Anxiety. Depression. Suicidal Thoughts.

Anxiety. Depression. Suicidal thoughts. They are all rolled up in one.

I am anxious about a lot of things these days. From something as mundane as sitting here typing on the computer to driving to cold calling a prospective client (which may never pan out because I’m too anxious to call right now). My anxiety has been debilitating in the past where I didn’t want to leave my home, and I fear it’s getting to the point of debilitation again on some days.

My anxiety depresses me. It keeps me from doing things that no one would think twice about. But here I sit, a prisoner in my own body, freaking out about nearly everything. To escape this, combined with my severe lethargy, I crawl into bed and sleep, hoping that when I wake up, things will be better. But they usually are not.

Please don’t get me wrong. I have a life many people would envy: a loving husband, a supportive family, and a steady job. I am thankful for the good things in my life. But this attitude of thankfulness and gratefulness doesn’t take away the depression inside of me.

I do not want to go back to the hospital. If I fear anything worse than death, it may be going back to a psych hospital. I have passing suicidal thoughts about hanging myself, but I haven’t been able to act upon it. I can’t determine whether I am a harm to myself in which case I would need to go to the hospital. The point of the hospital (for me) is to get me away from things that would cause immediate harm to myself. But I can’t be locked up in a hospital forever. (I guess I could in a state institution but that would be a nightmare.)

Somehow, existing in this jumbled mix is me. Somewhere inside, I am bubbly, wonderfully wacky, and beautifully strange. The depression and anxiety fuzz all of that. I am only some of what I used to be. I go to sleep, hoping for some kind of reprieve from this dark cloud that hangs over me.

Anxiety

I’ve experienced anxiety for the past two days unlike anything I’ve experienced before. I’m afraid to do anything significant which includes leaving my home. I’m afraid to drive, travel, and interact with people other than my husband and impersonal Internet communication. I’ve cried every day and every night since Sunday. As part of anxiety issues, I’m battling depression as well. I’m simply paralyzed by fear and afraid to venture beyond my home. I’m somewhat paranoid about being watched as well. And no, I’m not on medication.

I don’t know what to do. Anyone have any advice to offer?

Loose Screws Mental Health News

ReadWriteWeb reports Stony Brook University researchers discovered too much exposure to “texting, instant messaging, and social networking” can make teenage girls more likely to suffer from anxiety and depression. This landmark discovery sampled a whopping 83 teenage girls.

computer useThe results of their tests, recently published in The Journal of Adolescence, showed that the girls who excessively talked with their friends about their issues had significantly higher levels of depression. Today’s online tools provide even more ways for this to occur. Says Dr. Davila, “Texting, instant messaging and social networking make it very easy for adolescents to become even more anxious, which can lead to depression.”

The problem with these electronic tools du jour is that they allowed the girls to discuss the same problems over and over again. This caused them to get stuck obsessing over a particular emotional setback, unable to move forward.

–snip–

It’s not necessarily the medium through which the chatter tasks place that’s the issue – it’s the amount of discussion that leads to the feelings of depression. Said Dr. Davila, “[The girls] often don’t realize that excessive talking is actually making them feel worse.”

So we can conclude then that keeping your teenage daughter from MySpace, Facebook, Twitter, AIM, and texting will help improve her mental health so she’s less likely to be depressed. Back in the day, I just wrote morbid poetry in a sad, lonely marble notebook. Alas, those days are gone. (pic via reviews-for-you.com)

On a related note, another study has discovered that teens who watch TV for long periods of time are more likely to be depressed. (Does nearly everything cause an increased risk of depression these days?) The study tracked over 4,000 teenagers and their TV-watching habits. The conclusion? Seven years later, participants were more likely to be depressed and the risk increase with each hour of television exposure. Perhaps it’s because TV creates an unrealistic perception of how a person should look and act and how life should be. Although researchers of the study did note that exposure to electronic media yielded the same result.

PregnantOn the Christian tip, I need to once again dispel this nasty rumor that the MOTHERS Act is intent on drugging pregnant women (and thereby the baby) to oblivion. (I addressed this issue around this time last year once again from Christians who think some left-wing liberal nuts are out to “indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.”) Once again, I need to repost the goal of the MOTHERS Act as stated in the original bill:

To ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services, and to increase research at the National Institutes of Health on postpartum depression.

The legislation is only intended to increase the resources for screening of mental issues in women. Women will NOT be forced to take medication if they do not want it.

In the Congressional findings, medication is mentioned only as a form of treating PPD. That’s not directly encouraging new moms to take drugs; it’s encouraging them to seek treatment, whether it be therapy or some other course. Not every new mom will need therapy, hospitalization, or medication, and this bill is far from attempting to “indoctrinate” moms with psych drugs. Also, the bill only mentions “medication” once. It does not even use the word “drug.”

It’s unfortunate to hear stories of women who suffered miscarriages or acted erratically as a result of medication. However, postpartum depression has become such a prevalent issue that proper screening — not necessarily medication — is needed. And the mother in conjunction with her doctor must make an informed and appropriate decision on how to proceed with treating her mental health. A great resource on the MOTHERS Act can be found at Postpartum Progress where blogger Katherine Stone vigilantly monitors the progress of this bill and clearly lays out what the bill entails:

  • Encouraging Health and Human Services (HHS) to coordinate and continue research to expand the understanding of the causes of, and find treatments for, postpartum conditions.
  • Encouraging a National Public Awareness Campaign, to be administered by HHS, to increase awareness and knowledge of postpartum depression and psychosis.
  • Requiring the Secretary of HHS to conduct a study on the benefits of screening for postpartum depression and postpartum psychosis.
  • Creating a grant program to public or nonprofit private entities to deliver or enhance outpatient, inpatient and home-based health and support services, including case management and comprehensive treatment services for individuals with or at risk for postpartum conditions.  Activities may also include providing education about postpartum conditions to new mothers and their families, including symptoms, methods of coping with the illness, and treatment resources, in order to promote earlier diagnosis and treatment.

Although a vote on the act was blocked in the Senate in September, Sen. Robert Menendez of NJ has reintroduced the bill, championing the cause for PPD awareness at the federal level.

And on a humorous note, if you are single and mentally ill, you can go to TrueAcceptance.com and find someone who suffers from mental illness just like you. That’s right, TrueAcceptance matches the mentally ill with… the mentally ill. The premise is based on the idea that matching people who both suffer from mental illness are more likely to understand and support each other. The idea amuses me but I’d be too afraid that being with someone else who suffers from mental illness would end up being an enabler. (via Fox News)

Song of the Week: It's Going To Be Alright by Sara Groves

Another regular feature that I’ll try to do is post songs each week that really mean something to me and apply to my life during this week. One of my favorite artists is Sara Groves who writes so many songs that have helped me through different periods in my life.

This past week, I suffered from severe social anxiety on Tuesday and ended up having a panic attack. (I thought I was going to die; I couldn’t breathe!) My husband and I were on our way to counseling that night and Sara’s song “It’s Going To Be Alright” came on. I sang along with the song, fighting back tears the entire time. Finally my husband asks, “What does that song mean to you?” Immediately I burst into tears and told him I was fighting back tears, especially toward the end of the song where she urges the listener to “cast your cares.” That specific line is based on I Peter 5:7 where Peter writes, “Casting all your care upon Him, for He cares for you.” I’ve been really struggling with trusting God in the midst of all this, freaking out about what my coworkers think of me. I’ve been going through a “Are You There God? It’s Me, Margaret” phase. Where is God in the midst of my social anxiety? Where is he when I’m feeling alone and abandoned because my coworkers go out to lunch and don’t invite me? Where is God when I’m on the outskirts of forming close bonds with my coworkers just like they’ve formed close bonds with each other? Why am I the weirdo and the freak? What makes me so socially repulsive?

Then I hear Sara sing to me (it felt like it anyway), “I believe you’ll outlive this pain in you heart, and you’ll gain such a strength from what is tearing you apart” and those lyrics just GOT to me. It was as if God was speaking to me through the song and said, “Hey, it’ll be okay. I’m here for you and you’ll only get stronger from this situation. Marissa, you’ll be fine. It’ll be alright. Just talk to me. Tell me what you’re feeling. Tell me all about your pain. I’m here to listen and give you strength each day.” After feeling like God’s been like my dad for the past few years—not alive but up in the heavens somewhere, it’s like the silence was broken and He finally just communicated to me to turn to Him instead of running straight to my husband first. Talking to God is easier (and cheaper!) than talking to my husband.

Enough of the backstory. But now you know why I’ve chosen this particular song for Song of the Week. It seems like a good way to end the week on a good note. You can listen to the full song here. The lyrics are included below the cut.

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This Girl's Biblical View

Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God; and the peace of God, which surpasses all understanding, will guard your hearts and minds through Christ Jesus.
Philippians 4:6-7
(NKJV)

Personal interpretation
Don't worry about anything. Pray and ask God for your needs and desires, thanking Him for everything He's already given to you, and God will provide you with assurance—a kind of heavenly, unfathomable assurance—that will protect your heart and mind from constant worry and anxiety.

Personal meaning
While I know I shouldn't worry about anything, I still freak out over things and usually they're the littlest things. (See Don't Sweat the Small Stuff.) The verse encourages me to pray and beseech the Lord for help but I've got to admit, I often forget and try to do things on my own.

Personal application
The verse encourages me to really talk to God—to make God real in my life as though He were standing face to face with me. Just like I would talk to my mom and go, "Hey, Mom, I'm a little short on cash. Can you help me out today?" Well, not that irreverent but that's the idea. If I have a good relationship with my mom, I wouldn't sit in my bedroom, fretting and worrying about whether I should ask her for money or not—especially if I know she has the money she can spare me.

God wants to hear me talk to Him. And instead of opening my big mouth to Him, I start complaining about my worries and fears to other people. Voicing my concerns isn't so much a problem as ignoring that God can handle it is. And God's word promises that if I give my burdens over to Him (with faith in Jesus Christ), He will provide me with comfort and reassurance that He's got everything under control.

As I am wont to say: It sounds nice in theory. Maybe I should try testing it.

Mood rating: 5.7

Do antidepressants provide psychosomatic improvement?

Despite all the hype surrounding antidepressants and their effectiveness, the AP has reported on a new study from the University of Hull in Britain that says antidepressants only help severely depressed people and “work no better than placebos in many patients.”

The drugs used in the study: Prozac (fluoxetine), Effexor (venlafaxine), Paxil/Seroxat (paroxetine), and Serzone (nefazodone).

Irving Kirsch, who headed the study, said: “Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great. This means that depressed people can improve without chemical treatments.” (AP)

This is a pretty controversial finding considering the widespread use of antidepressants among those who have been diagnosed with clinical depression and other forms of mental illness, i.e. anxiety.

According the NIH, depression (the clinical term is major depressive disorder) affects an estimated 14.8 million American adults. CNN cites a study from the U.S. Centers for Disease Control and Prevention that says 2.4 billion drugs were prescribed in 2005; of those, 118 million were antidepressants. I can only imagine as “awareness” of depression increases, the number of prescribed antid’s has increased as well.

Adult use of antidepressants almost tripled between the periods 1988-1994 and 1999-2000.

Between 1995 and 2002, the most recent year for which statistics are available, the use of these drugs rose 48 percent, the CDC reported.

Many psychiatrists see this statistic as good news — a sign that finally Americans feel comfortable asking for help with psychiatric problems. (CNN)

CNN quoted Dr. Kelly Posner, an assistant professor at Columbia University College of Physicians and Surgeons in New York City, who said that “25 percent of adults will have a major depressive episode sometime in their life, as will 8 percent of adolescents.” If 25 percent of adults have a “major depressive episode,” does that mean that those 25 percent will require antidepressants as well? I’m concerned about the relatively high number for adolescents. I’m not a fan of throwing pills at growing children.

In light of the U of Hull study, the first course of treatment regarding depression should be non-medicated therapy of some kind. Whether it be “talk” therapy or cognitive behavior therapy, tackling depression really should first be treated with psychologic therapy. Posner says “25 percent of adults will have a major depressive episode.” Major depressive episode does not equal clinical depression or major depressive disorder, for that matter. A major depressive episode could mean anything: bereavement, loss of employment, or a difficult situation without an immediate resolution. I am strongly against prescribing antidepressants to help people cope with “normal” life events. People feel as though that their grief is too much to bear so they go to the doctor in the hopes that an antidepressant will help “dull” their emotions. I can only hope that a doctor will be able to differentiate between true clinical depression and a difficult situation that could be helped without the use of psychiatric medication.

P.S. I looked up Dr. Posner’s conflicts of interest and they were “TBD.” I would feel better had it listed “no conflicts of interest to disclose.”

Physical methods to beat stress

I received outpatient treatment for my "depression" in late September and late October/early November. I've gotten a ton of "ways to beat stress" things thrown my way and in digging through my e-mail (yes, I finally got to an e-mail from November – shocker!), I found the following. They're all pretty practical, but I laugh my butt off at the last one. (Apologies to those who still sleep with a stuffed animal.)

Physical methods to beat stress
There are over 101 ways to beat stress. These are just a few

1)      Ten breaths to peace sitting or standing slow deep breaths
2)      Giant yawn
3)      Aerobics
4)      Shoveling snow, mowing the lawn
5)      Walking
6)      Exercise
7)      People watching
8)      Dancing
9)      Cuddling with small children, or spouse
10)  Sewing or knitting, crocheting, embroidering, or any craft
11)  Go to a park
12)  Hot bath (bubble bath)
13)  Small planet on a dark night finds a place to look at the stars
14)  Counting from 99 to 1
15)  Speaking of, singing it  is therapeutic
16)  Journaling
17)   Cup of herbal  tea
18)  Steam bath
19)  Making things
20)  Gardening
21)  On tour of an old public library in your town
22)  Telephone  call a friend or relative
23)  Movie party  call several friends let  another friend organize the rides and popcorn
24)  Writing write your life history in the third person
25)  Write a letter to an old friend
26)  Bird watching   in the woods, park, or near water and watch birds
27)  Beat stress with animals  groom your dog or cat
28)  Wheels get on your bike and go or a ride
29)  Pucker up get yourself some bubble mix and blow some bubbles
30)  The way to their heart  bake some cookies for someone shut in, sick or grieving
31)  Visit a homeless shelter take them old magazines or books
32)  .Just one more, please  go out with a camera and take pictures of places or scenery
33)  Swing go to a park get on the swings
34)  Play  games with  children
35)  Clean someone else’s house
36)  Golf
37)  Tie-dye shirts do them for your whole family
38)  Go for a long drive in the country
39)  Read to a child, spouse, or elderly person
40)   Hug a stuff animal

Enjoy all that fun stuff.

Panic disorders relieved by talk and behavioral therapies

The NYT published a story on Feb. 6 about how talk therapy aids panic disorders.

The study seems interesting. The psych world is excited because of its promising results. The results do seem hopeful but give the sample size, it's too early to tell.

"A team of New York analysts published [in The American Journal of Psychiatry] the first scientifically rigorous study of a short-term variation of the therapy for panic disorder, a very common form of anxiety. The study was small, but the therapy proved to be surprisingly effective in a group of severely disabled people… The brand of therapy tested relies on core tenets of analysis, like the search for the underlying psychological meaning of symptoms. But unlike traditional psychoanalysis, it focused on relieving symptoms quickly, and was time-limited. Previous studies of similar approaches have shown some promise for other disorders, like depression."

Perhaps Dr. David H. Barlow, a psychologist at Boston University, had the best insight:

"[He] said… that the study was too small to be conclusive but that 'the authors should be congratulated for actually  taking the first step in doing the hard work of beginning to evaluate treatments” that are widely used without good supportive evidence.

The researchers tested a pared-down version of analysis tailored specifically for panic attacks, the breathless, paralyzing dread that strikes some 1 percent to 2 percent of people, seemingly out of nowhere. Previous studies had found that other kinds of therapy — including exposure techniques, in which people learn to diffuse their anxieties by facing them one small step at a time — can relieve panic attacks in half to two-thirds of patients, depending on the severity and type of anxiety."

The article doesn't mention where the estimated "some 1 percent to 2 percent of people" comes from so I'll probably do some digging around to find out how many people are estimated to suffer from anxiety disorders and panic attacks. It's also interesting to note that studies used a form of psychological behavioral therapy to help patients manage their symptoms.

"Half of the group received a form of relaxation training, in which they learned how to moderate their arousal by tensing and relaxing specific muscle groups. The other half received psychodynamic therapy, working with their therapist in two weekly sessions to understand the underlying meaning of their symptoms — when the reactions first started and how they might be linked to loss, broken relationships or childhood experiences that unconsciously haunted their current lives."

Relaxation techniques — don't Ativan and Klonopin achieve the same result except much faster?

"After 12 weeks, 39 percent of those working with relaxation techniques improved significantly on standard measures of anxiety and reported fewer panic-related problems in their relationships and work. But almost three-quarters of those receiving psychodynamic therapy reported similar benefits. "

Thirty-nine percent of 49 patients equals about 19 patients who "improved significantly." It's not brain science, but you've left with another 30 who didn't. However, nearly 75 percent of the sample size "reported similar benefits" from psychodynamic therapy. Perhaps it wasn't revealed in the American Journal or it's a shoddy article thrown together at the last minute, but I'd like to know what "similar benefits" the study is speaking of.

Also, isn't 12 weeks longer than most clinical trials funded by drug companies? Perhaps I'm thinking that's just the first phase of a clinical trial…?

"One former patient treated with this therapy began to have panic attacks after witnessing a young woman die of an illness, said her doctor, Fredric N. Busch, a Cornell psychiatrist and a co-author of the new study.

The patient, who was not a part of the study, described the death as deeply unfair, and in sessions explored perceptions of unfairness in her work and her life, including her childhood. “Once she was able to understand this pattern, the panic became less frightening, she felt safer and was eventually able to get rid of the symptoms,” Dr. Busch said."

I'm no doctor, but this sounds more like Post-Traumatic Stress Disorder. This example makes PTSD sound less like a mental illness and more like a behavior to be unlearned. Perhaps it's true? How do events "trigger" a mental illness? Is it inherited or can it be acquired? What a debatable topic. Oy.

"The researchers said that even if this approach was not for everyone, it appeared to be especially beneficial for a particular group. In an analysis of individual patient’s responses, the researchers found that those who also had a personality disorder, like avoidant personality, showed significantly greater improvement than those whose symptoms were related solely to anxiety. Patients with multiple diagnoses are usually more difficult to treat. "

It's nice to think that these techniques could replace anti-anxiety meds. But alas, they won't; Big Pharma wouldn't allow it. But a girl can dream, can't she?

(The boss won't let me skip lunch and leave early so… here are your updates…)

Mind Over Matter, Pt. 2

Perhaps I've written about this previously. Perhaps I haven't. Regardless, I'll tackle it anyway.

Some people with a mental illness who hear what I'm about to say will tell me I'm crazy. Perhaps I'd get "partially correct."

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Loose Screws Mental Health News

Canada.com reports that a Canadian mental health survey found that more than 75 percent of people diagnosed with clinical anxiety or depression experience a severe relapse during the winter months, namely December and January.

“Among the symptoms those people reported, more than half said they experienced ‘feelings of worthlessness,’ ‘inappropriate guilt’ and difficulty thinking or concentrating during the winter holiday season.”

The survey also found that decreased daylight hours and increased debt during the holiday season contribute to stress among those with chronic mental illness. At least the article didn’t say there was a spike in suicides…

Lorraine BraccoLorraine Bracco, known as Dr. Melfi on The Sopranos, has written a book about her struggle with clinical depression. She notes the difference between how she functioned before her depression hit and after. She cites Zoloft as the antidepressant that helped her overcome the hump and a mental realization that she needed to get help. She no longer uses antidepressants but she feels that the antidepressant got her to a place where she could find herself again, “I found my joie de vivre, my spirit, my voice.”

And finally, it’s time to be pissed off at Eli Lilly. Documents obtained by a mental health lawyer, given to The New York Times, show that Lilly execs tried to downplay the risk of obesity and hyperglycemia in Zyprexa. The two side effects can lead to a significantly increased risk for diabetes. Lilly material even included statements to sales reps telling them to downplay those risks when pitching the atypical antipsychotic to doctors. Zyprexa, Lilly’s best-selling drug, has been sold to 2 million people and has raked in $4.2 billion worldwide. The drug is primarily prescribed for schizophrenia and bipolar disorder. Of course, Lilly execs, aware that the side effects would keep patients away from the drug, downplayed the risks and even went so far as to say, “There is no scientific evidence establishing that Zyprexa causes diabetes.”

Lawsuits speaks differently, however. Lilly has agreed to pay $750 million to 8,000 people who claim that Zyprexa has caused them to develop diabetes or other medical problems. According to the Times, “thousands more suits against the company are pending.”

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Too Much Stress?

I usually get rid of the newsletters from my credit union because I find they don’t provide me with anything particularly helpful. There was one article that I found so helpful, though, that I had to clip it. Here it is:

Stress can be brought on by a sudden or major change in your life, your job, too much to do, or unexpected events. Ask yourself what fators are causing you stress and how you are currently dealing with it.

Here are ways to help relieve stress:

  • Peforming physical activity or writing can release tension and emotions
  • Talking about your feelings with a confidant may get to the root of your stress
  • Laugh and cry it out so it doesn’t build up
  • Manage your time more effectively
  • Massage your neck and shoulder to help relax the muscles
  • Do yoga or meditation
  • Engaging in muisc or humor therapy can brighten your mood

Remember to try and remain healthy by eating and drinking sensibly in times of stress. Having a strong social support system, managing your time, having an activity to release stress, and altering your thinking will consistently help to reduce and relieve stress.
Source: http://www.webmd.com

No life-shattering advice there, but the same things to relieve stress can also help alleviate mild to moderate depression.