RSS Anxiety Disorder?

Just how many types of anxiety are there, anyway? I got to thinking about this as I read a blog that mentioned "RSS Anxiety." For those of you who have not yet come face-to-face with this little acronym, it stands for Real Simple Syndication and it spreads whatever you want all over the internet, virtually creating an immortal life all its own.

Can you kill an idea once it is out on the internet? No. Can you try to correct it? Yes, but you'll never accomplish this goal. Why? Ah, I try never to answer or ask "why" questions, but this time I'll let you get by.

Think of it as you would a front page headline in your daily newspaper. Something like "Mary Smith Ax Murderer" and later it turns out that Mary Smith is not an ax murderer but only a woman who won't have axes around her home because she dislikes tools of that type.

Where will it go and how many people will see it? The story will probably make the back pages, unless Mary, in her infinite wisdom, decides she would like some compensation for her ruined reputation. She then gets an attorney, files a suit and it drags on for who knows how long. In the end, just as it does on my favorite TV show, Boston Legal, Mary will sit in a conference room and come to an out-of-court settlement with whoever she intended to sue. Denny Crane will take care of it. No headline, no news, nothing.

So, to my mind, there should be some sort of anxiety associated with RSS, not because it's a bad thing, but because it can be very problematic if it gives the wrong impression about a product, service, person or whatever. And it lives on and on and on.

I'm also reminded about the popular belief that you shouldn't wear anything opal unless it's your birthstone. This wonderful bit of urban legend was dreamed up, as I heard from a jeweler many years ago, by the people who were selling pearls. Seems that opals were becoming far too popular and the market for pearls was suffering from it. How to handle this? Do a bit of PR management on the opal, create a good bit of anxiety, and here we are today with people still thinking that opals are "bad luck" unless it's your birthstone.

Do you believe this one? I don't. I like black opals and don't buy them because they are far too expensive for me, so I admire them from afar.

Just as I've thought about types of anxiety, and we're about to get a new DSM, so we'll probably have other disorders, too, I think about phobias. Once, when I was studying French in college, I couldn't resist coming up with a phobia with a French name. If it were said in French it might have sounded so nice. So, I had La Femme dans la Chevy Phobia (fear of women in Chevrolets). French scholars, please do not correct my rusty French here and tell me it should be "en" instead of "dans." I admire you for remembering all of those rules.

The idea of a new phobia concocted by moi was motivated by the fact that I'd just seen, in a psychology book, that there were something like 1,100 phobias in the 1930 and people seemed to be falling over their feet trying to come up with new ones. Did it help anyone? I doubt it, but it may have gotten some people to think someone was awfully smart, which he was, of course, but not in the way they thought.

The moral of this story is that you should always take everything with, if not a pinch of salt, a grain, as they say.



Related Topics: WebMD Daily: Too Scared: A Tale of Social Anxiety Disorder, The Fear Factor: Phobias

Technorati Tags: RSS, anxiety, phobias

R.E.S.P.E.C.T.

Many people who post to our Anxiety/Panic Board talk about their concerns about going to see a doctor and how this can be a significant factor in their not seeking treatment. Others indicate that there's a rift between them and their healthcare provider that is maintained by the provider's disrespectful attitude toward them.

An article in an issue of Annals of Family Medicine contained the results of a small survey of patients regarding why they were no-shows for appointments. The results would seem to be of interest to all of us.

Up to 42 percent of healthcare appointments were no-shows and that is a significant number of office visits missed. The majority of participants (65 percent) who were no-shows indicated that they experienced anxiety about procedures or receiving bad news.

Forty-four percent said it was as a result of issues of respect by the system and providers who appeared to show little respect for patients' time, opinions or feelings. Recently, I received a bit of this first-hand as I called a company to report a product that had caused a rash after I used it. The nurse who was to take my information and who was someone I didn't know and would never meet, proceeded to call me "hon" and I really didn't care for that. Her company may have thought that would create a more personal encounter, but they didn't consider me when they instituted that policy. Nor did I like being called "Patricia" by this person who didn't know me. I believe I reserve the right to tell them to call me by my first name, if I wish.

The authors of this study found that a sense of disrespect would leave patients feeling they have no obligation to call to cancel appointments that will be missed, not to be concerned about the financial hardship it causes the provider and they thought it might actually be a benefit for a busy facility.

So, it pretty much boils down to a matter of respect. Aretha are you listening?



Related Topics: Choosing A Doctor, A Woman's Guide to Taking Care of Yourself

Technorati Tags: patientrespect, healthcare, missedappointments

Tai Chi and Me

The weather has turned hostile in my part of the country and it's increasingly difficult to motivate myself to get out of the house and into the gym. I'm no different from many others who know they need to exercise but can't face weather in the teens or just above.

What to do about this dilemma? For me, it meant getting a tai chi tape that I could pop into the VCR and do the exercises at will, any time of the day or night when I happen to have free time. Several years ago, I had noticed some of my Asian neighbors out in their backyards during the very early morning hours and they were doing their tai chi.

Actually, I realize it would be better for me to put some structure, as they had done, into my schedule, so I'll be doing it daily at the same time, if possible. You see, I like everyone else, has to put a bit of flexibility into my schedule for all those unexpected things that turn up at the last minute.

Tai chi is really a beautiful form of exercise that looks more like effortless flowing of the arms and movements of the legs, but has been found to help in many ways. Not only does exercise help us handle anxiety and depression, recent studies show it also helps to reduce falls in the elderly. A study in the British Medical Journal (Campbell et al, October 25, 1997) related how the authors studied 233 elderly women in terms of improvement in balance and fall protection after a series of tai chi classes over a period of months. Results indicate that women who participated in the tai chi classes were two-thirds less likely to have a fall and there was significant improvement in measures of balance and reaching forward beyond arm's length.

Tai chi was also found to be useful in recovery from cancer treatments where a study in the Online Journal of Issues in Nursing (8/30/05) found "evidence that regular physical activity or exercise can decrease emotional stress, blood pressure...and pain." There was also improvement in cognitive processes. The authors noted that exercise was useful in the management of "nausea, fatigue, pain, anxiety and depression."

It's a simple exercise that you can do anywhere you care to and it has incredible benefits and there's no strain, no pain and no huffing and puffing associated with it. Beautiful to watch, too. I'd say everyone should get on the train to tai chi.

Related Topics: Alternative Therapies for Depression, Tai Chi May Help Seniors Avoid Falls

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Anxiety, Depression and Allergies

Unfortunately, some researchers are still using the term "neuroticism" when most of us understand that to mean "anxiety." It's a throwback to the time when Freud believed, probably rightly so, that this disorder was largely based on problems in the nervous system. Freud, you see, was a neurologist who was responsible for formulating one of the most important nerve tissue stains still used today. This was prior to his rise to fame for his theory of psychoanalysis.

A recent study, published in Psychosomatic Medicine (68:94-98, 2006), of 3,032 adults age 25-74, found that there may be a link between major depression, anxiety and childhood allergies. Both males and females appeared to show this association with anxiety. Just how this link works is still something to be studied.

This association would seem to strengthen, in my opinion, the idea that there is a connection between childhood illnesses, food allergies and other, perhaps unknown, environmental factors.


Related Topics: FDA OK's Generic Version of Flonase, Poverty Tied to Poor Stress Test Score

Technorati Tags: allergies, childhoodillness, panic, depression

The 10-Second Rule

Remember when you were a kid and one of the adults who got angry or upset over something would suddenly stop and count to 10? It was a good thing to do and it's still a good thing.

Now, instead of just counting to 10, I recommend what I'd call "The 10-Second Rule." The rule is simple. You stop, hold any comments, breath in through your nose and whoosh out through your mouth (almost like a sigh actually) and repeat it several times as you think about the position of your shoulders and ribs.

Since I haven't seen anyone doing any research into sighing, I wonder if that's Mother Nature's way of telling us to take a breath and calm down when things are getting to us. I'm constantly amazed at how we do some things instinctively and they help.

What I've suggested is a brief form of relaxation breathing and it allows you to do two things; take those few extra beats to short-cut any angry outbursts and let your body calm down.

Become a proponent of The 10-Second Rule and use it whenever possible. It can make life and living with stress a lot easier.

Related Topics: Anger Tends to Wane with Age, Simmer Down Anger To Avoid Injury

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Crusade for Courtesy

Each of us can make a difference in this world but it's not always evident how we can do it. I've found one way I may make a small difference not only in my own life, but that of strangers.

One thing I was taught as a small child was to be courteous and, in fact, in school we had classes in etiquette. I can't, for the life of me, remember one thing I learned in those classes, but it must have been absorbed deep into the recesses of my mind where it has established its presence. I know it's there because I make it a point of saying "please" and "thank you" to people who I don't know and who I'll probably never see again. I still say "God bless you" when people sneeze, even though I don't know if they believe in God or not. It's just what you do and I do it.

I'm sure that my crusade for courtesy has been somewhat of a surprise to those who have become, unknowingly, involved in it. For instance, when someone holds an elevator door for me or asks which floor I'm going to and they punch the button for me, I make it a point to acknowledge this. I tell them that it's nice to meet people with good manners and who are courteous and how much I appreciate it because it seems to be missing in much of our lives. Compliments are something I like to receive and I'm sure they do, too. Sometimes, I tell them that their parents would be proud to know that they've raised a considerate adult who is making the world a little less stressful for people like me.

When someone lets me pull my car across a road in front of theirs and makes it possible for me to make that turn, I always wave and say "thank you." I find it not only something I want to do, it's something I think will rub off on that person and maybe their day will be a little nicer.

Not so long ago, it was a common courtesy of the road for an over-the-road trucker to flash their lights as a "thank you" when you let them come over into your lane. I enjoyed that, but I rarely see it anymore and I wonder what's happened.

So, I'm going to go ahead with my crusade and hope that it spreads and takes hold in other people's minds. We all need a little bit of common courtesy now and then and I'm going to make it more now than then. Want to join me? Post a comment and share your experiences!

Related Topics: A Handshake is Worth a Thousand Words, The Science of Good Deeds

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Just a Bit of Exercise

Exercise is something we all know is good for us and we also know that it's often difficult to fit into our daily schedule.  Researchers are constantly telling us that it not only helps relieve stress and depression, it can aid in other ways such as your overall feeling of well-being.

A new study published in Medicine & Science in Sports and Exercise looked at a small sample of participants (just 40) and found that 30 minutes of walking on a treadmill left this group feeling "good, as shown by elevated scores for 'vigor' on one index and 'well-being' on the other."  Granted these weren't psychologists who conducted the study, but it shows the power of just one brief stint of walking.

So, what about you?  Can you walk for 30 minutes?  If not, there's research that seems to indicate that you may get the same benefit from spaced exercise throughout the day.  

Can you do five minutes?  Does it need to be walking outside or can you walk in place anywhere in your home?  I think it's really what works best for you.  You are going to feel better if you do even a bit of exercise and both your body and your mind will tell you which exercise regime works best for you.

Related Topics: Overcoming Barriers to Starting a Fitness Plan, Your Workout Personality

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Differences in Medications?

Patients have been telling me for years that there's a problem with their medications when they are switched to generics. I've heard this when I worked in psychiatric hospitals and in private practice and, sometimes, on the board. In the hospitals, unfortunately, the patients were often dismissed as being difficult because the physicians believed there was absolutely no difference between the two formulations of the medications.

Unfortunately, many healthcare providers have seen this as an indication of something akin to the placebo effect seen in clinical trials. In other words, they weren't believed.

Well, now mental health professionals are beginning to talk about it openly and do some research in the literature. What it has turned up should be of interest to anyone who has been having problems with their anxiolytic or antidepressant medications.

The journal Clinical Therapy in both 2003 and 2004 noted that there is a difference between brand and generic medications. The journal Hospital Practice also looked at the differences between generics and brand benzodiazepines. The differences can, according to psychiatrists I've heard from, be as much as 20-30% in the bioavailability of the medication.

Simply put. this translates into the percent of a medication that can be absorbed and utilized. Some psychiatrists have noted that they've had to increase the dose of a generic as much as 50% to get the same effect they would get with the brand name.

So, if your med doesn't appear to be giving you the same effect and you've been changed from a brand, perhaps you and your doc might want to research this literature further. I did a quick search on PubMed and found 18 citations talking about this problem. The areas of concern were in transplants, birth control, psychotropics and seizures.

The literature indicates that some medications may dissolve slower and not provide the necessary medication into the blood while others (meds for seizure disorder) resulted in breakthrough seizures. Remember, not all the medications found in this preliminary search were for anxiety or depression, but they provide some needed insights into how medications may differ.

As always, be an informed consumer of any product or service and ask whatever questions you need to in order to come to an informed decision. Caveat emptor is always a good thing.

Related Topics: Cost No. 1 Prescription Issue, Pharmacists Say, The WebMD Rx Guide for Patients


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Researchers Say...

The office was buzzing today with physicians telling other physicians about the "exciting" news published in The Journal of the American Medical Association on a huge, multi-year study of diet and women's health.

Now, I must tell you that I always have a problem with blanket statements that will, invariably, be on the evening news in the form of "researchers say…" and then give me some statement like being a coach potato is actually good for you. Of course that's a gross exaggeration on my part, but you know what I mean.

In its simplest, most incorrect form, this is being seen as indicating it doesn't matter whether you eat a low fat or a who-cares-how-much-fat diet because it made no difference in certain measures of cardiac conditions in the women. As I always say to my students and patients, what's the problem here?

Before you stare down that cheesecake or turn your nose up at a burger (not that I'm trying to coax you into either), think what the problem with the above interpretation of the research might be.

For one thing, there are many more things involved in health than your diet. True, high fat diets probably aren't good for you (I leave that debate to the dieticians), but diet is only one thing to consider when you're thinking about health. There's lifestyle, genetic inheritance, exercise and stress level. Yes, stress level can, according to some research, contribute to problems in cardiac functioning and cholesterol levels.

So, where was the discussion about stress and all the other factors? It got lost somewhere after the first three paragraphs I guess and that most impressive statement about diet not being terribly important was blown out of all proportion. This is a glowing example of simplistic thinking if ever I saw one.

Shotguns for the Suicidal?

The field of mental health has, to me, always been a profession where we help people to both learn to help themselves and protect them from harm, so it was with a degree of both dismay and incredulity that I saw an article in The Sunday Times of London, February 5, 2006.

It seems that a debate among nurses in Great Britain will be taking place shortly and that's something I would have missed if it weren't for the topic to be discussed: giving blades to self-harmers. My thinking is that would be tantamount to advocating for shotguns for the suicidal. I don't intend to sound like I'm taking this lightly, I can assure you.

One of the nurses interviewed stated that self-harm patients (aka those who engage in SIB or Self-Injurious Behavior) need clean, sterile blades for their cutting rather than razor blades, dirty knives, broken glass or tin cans. This poses another question in my mind: Do SIB patients intend to cause flesh injuries or start an infection that could endanger their lives? I don't believe they do intend to cause an infection and it is unlikely that they would choose particularly dirty implements. The few SIB patients I saw in the hospital all used clean, new razor blades or kitchen knives. All of them let other patients and staff know they had cut themselves and were given immediate medical care.

The rationale also used to advance this proposal is that we provide clean needles for drug addicts, so why not clean blades for SIB patients? I do see a connection, but it's a bit beyond my reach to explain in terms of the neurobiology behind it. SIB patients may, in some way, be addicted to this behavior. We do know that, when interviewed about why they cut themselves, they will say because it makes them feel better and they have a sense of relief after the cutting. I once saw a woman who had so many cuts on her arms that both of them were covered in straight white welts from just above her wrists to the beginning of her shoulders.

One advocate not only favors the clean "sharps," but believes it would be a good idea to sit there as the patient carves away. Even further, there is a suggestion that a nurse could facilitate where and how deeply to cut. I find this very disturbing and I'm curious as to where the research providing support for this approach can be found. If there is no research, then what do these nurses propose to do? Perhaps they want to explore new ground, but it concerns me as both a mental health professional and a caring human being.

Now, I come to yet another question: Is or isn't SIB a form of mental disorder and can a person with such a disorder make a rational judgment about their safety? The question of civil liberties has been brought into this discussion here in the US where patients are seen as having a right not to take medication or accept treatment, unless they are deemed a danger to themselves or others. Unless someone makes that determination, they can do as they please.

What do you think?


Related Topics: Self-Injury: One Family's Story, When Scab-Picking, Cutting Becomes Addictive, Self Harm: Support Group

Technorati Tags: self harm, cutting

Do We Need More Diet Books?

Have you noticed how many of the bestselling books are on diets? I have one question: If all of these diets are so great, then how come we need more diets and diet books? Seems to me that if there were a really great diet that was easy to stay on, helped you lose weight anddid its job beautifully and didn't leave you feeling either hungry or wanting to pig out on cheese cake, that would be just fine.

The fact that there are so many books on diets leads me to think that everyone is looking for the "perfect" diet and why is that? Well, the "perfect diet," I suppose, would give us that "perfect body" that the magazines keep telling us is desirable and then everything else in life would just fall into place. Wrong.

Diets are distractions and making people believe that they can do what they can't is just wrong. Yes, there I go again with my "wrong" thing. What are they really aimed at?

Basic insecurity is one of the things that psychologists have been looking at for years and it's one of the major appeals in any advertisement. I can remember taking a course in advertising copywriting and the instructor told us what would be the most effective. We were supposed to think of safety, love relationships (sex, if you will), self-esteem, responsibility to others and the "be all you can be" concept, among others.

So diet books are aimed at that basic sense of insecurity that is pounded away at by countless magazine articles full of air-brushed bodies and bulging six-pack stomachs. Do you know how those men and women get that way? I once had someone let me in on some of the secrets.

First, they get three months notice about magazine covers for which they have to prepare, then they go on crash diets to make those muscles stand out and they work out feverishly every day, six or seven days a week. Who wouldn't have those muscles? Of course liposuction doesn't hurt, either or good lighting and body make and then there's that wonderful computer software that can cure a host of ills.

Anorexia is one of our most serious eating disorders which are driven by anxiety, depression, poor self-esteem and the body's positive response to starvation. We found the latter out through the work of Ancel Keyes in the 1940s where he actually discovered that, once the hunger pangs went away, starving people actually began to feel quite good. It's the brain's way of handling a life-threatening situation.

So, the allure of diet books is really a statement that we're still looking for that miracle diet that will cure a host of ills, one of them being our own anxiety about our looks. I'm all for health and fighting obesity and diabetes, but I don't believe these books are the way to go. Dieting isn't easy, but it is simple and there needn't be anything trendy about it.

Related Topics: The Skinny on Diet Scams, Eating Well With Cancer

Technorati Tags: health, diet, wellness

The Power of Human Touch

Schools of nursing began teaching their students about the value of the human touch decades ago and now research to be published this year in a professional journal (Psychological Science) outside nursing has proven what the nurses knew all along; a human touch can soothe a lot of jittery nerves.

Psychologists, too, have noted the effects of human touch and healing and an article in Families, Systems & Health (23(3), Fall 2005, 251-260) discusses how many cultures have used this healing touch in healing ceremonies.

In some countries, people believe that healing and calming can be achieved by simply sitting close to someone. I had one of my students tell me that while in a Latin American country a family got on the bus with them and the mother sat close to my student's husband. My student thought it might have been because of the tight seating, but the woman's husband explained that his wife knew the student's husband had been sick and she wanted to provide her healing power to him. The student's husband was recovering from a heart attack, in fact, but they hadn't told anyone on their trip about it.

This latest research seems to indicate that neurons actually respond positively to human touch in anxiety-evoking situations. The researchers saw positive proof on an MRI of how dramatically human touch can even blunt physical pain and the anticipation of it. So, when faced with a threatening encounter of any type, make sure you have someone to hug or hold you beforehand. It's not a prescription, but seems like sound advice for people with close relationships.

Related Topics: Does Prayer Help Others Heal?, Massage, Chiropractic Top Medical Alternatives

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