“Foolproof Ways to Battle Anxiety

Tuning out your worries and improving your state of mind is easier than it sounds.

Rebecca Ruiz- Forbes
1.20.09

If the Dow just closed after a dismal day of trading and a tightening sensation is beginning to spread through your chest, stop and try this exercise:

Instead of focusing on the money you’ve already lost or obsessing over future losses, try zeroing in on the present moment. Let go of distractions like a looming bill or the record unemployment rate and concentrate on your breath. Take in all the air you can, pause and then release.

“It’s actually totally boring concentrating on your breath,” says Dr. Michael J. Baime, director of the Penn Program for Stress Management at the University of Pennsylvania Health System. “Lifting a barbell is totally boring too, but it’s exercising a muscle.” After 10 repetitions, he says, you should start to feel some degree of calm.

Though anxiety is the body’s natural response to a threat, that alarm system sometimes sounds unnecessarily, cluttering the mind with the chatter of negative thinking. The breathing exercise helps divert the mind’s attention elsewhere.

Controlled breathing isn’t the only strategy for anxiety relief, either. Others include engaging the brain and body, cognitive and behavioral adjustments and meditative techniques.

The Origins of Anxiety
If it’s difficult to understand why you are plagued by certain anxious thoughts, don’t take it personally–it’s a phenomenon that still eludes scientists. What is known, says Dr. Sonia Bishop, an assistant professor of psychology at the University of California, Berkeley, is that anxiety involves responses in two parts of the brain: the amygdala and the pre-frontal cortex.

The amygdala is responsible for the fight-or-flight response, while the pre-frontal cortex controls executive functions like decision-making and planning. A human foraging for berries, for example, would use the pre-frontal cortex to decide which berries to collect. If a predator suddenly jumped from the bushes, the amygdala would sound the alarm.

Scientists don’t fully understand why certain individuals are more prone to anxiety, but some theories suggest varying levels of neurotransmitters–the chemicals that relay signals between neurons and cells and affect how well the amygdala and pre-frontal cortex function–may play an important role.

What interests Bishop, however, is how the anxiety-ridden can reverse course regardless of pre-disposition. That’s why she recently conducted a brain-imaging study with 17 participants, some of whom had “high trait anxiety,” which was determined using a standardized measurement.

While being monitored by an MRI that tracks changes in brain activity, each participant had to engage the pre-frontal cortex by identifying certain letters and ignoring others. When the task increased in difficulty, both groups did well on recruiting that region of the brain. But when the task was easy, those with trait anxiety did a poor job. This was particularly telling, says Bishop, because the participants were not exposed to any anxiety-triggering threats.

The results have led her to believe that the anxiety-prone may have difficulty preventing the mind from lingering on distractions when performing easy, day-to-day tasks.

Though not yet tested by other scientists, Bishop’s conclusion seems to reflect what works well in other successful techniques for battling anxiety: meaningful distraction.

Overcoming Anxiety
You could try informally testing Bishop’s theory by doing a crossword puzzle instead of watching TV. More commonly accepted remedies for curbing anxiety include socializing and exercise, the latter of which can increase levels of dopamine, the body’s naturally occurring, mood-boosting chemical. Such distractions are most effective, though, when paired with a real effort to switch your focus.

In the simplest terms, that’s what Dr. Israel Liberzon,a professor of psychology and psychiatry at the University of Michigan, tries to teach his patients. Using cognitive and behavioral techniques, Liberzon shows patients–many of whom suffer from anxiety disorders–how to change the way they deal with their worries.

Often he advocates for reconsidering what you associate with anxiety, trying to judge perceived threats using a more rational scale or creating an emotional distance from certain fears. In other words, putting things in perspective.

But since that reaction is hardly intuitive, Liberzon recommends seeking out professional help. In addition to the Anxiety Disorders Association of America, a nonprofit organization that provides information on anxiety treatments, Liberzon says support groups and local universities with anxiety and stress research centers can serve as useful resources.

Like Dr. Bishop, Liberzon also recommends mindfulness meditation, a well-regarded technique that has been shown as effective in clinical settings. Mindfulness meditation emphasizes focusing on the present moment instead of dwelling on regrets or worries.

Dr. Baime, of the Penn Program for Stress Management, teaches dozens of these meditation techniques and says they can be learned by reading literature on the subject. He recommends Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness by pioneer of mindfulness meditation Dr. Jon Kabat-Zinn, which Baime uses as a textbook in his classes.

Another alternative is to find local practitioners. While there is no certification process required to teach these methods, Baime says consumers can weed out potential snake-oil salesmen by asking to speak to previous students and inquiring about where the instructor learned the methods and how many students he or she has taught.

With the right tools, says Baime, mindfulness meditation can help the anxious reclaim their lives.

“When you learn to bring your attention into the present moment in a balanced way,” he says, “you learn to undo those negative predictions for the future.”"

9 Foolproof Ways To Deal With Anxiety (originally posted in Forbes)

“Try a Breathing Exercise

Instead of focusing on a looming bill or the record unemployment rate, take a moment to concentrate on your breath. Take in all the air you can, pause and then release. After 10 repetitions, you should start to feel some degree of calm, says Dr. Michael J. Baime, director of the Penn Program for Stress Management at the University of Pennsylvania Health System.

Mindfulness Meditation

Mindfulness meditation emphasizes focusing on the present moment instead of dwelling on regrets or worries. To learn more about it, try reading Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness by Dr. Jon Kabat-Zinn, the pioneer of the subject. You can also find a local practitioner in your community, but be sure to speak to previous students and inquire about where the instructor learned the methods and how many students he or she has taught.

Engage Your Brain

The brain processes anxiety in two separate regions. The amygdala emits a fight-or-flight response while the pre-frontal cortex handles executive tasks like decision-making. A recent brain-imaging study showed that those prone to anxiety may have difficulty mediating their worries if not engaged in a task that requires diverting attention from the amygdala to the pre-frontal cortex. Though not yet replicated by other scientists, the findings reflect what works well in other successful techniques: high-quality distraction.

Socializing

Spending time with friends and family is not only a diversion from obsessing over the unknown, it can also improve your mood by forcing you to laugh or gain perspective on your fears and worries. During these rough times, socializing can also mean commiserating with your peers. But instead of collectively dwelling on the negative, try discussing positive developments.

Physical Activity

Exercise is another great diversion tactic. At a vigorous-enough pace, exercise can help produce increased amounts of the body’s naturally occurring, mood-boosting chemical dopamine. Getting active also gives people a sense of control and accomplishment, which can eclipse feelings of doubt and anxiety. There is one thing to remember, though: Be sure to focus on the task at hand instead of letting the mind wander.

Preventive Care

Anxiety is a powerful emotion that can overwhelm those who experience it. But instead of turning to alcohol, fatty food or television, try following the basic rules of good health and preventive care: stay physically active, eat well and get plenty of rest. Also avoid chemical substances like caffeine and nicotine, which can worsen anxiety, according to the Mayo Clinic.

Cognitive and Behavioral Techniques

Dr. Israel Iberzon,a professor of psychology and psychiatry at the University of Michigan, uses cognitive and behavioral techniques to help his patients overcome anxiety. These include “changing the narrative” associated with the anxiety, creating emotional distance and assessing the threat with a new perspective. Since these reactions are hardly intuitive, Iberzon recommends seeking out professional help to better understand them.

Psychotherapy

Therapy can be an effective tool for those who want to learn more about cognitive and behavioral coping techniques, but it may also be necessary for those who have a clinical disorder. Anxiety disorders, according to the nonprofit organization Anxiety Disorders Association of America, are the most common illnesses in the U.S. A psychotherapist can make an official diagnosis and provide support and treatment.

Anti-anxiety and Anti-depressant Medications

Prescription medicine can alleviate symptoms of a clinical anxiety disorder. For short-term relief, patients can take benzodiazepines, which work as sedatives. Anti-depressants like duloxetine (Cymbalta) and fluoxetine (Prozac) have also been used to treat anxiety disorders, according to the Mayo Clinic. A new study in the Journal of the American Medical Association found that the anti-depressant Lexapro was very effective in treating adults with Generalized Anxiety Disorder over the age of 60.”

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Check out this study that shows a link between prematurity and mental illness.

“New Zealand Herald
Early Births Linked To Mental Illness
Jan 05, 2009

A study of premature babies has shown a link between pre-term births and mental illness, which an expert says has implications for the way mothers and babies should be treated.

The Swedish study of more than 500,000 babies showed infants born between 24 and 28 weeks were more than twice as likely to be admitted to hospital for a psychiatric disorder in their early 20s than those born at full term.

The study by researchers at Sweden’s Karolinska Institute showed 5.5 per cent of those born very early had been admitted to hospital for a psychiatric disorder, compared with 2.4 per cent of those born at full-term.

The conditions included mood disorders, stress-related complaints and suicide attempts or deaths. Even those in the moderate prematurity group, born at 33 to 36 weeks, were at risk, with 3 per cent having been admitted to hospital for a psychiatric disorder.

The study, which followed up premature babies born from 1973 to 1979 through their medical records, made adjustments for other mental illness risk factors, including family history and low socioeconomic status.

“Pre-term birth carries some risk for psychiatric disorders requiring hospitalisation in adolescence and young adulthood,” the researchers concluded in the study published in the journal Paediatrics.

Sydney University’s Brain and Mind Research Institute executive director Professor Ian Hickie said the study was one of the few to focus on the long-term mental development of premature babies.

Professor Hickie said premature birth disrupts a critical phase of brain development in the mid-to-late stages of pregnancy.

“The critical brain connections and the critical brain pathways are probably harmed by premature birth,” he said.

A renewed focus on the importance of maternal health, particularly in indigenous populations, would decrease the chances of prematurity, Professor Hickie said, as activities such as smoking and alcohol use in pregnancy contribute to premature birth and difficulties in the womb.

Babies born pre-term would benefit from being monitored through every stage of their development, “through into their teenage and early adult years, when there might be increased risk of developing one of the major psychiatric illnesses”.

- AAP”

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“Kristin Davis: A Postpartum Depresion Interview With An Extraordinary High School Student
Written by Kristin Davis: Empowher Women’s Health Magazine
December 12, 2008
I was recently contacted by a high school student named Ashley clear across the country who asked if she could interview me for a high school project. She had chosen to write about Postpartum Depression with the hopes of educating others on how devastating and misunderstood it is. Ashley found me when she came upon this blog and I was so thrilled and honored to help her out. Below are her questions to me and my responses during the interview.

What was your initial reaction to finding out you had Postpartum Depression, how did it impact your life?

My initial reaction, as sappy as it sounds, was crying tears of joy. Receiving a diagnosis of Postpartum Depression had a major impact on my life at the time. I had spent three months suffering horribly, some of that time in and out of the hospital, with so much of my stress wrapped up in the fact that I had no idea what was wrong with me. The doctors caring for me had no idea either, so I felt completely isolated and alone. Being diagnosed was incredibly empowering because at last I could say: here’s what’s wrong with me and it’s treatable. There was a name for my agony. That knowledge literally brought up from the darkest place where I was contemplating suicide to one where I felt some hope.

What symptoms of Postpartum Depression did you have to suffer through, and if you had any, what physical changes occurred as well?

My symptoms were largely gastro-intestinal; mainly comprised of stomach pain, vomiting, diarrhea, fainting, dehydration, dizziness, major weight loss, lethargy and nausea. The nausea was far more intense than even the worst morning sickness that I’d ever experienced with any of my pregnancies. The most disturbing symptom was the extreme dizziness. The room would start spinning the moment I lifted my head from my pillow. I would have to literally crawl on the floor to make it to the bathroom. I went from being a very healthy and physically active (former marathon runner) 30-year-old woman to being completely debilitated and unable to function. Even the simplest everyday tasks, such as brushing my teeth, were impossible at times.

What impact did your Postpartum Depression have on your family and friends?

It destroyed my relationship with my parents, who did not understand depression (especially PPD) at all. During my second hospitalization for dehydration, my dad called me on the phone and told me to “get off my butt and start taking care of my babies.” I begged my parents to help me and my husband take care of our babies so that I could get out of the house for doctor’s appointments, but they refused and said it was my choice to have the babies, therefore I must deal with the consequences. When I was finally diagnosed with PPD, I needed some financial assistance in order to see a psychologist who was a PPD expert, and when I asked my parents for a loan they responded similarly. It has been nearly twelve years and I haven’t had a relationship with my parents since. I was so deeply affected by their ignorance of the reality of mood disorders and their lack of compassion that I’ve chosen to keep them out of my life. At the time, I was too ashamed about having PPD to tell any of my friends, so I didn’t share or ask for support from them. I think I feared they would react the same way my parents had.

What treatments did you go through for Postpartum Depression and if there were multiple treatments, which ones do you believe to be the most effective?

Immediately after my diagnosis, my obstetrician put me on an anti-depressant, Prozac, and it started working quickly. In only two weeks I felt nearly like my former self and I was able to take care of my babies and function well around the house. I also immediately began seeing a psychologist who specialized in PPD. Talk therapy helped enormously and I continued seeing her regularly (first once a week and then eventually once every two weeks) for about a year until I felt I was completely recovered. In addition, my psychologist recommended that I start writing in a journal, which I did, and also found very helpful. In fact, I credit that as the official start of what became my career in writing. I had never dreamed of becoming a professional writer, but after journaling and writing extensively about my PPD experience, I found that I loved writing so much that I became a freelance journalist. In addition to talk therapy and taking Prozac, my psychologist recommended that I take a class of some sort or join a book club, etc, to have an excuse to get out of the house and do something just for me. I signed up for my first yoga class, one evening a week at the time, and that in itself made a major impact on my life. Not only was I getting out of the house by myself, I was doing a wonderfully therapeutic form of exercise that has taught me a great deal about the mind/body connection. I still do yoga regularly and my kids have done yoga since they were small.

Where there times when you would just want to give up because everything just seemed so stressful and overwhelming?

YES. There were many times when I couldn’t raise my head from my pillow and I’d think that I was so worthless that my life wasn’t worth living. I truly believe that if I had gone on much longer without a diagnosis that I wouldn’t be here today.

How do you feel when people assume that Postpartum Depression is just the “baby blues” and that “everyone goes through it, so it’s not a big deal”?

Whenever I hear or read the term “baby blues,” it makes me extremely angry. It’s a load of crap. That term was created either by a man, or by a woman who never experienced a perinatal mood disorder. It’s like saying cancer is just a mild discomfort. And PPD is indeed a big deal since women have died from it since the beginning of time. They’re still dying.

Did you ever feel like people would judge you unfairly when they found out you had Postpartum Depression?

Yes, I totally felt like I would be judged since there’s still such a stigma surrounding mental disorders. The reason I began speaking out about my PPD experience is because I got so tired of hearing how women are still suffering every day, being misdiagnosed or left undiagnosed. And their children are suffering, both emotionally and cognitively. I don’t believe we’re any further along in decreasing the incidences of PPD than we were in 1996 when I had it.

Do you feel that after your recovery, you are a changed person or generally the same as you were before you knew you had Postpartum?

I am a completely different person. I feel like I’m more compassionate in general, but especially when it comes to mental disorders. I actually look at my PPD experience as a gift in a way because I’ve learned so much about my body and how to cope better with stress. A few years after I suffered from PPD, one of my children was diagnosed with both Asperger’s Syndrome and Tourette’s Syndrome. Since I had worked so hard to educate myself on my own mental disorder, it was easier to understand and deal with the challenges that my child faced.

How do you feel about the controversy that erupted between Brooke Shields and Tom Cruise a few years ago?

I’m really glad it happened because it did a great deal to raise awareness of PPD among the general public. (It also demonstrated what an idiot Tom Cruise is and how that particular way of thinking needs to stop.)

Is there anything else you would like to tell the class regarding Postpartum Depression?

The main thing that I would like to express is that PPD is not only treatable, it is preventable as well. Many women don’t realize this, especially if they’ve already suffered from PPD. They assume they’ll have it again, and roughly 30% of women in this category even consider abortion when they find they’re pregnant again, rather than face PPD another time. I write a lot about PPD prevention on my blog and share my story of having a wonderful postpartum with my fourth baby in 2001, several years after my horrible PPD experience. As in most cases, knowledge is power, and I was truly empowered when I became pregnant my fourth (and last) time around. I knew what my PPD symptoms looked like, knew to watch out for them, knew to ask for help, to set up a strong support system of loving family and friends, and most of all, to take care of myself through the pregnancy and birth. For more information and access to some resources that I think are really great, you can always visit my blog or e-mail me. Ashley, I cannot thank you enough for tackling this important topic and spreading awareness through your work. The more we talk about PPD, the more women and medical professionals will be educated so that one day we can bring an end to this devastating disorder.”"

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I wanted to post something for all the new moms, or soon to be new moms, out there. Postpartum depression is a very real, very scary possibility after giving birth. You are exhausted, stressed, trying to adapt to a completely new life with a new person as your top priority, and on top of everything your hormones are dropping off drastically after 40 weeks of adjusting to the higher levels. If you are feeling any symptoms of this disorder, please talk to your doctor. It is so much more common that you think. I know that a lot of women feel ashamed that the are not blissfully happy after giving birth and don’t want to admit to it so they don’t seek treatment. This can be dangerous for both you and your baby. Remember how crazy you were during your pregnancy and how you accepted those wacky hormones as part of the process? This is the exact same thing; you’re reacting to abnormal hormone levels. Talk to your doctor and get the help you need so you can enjoy this wonderful time with your new child.

“Sleep Lack Worsens Post-partum Depression
United Press International
Published: Dec. 11, 2008
Post-partum depression can lead to poor sleep, and depression symptoms worsen in patients when their quality of sleep declines, U.S. researchers said. All new mothers experience some sleep loss following childbirth, as their estrogen and progesterone hormone levels plunge. They typically spend 20 percent more of the day awake than average during the first six weeks after giving birth.

Study author Bobbie Posmontier of Drexel University in Philadelphia compared sleep patterns of 46 post-partum women — half with symptoms of post-partum depression and half without. Sleep patterns were monitored for seven consecutive days.

Results showed that mothers suffering from post-partum depression took longer to fall asleep and slept for shorter periods. The worse their sleep quality, the worse their depression.

Sleep deprivation can hamper a mother’s ability to care for her infant, as judgment and concentration decline. Sleep-deprived mothers may inadvertently compromise their infants’ sleep quality because infants often adopt their mothers’ circadian sleep rhythms.

Posmontier recommends that clinicians treating women for post-partum depression address the importance of adequate sleep.

The findings are published in the Journal of Obstetric, Gynecologic, & Neonatal Nursing.”

“Postpartum Depression: More Than Just The “Baby Blues”
PotterWorldOnline

The earliest medical records about postpartum depression dates back to as far as the 4th Century BC. However, despite the early awareness about this form of depression, the postpartum sadness has not always been formally recognized as an illness. As a result, it continues to be under-diagnosed. There is no single cause for depression after childbirth. Physical, emotional, and lifestyle factors may all play a role. Unlike the “baby blues”, postpartum depression does not go away quickly. Very rarely, new moms develop something even more serious. They may stop eating, have trouble sleeping or develop insomnia, and become frantic or paranoid.

Postpartum depression affects 10-28% of new mothers. It can begin days, weeks, or months after delivery. Studies show that depressed mothers are less involved with their infant. They vending machine also shows signs of inconsistentcy in terms of how they respond to their infant. They can be loving and attentive one minute, and withdrawn the next. In addition to the signs mentioned, some other symptoms of postpartum depression may include:
Exhaustion
Excessive sleeping but still feeling exhausted
Loss of sexual interest
Crying spells without obvious cause
Feelings of guilt
Sadness
Anger
Feelings of despair and/or worthlessness
Forgetfulness
Difficulty making decisions
Poor concentration

Treatment for postpartum depression can be as varied as the symptoms. Some of the more common approaches to therapy or treatment include:
Creating a supportive environment for the mother
Self-Care
Joining a support groups
Counseling
Psychotherapy
Medication

More often, postpartum depression is not recognized or adequately treated because some normal post-pregnancy changes which cause similar symptoms in new mothers. Moreover, some women do not tell anyone vending machine their symptoms because they feel embarrassed, ashamed, or guilty about being depressed about their pregnancy and childbirth when the normal response would be that of elation or happiness.

Early detection and treatment of postpartum depression is critical not only for the mother but for the infant as well. It can also help if the father or another caregiver can assist in meeting the needs of the baby while the mom is depressed vending machine still recovering from depression. The less exposure the infant has to the mother’s depression, the lower the risk of long-term problems in the child.

Research shows that infants of depressed mothers are at increased risk of behavioral problems, emotional difficulties, and delays in growth and language development. If the mother’s depression is not treated promptly, the baby vending machine be greatly affected. Women with postpartum depression may feel like they are bad or inefficient mothers and might become increasingly reluctant to seek professional help. It is crucial to remember that hope and treatment are available to them. With a combination of proper medication and therapy, a woman can overcome postpartum depression and regain the ability to love and care for her newborn child.”

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A little something to make you start your day with a smile.

World Mental Health Day (October 10), is a day for global mental health education, awareness and advocacy. It was first celebrated in 1992 at the initiative of the World Federation for Mental Health, a global mental health organization with members and contacts in more than 150 countries.

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