?

DEAR DOCTOR K: I think I might be having panic attacks, but I'm not sure. What does a panic attack feel like?

DEAR READER: People who have never experienced a panic attack typically think it's a mild feeling of nervousness. But in fact, it's a lot more than that.

First of all, it usually starts very suddenly; it doesn't slowly creep up on you. Second, it's not mild. A panic attack causes a sudden wave of intense anxiety, apprehension, fearfulness or terror. Usually, you have a terrible sense of impending doom, or of a looming catastrophe.

How can I protect my middle schooler from cyberbullying?

DEAR DOCTOR K:My daughter will be starting middle school this year. How can I protect her from cyberbullying?

DEAR READER: Bullying can be particularly difficult during middle and high school, when popularity and peer acceptance feel like the most important parts of life. Adding technology to the mix makes it worse still. Cyberbullying is not simply bullying that takes place through electronic means.