Tag Archives: Anxiety

Anxious? Distressed? You’re not alone

Hundreds of thousands of Americans live with serious psychological distress. (Courtesy Spectrum Health Beat)

By Dennis Thompson, HealthDay


More Americans than ever before are stressed, depressed and anxiety-ridden, and many are unable to get the help they need, a study suggests.


An estimated 8.3 million American adults─about 3.4 percent of the U.S. population─suffer from serious psychological distress, an evaluation of federal health data concluded. Previous estimates put the number of Americans suffering from serious psychological distress at 3 percent or less, the researchers said.


“Mental illness is on the rise. Suicide is on the rise. And access to care for the mentally ill is getting worse,” said lead researcher Judith Weissman. She’s a research manager in the department of medicine at NYU Langone Medical Center in New York City.


This increase is likely a lasting after-effect of the Great Recession that began in late 2007─a stress-filled time that caused long-term emotional damage to many Americans, Weissman suggested.


Many people psychologically affected by the Great Recession haven’t been able to get the help they need, either because they can’t afford it or because their condition hampers their ability to seek out treatment, she said.


As a result, hundreds of thousands of Americans live with serious psychological distress, an umbrella term that runs from general hopelessness and nervousness all the way up to diagnosable conditions such as depression and anxiety, Weissman explained.


“The recession seemed to have pushed the mentally ill to a point where they never recovered,” she said. “This is a very disturbing finding because of the implications of what mental illness can do to a person in terms of their ability to function and their life span.”


The study included national health data from a survey conducted by the U.S. Centers for Disease Control and Prevention. More than 35,000 households nationwide participate each year.


The investigators found that between 2006 and 2014, access to health care services deteriorated for people with serious psychological distress, compared to people without emotional distress.


Comparing self-reported psychological distress symptoms across nine years, the research team estimated that nearly one in 10 distressed Americans in 2014 did not have health insurance that would give them access to a psychiatrist or mental health counselor.


In 2014, people with serious psychological distress were nearly three times more likely to experience delays in getting professional help due to insufficient mental health coverage than people without serious distress, the study findings showed.


Approximately 10 percent of people with serious psychological distress could not afford to pay for their psychiatric care in 2014, up from just under 9 percent in 2006.


The economic turmoil caused by the Great Recession struck at the heart of the American dream, rattling some to their core, Weissman said.


“Earning and sustaining a living is getting harder for people, especially for men,” Weissman said. “The loss of jobs could mean there’s a loss of community and a loss of role as wage earners and providers.”


Dr. Harsh Trivedi is president and CEO of Sheppard Pratt Health System, a Maryland mental health provider. He said constant noise from the internet and social media likely serve to amp up people’s anxiety and angst.


“In the past, you may go out and meet with your friends and talk about something, but when you got home you’d go to sleep,” Trivedi said. “The difficulty now is you can’t really turn things off. We don’t necessarily have downtimes to recharge and get our bearings straight again.”


Weissman pointed out that psychologically distressed people already struggle to deal with the health care system, and on top of that there are national shortages of mental health professionals.


And, Trivedi added, the ongoing debate over the Affordable Care Act isn’t doing distressed individuals any favors.


“If you are in a more distressed state, how easy is it for you, from a psychological perspective, to seek care?” Trivedi said. “If the overall market is shifting, and you are more psychologically distressed, how are you going to have the faculties to keep track of your access to health care?”


Weissman said insurance companies should pay for mental health services, which need to be more fully integrated into primary care for people.


“We need to increase access to care for the mentally ill,” she said. “We also need to put trained psychiatrists and mental health providers within the primary care setting. If you have linkages of care within primary care, then the mentally ill patient can be helped even if they’ve come in for some other reason.”


The study was published in the journal Psychiatric Services.


Reprinted with permission from Spectrum Health Beat.






Manage your caffeine craze

If your tensions already run high, you may want to skip that extra cup of brew. (Courtesy Spectrum Health Beat)

By Robert Preidt, HealthDay


If you struggle with anxiety, you might want to skip that second cup of coffee, new research suggests.


For some people, caffeine may help with concentration and provide an energy boost, but it can cause problems for those with general anxiety disorder, said Dr. Julie Radico, a clinical psychologist with Penn State Health.


“Caffeine is not the enemy,” she said in a university news release. “But I encourage people to know healthy limits and consume it strategically because it is activating and can mimic or exacerbate the symptoms of anxiety.”


Low doses of caffeine are in the range of 50 to 200 milligrams. Consuming more than 400 milligrams at once may lead to feeling overstimulated and anxious and bring on symptoms such as racing heart, nausea or abdominal pain.


Anxiety is a common problem, but many patients and their doctors don’t think about caffeine as a potential contributing factor, said Dr. Matthew Silvis, vice chair of clinical operations in the division of family medicine at Penn State Health.


“We want people to consider whether there may be a connection between their caffeine consumption and anxiety,” he said.


As well as being a potential problem for people with anxiety, caffeine can interact negatively with medications for seizure disorders, liver disease, chronic kidney disease, certain heart conditions or thyroid disease, Silvis noted.


“Medical disorders that a patient may already have can become more difficult to control,” he said.


In terms of amounts of caffeine, an average cup of home-brewed coffee has about 100 milligrams, compared with 250 milligrams in a tall Starbucks coffee and as much as 400 milligrams in energy drinks.


A can of Mountain Dew has 55 milligrams while a can of Coca-Cola has 35 milligrams.


Many vitamin and sports or nutritional supplements also contain caffeine, but many people don’t think to check the labels of those products, Silvis added.


Reprinted with permission from Spectrum Health Beat.





Don’t let anxiety or depression take control

Break through the fog of depression. You can do it! (Courtesy Spectrum Health Beat)

By Diana Bitner, MD, Spectrum Health Beat

 

Depression and anxiety are both common and potentially serious health issues.

 

In fact, approximately 10 percent of us suffer from one of these disorders, with anxiety being more common in women than in men.

 

The symptoms of anxiety and depression can go away and come back throughout life if left untreated, and many people find it difficult to admit they have anxiety or depression, thinking there isn’t a cure for what they are experiencing. Fortunately, this couldn’t be further from the truth.

 

A few months ago, a patient I’ll call Cindy came to see me for her annual visit. She started to talk about her life and how she was feeling down most of the time. She didn’t understand why she was feeling this way—everything seemed like it should be nearly perfect.

 

Cindy is married, has three great kids and a part-time job she enjoys. She also has a strong group of friends at church and her parents live nearby, so she really feels like she has a good life.

 

As I probed a bit further with questions, she admitted she had been feeling down for about three months and wondered if she would ever feel like her old self again.

 

Her kids are doing well, but they are becoming busier with sports, church and school. Of course, this meant that Cindy is becoming busier as well. Although she generally isn’t feeling stressed or anxious, she started noticing some changes in herself: doubting how well she could handle her busy life, losing interest in playing games with her kids, making excuses to avoid going out with friends, cooking less (something she once loved to do), losing interest in sex, and exercising less.

 

When I asked Cindy about her extended family, she said that her mom had suffered from depression during Cindy’s childhood, and she remembers her mom withdrawing and spending quite a bit of time in her bedroom.

 

Cindy felt that her mom didn’t really know her and was never supportive of anything she wanted to do. In fact, when Cindy wanted to join the cheer team in high school, her mom would not take her to practice, and never encouraged Cindy to practice on her own or exercise to stay in shape. In addition, her mom always seemed sad and unusually quiet, her dad worked long hours and was never home, and her brother kept to himself most of the time.

 

Cindy obviously didn’t have a perfect childhood. She once had big dreams of attending college, but those dreams never materialized. She hadn’t thought about her college dreams in a long time, but talking to me about her childhood stirred up some old memories.

 

On a positive note, Cindy doesn’t drink much alcohol, never smoked, and eats a fairly healthy diet. She also walks the dog around her neighborhood daily, but she didn’t follow an intense workout program. Although she feels OK with her weight, she admits that she would feel better if she lost a few pounds.

 

Cindy just wanted to know how she could feel better. I certainly understand Cindy’s frustrations, and I was anxious to figure out why she was feeling this way and help her develop a plan to move forward.

 

I talked with her about anxiety and depression. We first looked at common risk factors of both: genetics (family history), low self esteem, prior traumatic events, abuse or neglect, substance abuse and early onset of anxiety and depression.

 

Cindy obviously had at least one of these factors in her life. We also talked about other reasons people struggle with these issues.

 

Anxiety and depression can be related to life events (past and present), but they can also be caused by chemical imbalances in the brain. The analogy I use to explain our brain chemistry goes something like this: brain chemicals are like money in the bank—we only have so much to spend before we run out. We make brain chemicals when we sleep, and genetically (linked to many genes), some of us make more than others. We spend brain chemical on life events, which can cause our supply to get low.

 

For Cindy, life events (busy kids, busy husband, busy household) were causing her to use her supply of brain chemicals. She also had unresolved issues come to the surface: her kids getting to do things she never did in her childhood, her husband working long hours (just like her dad did), and thinking more about her earlier dreams of college. Add to all of this a little weight gain, and you can imagine the stress Cindy felt.

 

When we have unresolved issues on our minds (like Cindy did), they cost brain chemicals. Sometimes we may not even be aware of some of the things that are floating around in our head. So, when our friends ask us out for coffee or it is time to make dinner, we don’t have enough brain chemicals to propel us forward. We slowly start to shut down, and life starts to pass us by. Depression can set in and affect not only ourselves, but our family, friends and co-workers as well.

 

There are several common symptoms of depression that you can look out for, including feeling down most days, losing interest in usual things, sleeping too much or not enough, losing or gaining weight, feeling unable to concentrate or think clearly, and thinking you are not good enough.

 

If depression is left untreated, other issues can arise, such as anxiety, diabetes, heart disease and thyroid disease.

 

In order to help Cindy, I first ordered some lab work, which included her blood count, thyroid levels, body chemistry function, vitamin levels, and sugar levels. All came back normal. My hope was that we could work together to treat her symptoms.

 

Cindy felt a sense of relief just getting her worries off her chest, and she became hopeful when I told her she wasn’t crazy. Her experiences are normal, common and treatable.

 

I first recommended that she see a therapist who practiced Cognitive Behavioral Therapy to help her sort out issues from her past. I also suggested more exercise in her daily routine, even if it is in small amounts (like 10,000 steps per day).

 

And, finally, I recommended a short-term course of medicine from a group called SSRIs (Selective Serotonin Reuptake Inhibitors). These drugs increase the brain chemical levels so there is “more money in the bank” to help people like Cindy get back on track and stop the downward spiral.

 

Cindy came to see me two months later, and she felt much more like herself again—hooray!

 

She had seen her therapist several times and had started a very low dose of the medication. She also developed a meal and exercise plan that worked well. Her kids and husband had noticed, and commented that they had missed having fun with her and were happy to have her back.

 

Cindy started to think about her part-time job and maybe quitting so she could go back to school. She had coffee with a friend and realized how good it felt to stay connected and laugh again.

 

I have no doubt that Cindy will be fine, but she will always have to be aware of her feelings, or even ask a friend to check in with her if she notices any new symptoms Cindy might be displaying. Cindy will inevitably experience stressful events in her future (we all will), so she will always be at risk for starting a downward spiral at some point.

 

However, with treatment and awareness, she should live a happy, connected and fulfilled life.

 

Reprinted with permission from Spectrum Health Beat.

 

Baby blues—or something worse?

Postpartum depression can affect up to 20 percent of new moms, making it difficult for them to care for their baby. (Courtesy Spectrum Health Beat)

By Samantha Kauffman, Spectrum Health Beat

 

If you’ve experienced depression, it may help to know you aren’t alone.

 

More than 16 million people experience at least one major depressive episode at some point during the year, according to the National Institute of Mental Health.

 

The positive angle on this: We know of many things that can help fight depression, including therapy, exercise and medication.

 

Sometimes the treatment depends on the circumstances.

 

Depression after having a baby, known as postpartum depression, is more common than people may realize.

 

About 15 to 20 percent of women in the U.S. experience major depression after having a baby. This type of depression is different from the more common baby blues, which about 80 percent of new mothers will experience.

 

Baby blues pertains to hormonal changes from having a baby, as well as lack of sleep with a new baby and a new role that comes with new pressures and other circumstances.

 

Some people are surprised to learn that dads can also get baby blues and depression.

 

Postpartum depression in moms, however, is more extreme and can interfere with a woman’s ability to care for herself and her family. Severe symptoms usually require treatment.

 

Over time, we have come to realize that postpartum depression can happen quite often. Many moms will suffer in silence, however, because they don’t know what signs to look for or they don’t know what to do about it even when they know what’s happening.

 

This is one of the reasons the American College of Obstetricians and Gynecologists is recommending earlier postpartum visits after birth.

 

I should also point out that women can also suffer from depression during pregnancy, not just afterward. An estimated 14 to 23 percent of pregnant women will struggle with depression, according to the American College of Obstetricians and Gynecologists.

 

While it may seem reasonable to assume this depression results from a pregnant mom’s changes in hormones, this is only partly true.

 

Depression in pregnancy can also be triggered by an unplanned pregnancy, partner violence, a previous pregnancy loss, relationship issues and more.

 

Some of the symptoms to watch for:

  • Thoughts of death or suicide
  • Sleeping too little or too much
  • Sadness that won’t go away
  • Inability to concentrate
  • Loss of interest in things you once enjoyed
  • Anxiety beyond what might be considered a normal amount
  • Feelings of guilt
  • No desire to eat or eating all the time
  • Extra stress

Some of these symptoms are normal with pregnancy, so it’s important to remember that you need to watch for extremes.

 

Make sure you talk with your OB provider if you’re worried about depression or anxiety during pregnancy.

 

A study published earlier this year in JAMA Pediatrics found evidence suggesting that depression during pregnancy could result in poorer emotional and behavioral outcomes in children.

 

Of 101 pregnant moms surveyed for the study, 42 met the criteria for mild depression. Researchers then took MRIs of each baby’s brain at 1 month of age.

 

“Our study suggests that moderate levels of maternal depression and anxiety symptoms during pregnancy were associated with variations in the brain’s white matter microstructure or ‘wiring’ at one month of age,” said lead author Douglas Dean III, of the University of Wisconsin-Madison.

 

Up to 1 in 5 pregnant women experience depression and anxiety, according to the report, adding: “Mounting evidence links these conditions with poorer emotional and behavioral outcomes in children.”

 

Other studies, meanwhile, have found that untreated depression during pregnancy is linked to lower baby weight at birth.

 

Bottom line: If you are pregnant and feeling symptoms of depression or anxiety, please talk to your OB provider.

 

Reprinted with permission from Spectrum Health Beat.

7 tips for managing stress

Anxiety disorders are highly treatable, yet only 36.9 percent of those suffering receive treatment. (Courtesy Spectrum Health Beat)

By Maura Hohman, HealthDay

 

A little bit of stress can motivate you, but too much might cause an anxiety disorder that can prevent you from living your life to the fullest.

 

If you feel anxious on a daily basis, try making changes to your lifestyle to manage anxiety on your own.

  1. Exercise regularly to release the body’s endorphins, natural feel-good chemicals. Set a goal of 30 minutes at least five days of the week.
  2. Be sure to get enough sleep, typically between 7 and 8 hours every night.
  3. During waking hours, take short breaks from whatever stresses you out. Meditation and listening to music are great ways to clear your head.
  4. Eat healthy and don’t skip meals.
  5. Limit alcohol and caffeine, which can worsen anxiety and trigger panic attacks.
  6. If adjustments to your routine don’t lessen your anxiety, talk to your doctor, especially if anxiety or depression run in your family. You could have an anxiety disorder.
  7. Keep a symptom diary and be alert for the warning signs of an anxiety disorder.

Possible anxiety disorder symptoms include:

  • Constant worry.
  • Avoiding social situations.
  • Panic attacks.
  • Nightmares.

If you’re diagnosed with an anxiety disorder, stay positive. There are many treatments available, such as cognitive behavioral therapy to help you change your thought patterns. Also, there are other types of therapy, medication, and simple adjustments to your daily routine.

 

Most important is finding a therapist you’re comfortable working with and who’s experienced in treating anxiety disorders.

 

Reprinted with permission from Spectrum Health Beat.