INTEGRATIVE + ONLINE PSYCHIATRY + HOLISTIC HEALTH

Tag: Integrative

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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