The blog World of Psychology published an excellent post by Margarita Tartakovsky that examined an atrocious "editor's letter" that recently appeared in the chick mag Women's Health. The letter, by editor-in-chief Michele Promaulayko, was an abysmal failure in women's ongoing search for dignity in a world that demeans us at every turn. You can go over to World of Psychology to read the heinous text, then the five insightful criticisms of it made by Ms. Tartakovsky.

I cannot contain within myself a sixth criticism that was no doubt omitted only due to lack of space (really, a lot more than just five criticisms could have been made, but that would have required a whole series of blog posts). Ms. Promaulayko boasts, "We came up with a plan to help you look great naked—or in a barely there swimsuit."

Why exactly, Ms. Promaulayko, should women be so eager to parade around naked—or nearly so—in public? You did not say "nude," which implies a certain dignity in the natural human form—you said "naked," which is a much more sordidly suggestive word. Why should we do this? Because modern women should have no self-respect whatsoever? Because we should have no sense of modesty, nor view our bodies as temples? Is it because you feel it's important to women's health to manipulate and frustrate men (not to mention, the Catholic in me must add, tempt them to sin), or to to play petty games of intimidation with other women? Really, Ms. Promaulayko.

And no, the answer is not "it's encoded in our DNA."

National Anxiety and Depression week is over. This event is sponsored every year by Freedom From Fear, which has advocated for the mentally ill for 25 years.

Freedom From Fear was kind enough to send me a free kit to help me spread the word about clinical depression and anxiety disorders. The kit includes two DVDs:

"The Pain of Depression: A Journey through the Darkness"

"Stories of Hope and Courage" (about anxiety disorders)

I am giving these DVDs away FREE to my readers! I have seen "Pain of Depression" when it aired on PBS, but I haven't seen "Stories of Hope and Courage."

Here's how it works:

Leave a comment to this post. Share a story about how mental illness has affected your life or family, or just say hi. If you prefer one or the other DVD, make a note of that and I will try to accomodate you if you win. Make sure you include your e-mail address with your comment or leave a link to a page where I can find it. The deadline is Sunday, May 17th, at midnight CDT. One entry per person!

I will number the comments in the order they appear on the page, then use a random number generator to pick two winners, one for each DVD.

Good luck! I hope to hear from you.

So you think you or someone you love may suffer from an anxiety disorder or mood disorder. Now what? There is hope for you! You have many options:

• See your primary care doctor to make sure you are physically healthy and to ask for a referral for mental health care.
• If your employer (or spouse's employer) has an Employee Assistance Plan, call them.
• Ask your church. They may be able to refer you to someone who can help.
• If you have health insurance, call them or visit their website for covered behavioral health specialists.
• If none of the above will work, try Googling for community mental health services in your area. There are many groups offering help at reduced-cost and sliding-scale fees.
• If the person who is suffering is someone close to you, above all be there for them, and understand that their behavior is a symptom of a disease. Just as a person with muscular dystrophy has trouble walking, a person with, for example, depression has trouble doing even the simplest tasks, reaching out to others (though they may be desperately lonely), fulfilling their obligations, even getting out of bed (depression is also a sleep disorder).
  

Where can you turn for help in the meantime? Here are some recommended websites and books:

• PsychCentral, one of the best mental health websites on the web
• Blueprint for Hope, a website for people with depression
• Patients Like Me, an online community with areas for mood and anxiety disorders; also has online tools like mood logs, medication logs, etc.
• Feeling Good: The New Mood Therapy Revised and Updated, by David Burns
• An Unquiet Mind: A Memoir of Moods and Madness, by Kay Redfield Jamison, about her experience with bipolar disorder (the title is an understatement)
• Change Your Brain, Change Your Life: The Breakthrough Program for Conquering Anxiety, Depression, Obsessiveness, Anger, and Impulsiveness, by Daniel Amen; this book takes a brain-based approach but contains natural and alternative remedies as well
  

Last year, I wrote a post to clear up an assortment of depression and anxiety myths. Here are more myths about depression and bipolar disorder (also called manic-depressive illness), including children's depression and postpartum depression.

Myth: I'm not sad all the time, so it can't be depression.

Fact: To be diagnosed with clinical depression, you must have either dysphoria (sad, bad, or depressed mood) or anhedonia (loss of interest in activities or inability to feel pleasure). If experience anhedonia without sadness for two weeks or more, and have other symptoms such as sleep disturbance, fatigue, appetite disturbance, or an obsession with death, you may have depression. See my post "Have you experienced depression?" for a full list of depression symptoms. Or take this free depression screening from the excellent website Psych Central.

Myth: Children don't get depressed.

Fact: Children can and do get depressed, as do adolescents. Childhood depression is a serious illness that should not be ignored. Symptoms are similar to the symptoms of depression in adults, but children are more likely to have physical symptoms (such as stomachaches and headaches). Depressed children may talk about running away from home or attempt to do so; may do poorly in school; and become socially isolated. The American Academy of Childhood and Adolescent Psychiatry has more information on depression in children.

Myth: Only new mothers get postpartum depression.

Fact: The hormone changes that occur in a woman's body after childbirth are widely assumed by the public to be the only cause of postpartum depression. But the stress of a newborn, lack of sleep, and changes in family life and roles can all contribute to postpartum depression. It should be no surprise that these factors can contribute to depression in new fathers and new adoptive parents as well as in women who have given birth.

Myth: Mania, in bipolar disorder, is a feeling of extreme happiness.

Fact: Mania is much more than that — and often much less. More, because it also includes symptoms like hypersexuality, decreased need for sleep, grandiosity, delusions, hallucinations, constant rapid speech, "flight of ideas," and more. Less, because the mood, while high-energy, is not always euphoric. It can be angry, anxious, aggressive, or a mix of all of these. It can be extreme, or it can be milder (hypomania). It can last weeks, or it can last hours for rapid cyclers. Or it can be mixed with depression — a truly terrifying experience for everyone. Kay Redfield Jamison, a psychiatrist and author who suffers from bipolar I disorder, describes mania as "madness."

Image credit: "Self" by The Wandering Angel. (CC) Some rights reserved.

Anxiety disorders are widely misunderstood. Everybody feels anxious at times, but in an anxiety disorder, the feelings take over a person's life. Here are the facts about four common anxiety disorders.

Myth: Being worried all the time is not an actual illness. Everyone is anxious sometimes.

Fact: Everyone is worried sometimes, but it is not normal to be worried almost all the time. People who cannot shake irrational worries, who worry about things out of proportion to their importance, or who have a constant sense of "free-floating" anxiety may suffer from Generalized Anxiety Disorder, a common but very treatable anxiety disorder.

Myth: If you can't stand to step on cracks, are fussy about your things, or wash your hands a lot, you "are OCD" (have obsessive-compulsive disorder).

Fact: Obsessive-compulsive disorder is a debilitating illness that robs people of their time, often hours a day. It profoundly disrupts people's lives, activities, and relationships, and its sufferers might feel like prisoners to their obsessions (intrusive thoughts) and compulsions (actions they must do to get rid of the intrusive thoughts). Many people have quirky little compulsions like avoiding cracks or arranging their food "just so," but this should not be confused with true obsessive-compulsive disorder, which is many times more severe.

Myth: "Social anxiety disorder" is a made-up disorder. Lots of people are shy.

Fact: Shyness is not the same as social anxiety disorder. In this disorder, normal, everyday social situations cause extreme fear and self-consciousness, and sufferers often avoid these situations. The situations that are unbearable for sufferers of this disorder are things like making transactions with cashiers, eating in front of other people, talking to receptionists, and other unavoidable activities of everyday life.

Myth: Panic attacks are not a real illness, like a heart attack is.

Fact: The symptoms of a panic attack are very much like the symptoms of a heart attack and can include chest pains, choking, tingling in the extremities, difficulty breathing, and a sense of impending doom. Onset is sudden and may not have any apparent trigger.

Unlike a heart attack, a panic attack does not cause any long-term physical damage. But panic disorder, a condition in which the sufferer experiences recurrent and severe panic attacks, often does cause long-term damage, both psychological (phobias, depression) and physical (medical complications, substance abuse, suicide). People who suffer recurrent panic attacks should be encouraged to get treatment.

Read more information on panic disorder from the American Psychological Association.

It's that time of year again: National Anxiety and Depression Awareness Week is May 3-9, 2009. Some of last year's series of depression and anxiety posts turned out to be the most popular articles on this blog. This week will feature all new posts about mood and anxiety disorders.

Are you participating in National Anxiety and Depression Awareness Week? Bloggers, do you have blog posts in your archives about depression or anxiety? Leave a comment and I will give you a dofollow link.

A recent article in Maternal and Child Health Journal found the more culturally Americanized a pregnant Latina woman is, the more likely she is to be suffering from depression. Hispanic women who speak English or were born in the United States scored higher on the Center for Epidemiologic Studies Depression (CES-D) Scale.

Based on the abstract, this article's conclusion appears to be badly flawed. The problem is that the CES-D appears to be focused on measuring depression in people coming from American culture. Depression, curiously, appears different in Latino culture. Somatic (physical or physiological) symptoms are much more common, and may include headaches and stomach problems. The cultural place of women, in particular, may lead them to find it inappropriate to express opinions contrary to those held by people in authority over them, which "obviously may interfere with necessary self-disclosure," according to the Mental Health and Aging Website.

It is possible that in this study, Latinas who were less Americanized experienced depressive symptoms more as physical complaints and less as mental or psychic pain. They also may have felt inhibited from giving completely open responses on the questionnaire, even if they was kept confidential, if those responses might be in conflict to what authority figures (husbands, boyfriends, fathers) expected of them. Women who have internalized American cultural values to a greater extent would be more likely to have high scores on an American depression scale.

The abstract does not indicate whether these issues were addressed in the study. If not, it may show only the predictable result that Americanism leads to a specifically American experience of depression in pregnant Latinas.

Image credit: Maria & Michal Parzuchowski. Some rights reserved.

John Grohol, the primary author of Psych Central's blog World of Psychology, has an excellent post up listing ten myths of mental illness. Be sure to check it out!

For further reading:

• Depression and Anxiety Myths
  
• Depression Facts
  
• Anxiety Disorder Facts

When I was a child, our priest preached a sermon every year on how we are to pray. He illustrated his point with the absurd example of a robot programmed to recite a prayer over and over. "This," he explained, "is not prayer."

From this, my childish heart took away the lesson that for prayer to "count," I had to "mean" every word of it. And since it was tied to the forgiveness of my sins, I figured this went double for penance prayers said after confession. So I would sit for long periods in the pew, obsessing over my concentration on every single word of my three Hail Marys.

The importance of the moment of consecration as the climax of the Mass was also impressed on me, so I figured that it was critical to focus on it. To be distracted from it was surely a sin.

This was long before anyone -- least of all me -- knew that my mind is more distractible than the typical person's.

For those of us with attention-deficit/hyperactivity disorder (ADHD), perfect focus on prayer is simply not possible. (I don't know how possible it is for less distractible types, for that matter.) It is entirely natural for one's mind to drift right at the apical moment of consecration. I now think in different way about prayer.

• First, turn your mind and heart to God. This is the most important thing. God understands if your mind wanders; he created it that way. What is important is that your will chooses prayer even if your attention does not always obey.
  
• If you are reciting a prayer, consider its topic and theme first. Try to focus on that, rather than on the individual phrases.
  
• Use a physical object to focus your prayer, such as a Bible or rosary. The sensory feedback from holding it in your hands will help you focus. (Why do you think the string of beads used for the rosary has always been popular?)
  
• Likewise, praying with your body as well as your mind will help with focus. Kneel while praying. Or pray during physical activity -- I had some of my most fruitful meditations in college, when I would pray while walking to class.
  
• Pray unscripted, rather than reciting a prayer. A spontaneous conversation with God will occupy all your attention, and you can let it wander wherever it will. If you are new to this type of prayer, simply talk in your mind as if he is listening -- he certainly is.
  
• If you find yourself anxious about your mind wandering during the liturgy, relax and remember the words of the prayer said during the Mass immediately after the Lord's Prayer: Keep us free from sin, and protect us from all anxiety. Trust that if your mind and heart are turned to him, God will not blame you for human weakness.

For further reading:

• All About Catholic meditation
  
• Forum discussion on concentration during the rosary
  
• Centering Prayer: How not to pray
  
• Quietism heresy: What happens when you remove all distractions
  
• Protect Us From All Anxiety: Meditations For The Depressed, a book by William Burke

del.icio.us

I hereby hold Michael Medved accountable for his Townhall.com post on American DNA. Also hereby held accountable are the psychiatrists he cites, Peter Whybrow for his book American Mania: When More Is Not Enough and John Gartner for his book The Hypomanic Edge: The Link Between (A Little) Craziness and (A Lot of) Success in America. I have not read the books, but I have read Medved's article.

Gartner's thesis is that many historical American figures (he profiles nine of them) were "hypomanic." Apparently he is using this term apart from its usual meaning as a pathology of Bipolar II Disorder, redefining it as a personality trait that has lead to material success achieved by these men (yes, they are all men), who include Christopher Columbus, Andrew Carnegie, John Winthrop, Alexander Hamilton, David O. Selznick, and Craig Ventor. The reviewers indicate he has further defined this personality trait as uniquely American, which if correct, mars his book with a deplorable bit of nationalism. Analyzing the psyches of people long dead is always tricky business, even when one is not reinventing psychiatric terms and concepts.

Amazon.com was kind enough to let me view a page from the book, which describes Carnegie's passion for philanthropy (p. 164). You can't judge a book from a single page any more easily than by its cover, but it does seem a far reach to link philanthropy with mania. It would be interesting to see how Gartner justifies this thesis.

Whybrow's thesis troubles me more because, according to reviews, he generalizes it to the gene pool of the entire U.S. population. He links it to a particular allele in the dopamine reward system, which he asserts has a higher frequency in America than elsewhere due to self-selection. Specifically, he argues that individuals with this allele crave material rewards and are more inclined to seek them out actively than individuals without the allele. Since the immigrant ancestors of today's Americans presumably shared a desire to seek material success in the New World, Whybrow assumes they must have possessed this allele, which has been passed down to us. Further, he blames this allele for American materialism.

The speculation is interesting, and reminds me of Edward Hallowell's speculation that America's relatively high rate of ADHD is due to similar self-selection among immigrants. But leaping off this speculation and blaming America's cultural flaws on genetic heritage disturbs me. What about the materialism of Europe and Japan? I wonder if Whybrow has statistics as to the frequency of the allele in question in different world populations.

Curiously, Medved takes what Whybrow (judging from the reviews) considers a negative trait and recasts it as a positive one. It seems inevitable that racial politics would eventually come into a discussion like this, but I am surprised that it came from the usually-measured Medved himself. His same post also notes that African slaves did not have these (desirable, in his view) genes -- but tries to cover up this racist potshot by adding that there are a lot of African immigrants in America today, who presumably do share the gene. Nice try, Mr. Medved, but you can't make such an egregious statement "okay" by backpedaling.

Politicizing the issue even further, Medved's final argument is that a "welfare state" (right-wing-ese for a state with social programs to take care of its population) wouldn't work in America the way it does in Europe because Americans just don't have the genes for it. Now speculation has degenerated into virtual incoherence. Maybe Medved just has too much good old American hypomanic craziness to sound rational 100% of the time.

For further blog reading:

• Is Having Depression or Bipolar an Advantage? (World of Psychology)
  
• Is Bipolar Disorder a Dangerous Gift? (World of Psychology)
  
• "Once Diagnosed, Never Underdiagnosed", on whether bipolar disorder is a gift (Furious Seasons)
  
• Kenyan Runners and a non-genetic explanation for their dominance in running events (Gladwell.com)
  
• James Watson, six months later, still apologizing for remarks he denies having made about the inferior intelligence of Africans (Scientific American blog community)
  

del.icio.us

Here is a selection of titles for more information on depression and anxiety disorders.

	Dr. Edward Hallowell is a psychiatrist whose writing I admire highly. Amazon.com has this to say about his book Worry: "Illustrating his theories with the personal stories of and dialogues with clients, Hallowell provides a full picture of the ordinary yet chronic worry-problems." It also claims the author "emphasizes the physical, not the psychological aspect of worrying," which I take to mean that relaxation techniques are a major theme of the book. When Panic Attacks is written by a psychologist and focuses more on eliminating "stinking thinking." These are techniques proven effective by psychological research, not just psychobabble.
	Dr. Hallowell is also a loving father, and I trust his advice on helping children avoid the ravages of depression in later life. He recommends emphasizing optimism over achievement and confidence over competition. Biddulph is an Australian psychologist who appears to have a behavioral approach to teaching children to avoid the patterns that lead to anxiety and mood disorders, combined with an emphasis on family connections. Sounds like good medicine, since social connections can prevent adult mood disorders and cognitive-behavioral therapy is one of the most effective treatments ever devised.
	Depression affects everyone close to the person who is ill. It's important for family and close friends to keep their own mood and spirits healthy. This book provides advice not just on supporting the depressed person, but on holding him or her accountable and on keeping one's own self well.
	A general reference work on depression and other mental disorders. This is not a self-help books and does not promote an agenda; it merely provides information.

del.icio.us

The makers of Cymbalta, an antidepressant, have also made commercials. Without saying anything positive or negative about the drug, it must be said that the commercials capture the heart and pain of depression in a way that puts the filmmakers of Cannes and Sundance to shame. View the first twenty seconds or so of this commercial to feel what it is like to have this illness. Their previous ad was even better, but it could not be found online. (Have a link? Post it in a comment!)



What is it like to have depression?

There are people out there with depression. He knows it's something real. He knows it makes them sick. That's not what he has. He is not sick. He is just bad. There is something wrong with him; he is defective; and he tries not to think about it because it hurts, but he knows it is true. He is terrified to admit these feelings because he doesn't want to believe he is bad. But he knows it is true.

I was walking to my therapist appointment. It was fall, and the management at the office building had planted pansies in beds in front of the building. I saw those pansies because I was looking down. I almost never raised my head in those days. And what I felt was guilt, guilt over those pansies -- guilt because I had never planted my garden that summer, that there were weeds there. Oh, what a bad and worthless person I was, because of those pansies. And I had the presence of mind to know that this feeling was utterly irrational and unrealistic. And it didn't matter; I still felt the guilt. Even today I cannot see pansies without remembering that day.

Death becomes your constant companion. The depressed person dies an invisible death a thousand times a day. She knows she will die young; she knows it is inevitable. She feels it. Her mind wanders because depression makes it difficult to concentrate, and it wanders to the manner of her own death. If she is in the car, she know she will die soon in a gruesome accident. If she is walking down the street, she knows she will be murdered in a random killing. If she is at home, she knows she will die alone when a piece of furniture falls on her, and nobody will notice that she is gone until she has been dead for weeks. She is not afraid of it, but she is already grieving it.

My dream was short, because I slept only in short spurts, and woke up four or five times a night. It was a mercy that this dream was short. The bedroom door was closed, and a river of blood began to flow under the door into the bedroom. In the river of blood were the severed heads of babies. Sleep was my refuge from pain, but sometimes it betrayed me.

She knows she is destroying her family. She knows she is causing pain for her husband and devastating her children. She knows they would be better off without her. She knows her suicide is the second worst thing that can happen to them, but the thing that would be worse would be her continued presence. She is held back only by knowing that the life insurance won't pay out for her suicide in the first two years, so she has to wait six more months. Her husband doesn't even realize that she has just six months to live if they don't find a successful treatment.

That is what it is like to have depression.




del.icio.us

No illness, not even AIDS, is subject to more myths and misconceptions than mental illnesses. Here are some common myths about depression and anxiety.

Myth: Depression is a chemical imbalance in the brain.
Fact: Certain neurotransmitters, particularly serotonin, norepinephrine, and dopamine, are thought to play a role in depression. However, depression is more than a chemical imbalance. It has psychological factors as well. Depression may have multiple causes, and biological factors may be more important in some people than in others.

Myth: Depression can be cured by taking an antidepressant.
Fact: Some depressed people respond very well to drug therapy. Some people may respond better to some medications than to others. In terms of numbers, psychotherapy (particularly cognitive-behavioral therapy) is just as effective as medication, and the most effective treatment is a combination of both. However, in some cases, depression is resistant to both types of treatment.

Myth: People who seek psychotherapy are weak, selfish, or stupid.
Fact: Depression and anxiety are real, persistent, chronic illnesses with physical as well as emotional and cognitive symptoms. They are recognized as diseases by professionals worldwide, and they have affected people from the beginning of time. They are found in all cultures, all age groups, and all levels of intelligence. People seeking psychotherapy for depression and/or anxiety are suffering from real illness.

Myth: People with severe depression and/or anxiety aren't really disabled.
Fact: Symptoms of depression and anxiety disorders include difficulty concentrating, insomnia, and extreme fatigue. Depressed people may suffer from a severe lack of motivation that is like being "frozen" or "paralyzed." People with anxiety disorders may experience headaches and/or a racing heart. People with panic disorder and social phobias may not even be able to leave their homes, and people with obsessive-compulsive disorder may lose hours every day to their compulsions. All of these symptoms are disabling, and in fact the Social Security Administration recognizes depression and anxiety disorders as valid causes of disability.

Myth: Post-traumatic stress disorder is a normal reaction to extreme situations such as life-threatening experiences or combat.
Fact: PTSD is a common reaction to these experiences, but not a normal reaction.

Myth: Suicidal talk and suicide attempts are just attention-seeking behavior.
Fact: It is never, ever normal for a person to talk about committing suicide, certainly not just to get attention. All talk about suicide should be taken seriously. Suicidal talk and suicide attmepts are a sign that a person's life is in grave danger. Professional help should always be sought when a person's talk or actions turn to suicide, even if they don't seem serious. Everything about suicide is serious.




del.icio.us

What are the symptoms of depression? How do you know if you have it? The DSM-IV-TR, known as the "Bible" of clinical psychology, defines a major depressive episode as having one or both of the following, lasting at least two weeks:

1. Sad, down, or "empty" mood, lasting almost all day, almost every day (dysphoria)
   
2. Loss of interest in activities you once enjoyed (anhedonia)

Other symptoms may include the following:

1. Changes in appetite (either increased appetite or loss of appetite) and/or sudden changes in weight
   
2. Sleep disturbances, particularly insomnia, early waking, or oversleeping
   
3. Physical symptoms such as digestive trouble, headaches, or backaches that do not respond to conventional medical treatment
   
4. Lack of motivation, which in severe cases may be experienced as "paralysis of the will"
   
5. Difficulty concentrating, remembering, or making decisions
   
6. Psychomotor agitation or retardation -- that is, a "speeding up" or "slowing down" of one's movements, observed by others
   
7. Irritability or restlessness
   
8. Low self-esteem and/or feelings of worthlessness, helplessness, guilt, or hopelessness
   
9. Social withdrawal
   
10. Fatigue, loss of energy, feeling run down or sluggish
    
11. Death or suicidal ideation -- that is, thoughts of one's own death, the death of others, or of taking one's own life
    
12. Suicide attempts

Major depressive disorder is diagnosed when a major depressive episode as described above is experienced without a history of mania or hypomania. If there is a history of mania or hypomania, a bipolar disorder is diagnosed.
Symptoms of mania include the following. Hypomania includes the same symptoms but is less severe than full mania.

1. Racing thoughts or "flight of ideas"
   
2. Extremely decreased need for sleep -- this is different from insomnia in that the person does not even seem to need sleep
   
3. Extremely high, happy, and euphoric mood, or a very intense and active bad (dysphoric) mood, perhaps rageful or anxious
   
4. Abnormally high energy levels
   
5. Grandiosity
   
6. Distractability, impulsiveness, and risk-taking, typically greater than what is seen in attention-deficit hyperactivity disorder (ADHD)
   
7. Pressured speech -- meaning that the person talks very fast as if there is a torrent of words pent up and the dam is bursting. A manic person with pressured speech is several steps of intensity beyond, for example, an auctioneer's calling
   
8. Hypersexuality

Take the Quick Depression Screening Quiz at Psych Central. Remember this is only a screening and cannot diagnose depression or any other illness. If you have a positive screening, it's recommended that you seek appropriate help, preferably from a psychologist or psychiatrist, or failing that, from your general physician.




del.icio.us

Anxiety in small doses is healthy, but it can grow out of control, causing significant suffering and disability. A number of different disorders result from anxiety gone awry.

Generalized Anxiety Disoder (GAD) is exaggerated worry about everything or nothing that is present most of the time. People with GAD worry about health, finances, career, family, etc. -- even when there is no sign of trouble. GAD is out-of-control anxiety that is greater than the normal anxiety that everyone experiences. Its prevalence of about 2.8% in the U.S.

Obsessive-Compulsive Disorder (OCD) disables by stealing time from its victims. It starts with obsessions, or intrusive worries, which can only be mitigated by engaging in compulsions, or rituals that soothe the worries. An obsessive-compulsive person may, for instance, worry that the stove was left on and have to go check it -- over and over again. People suffering from OCD know that their obsessions and compulsions are irrational but are helpless to resist them. Common themes in OCD include a need to check on things, worries about contamination, a need for symmetry or neatness, and a need to count things.

Phobias are extreme, irrational fears that are grossly out of proportion to the thing that is feared. Many phobias involve things that were dangerous in our ancestors' world, such as spiders and snakes. A mentally healthy person may fear snakes, but a phobic person may literally be affected all day by just hearing a conversation about snakes. (Sorry if you are snake-phobic and reading this!) Social phobia, also called social anxiety, is a particularly disabling phobia. Social phobia is far more than shyness; those suffering from it feel they are being constantly watched and judged by others and are petrified of being embarrassed or humiliated, to the point that it interferes with their daily lives. Its prevalence is a whopping 3.7% in the U.S. (that's over 10 million people).

Panic disorder involves recurrent panic attacks that have no apparent cause. In a panic attack, a person may sweat, have a racing heart, have trouble breathing, and may feel out of control. Some people describe panic attacks as feeling like things are "crashing down" on them, or as if they are dying. In fact, a panic attack may be mistaken for a heart attack. Fear of having a panic attack in public may lead to a person becoming homebound, a condition called agoraphobia.

Post-traumatic stress disorder (PTSD) is an abnormal reaction to a life-threatening situation such as a physical or sexual assault, an accident, a disaster, or military combat. It is important to note that the trauma is completely subjective -- PTSD can be triggered by an event that does not appear serious to outsiders, as long as the person experiencing it felt intensely threatened. Symptoms include flashbacks (ranging from dreams to waking hallucinations), hypervigilance, dissociation (a feeling of disembodiment or unreality), sleep trouble, depression and anxiety, feelings of guilt, and irritability. Physical symptoms are common too, such as headaches, digestive problems, chest pain, and immune system problems. Substance abuse is very common in those with untreated PTSD.

Sources and more information

• GAD, OCD, social anxiety, panic disorder, and PTSD (Freedom From Fear)

Don't miss any posts in this series. Subscribe now!




del.icio.us

This is National Anxiety and Depression Awareness Week, sponsored by Freedom From Fear, an American mental illness advocacy group. All this week, I will be posting about depression.

Facts about depression:

• Depression is an illness that affects one's body, mood, and thinking. It typically has real physical symptoms in addition to emotional and cognitive symptoms.
  
• It is not the same as a "blue mood" and you can't just "snap out of it." It's not an attitude problem, a sign of weakness, or a result of self-absorption.
  
• Women are twice as likely to be affected as men, and the overall prevalence in the United States is about 6-7%. That translates to some 20 million Americans experiencing some form of depression in any given year.
  
• Depression appears in several forms. Major depression is profoundly disabling, with symptoms lasting at least two weeks. Dysthymia is less severe but lasts for years, and may be more resistant to treatment. Bipolar disorders, also called manic-depressive illness, are characterized by fluctuations between depression and extremely high mood (mania and hypomania), and require very different treatment from so-called "unipolar" depressions (major depression and dysthymia).
  
• Depression very frequently occurs along with other illnesses and disorders, ranging from chronic medical conditions such as HIV and diabetes, to substance abuse and other mental health disorders.
  
• Depression can affect people in all age groups, including young children and the elderly.
  
• Up to 15% of depressed people die of the disease via suicide. In addition, people suffering from depression are at higher risk of other medical illnesses.
  
• Depression is one of the most treatable mental disorders. Most people can be helped by either psychotherapy or medication, or a combination of both.

del.icio.us

National Anxiety and Depression Awareness Week falls from May 4-10 in 2008. All next week, I will be posting about these illnesses, including facts, myth-busting, and personal stories. If you would like to share a personal story, e-mail me (check my profile for the e-mail address). You can leave your story anonymously if you like, or you can do a guest post.




del.icio.us

A new drug called Riobant (rimonabant) has been developed to help people lose weight. Users lose an average of ten pounds more over a year than people using a placebo. Story here.

The drug is an "endocannabinoid receptor antagonist," which is another way of saying that it's reverse marijuana. Apparently you lose weight because you get the anti-munchies.

Think for a second what else marijuana does, though: It makes you feel happy. So would reverse marijuana make you sad? Turns out the answer is yes. Users of rimonabant reported a high incidence of depression, anxiety, and insomnia compared to the placebo group.

Normally, a doctor and/or patient would weigh the risks of a drug against its potential benefits. Obesity is a risk factor for deadly diseases such as heart disease, so on the surface it would seem rimonabant might be worth the risk for obese people with unhealthy arteries. Unfortunately, weight loss associated with rimonabant does not improve coronary artery health.

So in my opinion, this drug should not be approved. "Psychiatric side effects" are a huge deal. Depression is one of the leading causes of disability in the U.S. The benefit of slight weight loss (less than a pound a month, remember) does not outweigh the risk of these unwanted effects, if the weight loss has only cosmetic impact.

Anybody disagree? Would losing weight, but not improving health, be worth depression, anxiety, and insomnia?

It's a common theme on Star Trek: The Next Generation: Commander Data, the android who aspires to be human, is baffled by a phenomenon of psychology that we take for granted. In at least one episode he wonders about "intuition" -- what, exactly, is it?

We all know what it is — intuitively. But how might one describe it to an android? Or to an anthropologist on Mars? How about this:

Intuition is the phenomenon of unconsciously synthesizing available data with memory and experience to arrive at a conclusion.

I wonder and ponder* about intuition a lot because we dynamic attention types† are said to be intuitive. (I would say that is true about myself, although it's an observation based on intuition, so I don't have a list of concrete examples.) I suppose the idea is that because our attention is constantly shifting, we have a much larger pool of available data, memory, and experience to go on, compared to static attention types.‡

I have an intuitive approach to both science and faith, which may explain why I find it so natural to integrate the two.

What do you think about intuition? How would you define it? What would you give examples of it for the edification of androids?

*Side observation -- those words don't rhyme even though they look as if they should.
†A term I invented to refer to those of us with the poorly-named condition "attention-deficit hyperactivity disorder".
‡My term again, for people variously called called normal, neurotypical, and farmers.