Category Archives: Anxiety

New study on treatment of separation anxiety disorder

Professor Silvia Schneider, Director of Clinical Psychology of Children and Adolescents at the University of Basel, Switzerland has just published in the current issue ‘Psychotherapy and Psychosomatics’ a groundbreaking new study on treatment of separation anxiety disorder

This is the first study to show that cognitive behaviour therapy is effective on young children. Until now, there has been no randomised controlled trial involving a disorder specific treatment program for children suffering from separation anxiety disorder.

The study

Forty three children between the ages of 5 and 7, all diagnosed with separation anxiety disorder, were assigned to one of two groups. The children’s parents were also involved.

One group received a 16 session disorder-specific separation anxiety disorder treatment program which included parent training and classical cognitive behaviour therapy. The other group were assigned to a 12 week waiting list.

Data on anxiety, impairment/distress and quality of life was collected at the start of the trial, after treatment or spending time on the waiting list, and at a 4 week follow up.

Results

Significantly, over 91 percent of the children had improved immediately after treatment. The children were rated either by themselves, their parents or their therapist.

At the follow up, over 76 percent of the children in the treatment group no longer satisfied the criteria for a diagnosis of separation anxiety disorder compared to just under 14 percent in the waiting list group.

The researchers concluded that the results indicate the short term efficacy of a disorder specific treatment approach for separation anxiety disorder.

Symptoms of separation anxiety disorder

The main symptom of separation anxiety disorder is severe distress when separated from the attachment figure i.e. mother, father, significant other or home etc. or when separation is anticipated.

This can manifest itself as persistent fretting, crying, worrying, fear and anxiety, and a reluctance to let go of the subject of attachment. A child may not want to go to sleep or go out or go to school and may suffer from nightmares where the recurrent theme is separation or being lost. Other symptoms that may be present can include stomach pains, headaches, and feeling nauseous.

Separation anxiety disorder may also be a symptom of another underlying condition such as ADHD, Pervasive Developmental Disorder, Panic disorder or other mental health problem and so a proper assessment by a qualified practitioner is necessary for an accurate diagnosis.

Can salt help alleviate social anxiety?

Have you ever wondered why so many of us when having a drink at our local bar we enjoy eating a packet or two of salty peanuts or crisps?

According to new research the effect that the salt in these snacks may have on our bodies could be a lot more than simply increasing our thirst, the salt may also be helping us to overcome social anxiety.

Researchers for the University of Cincinnati found that when sodium levels are increased, they have the effect of inhibiting certain stress hormones in the brain that would otherwise be activated when we are faced with a stressful situation.

Research assistant and first author of the study Professor Erik Krause, PhD from the University of Cincinnati’s department of Psychiatry and Behavioural Neuroscience, says they call this the “Watering Hole Effect”.

“When you’re thirsty, you have to overcome some amount of fear and anxiety to approach a communal water source. And you want to facilitate those interactions — that way everyone can get to the water source” he said.

It also appears from the research that when sodium levels are elevated it not only helps to limit the release of certain stress hormones, it also promotes the release of an anti stress hormone called Oxytocin which can help us feel more relaxed.

When in a bar packed full of people, or indeed anywhere else where we are mixing with strangers,  it’s quite understandable that there may be some level of social anxiety but who would have thought it could actually be the crisps, peanuts and pretzels that make us feel more relaxed – interesting stuff.

Seriously though, the research has important implications in other areas too, particularly in autism.

Professor Kraus says that future research will examine the hormones involved and their pathways to identify their role in social anxiety disorders as well as autism. One of the characteristics of autism is a reduced ability to function effectively in social situations.

“Oxytocin deficiency has been implicated in autism in previous studies,” says Krause.

“We’d like to investigate the possibility that dysregulation in fluid balance during pregnancy could result in autistic disorders.”

Salt may not be so bad after all.

The research has been reported in the Journal of Neuroscience, issue April 6th 2011.

Could lactose intolerance be stress, anxiety or depression in disguise?

According to recent research from Italy, the symptoms of lactose intolerance and other food allergies are all in the mind and are more likely to be a result of depression, anxiety or stress.

This may be hard to swallow for anyone currently suffering but that is actually what a study by researchers from the University of Milan revealed.

Previous research has already found that as many as nine in ten people in Britain who really believe they have a food allergy or intolerance are actually perfectly healthy the MailOnline reports, and that although 20 percent of men and women claim they are suffering from food allergies, the reality is that that less than 2 percent actually do.

The Italian study was led by Dr Guido Basilico and involved more than 100 people who were showing signs of lactose intolerance which include symptoms such as stomach pain, bloating, and loose bowels. Dr Basilico and his team carried out tests to discover whether they really had a problem breaking down the sugar in lactose.

Part of the study also involved asking the participants about their mental and physical health and any aches and pains they experienced.

According to Dr Basilico, most people tested in the study were not lactose intolerant at all as they were perfectly capable of digesting lactose and the symptoms they experienced were more likely to be a result of stress, anxiety or depression rather than the milk in their coffee.

Dr Basilico is not saying that lactose intolerance doesn’t exist of course, as there are cases where a person’s genetic makeup may make it difficult for them to tolerate lactose; however, he is saying that for a large majority, the symptoms of lactose intolerance have more of a psychological basis rather than a physiological one. Just as stress can cause headaches, it can also cause tummy problem.

Believing yourself to be lactose intolerant when you’re not has implications on health as a shortage of dairy products could leave people severely short of calcium, increasing the odds of brittle bones, falls and fracture in old age so Dr Basilico is urging people to think twice before cutting out dairy products.

“Excluding dairy products should be discouraged and doctors should pay more attention to the psychological problems of their patients” he said.

Big Stars Suffer Mental Illness Too

Zoro star Catharine Zeta Jones (41) has been hospitalised and treated for bipolar disorder II. She spent five days this month in the Silver Hill Hospital in Connecticut.

Bipolar Disorder II is a condition where the sufferer experiences bouts of hypomania, along with depression.

It is not the severest form of Bipolar Disorder however, and severe mania that is inherent in Bipolar Disorder I is absent.

Not Detrimental

Whilst hypomania is known as being less severe than mania there are similarities between the two, there is an elevated mood, sleep deficiency, racing thoughts, delusions of grandeur, and raised activity. None of these representations of mania style happenings however are as detrimental as to make a working and even a social life impossible.

In effect none of these symptoms are disabling enough to impair a person’s life as manic episodes are capable of doing, i.e. there are mood swings, but they are less severe in nature than those experienced by sufferers of Bipolar Disorder I.

Stressful Year

A spokesperson for Catharine, blamed a busy year and stress for the Hollywood Actress‘hospitalisation. It was her decision to check into the hospital in order to receive treatment.

The spokesperson went so far as to say that the starlet is feeling great, and is ready, and able to continue work on two upcoming blockbusters. It is being billed that the stress Catharine is experiencing is due to the illness being suffered by her husband; Wall Street Actor Michael Douglas. His ill health may have led to the hospitalisation.

He is currently in receipt of treatment for throat cancer, but in January he announced that he is managing to beat the cancer.

Tip Top / Traumatic Event

Hollywood sources have stated that Catharine was just seeking to make certain she was in tip top condition, before commencing her latest movie projects.

She has now checked out of the hospital, but experts say that a traumatic event is often a trigger to the episodes inherent in Bipolar Disorder II.

Other Celeb Bi Polar Sufferers

Catharine Zeta Jones is not alone in her suffering from the disorder. There are a host of well known names that suffer, or have suffered from the mental malaise.

Names like Patty Duke and Stephen Fry; names like Richard Dreyfuss and Maurice Benard, all of these persons have been diagnosed with either Bipolar Disorder I or II.

So too Linda Hamilton, Carrie Fisher, Mel Gibson and Russell Brand, all have experienced issues with the condition.

Tough Guy

Tough guys can get it too, with Jean Claude Van Damme battling the mental condition also.

In his case he took to beating the depression he suffered in childhood and indeed the bipolar disorder with a mix of ballet and karate. He found that in his youth if he avoided training for even a short period of time then the result was unhappiness within himself.

His condition may also have played a part in his experimentation with cocaine in the early 90’s, after seeking out rehab for this in 1996 he left after just a week, the condition worsened, he became suicidal, until a late 1996 turning point.

It was only then that he was diagnosed with bipolar disorder (rapid cycling.) For his condition he was given ‘that simple salt’ which is actually sodium valproate. He found that the simple salt actually did the complex job of settling him very well. He refers to it as, ‘all the water moving left and right of me, all of the commotion, became like a lake.’ From then on in it was easy for him to beat his cocaine addiction.

Anxiety from Obesity as Severe as Other Forms of Anxiety

Those persons’ who have a social anxiety born out of obesity, are demonstrating in many instances the same level of anxiety as persons suffering from social anxiety disorder (SAD) according to new research collated by Rhode Island Hospital Researchers.

These findings are going against the grain of modern thought pertaining to SAD and conflict with the SAD criteria as lain down by the Statistical Manual of Mental Disorders.

The manual dictates that it is only when there is no link to a medical condition, can a person who has a medical condition be diagnosed with SAD.

Change Afoot

However a workgroup who are in charge of a new chapter of this Manual have made a recommendation that there should be an amendment in this instance. A modifying of the criteria needs to be made to meet the needs of many with medical conditions whose actual level of anxiety experienced is excessive.

In effect this workgroup are making a space for persons with medical conditions, be they stutters, Parkinsons Disease, obesity or otherwise to be diagnosed based on the severity of the anxiety they suffer in society.

Stutterers Covered

Several studies have been conducted on persons who stutter in relation to their social anxiety levels, however new research by scientists at Rhode Island Hospital have for the first time published research into the severe level of social anxiety experienced by obese persons.

Research Method

For the research, an evaluation of close to 800 persons was made. 135 individuals, all of whom had been diagnosed with DSM-IV SAD were the first to be taken. Kristy Dalrymple led the study. In this study 40 persons who had anxiety levels leaving them diagnosed as (modified SAD) pertaining to their experiencing anxiety due to their weight only, and also 616 persons with no psychiatric disorder history.

The two SAD groups were found to have had a very bad capability in functioning socially whilst in adolescence, compared to the group who had shown no history of disorder, in this case there was no difference between the two different SAD groupings.

They were queried on the last five years of their lives, similar results were found in this period. The SAD group were also recognised as having spent a great many more work days absent as a consequence of their emotional and psychopathology reasons, than either the healthy subjects or the modified SAD group.

Higher Social Life Disruption

Results were also demonstrated, as showing that the persons in the SAD group that was modified, did experience more disruption. They showed a significantly higher disruption in their social life and demonstrated much more distress in their social anxiety than did the healthy group or indeed the regular SAD group.

Not by the Book

Study creator Dalrymple, said in relation to this finding that it was an interesting point to note how there were greater disruptions to social life in the modified SAD grouping. It was surprising that this was more evident in the modified grouping, as indeed it did go against what the manual says.

The suggestion is that the level of impairment is just as high, if not worse than regular SAD in the modified SAD group; this was in spite of their impairment being obesity only. The scientist went on to offer potential reasons behind the cut in social life standard. She said it may be down to recent weight changes i.e. occurring over a short period of time, meaning that there has been less time to adapt to the changes, than say someone who developed SAD years ago would have had. In a way it is natural that this would be more disturbing for them than if it the social anxiety had been experienced in a generalised form for years.

Benefit from Treatment

It was concluded that perhaps these individuals could benefit from treatment of the SAD disorder, and therefore it is being decided to indeed enter this source of SAD symptoms as a precursor to SAD itself in the training manual, and through its being diagnosed it can then be treated.

Panic Attacks A Breath of Relief

Panic attacks can be reduced through the use of breathing therapy it has been determined through a new study.

The study found that breathing therapy is more effective than the traditional forms of therapy used for panic attack sufferers, such as cognitive therapy.

The new therapy method has seen success in reducing the dual symptoms of hyperventilation and panic.

Panic disorder expert Alicia E. Meuret of the Southern Methodist University of Dallas is a part of the biological-behavioural treatment program in which the study was conducted. The programme is otherwise known as Capnometry- Assisted – Respiratory – Training, or CART.

Learning to Breath

The breathing therapy (CART) is designed to assist patients in learning how to breathe in a way that can lead to the reversal of hyperventilation. This reverse of the stressful condition is actually a very comfortable state, where the low levels of carbon dioxide are at abnormal levels in the blood stream.

Hyperventilation is very common in patients with panic disorders, and is a state where excessive breathing occurs, it stems from beginning to breathe deeply or rapidly. It was determined by the scientists in this study that the changes in panic symptoms are caused by the therapeutic change in carbon dioxide levels and not according to Meuret, vice versa.

Twice Daily Dose

The exercises were carried out twice daily, and in the treatment it was the simplest breathing techniques defined by CART that were practiced. A capnometer was used. This is a device that gave the scientists feedback on the CO2 levels in the patient. The goal of the exercises being to make the symptoms associated with chronic and acute hyper-ventilation as well as the condition itself disappear.

Slower and Shallower

The main point of focus was not only to breathe much slower, but also to breathe in a shallower way. It is often believed that taking a deep breath is good for us, yet in fact breathing in deeply for sufferers actually worsens the hyperventilation and the physical symptoms.

Meuret reports that the bulk of panic disorder patients are terrified of shortness of breath or dizziness; the physical symptoms. Whilst the effects of the breathing did not affect the psychology that leads to this fear, it did effectively reduce hyperventilation. So too the scientists determined that cognitive therapy brought little or no change in respiratory physiology.

CART V’s Cognitive Therapy

In the study the CART system was pitted against the more conventional cognitive technique. The cognitive means focuses on the psychology of the patient with the intention of reversing the way their thoughts work, and the trigger they play in bringing on panic attacks or hyperventilation.

The study involved 41 participants and they were split into two groups. The breathing or the cognitive therapy enacted specific to one group or the other. Amongst the 41 there were sufferers of agoraphobia (trapped feelings) and sufferers of panic attacks.

Both Effective

Meuret has declared that both systems of treatment were in fact effective in the reduction of symptoms, it was noted however that CART was the only one of the pair of treatments that managed to actively reverse hyperventilation.

It was found also that the treatment helped the patients address the terror they feel when panic sets in. The study included a control trial that was randomised in order to give a true measure of CART’s effectiveness. In that the patients were now able to reverse hyperventilation it was now possible for the patients to also reduce panic symptoms.

New Approach

In cognitive therapy however it was determined that when a shortness of breath occurred there should be a new approach to beating the fear held by the patients. The researchers challenged the assumption on which the fear is based, and asked the question’ how often the person actually suffocated during the panic attack?’ The intention behind this cognitive therapy technique being to reverse the way the patient thought about the attack.

Challenge

The process was a challenge for many of the patients because whilst it recognised that there was a symptom, the technique represented that the symptom should not be seen as a problem. Whilst CART is able to tell researchers when CO2 levels are very low in the patient, it is also giving the patient the power to effect a change on the symptom itself.

False Assumption

The study ascertained for the first time that the assumption that if a person worries less about the issue then it will be less severe is actually incorrect. In truth it was found that hyperventilation will remain unchanged by thinking this way. The study agreed that there are severe health outcomes occurring in the individual as a result of hyperventilation.

Big Plans

There are plans afoot to take the CART programme into the community at large, in particular it is intended to bring the technique into the ethnic minorities. The reason they are approaching ethnic minorities being that due to CART being a physical exercise, it will be more readily accepted than a cognitive form of treatment or intellectual method.

This physical nature makes it accessible to those with low education levels, and divergent cultural backgrounds. There are intentions too to bring the study on further, and work with those who suffer from asthma or who have a fear of blood.

Adult Learning Benefits Depression and Anxiety Sufferers

Spending cuts to the adult leaning sector in the UK will prove a false economy according to The Mental Health Foundation.

They believe that the cuts will be counterproductive in tackling mental health issues in UK society.

There is grounding in their statement with evidence emerging from recent research that there is a significant improvement amongst sufferers of depression and anxiety through their attendance of adult learning courses.

Prevalent Mental Disorders

Anxiety and depression are by far the most prevalent mental disorders in the region. This of course has the result of a large duress being placed on the economy, along with the wellbeing of the population.

The latest stats report that 9% of adults suffer from mixed anxiety or depression. This 9% does not include a further 7.7% of the population who suffer from either general anxiety or have been diagnosed with some depression symptoms.

Economic Hit

Each year the economy suffers a loss of productivity as a result of this issue, with one fifth of all days lost to work due to the conditions. It is these statistics that the Mental Health Foundation are using to back up their plea for the use of good judgement in the austerity measures being put in place.

It has been determined in the aforementioned study learning for life that adult learning programmes demonstrated the effect of reducing depression and anxiety symptoms in adult students with the conditions, by 26% for depression sufferers and 22% for anxiety sufferers.

Even Better

When a follow up survey of participants took place, even more tremendous results were realised from the adult learning programs, with depression symptoms plummet reaching 35% and 31% respectively. This was against the levels which showed pre-commencement of the courses.

Necessity or Luxury?

The head of policy of the Mental Health Foundation Simon Lawton-Smith has gone on to state that the government are demonstrating that adult learning is not a necessity but a luxury. He pointed to the study Learning for Life findings’ to support his belief that they are very much a necessity.

It is demonstrated therein the real value of the courses, in benefitting those with mental health issues. He believes that if the cuts go ahead, there will be not only economic costs associated but human ones as well.

The implications of Learning for Life according to one of the lead authors Dr Dan Robatham is that the adult learning programmes can be very beneficial to combating both mild and moderate depression. It is possible here because there is no stigma attached to participation unlike in the traditional forms of treatment.

Cuts

This cut is just one of a series of cuts right across the board in Britain. Those cuts will be inflicted on the Health Service also, which will be required to make enhanced efficiencies. It has been noted when austerity measures such as these were applied in the past, that patient health suffered, and many who needed assistance were denied assistance.

Difficult

Whilst it is difficult for Government to look at the future benefits in economic terms, to keeping the adult learning initiatives in place at their current funding levels, it is fortunate that the recent study’s outcomes are there to help drive home the point.

That point being that there is a distinct economic advantage to keeping the levels at the point where they are, as a result of less work days lost and subsequent tax losses to the Exchequer as a result of depression.

So too, less depressed people means a decrease of drain on the limited medical resources in the United Kingdom, cuts of this manner are indeed a false economy. A statement from the Government in response to the argument has as yet not been made.

Marijuana use Linked to Anxiety and Depression. Or is it?

The Dutch have done it, they have found a link that many have suspected has existed for decades between the use of marijuana and anxiety disorder. The Netherlands National Institute of Mental Health and Addiction set out on a path of discovery to access a possible link between cannabis use and the onslaught of mood disorders.

Anxiety disorder and bipolar disorder were the main disorders they were attempting to uncover details of. They were seeking to find a correlation between use of the class C substance and the disorders emergence.

Their agenda was to determine, considering the disproportionate amount of people who seem to have an addiction to the substance, and a mutual disorder such as manic depression, if the ‘seem to’ was evident when held up against scientific study.

Their set of assumptions going into the study was that marijuana use could indeed be a trigger of a mood disorder.

Their research found a link not only for bipolar disorder and the smoking of marijuana but for anxiety disorder also, there was however one detail missing which made the study worthless in many ways. The notion, even the possibility that the disorder was already evident before consumption of the drug was not approached in the study.

Whilst it is a known fact that many of the symptoms of those disorders are the very symptoms that would lead a person to seek out drugs in order to behave in a more ‘socially acceptable way’ they neglected this detail in their research.

Obesity and Migraines Linked to Depression and Anxiety

A definite link between depression and anxiety, obesity and migraines has been found by researchers at the University of Toledo College of Medicine, Ohio.

They had found evidence of there being an increased incidence of obesity and migraines in the last number of years, and sought answers to explain the prevalence.

They noted that there was a possible connection between the increase and the emotional disorders of anxiety and depression, and took on a large focus group to determine if any correlation was present. They used from the focus group questionnaires which spanned a plethora of everyday questions boiling down to question about health and the loss of productivity as a result of bad health.

They incorporated into the questionnaires questions that dealt with headache frequency, days of work missed as a result, the individuals weight and body mass index and also pertained to amass information on psychiatric conditions amongst the group which had been diagnosed.

Their results showed that a definite link exists just as they had assumed. In 70% of the obese participants anxiety existed, with 42% of the obese in the survey reporting that they had a high incidence of migraines.

The main finding of the survey was that the conditions of depression, and anxiety are most prevalent in obese migraine sufferers.

Scientist locates “anxiety centre” in the brain

We all experience fear in our lives, some more than others, but what part of the brain is involved and why do some people go rigid with fear whereas others make a stand and fight when both are faced with exactly the same situation?

A scientist from Maudsley hospital in South London reckons he has found out where the “anxiety centre” is located and some of the preliminary findings of his ingenious experiment are proving quite interesting. For example, who would have thought that political leanings would play a part in anxiety levels?

Psychologist Dr Adam Perkins designed an experiment in which he subjected varying amounts of stress to a group of volunteers over a period of nine months. He himself was also included in his own experiment. He also used questionnaires to assess anxiety levels as well as MRI scans to observe what was happening in the brain whilst the volunteer was under stress.

In part of the experiment the subjects were asked to play a video game dubbed the “rat race”, which was a simplified version of Pong, no horrendous graphics or anything like that, just a very simple game with dots on a screen. Everyone suffered some level of anxiety but interestingly, there were massive variations in the level of anxiety experienced.

Using MRI scans, Dr Perkins was able to locate the region of the brain involved in fear. This “anxiety centre” as he calls it, is located in the part of the brain that we use for spatial awareness and memory, the hippocampus.

So what else has he discovered?

Well according to a write up in the Daily Mail, those who have right wing beliefs are much more likely to be anxious compared to those with more lefty ideals. The least anxious people were actually elderly liberal men.

The Daily Mail also reports that women are more anxious than men and older women were more anxious than younger women.

Some people who are very anxious can “freeze” when faced with a difficult situation, whereas some people remain calm. Dr Perkins may be able to discover why this is the case by looking at what is happening in the brain at the same time.

The study is ongoing so even more interesting insights might be revealed.

One of the benefits to come out of Dr Perkins experiment could be the creation of future drugs that are designed to more accurately target anxiety and depression.