Friday, June 20
by Paul Carey, The Western Mail
SHY individuals who fear change and meeting new people are probably born that way, new research released today suggests.
Scientists found that when pictures of unfamiliar faces were shown to people who had been timid toddlers, it stimulated the "fear centre" in their brain.
Read the whole thing here.
Thursday, June 19
Wednesday, June 18
APA: Virtual Reality Approach as Effective as Conventional Treatment for Panic Disorder With Agoraphobia
SAN FRANCISCO, CA -- May 26, 2003 -- A new treatment strategy utilizing virtual reality and cognitive behavior therapy to treat panic disorder with agoraphobia achieves results similar to those seen with conventional treatment, but in one third the number of sessions.
"This treatment, known as experiential cognitive therapy, is as effective as conventional treatment," said Young-Hee Choi, MD, PhD, associate professor of psychiatry at Inje University in Seoul, South Korea. "Conventional treatment consists of 12 sessions, while experiential cognitive therapy consists of 4 sessions." He presented his findings here at the 156th Annual Meeting of the American Psychiatric Association.
Dr. Choi developed experiential cognitive therapy as a way to integrate cognitive-behavior therapy with virtual reality exposure to treat panic disorder with concomitant agoraphobia. Virtual reality is accomplished through a head-worn monitor in which the scenes that induce the phobic response are simulated, such as scenes of crowds, an airplane cabin, and an airplane taking off. Dr. Choi conducted this study to compare the efficacy of experiential cognitive therapy with that of conventional therapy for this disorder, known as panic control program (PCP).
He recruited 40 patients who had been diagnosed with panic disorder with agoraphobia by the diagnostic criteria of the Diagnostic and Statistical Manual-IV (DSM-IV). The patients were randomly assigned to experiential cognitive therapy or to the control group, which received the panic control program. Each group consisted of 20 patients. The groups were similar demographically.
Dr. Choi measured the treatment efficacy with the Beck Depression Inventory (BDI), the Spielberg State Anxiety Inventory (STAI-state), the Anxiety Sensitivity Index (ASI), the Panic Belief Questionnaire (PBQ), the Body Sensation Questionnaire (BSQ), and the Agoraphobic Cognition Questionnaire (ACQ). He also assessed the patients' panic attack frequency, the clinical severity rating (CSR), and the end-state function (ES), as well as patients' success rate in being able to discontinue or reduce their anti-anxiety medication after treatment and at 6-month follow-up.
On all criteria, the 2 groups showed significant improvement after treatment compared with their baseline scores. Dr. Choi documented no significant differences between the 2 groups, either immediately after or at the 6-month follow-up assessment. These findings led him to conclude that the 4 sessions of experiential cognitive therapy were similarly efficacious to the 12 sessions of traditional treatment.
"This study might be the first pilot study to apply short-term cognitive-behavior therapy, in combination with virtual reality exposure, to the treatment of panic disorder with agoraphobia," Dr. Choi said. "I recommend this therapy for patients who have this combination of symptoms."
[Study title: The Development And The Effects Of Experiential Cognitive Therapy For The Treatment Of Panic Disorder With Agoraphobia. Abstract NR813]
Only about one in five Americans with major depression are getting effective treatment, although most can be successfully treated, according to new studies in today's Journal of the American Medical Association.
The illness strikes about 34 million in the USA at some time in their lives, suggests a recent survey of more than 9,000 Americans, and the average person with depression can't work or do normal activities for five weeks in a year, says study leader Ronald Kessler of Harvard Medical School in Boston. ''That figure was a great surprise,'' he says. It compares with about 15 days out of commission for people with diabetes or hypertension.
Employed adults with major depression lose about eight hours of productivity a week on the job, says a study led by Walter Stewart of AdvancePCS Center for Work and Health, a Hunt Valley, Md., pharmacy benefits manager.
Depressed adults often come to work but can't concentrate, work slowly or are fatigued, Stewart says. Depression costs U.S. employers about $31 billion a year in productivity, and that doesn't include disability-leave payments, he says.
Stigma prevents some from getting help, says Thomas Insel, director of the National Institute of Mental Health (NIMH). But even if they're willing, access is still a big stumbling block, with poor and rural residents often least able to get good mental health care. Even working adults may have very limited insurance coverage.
The new evidence ''confirms there's no scientific justification for treating mental disorders any differently than physical disorders,'' so insurance coverage should be comparable, Insel says.
In Kessler's study, about one in five depressed adults were getting effective treatment. Half of all the depressed were treated by general practitioners, but research has found such doctors often know little about treating depression. ''Some are not allowed to refer to mental health experts, others need to jump through lots of hoops to refer,'' Kessler says. ''There may be no incentive for them to treat depressed patients, or financial disincentives.''
More than half of employers with at least 1,000 workers now use specialized firms that handle care of mental disorders on a contract basis. Quality of care tends to be better, but about three-fourths of employees work at smaller firms, Stewart says.
These mental health contractors can be more expensive than an integrated system with general doctors trained to screen depressed patients for referral to specialists, Kessler says.
Nearly 30,000 Americans killed themselves last year, almost twice the number of homicides, Insel says. ''Depression is not a small public health problem . . . and only 21% are getting adequate care? I don't think that's acceptable. We wouldn't accept it for diabetes or hypertension, and we shouldn't accept it for depression.''
"...it is important to remember that some anxiety is not only a part of everyday life, but can even be useful. If anxiety is interfering with your life, however, try some of the suggestions mentioned, and do not hesitate to seek help from a qualified mental health professional. Always remember: anxiety symptoms are treatable."
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Tuesday, June 17
Imagine you've just stepped into an elevator and suddenly your heart races, your chest aches, you break out in a cold sweat and feel as if the elevator is about to crash to the ground. What's happening?
Imagine you are driving home from the grocery store and suddenly things seem to be out of control. You feel hot flashes, things around you blur, you can't tell where you are, and you feel as if you're dying. What's happening?
What's happening is a panic attack, an uncontrollable panic response to ordinary, nonthreatening situations. Panic attacks are often an indication that a person has panic disorder.
What is panic disorder?
A person who experiences four or more panic attacks in a four-week period is said to have panic disorder. Panic disorder may also be indicated if a person experiences fewer than four panic episodes but has recurrent or constant fears of having another panic attack.
Doctors often try to rule out every other possible alternative before diagnosing panic disorder. To be diagnosed as having panic disorder, a person must experience at least four of the following symptoms during a panic attack: sweating; hot or cold flashes; choking or smothering sensations; racing heart; labored breathing; trembling; chest pains; faintness; numbness; nausea; disorientation; or feelings of dying, losing control, or losing one's mind.
Panic attacks can occur in anyone. Chemical or hormonal imbalances, drugs or alcohol, stress, or other situational events can cause panic attacks, which are often mistaken for heart attacks, heart disease, or respiratory problems.
What are phobias?
Phobias are irrational, involuntary, and inappropriate fears of (or responses to) ordinary situations or things. People who have phobias can experience panic attacks when confronted with the situation or object about which they feel phobic. A category of symptoms called phobic disorder falls within the broader field of anxiety disorders.
Phobias are divided into three types:
Specific (simple) phobia: an unreasonable fear of specific circumstances or objects, such as traffic jams or snakes.
Social phobia: extreme fear of looking foolish or stupid or unacceptable in public that causes people to avoid public occasions or areas.
Agoraphobia: an intense fear of feeling trapped in a situation, especially in public places, combined with an overwhelming fear of having a panic attack in unfamiliar surroundings. This word means, literally (in Greek), "fear of the marketplace."
Phobias are usually chronic (long-term), distressing disorders that keep people from ordinary activities and places. They can lead to other serious problems, such as depression. In fact, at least half of those who suffer with phobias and panic disorders also have depression. Alcoholism, loss of productivity, secretiveness, and feelings of shame and low self-esteem also occur wit this illness. Some people are unable to go anywhere or do anything outside their homes without the help of others they trust.
What does it mean to "fear the fear"?
Many people with phobias or panic disorder "fear the fear," or worry about when the next attack is coming. The fear of more panic attacks can lead to a very limited life. People who have panic attacks often begin to avoid the things they think triggered the panic attack and then stop doing the things they used to do or the places they used to go.
Am I the only one?
It is estimated that 2 percent to 5 percent of Americans have panic disorder, so you are not alone if you, too have these symptoms. Usually panic disorder first strikes people in their early twenties. Severe stress, such as the death of a loved one, can bring on panic attacks.
A 1986 study by the National Institute of Mental Health showed that 5.1 percent to 12.5 percent of people surveyed had experienced phobias in the past six months. The study estimated that 24 million Americans will experience some phobias in their lifetimes.
Phobias are the leading psychiatric disorders among women of all ages. One survey showed that 4.9 percent of women and 1.8 percent of men have panic disorder, agoraphobia, or any other phobias.
What causes panic disorder?
No one really knows what causes panic disorder, but several ideas are being researched. Panic disorder seems to run in families, which suggests that it has at least some genetic basis. Some theories suggest that panic disorder is part of a more generalized anxiety in the people who have panic attacks or that severe separation anxiety can develop into panic disorder or phobias, most often agoraphobia.
Biological theories point to possible physical defects in a person's autonomic (or automatic) nervous system. General hypersensitivity in the nervous system, increased arousal, or a sudden chemical imbalance can trigger panic attacks. Caffeine, alcohol, and several other agents can also trigger these symptoms.
Researchers have found that sodium lactate, when injected into the bloodstream of some people who are predisposed to panic attacks, will induce such attacks. This suggests that people who experience panic attacks may have trouble metabolizing lactate, a substance usually produced by muscles during exercise.
Is panic disorder treatable?
Recovery from panic disorder appears to be most successful when a combination of treatments is used in fighting the disorder. Most often, medication is used to block panic attacks, and when it is used in combination with cognitive or behavioral therapy, it allows people to overcome their fears and return to normal, functional living.
On the other hand, even though 75 percent to 90 percent of the people treated have significant improvement, only about one-fourth of those who have this disorder ever seek appropriate treatment.
Cognitive therapy is used to help people think and behave appropriately. Patients learn to make the feared object or situation less threatening as they are exposed to, and slowly get used to, whatever is so frightening to them. Family members and friends help a great deal in this process when they are supportive and encouraging
Medication is most effective when it is used as part of an overall treatment plan that includes supportive therapy. Antidepressants and antianxiety medications are the most successful medications for this disorder, although beta blockers, which limit neuron activity in the brain, are helpful with social phobias. Ask your doctor about these medications or others that may help you. .
Healthy living habits may also help people overcome panic disorder. Exercise, a proper and balanced diet, moderate use of caffeine and alcohol, and learning how to reduce stress are all important.
Peer support is a vital part of overcoming panic disorder. Family and friends can play a significant role in the treatment process and should be informed of the treatment plan and of the ways they can be most helpful.
Anxiety Disorders Association of America
11900 Parklawn Drive, Suite 100, Rockville, MD 20852
Web site: adaa.org
American Psychiatric Association
1400 K Street, N.W., Washington, DC 20005
phone: 202/ 682-6000
Web site: www.psych.org/public_info/panic.cfm
National Institute of Mental Health
6001 Executive Boulevard, Room 8184, MSC 9663 Bethesda, MD 20892-9663
Web site: www.nimh.nih.gov/anxiety/anxiety/panic/index.htm
National Mental Health Association
1021 Prince Street, Alexandria, VA 22314-2971
Web site: www.nmha.org/pbedu/anxiety/panic.cfm
Monday, June 16
Daily Policy Digest
Social Issues / Health Issues
Friday, June 13, 2003
The claims made for high-self esteem by teachers, parents and psychotherapists aren't borne out by research, according to a new review of the scientific literature by Florida State University researchers.
Among their findings in the May issue of "Psychological Science in the Public Interest":
Individuals' high self-esteem, whether present from early childhood or induced by education programs, generally doesn't lead to improved school or job performance.
Those with high self-esteem on self-ratings aren't more likely to have satisfying relationships, assume leadership positions or avoid depression.
Nor does it prevent children and teen-agers from using tobacco, alcohol or other drugs, having sex or behaving violently.
Schoolyard bullies, as well as those who stand up to them, frequently report high self esteem.
Academic and job successes do often boost self-esteem, say the researchers.
Source: Bruce Bower, "Findings Puncture Self-Esteem Claims," Of Note, Science News, June 7, 2003.
For more on Health Issues
Avoid anything posted on about.com as far as anxiety/panic goes. They are poorly written, and fairly condescending. Sort of like reading Maureen Dowd since she quit her medication. The advice is mostly recycled crap, and the links don't work half the time.
Just a friendly warning from your neighborhood agoraphobic.
How does an Agoraphobic ever get to tell their story to Congress. I mean, lots of people seem to testify on the need for Mental Health Care, but since I am afraid to leave my house, do you think Congress could come by to listen? Maybe a corporate sponsor would help. Then they could call it a junket.
(Recommended for all Democrats, Peace Activists, French and Germans, Canadians and anyone who honestly believe Hilary Clinton)
Mental health assessment is a series of tests and observations that a health professional uses to evaluate your behavior. Mental health assessment may include a physical exam, a psychiatric interview, laboratory tests (such as blood and urine tests), and specific mental health assessment tests.
During a mental health assessment, a health professional will evaluate your:
Appearance and behavior.
Memory and thinking (cognition). This includes attention, concentration, level of consciousness, comprehension, and your ability to understand abstract ideas.
Thought processes and content. The health professional will evaluate your awareness of your surroundings (this is called orientation) and will determine whether you have an accurate understanding of time, place (where you are), and person (who you are). You will be asked whether you have had any suicidal thoughts, thoughts of hurting others, or strange and unreal thoughts (psychotic thoughts) or experiences, like hearing voices others don't hear or seeing things others don't see.
Ability to express yourself, by assessing your body posture, eye contact, and verbal expression.
Physical functioning, by evaluating areas such as sleep, appetite, or physical symptoms.
Insight and judgment.
Relationships. The health professional will evaluate your ability to relate to others and will assess the status of the your present relationships.
Read the whole thing here
Via The Washington Post
"Scientists say they've identified a flawed gene that appears to promote manic-depression, or bipolar disorder, a finding that could eventually help guide scientists to new treatments.
A particular variant of the gene was associated with only about 3 percent of cases in a study, but researchers said other variants might be involved with more."
As InstaPundit might say: read the whole thing.
Sunday, June 15
So, it will be a hard day for me, please wish me luck.
Couldn't go. Got dressed, made myself presentable, and the long suffering AgoraWife had to go by herself. I am so tired of being afraid.
"The Nashville Tennessean writes about the latest developments in the movement to draft Al Gore back into the presidential race. LINK
" … a rally to draft Gore is scheduled in Nashville tomorrow. Organizer Jim Tate of West Virginia has set high expectations, saying 8,000 to 9,000 people from across the country may attend."
"Organizers of the Gore rally think they have enough support to elect delegates to the Democratic National Convention to block the nomination of any of the nine contenders."
"The Gore rally will be at noon tomorrow at the Bicentennial Capitol Mall amphitheater."
From ABC's The Note Blog
Saturday, June 14
Check out this page by Ruth Ann, lots of good stuff here.
The AgoraWife and I must have a BBQ grill. I'm originally from Texas, and BBQ is required as a manly duty. Unfortunately, my new home in Scranton, Pennsylvania has exactly ONE Wal-Mart, where the sale is going on. That place is packed, always. I think a XANAX and a hand to hold should help (hopefully), and I will share one of my world-famous Texas BBQ recipes later. Wish me luck, gang!
"Enpsychlopedia.com offers a searchable interface to Psych Central, as well as about a dozen other mental health and psychology Web sites, offering a subject-specific guide to 40,000 psychology and mental health resources online."
Please read this. Be afraid.
Friday, June 13
Lots of atttention paid to seniors with prescriprion problems, but those of us that APPEAR normal, yet, have no chance for Medicaid? I am thirty-five years old, six-foot even, 225 pounds. Basically, I look like an NFL safety with out the the skin color.
Had several offfers from major colleges before my knee blew out, and now I am a boring blogger. Should I not get some compenstaion for being physically superior to my peers at my age group? Just wondering. Fate Sucks, ya'know.
I have been perusing many websites and articles regarding agoraphobia, social anxiety, generalized anxiety, depression and many other mental health issues in order to develop and fill this weblog with pertinent information.
One of the statements that was given as encouragement at the ENcourage Community (link to the right, highly recommended) was that I should continue blogging as this person was interested in reading about my reaction to my sickness.
Well, here is a typical day at the AgoraphobicPundit household:
Generally I awake when my wife does, around 6:00 a.m., no matter how long I may have been up the night before. I do this for two reasons.
1) It gives me a chance to run downstairs and see if I left a mess at my desk ( a major no-no! )
2) So that I can let the dog out and start her coffee.
Then, I check my e-mail and delete about 60-70 spam messages, saving the rest to peruse during the day.
My wife will come downstairs, make her lunch (I'm not allowed anymore after one unfortunate incident that we will NOT be getting into), grab her coffee, kiss me good-bye and leave.
After she leaves, I am alone until around 5:00 P.M., filling my day writing silly crap like this, maybe working on a new poem (for samples go here) and basically surfing the web.
This is life for an Agoraphobic.
I sincerely hope that most of you never get this bad.
If I have a doctor's appointment, I make sure and take an Ativan at least twenty minutes prior to getting into my car. I have an arrangement with my doctor. Her office is in a refurbished home, and one of her examination rooms is in the back room with a door that leads to a small patio. Her assistant will have the door unlocked and ready, and I will wait there instead of her waiting room.
Most of my psychiatric sessions take place over the phone, or my therapist will come here. Under no circumstances will I go to a mall, a grocery store, a movie theatre or other potentially crowded place.
In general, life sucks this way, but I am receiving treatment.
I will continue to fill my days posting info that I hope you find interesting, so please continue to visit often, and the information helps or your just in the mood, the tip jar is on the right ;).
Thursday, June 12
for the light posting. I am still getting used to this XANAX stuff, and you would not believe how incredibly boring it is to wade through Guv'mint documents to report on. I have to have my nappy times. As I get used to this, blogging will be much more frequent.
Sometimes Blogger only shows like the last two or three posts I have put up. If this happens, hit the "Archives" button on the left side, and the other posts should appear.
If you suffer from anxiety/panic disorders, may I suggest this site:
I just found it a couple of days age, and love it! Everyone there is a fantastic individual in their own right, and no one will judge you.
Look folks, I have attempted suicide six times. I have been to many treatment centers, many hospitals, and too many so-called counselors to count, but I would NEVER advocate this:
That link will take you to an excellent article in today's National Review Online. I suggest you read it, simply so that you can see some of the forces arrayed against those of us who have difficulty with everyday existence.
See you soon!
Tuesday, June 10
Monday, June 9
"Um, sorry, Doc, that was a joke."
"What kind of joke is that," she countered, " When my job is to assess your physical condition?"
"A poor one," I countered.
"You may have a poor heart, a defective heart, a diseased heart, but you never, EVER have a funny heart when we are speaking of your heart!"
Sunday, June 8
Ummm, isn't FNC part of the VRWC? I know that Shep Smith is on there, along with the insufferable Alan Colmes, and the barely watchable Greta Van Susteran, but a majority of politically identifiable folk are liberal?Amazing, and quite reasonable when you think about it. My few liberal friends are unfortunately Northeastern college educated, but I am making inroads with them. Is this the same as what FOX has done? I sure hope so.
I managed to qualify for unemployment. Next step, the Social Security Administration!
Saturday, June 7
I knew a man who ran a successful small business in North Carolina. Had a couple hundred, well-paid, happy employees.
One day, a man in a smart suit barged into his office, flashed a badge and demanded to know how many of my friend's employees were black.
"Due to Federal quota laws," began the badge man, " you MUST have at least 35 black men working here."
"Just a moment," my friend answered, as he punched the secretary extension on his phone.
"Mabel, how many blacks are working here?," he asked.
"Please wait a moment, sir, I will check," came the discombobulated voice.
My friend stared directly into the eyes of the Federal agent as he patiently awaited the answer.
"Sir,"Mabel responded, "According to our records, there are 40 blacks currently employed here."
Never taking his eyes from the Fed, my friend responded, " Fire five of them."
Wednesday, June 4
Her response? June 18th, 8 A.M.
I love the help available these days.
Please forgive multiple posts.
Wilt thou view Landscapes,
Wilt Thou see Designs,
Wilt Thou gauge the Tide,
or feel Pride?
Wilt Thou gaze Long,
or mime Strong?
Wilt Thou look Deep,
or seek Sleep?
Wilt Thou Believe,
What I mean is, why is my own knowledge insufficient, given that I pay attention to others?
Does anyone else feel this way?