All My Life’s a Circle
Hey, semi-loyal readers. It’s been awhile. 
I’ve been spending time being sarcastic and funny on my other site for several months, but I’ve returned to KnowFear for a simple reason.
I’m back in therapy – this time with a psychiatrist instead of a psychologist – hoping to make it up another level on the terrace of healing. Nothing like having lofty goals, right?
All of which reminds me of the lyrics to an old Harry Chapin song, suitable since Harry won’t be having any new songs:
All my life’s a circle;
Sunrise and sundown;
Moon rolls thru the nighttime;
Till the daybreak comes around.All my life’s a circle;
But I can’t tell you why;
Season’s spinning round again;
The years keep rollin’ by.It seems like I’ve been here before;
I can’t remember when;
But I have this funny feeling;
That we’ll all be together again.
No straight lines make up my life;
And all my roads have bends;
There’s no clear-cut beginnings;
And so far no dead-ends.
I’d been doing pretty well for a bit. Highly functional, I believe is the term, the moniker both descriptive and low-balling at the same time. But I’d developed some hitches in my giddy-up and thought it was time for someone who knew what they were doing to take a peek under the hood before I use too much torque and snap off a bolt.
The issues? Falling out of regular practice with my tools, because I get lazy when things go well for a bit until I’m reminded that the Soapbox Derby car only has momentum until it reaches the bottom of the hill. Then what?
Home issues have presented themselves as we attempt to balance a super-smart nine year old son with moderate-to-severe ADHD with a father dealing with anxiety problems and a mom with her own ADHD-driven challenges. There are just times when we’re all takers at the same time, when normally there’s a good balance within the triangle. What the heck is one supposed to do about that?
The good news is that spring has sprung. The trees (mostly) have buds sprouting, and we’ll be greening up nicely in the next couple of weeks. Spring is usually my mental rebirth after months of cold and gray, a period I long ago christened The Dark Ages. Seasonal Affective Disorder? Please.
I’m not sure how often I’ll write, or what topics will rise to the top of the pile. I’m leery of becoming a lamenter, worried that anything I might bring to the party might be either over-done or trite. But I’ll let the comments be my guide. I do read them all, you know.
The Anxiety Lamp is lit. Smoke ’em if you’ve got ’em.
Image via Wikimedia Commons
Germany Building a Better Anxiety Drug
Via Reuters, German scientists believe they have found a new drug for panic disorders that works effectively without many of the effects of 
current compounds such as Valium (drowsiness, forgetfulness) and that work much more quickly than SSRIs that can can weeks to build up effective blood levels.
The new drug, termed XBD173, appears to work by targeting a much different “panic button” in the brain than other medicines. It also appears to be both safe and fast-acting. Studies showed XBD173 began to work as quickly as one hour after being administered, which would be ideal for people having acute panic attacks.
Also promising is the discovery that there are no withdrawal symptoms once patients discontinue use of the drug. Valium and other similar compounds are well-known to present dependency challenges and unpleasant withdrawal.
Let’s hope research continues on XBD173 and we see it on the market sometime in the near future.
German research points way to better anxiety drug , via Reuters
Repressing Trauma Not Harmful?
Anxiety Insights has the details of a Geisinger Health Center study that suggests certain people exposed to traumatic events may not suffer harm when they repress memories of those events.
“Going back to the days of Sigmund Freud, psychiatrists and mental health experts have suggested that repression of traumatic memories could lead to health problems,” Dr Boscarino said. “Yet we have found little evidence that repression had an adverse health impact on combat veterans exposed to psychological trauma many years later.”
One thing that leaps out in the article is the view that the use of exposure therapy – where people are asked to relive painful or traumatic events – may actually serve to trigger PTSD symptoms and psychological distress in those who had otherwise been doing just fine, thank you very much.
“While the dominant therapy model for PTSD should not be abandoned at this point, emerging research suggests that it might need to be seriously re-evaluated, at least for some PTSD patients,” Dr Boscarino said. “More research is clearly needed.”
Repressing traumatic memories may not be harmful to some , via Anxiety Insights
Paxil Might Handicap Your Little Sperms
Great – as if taking an SSRI didn’t come with enough side-effects (erectile dysfunction, problems with ejaculation, your girlfriend no longer calling you Zeus), now comes word that up to half of men taking the compound paroxetine may suffer from increased DNA fragmentation, a predictor of compromised fertility.
First, let’s look at the bright side – since you’re medicated, you probably won’t be as anxious about this as you might have been, so that’s a plus.
From the study:
Lead author Dr Cigdem (Cori) Tanrikut explains that while the exact mechanism isn’t understood, the evidence points to the drug slowing sperm as it travels through the male reproductive tract from the testis to the ejaculatory ducts. Sperm gets “hung up,” she says, allowing it to get old and its DNA damaged.
Ack! My boys hit roadblocks and get punished on the way to the dance, so when they arrive, they’ve already got rumpled suits and tousled hair! They’ll never make it with the cute cheerleader now!
Since about half of all reproductive troubles are on the male side, this will be of particular interest to men who are looking to start (or increase) a family at the same time they are taking certain SSRI meds. Since the half-life of SSRIs isn’t very long, the study was able to show that guys returned to normal within a month of ceasing the medication.
It’s good information to have if you happen to be in that category of male patients being treated with SSRIs who are also trying to make a baby – certainly something to discuss with your doctor.
Paroxetine (Paxil®) may affect sperm quality , via Anxiety Insights
Internet Psychotherapy Proving Effective
You know, there might just be one good thing that comes out of Internet webcams after all!
Anxiety Insights links to an Australian study that demonstrates online therapy can be just as effective as face-to-face sessions. What’s interesting is that patients only required an average of 111 minutes of clinician contact over an eight-week period, which is far less than most patients spend in office therapy sessions over the same timeframe.
The online program centers around treatment for depression, and 34% of patients felt they were no longer depressed after the two-month program, while 82% reported being either very or mostly satisfied with the treatment regimen at completion.
This bodes well for those who avoid seeking treatment due to social stigma, transportation, and provider availability issues, and since most of the program involves email contact and homework lessons, high-speed Internet connectivity isn’t a requirement – sorry to disappoint you webcam fiends.
Technology is opening new treatment vectors all the time, and the online experience can help with one of the sticky aspects of conditions like depression, which is the tendency to withdraw and avoid contact. Online therapy is a good middle step between no treatment and office visits.
On-line psychotherapy as effective as face-to-face therapy, via Anxiety Insights
Effectively Treating Anxiety Disorders
Wow, this posting from Anxiety Cures breaks absolutely no new ground on the best ways to treat anxiety disorders. I’m linking to it as a way to keep the anxiety treatment conversation going!
The article posits that you can take medicine or not take medicine, depending on the kind of disorder you have. But first, try breathing, and relaxation, and meditation, and herbal remedies. If that doesn’t work, try therapy.
It’s not really that black & white, based on my experience. Anxiety is a complex, multi-triggered condition that affects each person differently, and therefore the treatment approach needs to be based on the triggers, the underlying drivers, and someone other than you looking at it unemotionally.
It’s really hard for someone suffering from anxiety to self-diagnose. First of all, if we were really good at analyzing and categorizing what was going on, we might not have an anxiety disorder to begin with. Secondly, the prism of panic and fear associated with these disorders tends to alter our perception about the world around us, distorting our version of reality – not all the time, but certainly during certain times of high stress.
It’s important that people who feel panic and anxiety gather data and information about their condition, but it’s also critical that you’re not the sole diagnostic and treatment point. Having a professional who is able to “peel the onion” of your anxiety into its more subtle layers will allow your treatment and healing to match the granularity of your condition.
Anxiety isn’t simple, so please don’t think that there is a four-paragraph solution.
East Meets West for PTSD Treatment
Anxiety Insights gives us a look at an interesting challenge faced at Boston Medical Center, where they needed to treat a large number of refugees monks from Tibet who were suffering from PTSD caused by the ongoing religious persecution there.
Doctors realized that there were significant differences in the approaches taken by eastern and western cultures, especially in how they viewed medicine, so the Boston Center for Refugee Health and Human Rights developed an innovative treatment program that leveraged and integrated both approaches.
Of particular interest was the participatory aspect of the treatment regimen, where the monks were able to actively engage in their treatment, rather than the typical structured approach, where the patient simply follows along where the therapist leads. This helped to ensure that any therapy involved did not conflict with religious or spiritual beliefs, which provided for a much smoother and hopefully more effective outcome.
Having used Buddhist learning and practice to compliment my own therapy, I can affirm that combining traditional and non-traditional techniques can certainly benefit the patient, and my own experience of integrating eastern and western methods leads me to be an enthusiastic supporter of this approach.
East meets west: Integrating cross-cultural treatments for PTSD
10 Ways to Beat the Blues
BBC News Magazine has posted an article on some recommendations from mental health professionals on steps we can take to get the funk out, as it were.
Here’s the abbreviated list:
- Lightboxes
- Going out in the garden
- Get yourself out of breath
- Cook a meal from scratch
- Stroke a cat
- Pat yourself on the back
- Take up a lifetime hobby
- Do something for someone else – for free
- Seek intimacy
- Good things take time
The common theme coming out of this list is to slow down, stay engaged, and get connected to those around you. If that doesn’t work, perhaps a little John Lee Hooker or Robert Johnson is in order.
Anxiety, Depression, and Chronic Disease
I’m about to make an entirely unscientific statement regarding anxiety – it wears me out! Makes me tired, snatches my mojo, makes my ass drag…insert your own favorite expression here.
What is scientific is the link between anxiety & depression and long-term, chronic diseases. And I think my earlier statement is just a layman’s view of what has been clinically proven.
An extract from a study detailed in the Medical Journal of Australia demonstrates this relationship. For example, it’s known that people with anxiety have a higher incidence of stroke, heart attack, and cancer compared to the general population. Great…one more thing for us to worry about!
There’s been lots written about how stress and anxiety affects the immune system, and for me, being tired and wiped out at times means I don’t get as much exercise as I should, my diet tends to suffer (especially if I’m stress-eating), and I’m just generally not in good shape. So I need to be proactive at all times with a regimen that includes nutrition, fitness, and relaxation to help buttress against the health challenges that typically result.
As always, the key message is that getting treatment for your anxiety-related condition can be beneficial in helping you combat chronic disease as well. Live long and prosper!
eMJA: Depression, anxiety, and their relationship with chronic disease
Joey Pants on Mental Health Care
Joe Pantoliano, speaking at the Hudson Union Society, wonders why it is that insurance companies make it so hard to get mental health treatment.
“You’re covering my heart. Why aren’t you covering my brain?”
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