Anxiety Disorders
http://thedianerehmshow.org/shows/2010-11-18/anxiety-disorders
Anxiety disorders are the most common psychiatric illnesses affecting children and adults. Yet out of the estimated forty million American’s suffering from it, only about a third receives treatment. The latest in research, treatment and education of this illness, and how to distinguish a disorder from everyday anxiety.
Guests
Dr. Jerrold Rosenbaum
President of the Anxiety Disorders Association of America,
Chief of Psychiatry at Massachusetts General Hospital,
Professor of Psychiatry at Harvard Medical School
Dr. Daniel Pine
Chief, Section on Development and Affective Neuroscience and Chief of Emotion and Development Branch in the Mood and Anxiety Disorders Program of the National Institute of Mental Health Intramural Research Program.
Dr. Richard Nakamura
Scientific Director of the National Institute of Mental Health (NIMH)
Dr. Elizabeth Phelps
Lab Director of New York University's Department of Psychology
Dr. Blair Simpson
Director of the Anxiety Disorders Clinic and of the OCD Research Program and Professor of Clinical Psychiatry at Columbia University.
Comments
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
I have suffered from anxiety disorder for decades. I have been to numerous psychologists, psychiatrists, and even went to Boston University's CARD (Center for Anxiety Related Diseases) where I was professionally diagnosed with PTSD. My particular issue with panic attacks and anxiety disorder began in my early 20's after extraordinarily stressful life over a long period of time since childhood but at 21 something different in the form of panic hit me and I was never the same. My mother suffered from it but at that time the the disorder was not understood.
I began an MSW degree but left before I finished and went into another profession that was less demanding. I worked for 30 years until my physical malady of post polio issues forced my retirement.
I have also tried meds. They have for me been of no use. It is a nightmarish UNCOMFORTABLE malady. I simply have lived with this horrible disorder. Why have psychiatric drugs for this disorder failed so miserably and why are there no techniques to study the brain in order to come up with satisfactory medications instead of dropping a variety of pills into a hat and a physician says take this or take that with little on which to base the treatment.
The ONLY drug that works to a degree for me is the benzodiazipine Alzopram (Xanax) BUT that is addicting and I have shied away from it in quantity because of that. I do take a small dose before bed. I am a health fanatic and very aware so I am VERY careful not get myself into difficulty.
Why is there so little psycho-pharmacological effectiveness for this disorder? Why can it not be diagnosed and medically treated like other bodily diseases such as diabetes?
No one I know loved life or had more curiosity for all things academic than I and no one I know wanted more out of life than I but this hideous disorder got in the way. There is literally no way out. I suspect there will never be help for me.
Caffeine and SSIRs: I suffer from generalized anxiety disorder and have been on Lexapro (SSRI) for some years now and have been doing great, in fact I have been contemplating getting off the medication. However, recently I realized there is an association between my coffee consumption and recurring episodes of generalized anxiety. I did some research and found out that others have reported similar experiences. So I stopped caffeine in-take and sure enough! The anxiety stopped and I have not had an episode since. Has there been any research done on possible interaction between caffeine and SSRIs?
I have suffered from an anxiety disorder most of my life. As a teenager I had several panic attacks which were so frightening, mainly because I had no idea what they were. All I knew was that I felt horrible. My heart was pounding all the time. Then I learned Transcendental Meditation. It changed my life. I had no more panic attacks, I felt peaceful and clear-headed for the first time since childhood. Everything in my life improved. I could not believe that such a simple technique had such an amazing result. I have now been practicing TM for almost 40 years, twice a day, every day. There is no more healthful way to make life better.
I suffered with anxiety and social phobia for more than 15 years, from the time I was around 13 until my late 20's. (I'm now 57.) During that time I developed several bizarre phobias that began with a fear of writing in public (scriptophobia) and spun off to fears of eating and drinking in public and fears of accepting change from a cashier, along with severe fear of public speaking and having my picture made. To make matters worse, these fears were shameful and embarrassing to me. I did not want anyone to know about them...they were my dirty little secret.
Leading a normal life is extremely difficult with these types of phobias, but I somehow managed to attend and graduate from Auburn University, received my master's, and taught special needs students for 26 years. I'm actually writing a memoir about this time in my life, and how I managed to overcome the fear. I say "overcome" because I cannot say that I ever was "cured" of social anxiety or social phobia. I believe that anxiety and severe phobias are like alcoholism: you learn to live with the problem, and you learn to control it rather than let it control you. But it never really goes away.
Today I do have a prescription for .25 mg Alprazolam, and it is wonderful to know that I have it in the chance of a panic attack (I never had medication in the 60's and 70's). The severe fears are under control, although I imagine I will always have the concern in the back of my mind that they might return in full force one day.
I want people who might be suffering from similar fears to know that there are ways to deal with them, and that they can survive this. It is a very difficult disorder to live with, but it can certainly be done, and with the knowledge we have today about social anxiety and social phobia, it doesn't have to be someone's secret fear anymore.
Thank you.
Thank you so much for highlighting this common and very crippling illness. I am a therapist in the Washington DC area participating in a study of short term psychotherapy for panic disorder. I hope you can inform your listeners that there is a 26 session psychotherapy available to a limited number of patients in the Washington DC metro area. It is free of charge to those accepted into the study and is conducted by experienced, licenced therapists who have special training in panic focused therapy. Anyone interested should call 301-230-3168 or email svinik@hotmail.com
I have anxiety related to my Fibromyalgia. Please discuss this situation.
Thank you for providing a forum for discussing this common and sometimes debilitating illness. A group of psychoanalysts and clinical psychologists in the DC area is currently conducting a study of the efficacy of the psychodynamic treatment of panic disorder. The DC Panic Disorder Treatment Study provides a free 24-session 3 month treatment. If anyone is interested in the Study please call Dr. Snejnevski at (202)679-3898 or email claudettepilger@gmail.com. There have been some promising preliminary results in our study and in others conducted around the country.
Here is a little bit more about why we are so excited about our study:
A real sea change in the area of PP research, in our opinion, was the development and publication of the Manual of Panic-Focused Psychodynamic Psychotherapy by B. Milrod, F. Bush, A. Cooper, and T. Shapiro from Cornell University Medical College. The PFPP manual offers a unique opportunity to define psychoanalytic treatment and to control its delivery in a research setting. Using the Manual B. Milrod et al have demonstrated the superiority of 12 weeks of twice per week manualized Panic-Focused Psychodynamic Psychotherapy (PFPP) performed by highly trained psychotherapists to Applied Relaxation Training (ART is a recognized behavioral therapy for Panic Disorder). This work is ground-breaking. For the first time, a study performed according to externally-recognized clinical trial standards has shown that a psychodynamic intervention is statistically effective compared to a control intervention.
Does this study constitute a very promising beginning of a revival, or a last flame of a dying fire of the old treatment-as-usual approach? The authors of this article are trying to prove the former. In an effort to replicate and extend the Milrod et al results, we started a clinical trial of effectiveness of Panic-Focused Psychodynamic Psychotherapy.
Could you comment on the connection between depression and anxiety?
I've noticed that people who suffer from depression often have anxiety along with it. When the depression is flaring up, the anxiety also gets worse. When the depression is under control, the anxiety seems to calm down or disappear.
Amy Rockford MI wrote:
I have a son who is now 12. He also happens to be gifted and talented. He has had several bouts of reoccurring anxiety. One way we have dealt with this is through guided imagery. What I have often wondered is if his anxiety is linked to his giftedness, as he has an ability to understand things that are beyond his maturity level. If so, can I hope that as he matures this may level out somewhat?
I was diagnosed with PTSD and recurring major depression in the early 90s and was treated for both for seven years with weekly cognitive therapy sessions and meds. Today I still struggle with depression but the PTSD is well under control. I almost never have flashbacks, panic attacks, or nightmares anymore, although very occasionally I do get triggered. When I start therapy the disease was so intrusive I was nearly non-functional.
One thing that bothers me is that while PTSD has been getting lots more press lately--which is good--the press it gets is almost exclusively about veterans and people returning from recent military combat. Frequently PTSD is portrayed as incurable in this context.
But PTSD is also common in women who have survived rape and long term childhood abuse, and in others who sustained major life traumas. With a few exceptions, it is usually very treatable (compared to other mental illnesses).
It's truly sad that with the loss of mental health services in the U.S., so many women and men are suffering needlessly and severely with this crippling condition. It CAN get better, but you need a good therapist, a good psychiatrist, and the resources to pursue treatment to its optimal endpoint. Few sufferers today can gather all three.
I am on an experimental treatment for chronic autoimmune inflammatory disease (in my case post-treatment Lyme, arthritis, and carpal tunnel syndrome) called the Marshall Protocol. The premise of the Protocol is that all these diseases have the same underlying cause: disregulation of Vitamin D and infection by cell wall deficient and bio-film bacteria. I have experienced great improvement with this treatment. A side benefit is that the extreme anxiety I experienced from time to time, including panic attacks, have disappeared. There are others on the Protocol who report relief from anxiety as well as from OCD symptoms.
Please comment on the shame and embarrassment associated with social anxiety.
My 7 and a half year old son is developing fear to elevators. He clearly talks about the similarity of feeling unbalanced while riding on swings and being in an elevator. He stands up close to me and holds his little brother in the elevator. What can do in order to prevent the development of a mayor anxiety later on? What techniques are more convenient at this age?
Thanks
Martha Q.
Our son, now 12, developed severe bouts of anxiety at age 9 after we got a dog that would get away from us from time to time. The fears/ panic attacks extended to not being able to be left in a room alone. We were at the point of seeking therapy when our own desensitizing and work at home improved his condition. The counselor at school was helpful and made some suggestions. He is also gifted like another listener's child. He was a "head banger" as a toddler which our pediatrician told us not to worry. He also had several head injuries. Does head trauma contribute to this condition? I am amazed that he is seemingly fear free now. Is he still vulnerable or could he live out his life without another severe attack?
Patty in Waterford, Va.
My husband and 8 year old daughter both suffer from diagnosed generalized anxiety disorder. We have not tried medication with my daughter, preferring instead to use behavioral modifications with her. My husband has tried several different medications, with varying levels of success. My daughter benefits from relaxation tapes, yoga, and talking about her worries. I have also read about the benefits of massage therapy for treatment of anxiety.
The brain is a giant self-medicating gland. Psychotherapies, in as much as drug therapies, will modify the chemical balance and the strength of the connections among nerve cells in the brain. Finding the right combination of therapies for each person may be the key to effective treatment particularly for anxiety disorders. Early diagnosis and intervention do help.
Read more here:
http://brainmindinst.blogspot.com/2008/06/brain-giant-self-medicating-gl...
I have suffered from panic disorder since I was a child. In my 40s, I was put on Paxil and have done well with it. But recently, I woke up one morning in a panic. It seemed to settle as the day went on but it happened for 5 days straight. I wasn't worried about anything and was confused.
The doctor said that I had a "breakthrough" the med, probably caused by the time change and change in weather. He slightly increased my dose. Is this a normal occurrence? Do people need to increase their dosage over the years? Why?
Great show!
I found that for my episodes of anxiety disappeared with no caffeine and limited pure carbs. Thought I'd share this.
Folks can get information, resources and support from the National Alliance on Mental Illness (http://www.nami.org/). Local chapters provide free programs for family members and consumers. NAMI has been a lifeline for us.
I really enjoyed today’s show, and would just like to add one comment. One of your guests mentioned the importance of studying animal behaviors for clues of how to deal with anxiety. Dr. Peter Levine has actually studied this, and found that animals who escape from life-threatening attacks by predators recover from that trauma by actually shaking or trembling for 20 – 30 minutes, immediately after their escape. That trembling is what allows their body to release the stress chemicals (such as adrenaline) that flooded their bodies while they were running of flying for their lives.
As humans, we generally think of trauma as being in our brains, yet it is also in our nervous system and in our bodies. Using very specific techniques, Dr. Levine created a modality called Somatic Experiencing that helps people very slowly and safely “titrate” the trauma out of their bodies, their muscles, and their nervous systems. Trauma is lodged, as your guests mentioned, in the amygdale – not in the frontal cortex, the rational part of our brains. So Somatic Experiencing is not a “talking cure:” rather, it works directly with the body and with the nervous system.
I practice Somatic Experiencing in the DC area, and more information on Somatic Experiencing is available at my website: http://www.daphnewhite.com.
I suffer chronic anxiety/panic/phobic disorder which started when I was 23 with first panic attack-went directly to chronic attacks and agorophobia. Not even a second available to stop and think about what was happening or how to heal myself-none of that psycho-babble mumble jumble would have worked on me. I was too chronic for most of their suggestions. I am now 40 and have gotten control over it with daily yoga, meditation, homeopathy medicine, eating healty (salads and raw & vitamin rich foods), cut out caffeine, excess sugar etc. positive thinking and getting away from negative/unhealthy people or places. Nutrition helps tremendously...fresh salads daily are a must to nourish the malfunctioning brain and help it heal and recharge. I do work slowly with a friend to get back out there in a safe/positive way to retrain my brain. I do self-medicate with a glass of wine (or two) and the very occassional atavan. But, otherwise I try to heal myself on my own. Has there been any research on the healing power of nutrition and mental disorders?
Natalie: I empathize with you and my own story has some real similarities. I recently got Daniel Amen's book, Change your Brain, Change your Life--it is excellent. And it sounds like his clinics and SPECT scan really try to get at each person's unique brain issue.
As a result of reading the book and looking for a supplement to help (giving up on just doing yoga and meditating etc) I am using Theanine Serene--I noticed a difference in less than a half hour. For the first time in 40+ years I feel calm and focused--no bad side effects. I googled it and see other similar outcomes. Just passing it along. I think the yoga, cognitive therapy and other things help and I will keep doing them also. The supplement just helps make them more effective.
I think they should stop calling this stuff "mental" illness when much of it is likely the result of a physical malfunction in the brain or elsewhere. Good luck!
Just listening to this show this morning and having had anxiety issues and even seizures that I stopped with diet. My issue with all of this is that no one talks about what/how people are eating. I do understand that there are brain malfunctions and such but diet does play a huge role in our nervous system as well as our whole beings.
And the typical American diet is sickening and extremely toxic. Not only with myself but there have been a few other people that I have known and watched change their neurological issues by changing their diets and eating clean, minimally processed foods. Eating more on the lines of how our ancestors use to eat. And also watching how foods effect you as you eat them. And even what foods to combine each other with and eating slowly and in a relaxed environment. Everything nowadays is all about convenience and big, bigger, more of and fast!! And our bodies, our minds, our very beings are diminishing very fastly nowadays.
Not only neurological problems but cancer, diabetes and inflammation disorders of all kinds are an epidemic now.
You are what you eat and our bodies are amazing but without proper diet they are not going to function too long properly.
Thank you for letting me be able to share this....
Time and place of meeting Friday on these disorders.
Thanks so much for giving this disorder air.
I have been suffering from a general anxiety disorder and OCD for years but never knew what it was until I finally received help.
SSRI's have worked along along with yoga and meditation but it has been a long hard road. I am always looking over my shoulder for when the anxiety bug will bite me in the butt!
Thanks to all of you for your good work.
John
My husband's struggles with anxiety,fear, and OCD hold our relationship and life hostage. Everyday my heart breaks for him. He is a kind soul whose life has been hijacked by anxiety. His life is driven by these fears that he doesn't understand, can't seem to overcome and can't explain. He has tried different medications, therapists and interventions however, anxiety and fear are powerful adversaries that seem to always win. I see him succumbing to a life half lived and missing out on true joy and peace of mind because the fear and anxiety are winning. I encourage him and others like him to believe that life CAN be different and that anxiety doesn't always have to win.
The free symposium -- Bridging Science, Treatment, and Public Education of Anxiety Disorders -- is on Friday, November 19, 1:30 – 4:00 pm in Rockville, Maryland (5635 Fishers Lane, Terrace Level)
Check the News and Updates section of the ADAA website: www.adaa.org.
Are some groups more prone to anxiety disorders? Racial minorites? Lesbian/Gay persons? Females? Religious groups?
I hear from your guests that the stigma that surrounds anxiety disorders is ever shrinking and I would like to say that in my personal experience we have much farther to go as a society in this regard. I am a single individual who has pursued single parent adoption and been flatly turned away by several adoption agencies after sharing about my treatment for anxiety. I am a very engaged individual who has had a wide array of life experiences, education, friendships and extensive work experience, yet I was deemed "unfit" to pursue this avenue (of adoption) when it was learned that I had taken medication to manage it. No effort was made by the adoption agencies to understand how it may have impacted, compromised or not compromised my ability to parent. No effort was made to determine how my anxiety history may have actually enhanced my ability to parent. This lack of reception has caused me to go underground more with my anxiety knowing that there are in fact repercussions and a price to pay for being real and forthright about this one aspect of who I am.
That medications are assumed to be the answer, and that we will always have to live with these mental debilitations and accept them as a fact of life just exposes (IMO) psychiatry for the sham, pessimistic-based profession that it is. Of course, we can get over these things. As one or two of the panelists pointed out, cognitive and exposure/response therapies can help, and as one caller blessedly pointed out, so can TM.
Where were the representatives of religion or spirituality on the panel? The humanitarians? Where were the skeptics?
Psychiatry has become over-specialized to their detriment - its practitioners have surgically removed themselves and the subjects they "treat" or study from life, from the rest of THEIR life, from each other, from society, from God.
Where are the stories of natural recovery?
Watch out for protests about "stigma," it's a cover for medication apology. These are also codewords to watch out for: "Afflicted," "lifelong." Don't you believe it. How awful and pessimistic. Question whether it really is a medical problem, or if you prefer - if your future truly lies in medicine's hands.
The approach of the professionals advocating medication is frightening and it's frightening that they have the mega megaphone of unquestioning hosts of programs like this.
Ugh. Brain based. Genetic. Flee from these words people! Some of today's guests are characters in a haunted house. They are updated characters from One Flew Over a Cuckoo's Nest. Smiling, more socially acceptable, and ever-protesting about stigma.
There was no mention of diet. Certain diseases have an anxiety or depression association.
And, why do certain populations not have these problems? Why is this question never asked?
Thank God someone recommends TM. A knowledgeable person not given to just hand over their destiny to so-called science and pharmaceuticals.
Expand the conversation, Katty.