The roots of anxiety disorders may reach back to infancy, say US scientists. They have found that mice that lack certain receptors in the first days of their lives are unusually anxious in adulthood - even if the receptors are later restored.
The neurotransmitter serotonin has long been associated with mood. Recently, it has been found that mice lacking receptors for serotonin are abnormally anxious, though no one was sure which receptors in particular were responsible.
To track these down, Cornelius Gross at Columbia University in New York and his colleagues created a line of mice that...
Many people make New Year's Resolutions to quit smoking. Two weeks into the new year many have relapsed and smoked a cigarette. New psychological research offers some reasons for this. One study found that if you can resist the urge to smoke, you will experience fewer cravings. Another study found that people with high self-esteem are especially likely to reject information suggesting that their health behavior (in this case smoking) has been unwise or risky.
In the first study, which appears in the February issue of the Journal of Abnormal Psychology, published by the American Psychological Association (APA), psychological researchers at the University of Pittsburgh and Carnegie Mellon University assessed smoking urges several times daily in 214 smokers who quit for at least 24 hours while participating in the study. Each participant was equipped with a palm-top computer to record their urges to smoke. The research revealed that how much craving a person experiences on a given day predicts the likelihood of relapse the next day. But the best predictor of relapse was morning craving -- the stronger the craving was...
Before starting to work on confidence, I recommend freeing yourself from the pressure to "be a confident person." Confidence isn't so much a personality trait as how comfortable you feel in particular situations.
See for yourself. Take out a piece of paper and write down all the situations you can think of when you feel less confident than you'd like. Now consider everything else you do. Tidying up, watching TV, surfing the Internet....There are dozens of situations you do face confidently. Think, too, if there's been a time when a friend you admired for his/her confidence voiced a problem with a situation you have no trouble with yourself. Even the most outgoing person at the office can freeze up on a first date!
The second tip is to focus on what you do feel rather than what you don't. How do you feel in those situations on your list? Worried? Self-conscious? Embarrassed? You might find, as I do, that when people talk of confidence, what they really mean is the absence of anxiety or self-consciousness. The last tip is to look carefully at the situations on your list. What do they have in common? Type of place? Type or number of people (strangers, professionals, big parties)? Which are the worst? Which are the best ? What do you feel is expected of you?
MIND-training gurus will tell you that while there is no such thing as a photographic memory, only effective memory techniques.
Psychologists categorise memory as sensory, working and long- term. Sensory memory is stimulated by our five senses and only those that grab our attention are passed into our short-term memory. These will eventually fade if they are not transferred to our long-term memory (the storage unit).
An example is learning the multiplication tables. When we first learn them (through our visual-audio senses), we read and repeat the tables after our teacher without committing them into our working memory until we are tested.
Knowing that we will be punished for not knowing the multiplication tables, we then...
A rash of new books is urging a rebirth of humility and decorum. No one would deny that our culture has become crass and vulgar, but these books have another, more insidious message: they equate innocence with ignorance.
KEEPING WATCH OVER YOUR KIDS' innocence is no easy task. Just ask Michael and Diane Medved, authors of Saving Childhood: Protecting Our Children From the National Assault on Innocence (Harper Collins, 1998). It's not enough to ban television from your home, as the Medveds have, to limit videos to six G-rated hours a week, to carefully screen prospective playmates. Threats to your children's blissful ignorance can still sneak past: a Girl Scout manual contains references to sex. A Judy Blume novel, recommended by a kindly librarian, mentions menstruation. Classmates let slip the names of the Spice Girls.
Fortunately for the Medveds, their offspring have joined in the effort to preserve their naivete. Should the news come on during the family's Sunday drives, the proud parents recount, "our children immediately beg us to turn off the radio, lest they hear something" that "spoils their contentment." And when a haunting song from the soundtrack of Showboat! plays on the stereo, their daughters scream "Fast forward! Fast forward!" because "they wouldn't even consider hearing lyrics that predict sadness or trouble on the horizon."
The Medveds' efforts to safeguard their children's tender sensibilities border on the fanatical (they have forbidden their eldest daughter to read any books published after 1960). But it's hard not to sympathize with their concerns. If innocence is not quite under assault, it has been treated none too gently by the late twentieth century, with its bruising rounds of sex and violence, cynicism and corruption. Our appalled fascination with schoolboy murderers and tiny beauty queens has its source in the fear that childhood's magic has faded, replaced by something harder and harsher.
Imagine yourself lying on an operating table in a humid hospital tent near abattle front during the Vietnam War. Writhing in agony, you plead with the medics to give you something to relieve the pain in your leg. But the supply lines were interrupted hours ago and there is no more anesthetic. What's more, the leg can't be saved. If they don't operate immediately, you hear someone saying in the background, you're going to bleed to death.
The nurse seems unexpectedly centered as she sits beside you, leans over, and looks into your eyes. "It's going to be all right," she says, and you can't help noticing the smell of the soap she uses and the tiny lines around the comers of her mouth. "I know you're a little nervous," she slowly continues, "but you're in excellent hands. You're just going to feel a little pressure while we fix you up." She is so reassuring that you find yourself wanting to believe her. You also find yourself going along with the suggestion that you're only a little nervous, and even feeling relieved to know you're in excellent hands.
As the surgeon attends to your leg, the nurse continues talking to you as though nothing unusual is happening. "You just feel a little more pressure," she says calmly, and you find yourself imagining that none of the pain you've been experiencing all along is really that bad. The operation is completed in what seems like no time at all.
It never occurs to you that you are under the influence of hypnosis, but that is what they tell you when you later ask what happened. You are thankful for the relief you experienced while the surgeon sawed off your leg. You are testimony to the popular belief that hypnosis is a special state of consciousness in which many mental feats become possible--such as enduring surgery sans anesthesia.
Borderline Personality Disorder (BPD) is one of the most controversial diagnoses in psychology today. Since it was first introduced in the DSM, psychologists and psychiatrists have been trying to give the somewhat amorphous concepts behind BPD a concrete form. Kernberg's explication of what he calls Borderline Personality Organization is the most general, while Gunderson, though a psychoanalyst, is considered by many to have taken the most scientific approach to defining BPD. The Diagnostic Interview for Borderlines and the DIB-Revised were developed from research done by Gunderson, Kolb, and Zanarini. Finally, there is the "official" DSM-IV definition.
Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder: in Trauma and Recovery, she theorizes that when PTSD takes a form that emphasizes heavily its elements of identity and relationship disturbance, it gets called BPD; when the somatic (body) elements are emphasized, it gets called hysteria, and when the dissociative/deformation of consciousness elements are the focus, it gets called DID/MPD. Others believe that the term "borderline personality" has been so misunderstood and misused that trying to refine it is pointless and suggest instead simply scrapping the term...
Borderline Personality Disorder (BPD) is one of the most controversial diagnoses in psychology today. Since it was first introduced in the DSM, psychologists and psychiatrists have been trying to give the somewhat amorphous concepts behind BPD a concrete form. Kernberg's explication of what he calls Borderline Personality Organization is the most general, while Gunderson, though a psychoanalyst, is considered by many to have taken the most scientific approach to defining BPD. The Diagnostic Interview for Borderlines and the DIB-Revised were developed from research done by Gunderson, Kolb, and Zanarini. Finally, there is the "official" DSM-IV definition.
Some researchers, like Judith Herman, believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder: in Trauma and Recovery, she theorizes that when PTSD takes a form that emphasizes heavily its elements of identity and relationship disturbance, it gets called BPD; when the somatic (body) elements are emphasized, it gets called hysteria, and when the dissociative/deformation of consciousness elements are the focus, it gets called DID/MPD. Others believe that the term "borderline personality" has been so misunderstood and misused that trying to refine it is pointless and suggest instead simply scrapping the term...
A new antidepressant called duloxetine improved symptoms of fibromyalgia -- a chronic and painful musculoskeletal disorder -- in women but not in men, researchers report.
Duloxetine (brand name Cymbalta) was recently approved by the U.S. Food and Drug Administration (news - web sites) to treat major depression and nerve pain suffered by those with diabetes. In the new study, published in the September issue of Arthritis & Rheumatism, the drug was used "off-label," which is legal.
"Antidepressants have been used to treat fibromyalgia for over 10 years," said study author Dr. Lesley Arnold, an associate professor of psychiatry at the University of Cincinnati College of Medicine. "The problem has been those medications are poorly tolerated," she said, adding that side effects include weight gain, potential heart problems and excess sedation.
CHARLESTON, SOUTH CAROLINA -– New long-term findings demonstrate that patients with difficult to treat chronic or recurrent depression continue to respond to vagus nerve stimulation (VNS) therapy for up to two years.
Results from the 60-patient long-term study, led by Mark George, MD, distinguished professor, departments of Psychiatry, Radiology and Neurology at the Medical University of South Carolina, indicate that extended treatment with VNS is associated with the elimination or reduction of depressive symptoms and an improved ability to perform daily functions.
The study, conducted to determine whether the promising results seen in an acute phase (three month) pilot study were sustained after one to two years of treatment with VNS, used remission and response rates as the primary indicators of success. Response means that a patient’s depression symptoms were cut in half; remission means that a patient has become virtually symptom-free. The study found that depressed patients with VNS improved over time in terms of remission and response and also improved in their ability to function:
WASHINGTON, DC -- August 25, 2004 -- Physical symptoms are nearly as common as emotional ones in patients suffering from depression, according to Indiana University School of Medicine research published in the August issue of the Journal of General Internal Medicine.
Patients with depression frequently talk to their physicians about symptoms such as headache, back or muscle pain, stomach ache and dizziness instead of symptoms more commonly associated with depression such as fatigue, lack of motivation and moodiness, says Kurt Kroenke, M.D., professor of medicine in the Division of General Internal Medicine and Geriatrics at IU and a research scientist at the Regenstrief Institute, Inc.
"Depression is a risk factor for symptoms of pain," he said. "The most reports of pain - such as muscle pain, headaches, leg pain - are two or three times more common in people with depression."
Living with social-phobia is like a balancing act. You are always balancing the pros and cons of leaving your house and running the risk of having to speak to someone. My illness has manifested to a point where I can no longer leave my house without a great deal of stress. Some days I am okay to go to familiar places. Other days will find me locked in my house with the curtains drawn.
I have not been able to work since 1989. I'm on disability now for my income. It isn't so bad really. I kind of appreciate the freedom of not having a job. I have never liked working. I did it out of neccessity but this social-phobia thing has stopped all that part. The fact that there were people that I had to relate to made it almost impossible for me to go in each day.
Let me start at the beginning. I guess you can say I have had socialphobia all my life. My earliest memories related to socialphobia were of quitting a ballet class because I thought my knees looked deformed and everyone was laughing at the ugly goose trying to be graceful. It was humiliating to point of pain. Pain in my head, fear I couldn't take the emotional rollercoaster anymore and pleaded with my mother to allow me to quit. When she asked me why I just said I didn't like it and no more was said and she allowed me to quit.
Another episode was my piano lessons. I couldn't perform for the private tutor because of stress. I couldn't make him understand I practiced my lesson but when he came my nerve went out the window and my fingers hit all the wrong keys. I was sure he considered me a complete and hopeless case. So again I quit.
Republican lawmakers on Thursday charged the U.S. Food and Drug Administration with hindering a congressional probe into whether the agency suppressed a possible link between antidepressant use and suicidal behavior in youth.
Rep. Joe Barton ... chairman of the U.S. House Energy and Commerce Committee, said the FDA (news - web sites) has been uncooperative during the committee's seven-month inquiry.
"Unfortunately, over the last several months, the committee has been met mostly with stonewalling, slow-rolling and plain incompetency from the FDA," said Barton, of Texas.
You have dissociative identity disorder, the psychiatrist told me. My mouth hung open in disbelief. This was the third psychiatrist I had seen in six months for evaluation, and this one was on the roster of official court ordered psychiatrists for the county. I had gone to him on my own hoping for a different diagnosis, and was sorely disappointed. Images of Sybil, or an out of control alter frothing at the mouth, flashed into my mind. I worried that I would be seen by others in this light. I knew very little about DID at that time, and had no idea how wrong my misconceptions of it were.
Dissociative identity disorder (DID, formerly called MPD, or multiple personality disorder) is a psychological response to trauma that is usually severe and occurs early in childhood. For the person with DID, the challenge is learning to cope with daily life, while healing from the traumatic events of childhood. In this article, I will be sharing from my perspective both as a health professional, and a survivor, on how to cope with DID. This is NOT meant to replace therapy with a qualified therapist or psychiatrist, but only meant to be informational based on one persons experiences with DID.
When the Food and Drug Administration opens an advisory committee hearing tomorrow into the safety of antidepressants, several committee members will push for tougher warnings saying that a child or teenager given the drugs can become suicidal in the first weeks of therapy, they said in interviews.
"I want the warning strengthened," said Dr. Richard Gorman, a member of the committee and a pediatrician from Ellicott City, Md. "I would also like the pharmaceutical companies to send out letters to doctors saying that, in kids, this stuff doesn't work."
Dr. James McGough, another committee member and a professor of clinical psychiatry at the University of California, Los Angeles, also said he wanted stronger warnings.
For more than a year, agency officials have struggled to find the appropriate balance between warning patients about the possible suicide risk of antidepressants and reassuring those patients that drug therapy can be an effective and safe remedy.
Somehow we never expect our doctor or psychiatrist to get sick. After all, isn’t their role is to guide us through our own suffering? So what happens when your doctor or psychiatrist experiences a mental illness? This week: the personal and candid stories of two health professionals, on mental health, their unexpected experiences of stigma within the profession, and the challenges of accepting one’s own vulnerabilities in a work culture that demands invincibility.
Transcript:
Natasha Mitchell: Hello there, Natasha Mitchell with this week’s edition of All in the Mind. Thanks for tuning in.
A slightly different program for you today, with two intimate stories of stigma and mental illness – but this time, from members of the medical profession itself. Somehow we just never expect our doctor or our psychiatrist to get sick. We all like to believe that they’re the invincible ones, and that their role is to guide us through our experiences of illness.
As it happens, many doctors aren’t very good at seeking help with personal health problems, and this is especially the case when it comes to their mental health. Self-diagnosis and self-medication among doctors is not uncommon, and as we’ll hear today, stigma towards mental illness exists even amongst their peers, in the very profession that’s charged with treating it.
So it’s rare to hear physicians and psychiatrists talk publicly about their experiences, for fear of the implications it could have for their careers. The two people you’ll hear from today are both successful in their work, but nevertheless – and much to their frustration – they’re still dealing with the ramifications of having experienced mental illness well over a decade ago.
Jill: While we continue to hide it, then nothing will ever change, because stigma can only really exist in an environment of shame. Without shame there is essentially no stigma, and while we continue to hide mental illness and hide the experience, then we perpetuate the stigma. I heard a wonderful suggestion just on that subject yesterday, which was that perhaps we should be encouraging everyone to tick the box marked “I have a mental illness” – and when asked what it is, just say “oh, I have a phobia of spiders”.
Chris: This is to the detriment of people in the medical profession who are supposed to be...
Nation’s ER’s Report: Abuse of Anti-Anxiety Drugs Up
The number of drug-abuse related visits to hospital emergency rooms (ERs) involving benzodiazepine medications exceeded 100,000 in 2002, a 41 percent increase since 1995, according to the Substance Abuse and Mental Health Administration’s Drug Abuse Warning Network (DAWN). Nearly half of the emergency department (ED) visits involving benzodiazapines -- which include such psychotherapeutic sedatives as Valium, Xanax, Klonopin, and Ativan -- were connected with suicidal ideation, gestures or attempts.
1. It does not matter íf you feel frightened, bewildered, unreal, unsteady. These feelings are nothing more than an exaggeration of the normal bodily reactions to stress.
2. Just because you have these sensations doesn’t mean you are very sick. These feelings are just unpleasant & frightening, not dangerous. Nothing worse will happen to you.
3. Let your feelings come. They’ve been ín charge of you. You’ve been pumping them up & making them more acute. Stop pumping. Don’t run away from panic. When you feel the panic mount, take a deep breath & as you breathe out...
Women seem to react worse to negative experiences Genes could explain why women are more prone to stress-related anxiety and mood disorders. US researchers have pinpointed a variation in a gene which controls regulation of a key brain chemical linked to mood.
Their work, on monkeys, suggests people with this variant may be more likely to react badly to negative experiences.
The US National Institute on Alcohol Abuse study appears in Proceedings of the National Academy of Sciences.
There is much we can do after our genes are laid down to enhance our ability to cope with stress.
Iain Ryrie The researchers focused on a particular variant of the gene, known as the s allele.
People with this variant produce less of a protein that is involved in regulating levels of a chemical called serotonin in the brain.
Walk (at least) 10,000 steps
Walking throughout the day touted as gradual, realistic approach to fitness
Just as people have looked historically to 12-step programs to restore sanity and sobriety, they now are looking to a 10,000-step program to restore a healthy weight or to maintain it.
From groups like America on the Move and AARP to employers like Piedmont Hospital that reward walkers with the most steps to the king of fast foods, McDonald's, people are recognizing that walking — throughout the day — is a key way to nudge Americans out of sedentary lifestyles.
PAYBACK BEGINS WITH ONE STEP
Step calculus: While losing weight is challenging to millions, the basic premise is simple: Take in less energy — or calories — than the amount of energy expended. Counting steps and adjusting calorie intake accordingly can be a useful tool in doing that. Consider the additional steps necessary to compensate for ordering larger sizes of some common fast-food items:
Based on a successful pilot walking program in Richmond and Madison, Wis., AARP will launch a walking program in 12 states, including Georgia, beginning July 1.
Millions of people have long turned to walking for exercise, but what's different now is walking throughout the day — in the office, at school — and measuring steps with step counters or pedometers clipped onto belts, trousers or shorts. The new walking attitude also focuses on small improvements and learning about energy balance in weight control.
The belief that one has received alcohol, but not alcohol itself, reduces social anxiety, according to study findings published ín the August issue of The American Journal of Psychiatry.
Dr. Joseph Himle, of the University of Michigan ín Ann Arbor & colleagues asked 40 patients diagnosed with social phobia to give two impromptu speeches ín front of a small audience. In the randomized, double-blind study, half of the group received placebo before both speeches. The other half received placebo before...
INDIANAPOLIS, IN -- August 24, 2004 -- Cymbalta® (duloxetine HCl; pronounced SIM-BALL-TA), a new treatment for major depression, is now available by prescription in pharmacies across the United States, Eli Lilly and Company (NYSE: LLY) announced today.
More than half of the nation's pharmacies, including drug store chains and independents, have stocked Cymbalta and can begin filling prescriptions immediately. Lilly expects more than 80 percent of pharmacies -- more than 44,000 stores -- to have Cymbalta on their shelves by Aug. 30. The U.S. Food and Drug Administration approved Cymbalta, a balanced and potent selective serotonin and norepinephrine reuptake inhibitor (SSNRI), on Aug. 3 for the treatment of major depression.
"The availability of Cymbalta is a long-awaited milestone for patients and physicians -- it's an effective antidepressant that helps treat both...
New Disease of the Week
by Snit
I had been having a somewhat bad several days - not horrible, mind you, not so bad I had missed work or ended up calling 911 or spending the night in the emergency room, but still bad. The night before I had not slept well, nor the several nights before that. Just as I would be falling asleep, I would feel one side of my body begin to go numb. I would get startled, and become *convinced* I was having a stroke or a heart attack or some such.
Considering that, the day was as good as I would expect. I felt weak and woozy and had a few minor attacks of faintness and palpitations, but managed to at least look productive and finally made it to 5:00. It was Friday. A whole weekend to sleep in and unwind.
I came home and relaxed in front of the tube. I ate some dinner. As food will often do, it made me feel even weaker. I took my temperature. It was low; about 97.1. Ah ha! When my temperature is cool, I take a warm bath, my temperature increases, and I feel better.
I filled the tub with warm water, added a few drops of soothing lavender oil, and grabbed a book. As I got into the tub I noticed a new spot or freckle or whatever on my leg. Hmmm... thoughts of skin cancer made my pulse quicken, but soon the water and the scent and the book helped me to relax. Ahhh... a piece of heaven. Then IT happened.
I looked down at my legs. The legs I had JUST inspected for spots. On my right leg - just above the knee. IT was there. A big, nasty horrible looking bruise that had appeared from NOWHERE. I was stunned. It was, without exaggeration, easily the size of my palm. And what an awful shade of blue-black. This was it! Mysterious bruises. My blood vessels were rupturing for no reason. This explained the weakness and the numbness and... and EVERYTHING. I was dying. I had only moments to spare. Soon I would pass out. My heart started to race. I ... must ... get ... help ...
I jumped from the shower and RAN to the phone to call 911. Before I dialed, I looked at my leg one more time. Was it really THAT bad. It *was* a very unhealthy color. For a leg. Very much the color of the book I had been reading. The book I had rested on my leg. Right at that spot. Not such a bad color for a book.
I rubbed the "bruise" and it smeared. And I lived to tell this story.
As Ricky Williams fights social anxiety disorder with marijuana, scientists are working to take advantage of the plant's anti-anxiety properties while avoiding the drug's side effects.
Ricky Williams' claim that marijuana helps stave off social anxiety may have scientific merit, but developing a drug that could produce similar results will take years, medical experts said Thursday.
In lab animals, higher levels of cannabinoids -- the compounds found in marijuana, and which occur naturally in the brain -- sometimes decrease anxiety.
Scientists are trying to develop a drug that would replicate this effect in humans. But even under the rosiest circumstances, it will take nearly a decade to bring the drug to market.
In the meantime, scientists recommend against smoking marijuana to relax.
WASHINGTON (AP) - A new Food and Drug Administration analysis backs earlier suggestions of a link between at least some antidepressants used by children and suicidal tendencies, prompting the agency to prepare new warnings.
Exactly what those warnings will say, and which drugs will be affected, hasn't been settled, according to FDA documents released Friday. The agency will take the debate to its scientific advisers next month for help in deciding.
"While there remains a signal of risk ... for some drugs in some trials, it is important to note that the data are not black-and-white in providing a clear and definitive answer," FDA psychiatric drugs chief Dr. Thomas Laughren wrote the advisory panel this week.
The controversy has simmered since last year, when British health authorities declared that a list of popular antidepressants might sometimes increase the risk of suicidal behavior in children and teenagers, and declared all but one - Prozac - unsuitable for depressed youth.
It's a difficult issue to sort out because depression itself can lead to suicide, and studies show that antidepressants have helped adult depressed patients recover. But, Prozac is the only drug FDA-approved to treat pediatric depression and there is little scientific evidence that any other antidepressant works in that age group, thus deepening concern about even potential risks.
In every way, depression is a growing problem. Rates of depression have steadily climbed over the last 50 years and are significantly higher in those born after 1945 than in those born before In addition, the average age of on set of a first depressive episode is steadily decreasing--it is now mid-20s whereas it once was mid-30s. Cross-cultural data show that the United States has a higher rate of depression than almost any other country, and that as Asian countries Westernize their rates of depression increase correspondingly.
The data make it abundantly clear that these changes are not the product of individual biochemistry or of family genetics but of pathology within our culture. There are many depressogenic factors operating in our culture. Information overload is one. Since 1945 we have accumulated at least as much information as we had throughout history until then. The more information there is, the more we end up essentially skimming the surface. This leads to a style of thinking in which we see only the big picture and miss the depth of detail. As a result, when we are faced with difficult problems, we do not recognize the many small steps that solutions typically require; things feel overwhelming and insurmountable, leading us to give up before we even start.
Depression is associated with an increased frequency of smoking. Addicted smokers are characterized by preoccupation with smoking, abnormal attachment to cigarettes and anticipation of brain reward from the drugs in cigarette smoke. Attempts to quit smoking often lead to a decreased level of pleasure and undesirable mood swings. Thus, once the brain has adapted to the daily dose of the drug, it seems abnormal to the brain if the user attempts to abstain.
Individuals with underlying or current depressive symptoms are more likely to experience mood disturbances when they attempt to quit. Furthermore, it appears that smoking may mask an underlying depression in some smokers.
New research has suggested that there may be something in cigarette smoke that has antidepressant properties, which explains why cigarette smoking is much more common among depressed patients. A survey of 3,000 individuals in the St. Louis area confirmed that lifetime frequency of major depression was more common among smokers than nonsmokers (6.6 vs. 2.9 percent) This study also demonstrated that smokers who reported at least one episode of major depression were less likely to succeed in smoking cessation programs than smokers without depression (14 vs. 28 percent). These findings have...