INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

Category: Anxiety & Panic

Awakening to the wonderment of nature

Epilogue to COVID-19

The U.S. and all the other countries of the world lost the cherished and innocent beliefs of individuality, separateness, and independence.

There was no security from a devastating infectious pathogen, quickly crossing permeable national boundaries. The self-conceived bubble of safety and autonomy had burst into the reality of living in a global interconnected population. The impact of one individual potentially effects the health and wellbeing of all on the planet.

If you prefer to listen, a podcast version is available as you go to the full post article.

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Planet in a hand with ocean and a butterfly

Pandemic LifeSavers

To ensure a safe journey through the present hazardous times of the COVID-19 pandemic, make wise choices.

Be vigilant to protect yourself and others from one of the most virulent and destructive viruses of the century. Keep tuned to the latest news and recommendation from reputable sources, but be careful to avoid any politically motivated misinformation. The COVID-19 infections and spread will continue until effective anti-viral drugs, vaccines, adequate testing, and contact tracing are available.

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fear and anxiety in a senior women

Pandemic Fear and Anxiety

Recognition and management of fear and anxiety are essential to maintain healthy emotions and mood. Cascading anxiety can contribute to emotional collapse and severe depression.

Fear can paralyze a person with a loss of productivity, effectiveness, and quality of life. Unchecked fear with worry can build to loss of confidence, insecurity, and significant emotional states like anxiety, panic, and depression. Today’s unique atmosphere of a viral COVID-19 pandemic is overwhelming for many. Our nation is experiencing a collapsing economy, with the devastating effect of an enormous number of people dying from the viral illness.

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COVID-19 graphic concept of viral attack

Coronavirus Anxiety

The Coronavirus (COVID-19) rapid spread and potential for severe respiratory illness and death, for the most vulnerable, has dramatically increased anxiety.

The current crisis calls for an understanding of anxiety states, getting help for severe anxiety, preventing the emotional overload, making a poor decision, viral spread, and vulnerability to infection.

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Sunrise amidst the clouds

Autism Spectrum Trait Recognition

Autism spectrum traits or characteristics (AST)

are common in our population and may contribute to unique advantages or disadvantages. There now is better recognition and awareness of autistic traits. Current scientific evidence supports that there is a predominant genetic origin of AST.

© Artem Oleshko/123 RF.com, Unique Talents

Autism Spectrum refers to the varied presentation of individuals that may have unique strengths but also challenges with difficulties in social skills, communication, motor coordination, repetitious movements or behaviors, and early-life developmental issues.

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Promise of Light on other side of a Wood Bridge of wood bridge in deep forest crossing water stream and glowing light at the end of wooden ways; Copyright: khunaspix / 123RF Stock Photo

Expert Mentoring – A Key to Restoring Mental & Emotional Health

Escalating mental health, emotional or related health issues may signal the need for mentoring or guidance.

When help is needed, it can be difficult to find the outside expert support you need. Developing your own personal self as a resource can also be a challenge.

A person in distress often recognizes that their customary coping mechanism and level of support are inadequate. The dependence on learned ways of dealing with adverse life events often does not help for an overload of stressors and emotional turmoil. The experience for some is like being entrapped in a swirl of thoughts, painful emotions and images. Before distress reaches too high a level, is the time to reach out to others for help and guidance.

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Meditation, mindfulness, happiness - zen garden with massage stones and waterlily

Meditation – Mental Health Essential

Meditation, Mindfulness, or Introspective Practices

have well proven their value in holistic mental health work for mood, anxiety, addiction, and health issues. Meditation can be an essential tool for happiness and mental health. Enhancement of longevity and decrease in brain aging has also been demonstrated as an added benefit. In many other areas, there are proven benefits as in work, school, athletic performance, sleep, and creativity. The mere awareness in meditation – that thoughts and emotion are of a changing and transient nature – is enlightening for those felt imprisoned by harsh negative thoughts and emotions.

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Spiritual Emergence, Recovery

Neuroplasticity – Recovery & Transformation

post 0716 pasque-flower-edited

Recovery and Transformation are often felt to be impossible for individuals with addictions or mental health problem as depression, anxiety, Post-Traumatic Stress Disorder, and other stress or painful conditions.

There is new hope with the advances in neuroplasticity, neuroscience and its technology to identify, modify or change neuro-circuitry, behavior, responses and reactions. Progress in better understandings of the psychology of the human mind and behavior have contributed to greater success in overcoming what was known previously, which in the past was considered hopeless and beyond the reach of those who had been affected by unrelenting, disabling conditions. The study of other healing methods and traditions, as the 12-Step-Programs for addictions, also has led to more successful integrative treatment programs.

As in the first two steps of 12-Step-Programs, for addiction recovery, there must first be the acceptance of the disease as such, and realization of the impossibility of recovery without profound change. Pursuing treatment on a superficial level for an addiction or any other persistent or chronic illness often fails, such as making limited attempts to make cosmetic changes in one personal way, learned habits, or in the expectation that medication will help. To the person afflicted, life has become unmanageable, and the individual “me” admits to being powerless to make the deep changes needed for recovery. The nature of the illness often has led to feeling hopeless, helpless and powerlessness.

The reason for repeated failures or relapses is that a person unsuccessfully tries to use what was learned from earlier life as:

  • non-effective coping
  • use of manipulation and attempts to control others and the environment
  • efforts to rebuild failing relationships to fulfill unmet needs for nurturance, love, and acceptance
  • repeated ineffective efforts to feel sufficient, empowered and adequate

To recover and transform, one has to get beyond ego, personality, habits, reactions, and behaviors.

If there comes a realization of the powerlessness to change the existing status quo, the opportunity exists to embrace the insight that there are the greater potentiality and possibilities beyond a person’s individual ways and self-identity. When one can’t find any viable alternatives from the repertoire of prior failed actions and behaviors – one has “hit the wall” or “rock bottom” – survival is threatened, the need to tap into a greater “well of resourcefulness” hopefully becomes apparent. After running out of the “customary” choices for survival, there has to be a willingness to let go of the old and embrace options out of the larger sphere of positive possibilities – turning one’s life over to a “higher power.”

The idea for acceptance of a higher power is confusing to some that come to 12-Step-Programs, who may associate this with earlier life negative religious experiences or associations with an abusive authoritarian or dominating figure, especially if there has been traumatic abuse. Gaining flexibility to explore and invest in behaviors or practices to bring about recovery and transformation is what is needed. When stuck in an inflexible state of a rigid self, one needs to shift from an unproductive personal belief about power and control existing in the limitation of individual development and programming since birth, to the realization that there is much more: a greater potentiality, a higher resource beyond the personal limitations and rigid entrapments.

One of the barriers to change relates to deep held core beliefs of:

  1. not being safe
  2. not being loved
  3. not being enough
  4. not being worthy – burdened with guilt and shame

Arriving at a place of great despair, a “dark night of the soul,” there is a need of letting go of the established, old limiting “ego identity.” Embracing spiritual attunement becomes the only viable option, with an acceptance that there is a greater field of possibilities and potentialities, where love, acceptance, and inclusion prevail. Embracing the essence of being – the higher power – allows for profound empowerment and motivation for the steps required for transformation – restoration of “sanity” as identified in the 2nd of the 12 Steps.

Spiritual emergence

is the experience of personal awakening, beyond the constriction and restriction, set by the trained and programmed part of the mind (the ego) – to a higher level of perception, realization, and functioning. A new developing integrative addiction treatment program in Asheville, NC – Center for Spiritual Emergence (see their website) – describes spiritual emergence as a “natural opening and awakening that many people experience as a result of coming to terms with the difficulties of life, through an established faith tradition, as a result of systematic spiritual practices or through unexpected peak experiences.  Spiritual emergences gently allow one to experience and embrace their natural connection to the transcendent domain, forever changing their limiting self-concepts into a more integrative, awakened self”.

Psychoneuroplasticity (PNP)

as presented by Lawlis in his well-done book – Psychoneuroplasticity Protocols for Addictions (Lawlis et al. 2015) is portrayed as an evidence-based science with restorative, rehabilitation, and transformational tools and applications. PNP is founded on post 0716 edit mindset-developments in neuroscience, neural therapies, rehabilitation medicine, addiction and other integrative approaches to mental health treatments.  Though the book focuses on evidence-based treatment approaches for addiction, it is very applicable to the care of other mental health issues and problems and supports the value of integrative approaches and therapies. Brain plasticity is based on the understanding of brain activity, neuronal circuitry, and the ability for the stimulation, modification, retraining, and growth of nerve cells and their complex networks.

Positive brain plasticity can be helpful in many problematic areas as:

  • cognitive processing, worries, physical pain, migraines
  • emotions, depression, anger, reactiveness, stress
  • anxiety, fear, phobias, obsessiveness, distractibility
  • alertness, focus, arousal, ADHD, brain fog, fatigue
  • PTSD, sleep disturbance, addictions, cravings, over-weight

To set the stage for healing, recovery, transformation, and neuroplasticity, any difficulties in above noted areas, may need to be addressed early on. Several are discussed in greater detail below.

Anxiety and fear

can be a disabling condition and a major interference with life and productivity and can act as a barrier to recovery from other mental health condition, including addictions and other health problems. The following can contribute to anxiety or panic like conditions:

  1. unmanaged stress
  2. prior life losses and trauma
  3. lack of adequate parenting or an early life nurturing environment
  4. adverse effects from medication and drugs
  5. life-threatening physical illness

Resulting impairment can become chronic with only temporary relief, if any, from drugs or use of substances that could be harmful to one’s health and well-being. Studies of brain waves often will show high-frequency beta waves in localized regions of the brain suggesting increased activation and the need to retrain and repair the brain’s neural networks to more relaxed frequencies and a healthier state. Mental health professionals sometimes will label people as having other mental health conditions or personality disorders, like borderline personality disorders, because they have not been able to grow and mature emotionally. The behaviors and personality may be related to earlier life abuse, persistent severe anxiety, and feelings of being overwhelmed – resulting in resistance or the inability to resolve severe chronic anxiety that blocks healthy development around their families, social network, and peers.

Traumatic life events

can lead to post-traumatic stress disorder (PTSD), which can either be of a simple type where there has only been one major traumatic event or complex where there have been multiple accumulative traumas. A person’s life development can get stuck in a time-relation to an earlier trauma. Integrative type treatment protocols and therapies focusing on treatment of  trauma, as those presented by Lawlis (Lawlis et al. 2015) have the potential to bring relief by relieving the emotional connection to trauma memories and supporting positive brain changes and plasticity . The use of neurofeedback type treatments as the BAUD (bioacoustical utilization device) can disrupt the reconsolidation of traumatic memory and has been shown to relieve symptoms of PTSD (RESET Therapy). Relaxation or stress-reducing therapies, music, meditation practices, breathing techniques, nutritional diet, neuro-biofeedback and skill development can be a part of neuroplasticity enhancing protocols. Other sensory or trauma-focused therapies as EMDR, are also utilized to form new and healthy neuro-circuitry and response patterns.

Depression

can interfere with recovery and be due a multitude of factors including:

  • response to negative life events, chronic stress, trauma, and losses
  • low self-esteem
  • genetics, nutritional deficiencies, and medical illness
  • toxic environmental exposure including to drugs and alcohol

With depression there may be associated: ruminations and obsessional thought, as seen in OCD (Obsessive Compulsive Disorder); anxiety; loss of productivity; feelings of loss of control; loss of interest in things; a downward spiral of increasing depression and development of suicidal thinking, which can lead to loss of life or complication with other medical illness. If suicidal thinking occurs, immediate help should be sought from mental health professionals.

The brain, if studied with EEG brain wave studies in identified areas of the brain, will show a pattern of under activation and low voltage waves. Neuroplasticity focused protocols look for healthy interventions to bring these areas of the nervous system back online and restore responsive feelings, energy, joy and happiness without the individual resorting to using potentially dangerous drugs or chemicals. Intervention may include therapies as noted above including:

  • neurofeedback or neuro-therapies, BAUD
  • psychotherapies including trauma-focused therapies as EMDR
  • exercise, nutritional diet, supplements
  • sound, rhythm, aroma, movement, and dance therapy
  • mindful meditation, breathing techniques
  • social network development with active peer support
  • coping, relapse prevention, and social skill development

Cyclic patterns of disturbed emotions and behavior

can interfere with recovery. These can present as periods of irritability, rage, heightened anxiety, obsessiveness, sleep disturbance, periods of dramatic increase in activity and hyper focus alternating with times of fatigue, depression, loss of motivation and loss of interest in things. These patterns are sometimes labeled as being in the Bipolar Spectrum (see Dr. Parks article) but can also be related to PTSD and prior accumulative trauma. Many of the above-noted treatments and others are considerations to correct altered behavioral pattern, skill deficits, dysfunctional brain patterns, and neuro-circuitry.

Consider broader integrative or neuroplasticity related approaches if you or a loved one has difficulties with any the above-discussed symptoms or conditions. Seek out competent and well-trained health care practitioners trained in these areas.

Written by Ron Parks, MD, edited by Shan Parks

Question:

What symptoms or conditions do you or a significant other have that may be helped by one of the above-discussed approaches? I would be interested in your comments or opinions. Please respond below.

Best Treatment For Panic and Anxiety

Prevent and reduce the frequency and severity of anxiety and panic.

A high percentage of panic attack suffers receiving appropriate treatment will be able to prevent and substantially reduce the frequency and severity of panic episodes. Cognitive behavioral type of treatments is often beneficial. This approach can help retrain and recondition an individual to reduce stress and anxiety. Therapy of this type may include:

  1.  intensive education about the disorder and of the body’s physiological reaction to stress and threat
  2. desensitization to the various physical sensations or triggers of panic through exposing a person to the actual object, situation or thought
  3. catastrophic thought reducing techniques
  4. learning relaxation, proper breathing to prevent hyperventilation and stress management techniques
  5. restructuring dysfunctional thoughts and patterns

Any contributing problems would need attention as:

  • substance abuse and the use or overuse of stimulants (drugs, caffeine and smoking)
  • post trauma or depression
  • environmental problems
  • allergies or reactivity to chemical and toxins

Evaluation, treatment or elimination of any related problems or contributing factors would be the first consideration. Natural alternatives and therapies can then be considered as:

  • mind, body or spiritual practices as yoga and meditation
  • stress and relaxation techniques
  • massage
  • acupuncture
  • herbal medicine, nutrition, vitamins, minerals, essential fatty acids and hormones can complement more traditional treatments
  • correcting deficiencies of amino acids (the smallest units of protein and the precursors of brain neurotransmitters) can sometimes be helpful in relieving anxiety – can be used alone or sometimes in conjunction with medication

If any history of severe depression or suicidal thought seek mental health services and a qualified therapist or psychiatrist. If there is a history of trauma or post traumatic stress disorder symptoms, some specific therapies may be helpful: Cognitive Processing Therapy or Prolonged Exposure Therapy, EMDR (Eye Movement Desensitization and Reprocessing), EFT (Emotion Freedom Technique) and Somatic Experiencing Therapy.  If evaluation or monitored treatment is needed for any of these issues, seek help from a qualified, holistic oriented, health care practitioner. (read more on complementary treatments)  (read more on PTSD)  (About Integrative Psychiatry, Medicine & Holistic Therapies)

 Medication may be of value in resistant or severe panic disorder.

women panic sizeAntidepressants as Paxil, Zoloft, Effexor, Prozac, MAO-Inhibitors, and tranquilizers as Buspar, Xanax, or Klonopin are used and sometimes bring more immediate relief. However, their long-term use is controversial with the concern for their possible cause of other medical issues and also because the withdrawal from them can be difficult. They may not have the same lasting effect as the retraining and reconditioning that takes place with the cognitive behavioral type of treatment, appropriate therapy work and the use of natural alternatives.

Try some of the following techniques to help calm the body and mind.

If not helpful or you recognize the need for skilled or professional help — seek a holistic oriented health care provider with expertise and training in the area of anxiety, panic and mood disorder treatment.

Stop all stimulants like caffeine or stimulant drugs • Notice and let go of fear-based thoughts and worries from the past or concerns for the future • Change your physical space: move to a quiet room or just adjust your posture to a more comfortable position or find a more cozy place to sit or lie down • Turn on some soft, pleasurable music • Notice and shift your attention to comfortable, physical sensations, passing through your awareness • Be aware of your breath: see if you can relax it into an even flow of in and out breaths • Center yourself: think of your whole-self as being enveloped in a loving warm cloud • Imagine a favorite place or moment that reminds you of peacefulness, warmth and total acceptance • allow yourself to accept “what is as is” including yourself in the timeless now moment • Feel completeness and contentment.

Meditate: Focus on the quietness and peacefulness of your breathing • carry yourself into deeper relaxation by releasing your mind from any remaining fears or concerns, or any feeling of mind or physical tension • keep a relaxed focus on any tension or thoughts that come up and let them go • coming back to the peacefulness of the eternal now • after a few moments take a few deep breaths and slowly open your eyes if closed • give a gentle stretch, and feel the peacefulness and relaxation • gently return to your daily tasks as a renewed spirit.

Take a yoga, chi gong, meditation class, and have a regular routine of exercise to do daily • Go outside and embrace nature • Do something caring or helpful for someone else • Drink calming herbal tea like chamomile • Take a relaxing herbal supplement like Valerian root, passionflower or amino acids such as Taurine, L-Theonine, or GABA • Add magnesium and calcium to your supplement regime • Take a warm bath or sauna • Get or give a massage • Call a supportive or nurturing friend • join or establish a supportive group or network • Go out and do some volunteer work or work in the garden • Spend time with a loving pet • Read a spiritual or inspiring book or poem • Eat some healthy organic vegetables or fruit • Take care of yourself!

If any of above discussion about anxiety or panic seems to apply to you or family member, and you are concerned, reach out for help, and get the support and direction you need. (a resource ADAA)  (Consultations)

Article by Ron Parks, MD and edited by Shan Parks September 2015

Question:

What is your next step to help yourself or others who seemed troubled with anxiety or panic??

Help for Anxiety and Panic

Has anxiety and panic attacks compromised your life?

Peace of mind and personal happiness may elude sufferers who deal with significant anxiety or panic attacks. You may discover that you are one of the many who find these issues replacing life plans, career, social and personal needs with pain and fear. Then you watch a TV commercial, hear a radio advertisement or read ads offering products, pills and all types of remedies for relief. Amidst all this, how do you sensibly choose the best way to get help or relief?

Barbara* a 30-year-old radiology technician, walking to her bus stop after work, was startled by an unexpected, overwhelming feeling of terror and panic. She felt flushed, lightheaded and dizzy. There was a weird sensation of chest constriction and difficulty breathing. Her heart raced and pounded in her chest. Thoughts of dying, losing control, or of going crazy flashed through her mind. With each wave of fear, her heart began to pound even louder. Her hands now felt sweaty, numb and tingling. There was a sense of unreality about things. A friend, noticing her distress, approached, and helped her to a bench near the bus stop. Over the next 5 to 10 minutes the feelings gradually subsided. Feeling some relief, but still shaky, her friend helped her to the nearby hospital emergency room. *(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).

 Barbara had just suffered a panic attack – a type of severe anxiety.

Unlike the brief and mild anxiety caused by a stressful event, the more severe anxiety disorders are serious medical illnesses. These affect approximately 40 million adults, 18% of the population, age 18 years and older — one in four adults in the U.S., at least once during their lifetime. Anxiety disorders cost the U.S. more than $42 billion a year, about one-third of the country’s $148 billion mental health budget. An estimated 75% of people with an anxiety disorder have at least one other accompanying psychiatric condition. See: http://www.adaa.org/about-adaa/press-room/facts-statistics

These disorders cause overwhelming, even debilitating, anxiety and fear that can become worse if not treated. Less than 30% of individual with these problems seek treatment, and many go undiagnosed by their primary care physicians. Common signs and symptoms of anxiety include muscle tension, trembling, fast heartbeat, fast or troubled breathing, dizziness or impaired concentration, palpitations, sweating, fatigue, irritability, and sleep disturbances.

Panic disorder, a type of severe anxiety, is estimated to affect over two million adult Americans, and is twice as common in women then in men. The lifetime prevalence of panic disorder in the U.S. ranges from 1.5% to 3.5%.  Symptoms of a panic attack include feelings of terror that suddenly strikes.  An episode can occur as a one-time event only or can repeatedly happen, triggered by something remembered or appear without warning — out of the blue.  Panic can cause waking at night; a pounding or racing heart; sweaty, nausea, numbness, tingling, weakness, faint or dizzy feeling. There can also be a sense of unreality; chest pain; fear of impending doom, of going crazy, of losing control; and avoidance of going to certain places. See: Advances in the Treatment of Anxiety Disorders

Panic attacks are both unique and common.

Pannic Attack - the Words in White Color on Cloud of Red Words on Orange Background.

As many as 20% of American’s are affected at least once in their lifetime. Considered one of the most distressing conditions that a person can experience, early recognition and proper treatment are important. Many of the symptoms reported by Barbara above are typical of panic attacks and are considered to be major health problem in the U.S..

Panic is different from fear and other types of anxiety – as panic attacks are unexpected. They are often unprovoked, appear suddenly and increase in intensity over a 5 to 10 minute period, peaks and then rapidly goes away over 20-30 minute period. These episodes can be disabling. One explanation for the cause of the panic disorder is the bodies normal alarm system of mental and physical responses to an actual threat, which triggers and activates to a non-actual threat. Panic increases in severity by hyperventilation or focusing on catastrophic thoughts or fears.

Panic disorder – as in most types of anxiety – affects women more than men, often begins in the 20’s and 30’s, and appears to be more common in some families. Sometimes an initial episode might be related to some identified causal or contributing factors:

  • Actual or transient medical problem as a middle ear infection, allergies, mitral valve prolapse (often a mild dysfunction of this heart valve closure), hyperthyroidism, low blood sugar
  • Earlier life history of significant trauma or post-traumatic stress disorder
  • Medications use or withdrawal, stimulant or substance use, or abuse (caffeine, alcohol, opiates, etc.) in a predisposed person who is vulnerable to panic attacks
  • Life events involving major stress, losses, threats of loss or the feelings of increase vulnerability may precede attacks

The panic disorder once rooted can become recurrent and chronically disabling.

If the panic attack occurs in a specific setting, as in a store or car, irrational fears or phobias about these situations, may occur. If a person begins to avoid these situations, he (or she) can become increasingly housebound, unable to drive and develop agoraphobia (fear of public place) in addition to the panic attacks. If the person doesn’t receive effective early treatment, major incapacitation may develop.

Panic disorder mimics many other medical conditions, and it is not unusual for the sufferer to be seen by a multitude of other medical or health-related services before receiving appropriate treatment. They will often go through extensive testing at great cost. The reassurance that “nothing is wrong that’s serious,” or “it’s all in your head,” doesn’t help. Medical personnel – not familiar with the potential ravaging effect and disability caused by the illness – often treat panic disorder lightly. Treatment of panic is often done with a mild tranquilizer or just reassurance. Dr. Weissman and Associates on November 2, 1989, New England Journal of Medicine, clearly point out the need for concern.  Compared with other psychiatric condition, untreated panic disorder has an increased risk of suicidal ideation. There is an almost three-fold increase in actual suicide attempts, independent of coexistence of major depression, alcohol or drug abuse or agoraphobia.

Recovery starts with the person deciding to seek help, treatment and a more life-affirming path. Hindrances that may need attention early on could include:

  1. Medical illness
  2. Developmental impairments
  3. Dysfunctional patterns of behavior
  4. Rigid beliefs
  5. Lack of social support.

Change happens with:

  • Willingness for self-examination without blaming or taking the victim’s role
  • A commitment to positive action and to the beneficial treatments that are available
  • Gaining awareness and opening up to new knowledge
  • Becoming a more discerning consumer of health information and available care
  • Developing the motivation to take effective action for necessary changes

For more information see:

Holistic approaches to anxiety and panic may include a combination of:

  1. Combination of conventional medications
  2. Lifestyle modifications and life skill education
  3. Alternative holistic treatments
  4. Targeted nutritional applications
  5. Psychotherapeutic interventions
  6. Enhancement of awareness and spiritual practice

Through an integrative approach, individuals can gain direction, move past the immobilization of misinformation and erroneous beliefs, and find possible solutions for their adverse health conditions.

Click here for more information;   Another Resource to read; 
For support: Anxiety and Depression Association of America, ADAA

Article by Ron Parks, MD and edited by Shan Parks September 2015

Question:

What is your next step to help yourself or others that seemed troubled with anxiety or panic?  See next post — “Best Treatment of Panic and Anxiety?”

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