Help! I’m Anxious about My Anxiety Management Class!

I took a seat at a large conference table in the university’s counseling center. I looked around nervously. I kept my hands in my lap, fingers (figuratively) crossed, hoping that I wouldn’t recognize a single face that walked through the door and into the Anxiety and Stress Management Class that I’d signed up for. It was a six-week class that I’d discovered via a flier posted on a bulletin board outside of my second home, the university library. As I sat and waited, my heartbeat felt large and uncomfortable. No doubt, I was anxious.

I was a first-semester graduate student at the time, trying to keep up with the 200+ pages I needed to read each week for my classes. It was just too much reading. (I hadn’t yet fully realized the fine art of skimming and scanning.) Theories would blend together and famous philosophers like Hume and Locke would inch their way into my dreams, uninvited. Even during the waking hours, I couldn’t relax. I’d try to zone out by watching a sitcom; instead, I’d find myself thinking about how little I know about designing research studies — and I needed to know for that exam on Monday! — and I’d only end up flustered and feeling unproductive when the credits rolled by. I couldn’t keep my anxiety level in check. Not even through the traditional notion of relaxing — sitting on the couch, remote control in hand, pleasant faces and canned laughter on the screen. Nope. Didn’t work.

I held my breath as a handful of fellow students began filtering into the conference room. “He looks unfamiliar,” I thought, as I eyed up the other anxious twenty-somethings walking through the door. “And that girl looks friendly…maybe. Wait, maybe not.”

I had been nervous enough while walking up the stairs to the Counseling Center, and I’d tried to hide my face in an issue of the school’s weekly newspaper while I was in the Center’s waiting room, eight long minutes early. This was almost too much for my anxiety-ridden self. I never had a problem with social anxiety before — my anxieties have always been a result of workload issues — but I suddenly felt like I’d had a new diagnosis. I just didn’t want anyone else to know that I was having a problem. I was excited for the content of the class, which advertised cognitive and behavioral techniques that promised to get me through my first semester, but not for the company. Sitting in that conference room, I felt stigmatized. It was like I had a banner flying over my head that read “Yes, I do have a problem with anxiety!” There was no going back.

Students continued to walk in. “Oh no, I’ve seen him before. Somewhere in the library, maybe? A student worker at the circulation desk?” I couldn’t remember. My heart felt like it was vibrating.

One of my professors would open each evening class by asking our class where we fell on the 1-to-10 “How ready are you to quit this program?” scale. That week, I was running on a 9.5…only because I was scared to admit the truth and give myself a 10. I had already been dressing my own academic grave and calling around for quotes on health insurance. Meanwhile, my classmates had all reported scores of 5 or below for that week. How could they be keeping their heads so level while I’m slowly cracking up from the pressure? How could they sit and watch television in the evening, or read a book for pleasure, or go for a walk knowing that there was a major amount of work to be done?

The halfway point of the semester was upon us, and the same professor with that brilliant scale idea had described the next seven weeks as a “downhill train ride” with no brakes. Oh, and the train was full of explosives. And there was a baby tied to the tracks ahead. (I’m not kidding; he actually said that!) How could the rest of my cohort sleep at night? Everyone knew that grad school wasn’t a walk in the park, but honestly? Explosive downhill trains to terror & babies tied to the tracks? I didn’t understand how everyone else projected such an A-OK, hunky-dory, we’ll-get-through-this image.

Where autism intersects with mental wellness: 2 levels of a diagnosis

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A mental health advocate questions harvard & mass general: full disclosure wanted

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Yale university: federal investigation: millions of dollars in grant money

(Source: soulful sepulcher)

True emotions

In case you haven't already seen it, be sure to check out our clicky iPhone Grand Rounds!It was years ago.  I was a resident on an inpatient unit and the patient was floridly manic.  I don't remember the details, what I do remember was that she was running on empty, high as a kite, going 99 revolutions per minute, you name the cliche.  There was a reason why she was on an inpatient unit and not being seen by an out patient doc.  She wasn't getting better and, as is often the case with people suffering from mania, she had no insight that she was ill, she was feeling good-- really good-- and oh so energetic, and even louder than that, and so what's the problem here? Let me outta this joint!  We're talking, I'm trying to reason with her, and finally, she screams at me in a way that stays clear long after her name and the details of her life have oozed from my memory,  "You're problem is you're not Italian!  You don't understand TRUE EMOTION!!"  She had a point.I'm not Italian, by the way.  And who defines what emotional response is true, what is valid, what is right to have?  So once patients get the label of Bipolar Disorder, they come under an added scrutiny that makes them, and those who know they suffer from this disorder, subject to both added analysis of their reactions.  It often leaves them feeling invalidated, or questioning themselves in a way that adds an entirely new dimension, if not burden, to life.  I can have a feeling--- it's just my feeling.  I may question if it's valid for me to have that feeling-- come on, we all check out our feelings.  How often do you ask Was it Him or Me?  Or comment that everyone thinks he's a jerk, just to be sure you're not the one being overly sensitive.  People with Bipolar Disorder take this a bit farther.  If they're angry, irritable, have a great idea, in a good mood, in a bad mood, have trouble sleeping...and the list goes on....then they're ill.  No bad hair days for the labeled labile.  They, and everyone around them, are constantly questioning their sanity.  There are other labels, though, and they aren't all about mental illness.  Perhaps you're a worrier, you want people to be considerate of the fact that you care about them, but they don't like to check in (--this particular example is for us moms).  Maybe they check in so you won't worry, or maybe they label you Neurotic, or Over-protective, or something that lets them blame you for your concern, that frees them from responsibility.  Or maybe you're very sensitive-- a trait that can be a very positive thing, especially if you're sensitive to the needs of others.  But once you're labeled as such, then the someone who says something that upsets you isn't held so accountable.  No biggie that I made Georgie cry, he's too sensitive, you know.Emotions are a funny thing.  Sometimes I wish they could just be what they are and taken for face value.  And even if I'm not Italian, let it be known on the record that I'll eat pasta and gelato with glee and enthusiasm.----- Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. (Source: Shrink Rap)

How Effective is Cognitive Behavioral Therapy (CBT) for Anxiety?

Cognitive behavioral therapy (CBT) is probably the most well-known and most-practiced form of modern psychotherapy. Even therapists who don’t identify themselves as a CBT therapist likely uses at least a handful of CBT techniques in their practice. And while much of CBT’s popularity is centered around its use for depression and related mood disorders, it’s also useful for many other disorders, including anxiety.

But to-date, there has been no systematic review of the efficacy of cognitive-behavioral therapy in randomized placebo-controlled research trials for anxiety. Until now.

In April, researchers from Boston University conducted an extensive literature review on CBT studies that reviewed the efficacy of CBT versus a placebo for anxiety disorders. Out of an original 1,165 studies identified, they found 27 that met their inclusion criteria.

They found support for the use of CBT in anxiety disorders. Specifically, the severity of anxiety symptoms was decreased for people who took CBT over placebo, and the effect of this decrease was most significant for people with obsessive-compulsive disorder and acute stress disorder. The smallest effect size the researchers found was for the use of CBT in panic disorder.

The researchers also noted that while they did find CBT effective for many anxiety disorders, there is considerable room for improvement for future research in this area. CBT is not a cure-all, but when wielded by an experienced therapist, it can provide helpful, beneficial results for most people suffering from an anxiety disorder.

Reference

Hofmann SG & Smits JA. (2008). Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry, 69(4), 621-32.

Senator charles grassley: science vs.integrity: we want answers

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New Study of DBS for Depression

Researchers report the initiation of a double-blind study assessing the efficacy of deep brain stimulation for individuals who suffer from major depression.

The study, called BROADEN(TM) (BROdmann Area 25 DEep brain Neuromodulation), is a controlled, multi-site, blinded study that is evaluating the safety and effectiveness of DBS in patients with depression for whom currently available treatments are not effective.

“We are excited to be part of the first double-blind study of Deep Brain Stimulation for depression and remain hopeful that this therapy may prove beneficial for this seriously ill patient population,” said Anthony D’Agostino, M.D., medical director of Alexian Brothers Behavioral Health Hospital and the principal investigator at the study site.

“The study is an important contribution to the advancement of treatment options for severely depressed patients.”

This study is researching a specific area in the brain called Brodmann Area 25 that is thought to be involved in depression.

The first research of DBS for depression was conducted in Toronto, Canada, by neurologist Helen S. Mayberg, M.D., and neurosurgeon Andres Lozano, M.D., in 2003.

They published their findings in Neuron in March 2005, reporting that brain imaging studies indicate that Brodmann Area 25 appears to be overactive in profoundly sad and depressed people.

St. Jude Medical owns the intellectual property rights, and has various patents issued and pending, for the use of neurostimulation at Brodmann Area 25. The Libra Deep Brain Stimulation System provides mild pulses of current from a device implanted near the collarbone and connected to small electrical leads placed at specific targets in the brain.

“This depression study represents a continuation of our commitment to provide solutions for those who are suffering and in need of additional therapy options,” said Chris Chavez, president of the St. Jude Medical ANS Division.

“The Brodmann Area 25 study is an important step in bringing physicians and their patients a neuromodulation therapy that, if successful, will treat this debilitating form of depression.”

The National Institute of Mental Health estimates that more than 21 million U.S. adults suffer from some kind of depressive disorder. Current therapies are effective for about 80 percent of this patient population according to the National Advisory Mental Health Council. That means approximately 4 million adult Americans live with depression that doesn’t respond to medications, psychotherapy or electroconvulsive therapy.

Source: St. Jude Medical

Some CAM’s Help Depression, Menstrual Symptoms

A new German quality control analysis has discovered some complementary medicines can help mild depression and premenstrual syndrome.

However, not all dietary supplements and “alternative” products are harmless. Accordingly, authorities recommend for consumers to critically analyze purported health claims of the products.

Many people use “alternative” or complementary products because they see them as a more gentle form of medicine.

The German Institute for Quality and Efficiency in Health Care analyzed the latest research on several products and released the results along with a guide for consumers.

St John’s wort (hypericum), for example, could help ease mild depression, but it does not help with severe depression. It also probably cannot help with the symptoms of premenstrual syndrome (PMS).

However, calcium and vitamin B6 (pyridoxine) might help relieve PMS. On the other hand, evening primrose oil has not been proven to help.

Herbal medicines and dietary supplements can also have risks

According to the Institute, conflicting research results in recent years have caused confusion and controversy about St. John’s wort. It concluded this is partly because the effects vary from product to product, and the effect depends too on how severe depression is. The controversy highlights the importance of looking at all clinical trial results to gain a better picture of health care treatments.

“Consumers need to be more critical of all health claims,” according to the Institute’s Director, Professor Peter Sawicki. “This is as true of dietary supplements and complementary medicines as it is of prescription medicine. Just because a product is made from a plant or vitamins, it does not mean it is necessarily safe in very high doses or for frequent use. And not all medicinal products can provide as much relief as patients expect.”

The growing evidence that high doses of some vitamins and antioxidants can cause cancer or earlier death is an important reminder that dietary supplements are not necessarily harmless.

All treatments and products should face the same scientific standards for effectiveness and safety

Patients need to consider several questions before choosing any treatment, including a dietary supplement.

Professor Sawicki:

“Doctors and patients need to know whether treatments have been proven to work in enough good clinical trials that measured benefits large enough to matter to the patient. Whether a medicine is made from a plant or manufactured in a laboratory, the same scientific standards apply if you want to know which treatment might be the best for you.”

To help consumers, the Institute also published a new guide for consumers considering using dietary supplements or complementary medicine products. The fact sheet lists key questions that could help people make decisions for or against a particular treatment. The fact sheet, along with research results on a range of treatments, is available from today on www.informedhealthonline.org.

Source: Institute for Quality and Efficiency in Health Care

Rating Mental Healthcare Facilities

By Guest Blogger, Cecie Kraynak

In the course of my most recent hospitalizations, my husband, Joe, and I have tossed around the idea of creating our own mental healthcare resort or at least implementing a 5-star-rating system for existing facilities. The first place I stayed would have earned a 1-star rating, and that was pretty much a mercy star. The second place, Valle Vista in Greenwood, Indiana, was a solid 4 (out of 5) Star resort compared to the other places I’ve stayed.

1-Star Facility (Name Intentionally Omitted)

Here are the ratings for the first place (I omitted the name, so they won’t sue me or treat me badly if I ever end up there again):

Admission: I must have been “forced” to sign 100 papers, none of which I could read due to blurred vision. I became so frustrated and agitated (and downright disgusted) I finally started to sign with a mad flourish of the pen that no more resembled my signature than my brain resembled that of a sane person’s. I can’t imagine how any document I signed in the condition I was in could be considered legally binding. 0 Stars

Bedroom facilities: I had a private room. 4 Stars

Food: Not bad, but I wasn’t very hungry anyway. 2 Stars

Bathrooms: All residents shared 4 bathrooms, all of which were a mess. They must’ve been afraid that the residents would use those removable toilet paper hangers to harm themselves and one another, because all the rolls of toilet paper – at least on one bathroom – were on the floor. Minus 3 Stars

Outside access: Almost complete lack of access to the great outdoors. We went outside one time in the 2-3 days I was there. 1 Star

Staff: Most of the staff were excellent, though one was downright rude to the point of meanness. 4 Star

Medical treatment: My meds were changed, but I wasn’t monitored long enough to really assess their effectiveness. In the hospital’s defense, I must say that I was pleading to get out ASAP. I don’t deal well with confinement when I’m in a manic “high” phase. But still, after they released me, I was re-hospitalized in less than a week. The proof’s in the pudding. 1 Star

Sense of humor: It was the most surreal scene you could imagine. When I was first admitted, I imagined that all of my fellow “inmates” could play roles in a movie I would make about my life. They all seemed to resemble someone from my checkered past. So I started interviewing them. One by one, I called them over to talk with them using the list of names that had evidently been placed on a dry-erase board on the wall during a therapy session earlier that day. I asked them whether they thought they could play the role I had in mind for them. Then, they had to write on the board the one thing they needed to work on (in life). Once they completed these tasks, I had each of them check off their name. In a couple instances, I told them we would change their name for the movie, but believe it or not, many of them had names that actually fit with the character’s name whose role they would be playing.

As compensation for their involvement in my project, I promised them a trip to a beautiful vacation resort on the Pacific Coast of Mexico. One of the patients was willing to participate only if I promised her that she could have her own stretch of beach to pace up and down on, because she had a hate-on for a couple of the other patients. She didn’t want a chance encounter with either of them, because it would ruin her vacation.

When the staff got wind of what I was up to, they sent three security guards to usher me to the isolation ward. I resisted. I was bruised physically and psychologically, not to mention the fact that all those people who thought they were going to Mexico with me are probably very disappointed. Minus 2 Stars

4-Star Facility: Valle Vista

Valle Vista (in Greenwood, Indiana) was like a vacation resort compared to the other facilities I’ve had the displeasure of visiting. Here are my ratings:

Admission: I signed one form and was told I didn’t have to sign it. (Note: This was a forced admission. My first stop was the emergency room at a local hospital, which was about 7 hours of hell. The doctor wouldn’t give me any meds to bring me down – he thought the people at the psych hospital needed to see me in full-blown mania to make an accurate assessment (that’s what he told my husband). He kept me in a room by myself, allowing a brief visit with my husband, but I can’t count all this against Valle Vista’s admission protocol.) 5 Stars

Bedroom facilities: Nice room, but less privacy. I had a roommate. She was nice. 4 Stars

Food: Deliciousand plenty of it. Some of my cohabitants complained that the meals were carb-heavy, but I found plenty of healthy juice, fruit, and veggies. 5 Stars

Bathrooms: Shared only with roommate, which is a very nice amenity. 4 Stars

Cleanliness: Considering the fact that there were some pretty messy people running around, they kept it pretty nice, although the waiting area (for visitors) was a hundred times nicer than in the back where they kept us. 4 Stars

Outside access: The facility had a concrete and brick courtyard with iron bars overhead – not exactly the ambience I was hoping for. Residents could head outside whenever the spirit moved them – as long as it wasn’t time for group therapy or a meal. Even though I was “incarcerated,” this made me feel as though I had some freedom. (I offered to sweep up the cigarette butts that littered the courtyard, but the staff refused to give me a broom; I still wonder why.) 3 Stars

Staff: Everyone was very courteous and respectful. They really treated me as though I was ill rather than just a trouble-maker. 5 Stars

Medical treatment: I experienced a two-day delay in getting on lithium because I told the doctor I had a dream that made me think I could be pregnant. Other than that, the change of meds proceeded smoothly and the doctor was receptive to my comments and reactions; for instance, when I reported having night sweats, he lowered the dosage of one of the meds, and the sweating stopped. He was also one of the few doctors I’ve ever had (and I’ve had plenty) who took me seriously when I reported that my mood shifts seemed to be associated with my periods. 4 Stars

Sense of humor: Well, I wasn’t making a movie here, but everyone was fun loving, and we all used humor to lighten the load. 4 Stars

If you stayed in a mental health facility or hospital, I’d like to read about your experience. Please post your account (and ratings) to share with others… including yours truly, Cecie. I don’t plan on checking into any more places like this in the near future, so don’t expect me to post any more ratings in the near future… or, hopefully, ever!

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