INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

Tag: Disability

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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Pampas Grass in natural setting

Bipolar Holistic Treatment – Part 2

A Holistic integrative approach to the study and treatment of Bipolar Illness — BPI (also referred to as Bipolar or Manic-Depressive Disorder) offers a better path to disease understanding, treatment and prevention. See prior post “Holistic Approach to Bipolar Illness”.

Ben is not doing well with his bipolar illness.

Ben* is on several medications prescribed by his psychiatrist and has just come back from a recent psychiatric hospitalization for his bipolar disorder. He had been hospitalized after he had an emergency room visit for a suicide attempt, after he had taken an overdose of his medications. Prior to that, he had progressively worsening depression with feelings of hopelessness, helplessness and had lost interest in almost everything. He felt that there was no help for him as his mood cycling illness was only getting worse – even with all the medications he was taking. The medications made him feel like a “Zombie.” He was sleeping less with frequent violent nightmares that had woken him up multiple times during the night. He had periods of severe depressed mood when he would stay in bed for most of the day. He would have then have some days of feeling relatively fine.  He then would experience periods of feeling – super “hyped-up” –  full of energy with little need for sleep, talkative with racing thoughts, craving sex and food all the time, feeling like he was a famous rock star, and spending huge amounts of money on things he really didn’t need. He had lost all of his recent jobs and was now divorced from his second wife.

In addition to his regular psychiatrist, his family encouraged him to see and work with a holistic, integrative health care practitioner and therapist. It was uncovered that he also had a significant alcohol problem (as did his bipolar and alcoholic mother), a history of severe early life trauma – probably PTSD, severe gluten sensitivity, and autoimmune thyroid disease with thyroid imbalance. When he was directed to specific treatment and therapy programs for his bipolar illness, his PTSD, alcoholism, nutritional problems and thyroid disease; he was then able to work closer with his regular psychiatrist.  His medications were reduced, and for the first time he began to sleep better with less mood cycling. His new therapy work also helped him to identify and work through some painful childhood issues. He also felt that he regained his spiritual connection.

*(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).

Finding a better model for helping BPI.

A broader open health-care model offers the potential for improved research, diagnosis and treatment of BPI. All disciplines can be included in an integrative model – including biochemistry, nutrition, psycho-pharmacology, psychiatry,  genetics, spirituality, psychology, sociology, physiology, endocrinology, environmental medicine and complementary mind/body/spiritual therapies. Effective outcomes can happen with patience, and the commitment to finding a suitable care and treatment program.

Early recognition, comprehensive assessment and an integrative approach to treatment – including natural therapies – can help bipolar sufferers improve their chances of stabilization, improvement in relationships, and productivity and work. As proper assessment and diagnosis can be of critical importance, seeking out skilled and experienced health-care practitioners is important – such as a psychologist, a psychiatrist, and/or a holistically oriented health-care provider who is trained in mental health work.  People with bipolar illness are sometimes misdiagnosed as having just depression or other conditions – and treated as such – often resulting in a poor treatment outcome.  These individuals would have responded better to a broader holistic and integrative type of treatment program that had benefited Ben’s recovery as described above.

Every individual is unique in their treatment needs.

Woman with Bipolar Disorder
©Sangolrl/Dollar Photo Club—Balancing Act.

Any individual who has difficulties with mood changes is unique regarding their treatment needs.  BPI can be influenced by factors as:

  • a person background
  • earlier life experiences, exposures or trauma
  • current lifestyle, nutrition, environment
  • individual medical issues, genetics
  • personality
  • psychological or addiction issues
  • traumatic brain injury

A person’s capacity to grow in awareness, learning, and to succeed with lifestyle changes will influence the choices and success of any selected treatment. As there are many individual differences as well as variation in the type and severity of bipolar conditions, the needs and type of treatment will vary or differ from person to person.

Natural non-medication approaches

Some of the non-medication or more natural approaches would be:

  1. improving lifestyle, nutrition, exercise and sleep
  2. addressing environmental issues
  3. stress management
  4. individual or group psychotherapy
  5. avoidance of alcohol and substance abuse
  6. education, behavioral, family, cognitive or trauma therapy
  7. other complementary mind-body-spiritual oriented programs.

Other complementary practices or therapies would be:

  • relaxation training, yoga
  • Oriental Medicine, acupuncture
  • religious, meditation and spiritual practices
  • regular exercise and sleep
  • use of fish oil, rich in EPA and DHA – has been shown to complement other treatments of BPI.

There is a body of work suggesting that nutrition and certain dietary programs can help in treatment of mood disorder, as a diet:

  1. high in healthy fats
  2. high in vegetables, rich in minerals and anti-oxidants
  3. adequate in good quality protein
  4. low in sugar and starches
  5. that avoids gluten (found in wheat, rye and barely — felt to be a trigger in some people for inflammation and auto-immune diseases). (see Grain Brain)

Specially designed light boxes, if carefully used under the guidance of an experienced health-care provider, are sometimes useful (especially if there is a seasonal component to the depression and mood cycling). Assessment and correction for any nutritional, metabolic, hormonal (as thyroid deficiencies), allergic or environmental problems need to be considered.

A genetic biochemical problem that can be improved with nutrition, called hypomethylation is worth assessing – as there is evidence that it affects the expression of bipolar symptoms – and if treated can bring benefits and improve outcomes. Methylation is also relevant to drug-nutrient interaction in the treatment of BPI and is one of possible underlying factors that can contribute to medications not working effectively. (see  “Bipolar Disorder” by Vinitsky and Parks, Advancing Medicine with Food and Nutrients, 2nd edition, Chapter 32, Dec. 2012, CRC Press)

Medication considerations

Some of the conditions or consideration for medication interventions and treatment are:

  • worsening of BPI with poor response to non-medication approaches
  • development of thought or cognitive impairment such as psychotic symptoms with delusion, hallucination or dangerous behavior, especially when accompanied by poor judgment and risk of self or other harm
  • actual or imminent need for a safe protective environment — psychiatric hospitalization
  • lack of capacity or willingness to follow non-medication treatment regimens or protocols
  • personal choosing of medication treatment over non-medications (after being fully educated about all options, including therapy programs or natural alternatives – other than medications) about risk of using medication vs. not taking them, potential for adverse immediate or long-term risks, or side effects from medication

According to some studies, those with bipolar disorder – not treated with appropriate medication or a mood-stabilizing agent when needed – have a significant increase risk of a more chronic condition, more frequent relapses of the illness and more severe outcomes – as suicide*.  More than 50 percent of people will abuse drugs or alcohol if the disorder is not recognized or treated.

Concerns about medication and risk:

  1. potential for short term, long term, or potential side effects: including weight gain, diabetes, metabolic problems, high blood pressure, heart disease, abnormal restlessness and/or involuntary movement disorders of face, mouth and limb (mostly a risk with anti-psychotic medication and possibly from some of the antidepressants)
  2. potential for making mood cycling worse or triggering more severe episodes of mania or psychosis.

So it is important for the individual to be educated about the use medication, benefits and risk – weighing the potential benefits of medication being helpful – especially in a well designed comprehensive treatment program – vs. risks of medication use and side effects.

There are several classes of medications considered when felt necessary in BPI, including:

  1. Anti-depressants: as citalopram and sertraline, which are selective serotonin re-uptake inhibitors – SSRIs that increase the amount chemical nerve factors (neurotransmitters) that helps relieve depression
  2. Anxiolytics (anxiety reducing medication) such as: benzodiazepines such as clonazepam and lorazepam that support the neurotransmitter GABA which helps relieve anxiety
  3. Mood Stabilizers as lithium, valproate and lamotrigine that helps to balance and stabilize brain activity and neurotransmitters (active brain chemicals) which sometimes have an antidepressant effect – as lamotrigine
  4. Antipsychotic Medication as: aripiprazole, risperidone, and lurasidone: helps to eliminate or reduce psychotic thoughts, which is abnormal or disturbed thinking as delusions and hallucination, helpful in reducing agitation, helpful with mood stabilization and sometimes helpful in reducing depression; read more: nimh.nih.gov/health

Fantastic sunset
©Allk Mullkov/Dollar Photo Club—Beauty in Nature.

Appreciating the many facets of BPI, the varied presentation and potential for adverse impact on people’s lives underscores the importance of early recognition, thorough assessment, and initiation of comprehensive and holistic/integrative treatment as outlined above. Effective treatment of BPI sufferers can potentially bring a return to a more stable, functional, fulfilling and productive life.

*If you or some one you know is thinking about self harm or suicide, seek help immediately (Call your doctor, 911 or go to a hospital ER, or Call the 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

Article by Ron Parks, MD; edited by Shan Parks

For additional help and resources check below links:

(psych.com/guides)

(dbsalliance.org/)

(NIMH on Bipolar Disorder)

(adaa.org/)

Question:

What would be your consideration and options if you feel that you or a significant other has difficulty with a bipolar illness? I would be interested in your comments.

Lost in Jungle with light ahead

Holistic Approach to Bipolar Illness – Part 1

BPI (Bipolar illness),

often referred to as bipolar disorder or manic depression, affects more than 2.2 million people in the United States. BPI is characterized by bouts of illness with significant often disabling symptoms, alternating with periods of less or no symptoms. These may be a sign of the disorder: unusual shifts in mood, energy or the ability to function.

What is happening to Sarah?*

conflicted young women
©Aleutle/Dollar Photo Club–Conflicted young women.

Because of the insistence of her family and one of her ex-husbands, Sarah had been to several mental health evaluations. She had been married and divorced four times and in and out of many jobs. She had an early life history of trauma: at age 14, she was sexually abused by her divorced mother’s live-in boyfriend; at age 15, she was raped when at a party. She occasionally had nightmares about the incidences and had triggered flashbacks, or panic like attacks, when she smelled certain odors or sounds reminiscent of her rape. She had made several suicidal attempts during recurring periods of severe depression. Hospitalization was required two times when her doctors considered her to be a danger to herself. Her mother and one aunt had a history of bipolar illness. Sarah never had any severe period of mood activation or mania, though one of her treating psychiatrist thought she had periods of what he called hypomania (milder periods of mood, behavior activation or changes). Her diagnosis was Bipolar II type of BPI and PTSD (Post Traumatic Stress Disorder). Her best response to treatment finally came when she received appropriate treatments and therapy for both BPI and PTSD, and when she also sought out the help of a holistically oriented health care provider who encouraged her to follow a more optimal health, nutritional, spiritual lifestyle program.
*(To protect confidentiality, the above is a composite of some clinical experiences and does not represent an actual person or any prior patients).

Sarah’s family and significant others began to pay attention and to take action when her once normal ups and downs of everyday life began to get more dramatic, extreme and destructive.  If you, a family member, or someone you know shows unusual shifts in mood and energy with uncharacteristic behaviors, it may be an early sign of bipolar illness (BPI).

Getting evaluation and treatment when needed.

Evaluation by a trained professional such as a psychologist or psychiatrist should be considered when changes in moods are severe, persistent, and interfering with daily life.  Identify BPI early in its course and treat with a comprehensive, holistic treatment program. If not, the illness can have devastating effects on relationships, careers and health – as was the case of Sarah.

Recurrence of bipolar episodes with depression, anxiety, mania or hypomania has adverse effects on family, social and occupational functioning. BPI disrupts many normal day to day activities in areas as:

  • social functioning and relationships
  • work and productivity
  • sleep and physical health

Recognize bipolar illness in all its forms.

The illness can lead to impaired thinking (cognition), poor judgments, increased distractibility (poor focus), dysphoria (painful moods) and physical discomfort with increased preoccupations with health problems. There can be compromised functioning as with:

  1. more impulsive or volatile behavior and expression
  2. loss of interest, pleasure and motivation in doing things
  3. suicidal thinking.

BPI’s early appearance is often not recognized by significant others or by health-care providers.  A key feature that separates the illness from recurring depression is the occurrence of hypomania or a more severe manic episode.  A manic episode is a period of elevated, expansive or irritable moods, and increase goal-directed activity or energy – often lasting for at least a week – which is a characteristic of the more severe bipolar I type of BPI.

Image of a conflicted brain
©Sangolrl/Dollar Photo Club—conflicted mind.

Other commonly associated symptoms may include:

  • inflated self-esteem or grandiosity
  • decreased need to sleep
  • more talkative than usual or pressure to keep talking
  • flight of ideas or the experience of racing thoughts
  • distractibility
  • increase goal-directed activity
  • excessive involvement in high risk activities
  • marked impairment in social and work functioning
  • sometimes need for hospitalization (if potential for harm to self or others and/or the presence of poor judgement and thought disturbance – psychotic symptoms)

In Bipolar I disorder, the manic episode may have been preceded or followed by hypomania or major depressive episodes. Milder “hypomanic” episodes can have:

  1. a persistent elevated, expansive or irritable mood
  2. signs of sharpened and overly active thinking (hyper-focused)
  3. increased energy and activity that last for at least four consecutive days (present for most of the day – nearly every day)

This “hypomania” alternates with frequent periods of depression and are typical of the less dramatic bipolar II type of the bipolar illness. Recurrent depression is characteristic of both conditions, and the depth of the depression usually determines overall severity.

Both bipolar I and bipolar II types of BPI can be both severe and disabling. Bipolar I disorder more specifically describes a sufferer who has experienced distinct periods of severe depression or hypomania, alternating with at least one episode of severe activation or mania. Bipolar II disorder, by definition, has not had any manic episode.  If mania later presents in bipolar II individuals, this results in reclassification to Bipolar I type of BPI.

Symptoms of Bipolar II have a similarity to those seen in Bipolar I but are often milder, less severe, or more subtle as:

  1. inflated self-esteem or grandiosity
  2. decreased need for sleep
  3. more talkative than usual or pressure to keep talking
  4. flight of ideas or racing thoughts
  5. distractibility
  6. agitation
  7. increase in goal directed, hyper-focused activity (school, work, socially or sexually)

Some subtler bipolar I or bipolar II conditions, at any given time, can present with milder and more difficult to recognize symptoms as irritability, anxiety, and moodiness – alternating with periods of less pronounced depression. Another classification, for the entire range of BPI in its varying expression, is — bipolar spectrum illness —  which would include even the less recognizable forms of recurrent depression with milder periods of activation, hypomania and less dramatic symptoms.

For clear description and definition of BPI, go to the current American Psychiatric Association — the official nomenclature that has been codified and defined in the DSM-5 (published by American Psychiatric Publishing).

What is the cause of bipolar illness and who is affected?

Bipolar illness is considered an inherited condition related to instability in brain neurotransmitters (nerve chemicals) regulation, which leads to greater vulnerability to emotional or physical stress, over-stimulation, upsetting life experiences, drug or alcohol use, and interference with rest and sleep.  The brain is not able to properly calm or activate itself, or restore its usual healthy balance.

Research studies strongly support inherited genetic factors as important contributors to BPI. First-degree relatives of people with BPI are seven times more likely to develop bipolar I type of BPI. Environmental factors (epigenetic factors) are also suspected to affect bipolar illness — physical factors (as radiation or trauma), chemical factors (as pesticides, toxic metals, and air pollution) and biologic influences (as bacteria, mold, viruses).

Lifetime prevalence estimates are 1% for bipolar I disorder — BP 1 type of BPI, 1.1% for bipolar II disorder (BP 2 type of BPI), and 2.4% to 4.7% for sub-threshold BPI (a person is not meeting the full symptom criteria for BP 1 or BP 2). Age of onset range from childhood to the  mid-20s and later, and BPI onset is unusual after age 40. Recurrence of active BPI over a five year period is very common – with the associate in between times of no symptoms, minor symptoms, or with significant residual symptoms. (see  “Bipolar Disorder” by Vinitsky and Parks, Advancing Medicine with Food and Nutrients, 2nd edition, Chapter 32, Dec. 2012, CRC Press)

When can depression actually be bipolar illness?

Recurrent depression is often bipolar illness unrecognized. Additional clues to underlying BPI include:

  • poor response to treatment for depression
  • manic or psychotic symptoms
  • rapid mood fluctuations triggered by antidepressants
  • family history of bipolar illness
  • onset or recurrent depression before the 20s
  • severe premenstrual syndrome, PMS, or premenstrual dysphoria syndrome (PMDS)
  • postpartum depression
  • atypical depression with a lot of irritability, sleep disturbance and anxiety.

At its worst, BPI can lead to higher mortality from suicide and other co-occurring medical illnesses. Among psychiatric disorders, BPI has a significant risk of death from suicide. The risk in bipolar 2 type of BPI for suicide is greater than bipolar 1 type of BPI – according to some studies. Unrecognized co-occurrence of BPI, with other mental or physical illness, can lead to ineffectual treatment and poor outcomes. Six months after suffering a myocardial infarction, victims with major depression – commonly seen in BPI – had six times the mortality rate of non-depressed patients. Presentation of BPI in the older population, greater than 50 years, will often have other medical problems at the time of diagnoses – including cognitive changes. More than 50 percent of people will abuse drugs or alcohol if BPI is not recognized and treated.

Bipolar illness can be overlooked or misdiagnosed resulting in inadequate treatment.

People with this disorder are sometimes misdiagnosed as having just depression, and treated as such, often resulting in a poor treatment outcome.  These individuals would respond better to a bipolar illness focused treatment program. (see for more information)

A holistic or integrative approach to the study and treatment of BPI offers a better path to disease understanding, treatment and prevention of future illness.

Sunset on tropical beach
©Slttltap/Dollar Photo Club—Harmony on a tropical beach.

With a broader open health-care model, there is the potential for improved research, diagnosis and treatment of BPI. All disciplines can be included in an integrative model – including biochemistry; psycho-pharmacology; toxicology; genetics; spirituality; psychology; physiology; endocrinology; sociology; and nutritional, metabolic, environmental, psychiatric medicine and complementary mind/body/spiritual therapies. Effective outcomes can happen with patience and commitment to finding a suitable care and treatment program as occurred with Sarah – as described above.

(For support and assistance consider below sites):

(psych.com/guides)

(dbsalliance.org/)

(NIMH on Bipolar Disorder)

(adaa.org/)

Part 2 of this topic: “Holistic Treatment of Bipolar Illness.”

Article by Ron Parks, MD and edited by Shan Parks

Question:

What would be your first consideration, if you or a significant other is developing signs of bipolar illness? I would like to hear your comments.

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?”

Helping Focus, Attention & ADHD

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Improper recognition or misdiagnosing of Attention/Focus Problems (AFP) and ADHD (Attention-deficit Hyperactivity Disorder also referred to as ADD) can lead to severe adult problems as:

  • Severe job compromise or loss
  • Interference with relationships and family life
  • Loss of self-esteem
  • Development of mental and physical health problems
  • Not getting things done
  • Discrimination in the workplace
  • Substance abuse
  • Disability

Marge* had gone to an ADHD specialist as she was losing her business and marriage. She couldn’t focus or attend to things and felt very scattered. She took a stimulant medication but developed disabling anxiety, panic and depression with suicidal thoughts.  She switched her care to a more attentive holistic practitioner. Their work together revealed recent significant trauma. Six months before the onset of her problems, she was assaulted after leaving her place of business. Soon after, she developed severe problems with attention, focus and symptoms of post-traumatic stress syndrome (PTSD). Also, it was found that she had a severe iron deficiency anemia and early signs of thyroid disease. She stopped her stimulant medication, started a PTSD therapy program and started treatment for her other medical issues. Her symptoms rapidly responded to treatment, and now her attention and focus are back to normal. Her business and marriage are now again successful.
* (To protect confidentiality, the above is a composite of many clinical experiences and does not represent an actual person or any prior patients.)

Having attention/focus problems (AFP) and ADHD difficulties can be problematic when an individual finds himself (or herself — gender assumed) in an adverse work or life situation. Examples would be: not being able to relate to others effectively, unable to get work done or meet the demands for performance and productivity.  Ill health can develop from being chronically overextended, not getting adequate sleep or from continued stress from the AFP.

There is often discrimination against people with AFP and ADHD in work, academic and social situations; however, attention problems in all forms are common in our population. ADHD, when diagnosed, allows for a workplace or school accommodations under ADA laws (American Disability Act).  Many with attention/focus (including ADHD) problems, if minor, would not be considered significantly impaired or disabled, even though they might struggle to remain focused or attentive at times . When in a positive fit with their life situation and operating within their capacity, many with AFP are some of our most creative, talented and productive citizens.

How do you recognize AFP and ADHD?

There are many conditions that can masquerade and significantly contribute to attention/focus problems or the actual condition of ADHD.  Information gathering and a holistic consultation can be helpful, especially when there hasn’t been a good response to simple or conventional treatments.

A significant percentage of childhood and adolescent with AFP or ADHD will continue to have symptoms and problems into adulthood. The inattentive type of symptoms seem to be the most prevalent ones in adulthood – as difficulties with organizing, sustaining

© lculig / Dollar Photo Club "ADHD Attention Words"
© lculig / Dollar Photo Club ” Words”

attention, distraction, finishing tasks, procrastination, losing things, forgetfulness and making mistakes.

In adults with AFP and ADHD, symptoms as internal restlessness, substance abuse may be common. Less likely symptoms of hyperactivity, difficulties with decision making and poor impulse control could also, though less likely, be present. In Childhood and Adolescent, one would more likely see difficulties with fidgeting, feeling settled, relaxing quietly, talking excessively, intruding into the conversation, blurting out answers, or running & climbing dangerously. See the following links for further information: ADDA, Adult ADD Univ. of Maryland questionnaire and Web MD.

A holistic approach to AFP or ADHD is important especially when:
  • other safer and more natural approaches may be available
  • medication are use ahead of careful examination for other causes or contributing factors
  • marked improvement is possible when other causes or contributing factors are addressed in a person with AFP and ADHD

Contributing factors often overlooked (important to find before considering medication) include:

  1.  medication side effects
  2. drug abuse & chemical dependency
  3. medical condition as: thyroid problems, hidden infection, inflammatory diseases, or nutritional deficiencies
  4. mood disorders as bipolar disorder, depression and anxiety
  5. Post Traumatic Stress Disorder (PTSD) or past trauma
  6. environmental allergies & sensitivities
  7. family disruption or dysfunction
  8. major losses and worries including financial problems, job loss, marital problems
  9. sleep disturbance
Holistic approaches to AFP and/or ADHD to be considered include:
  • identifying environmental illness, sensitivities and allergies
  • improving nutrition with diet with more organic, fresh whole foods, considering supplements as fish oil (omega 3’s), magnesium, zinc, B-vitamins (as B6, folic acid), melatonin, or iron if indicated
  • avoiding food additives, chemicals, refined sugars, overly processed food
  • AFP or ADHD coaching
  • Seeking accommodations when needed in educational and organizations settings
  • behavioral cognitive, family or other holistic therapies, to help modify dysfunctional patterns of interaction or behavior
  • EEG Biofeedback

It is recommended that if any if these approaches are considered that they be done under the careful supervision of a qualified holistic health-care practitioner.

For more information and references on AFP and ADHD click here. To learn more about assessment and treatment approaches offered by Integrative psychiatry, medicine and holistic therapy practitioner. Further reading re: ADD Resources – ADD R.  Recent review available for purchase: ADHD IN CHILDREN AND ADULTS, Audio-Digest Psychiatry, Volume 44, Issue 16, August 21, 2015, Managing ADHD in Preschoolers – Robert R. Althoff, MD, PhD, Adult ADHD – James Margolis, MD.

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

Question:

What is your next step, if you or your family is affected by AFP and ADHD?

 

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