Psych Central

Archive for August, 2009

Sniff your way out of Anxiety?

Monday, August 24th, 2009

In our last blog we discussed the use of Ecstasy in treating people with anxiety. Other researchers have investigated the role of oxytocin, a hormone that the body produces during orgasm in men and women as well as during childbirth and breastfeeding. Interestingly, Ecstasy increases oxytocin.

So, what does this have to do with anxiety? Researchers at the University of Zurich have found that people with social phobia who were given small amounts of oxytocin in a nasal spray minutes before participating in cognitive behavioral therapy, became more confident in social situations and seemed more open to engaging in their therapy.

It’s also interesting that oxytocin levels have been found to be lower in people with autism spectrum disorders. People with autism often have difficulty relating socially. And some limited research has found that giving oxytocin to a sample of adults with autism improved their performance on a task that required identifying emotional content.

Oxytocin has been found to increase people’s ability to trust others in some studies. In other research, it has increased people’s ability to understand the emotions of others. If you think of people with social anxiety, they tend to be excessively shy and worry about how other people are judging them. Most of the time, their worries are unfounded. So, improving the ability to accurately read feelings and be able to trust others would logically decrease social anxiety.

By the way, in general, we’re not wild about most medication approaches for anxiety. Some are addictive and others not especially effective. And it’s way too early to endorse either MDMA or oxytocin as anti-anxiety strategies. However, the possibility is intriguing, especially because their use in most cases would likely be limited to serving as an adjunct to exposure therapy sessions.

On the other hand, some medications may actually decrease the effectiveness of exposure therapies. For example, Michael Otto at the Massachusetts General Hospital has found that benzodiazepines (such as valium and xanax) actually interfere with exposure.


Agony and Ecstasy and PTSD

Tuesday, August 18th, 2009

The anxiety disorder called Post Traumatic Stress Disorder (PTSD) can occur when a person witnesses or is involved in a traumatic experience. In most cases, the person is present at the trauma, but other times the trauma happens to someone very close. The event generally involves a serious threat of death or injury. The person feels intense horror, fear, and helplessness. Here are three examples of PTSD.Although most people don’t have all of these, symptoms of PTSD which occur after a traumatic event include:

  • Intrusive and distressing images, thoughts, perceptions of the event
  • Recurrent Dreams
  • Flashbacks of the event
  • Intense distress when reminded of the event
  • Over reactive psychological symptoms
  • Avoiding talking about the trauma
  • Avoiding activities that bring back memories
  • Attempts to repress or forget the trauma
  • Less interest in life activities
  • Feelings of detachment
  • Belief that the future is limited
  • Increased arousal
  • Problems with sleep
  • Angry outbursts
  • Irritability
  • Problems with concentration
  • Hypervigilance
  • Easily startled

For those with PTSD, cognitive behavioral therapy is a very good therapeutic choice. Like those with OCD, exposure to the feared event is part of the treatment. The problem in the past has been that many people with PTSD avoid getting help because of a strong desire to avoid anything that reminds them of the trauma–and exposure certainly does that.

A few recent studies have introduced a new way to perform exposure. The patient is given 3,4-methylenedioxymethamphetamine (MDMA) during the exposure. Although the studies are preliminary, it appears that MDMA may facilitate exposure.

MDMA, aka, Ecstasy, is known for its positive effects on mood and empathy. The behavioral treatments with exposure and MDMA take no longer (usually 10-12 sessions) than standard behavior therapy. The drug is given under medical supervision only during the session and is discontinued after exposure is complete. Considerably more research is required before we can wholly endorse this approach. However, we thought you might find it interesting to know what’s in the pipeline of possibilities for treating PTSD.

Finally, this should not be tried at home! Nor are we recommending MDMA for other purposes. And we recommend that you avoid Raves as well.


School Days and Separation Anxiety

Wednesday, August 12th, 2009

School is starting in many areas in the next few weeks. Most kids are excited about the beginning of school. A few kindergarten kids and sometimes even older children will exhibit symptoms of separation anxiety. The main sign of this disorder is extreme anxiety and fear when separated from a caregiver. The symptoms of this disorder vary from child to child but can include:

  • getting upset while getting ready to leave for school
  • worrying that something bad will happen to the caregiver
  • worrying about getting lost or kidnapped when apart
  • refusal to get on the bus or out of the car
  • tantrums and screaming when pushed to leave
  • problems with going to sleep
  • nightmares
  • refusing to sleep in the child’s own bed
  • physical complaints when facing separation (stomach aches, headaches, even vomiting)

Separation anxiety can become a very serious problem. Concerned parents hate to see their children suffer. Parents understandably often respond to the first signs of separation anxiety with love and reassurance. When that doesn’t stop the fear, they try firmness, and sometimes nothing seems to work. Separation anxiety can appear in perfectly well adjusted children. A variety of factors likely cause it; some kids seem to be born anxious; sometimes it appears due to changes in the kid’s environment (e.g., moving, divorce, etc.); other times it just pops up seemingly out of nowhere.

My twins were sad and cried a little when I left them at home with a babysitter, but loved preschool and kindergarten. They’d pile out of the car and run full speed into school. But my younger son had separation anxiety when I dropped him off at daycare. I started each day feeling horrible-leaving him as he screamed for me. I knew that I just had to turn the corner and seconds later he’d be off playing with the other kids, but the guilt I felt was more than a little uncomfortable. By the time he was in preschool, the transition was smooth and now he travels all over the world, comfortable in almost any setting.

But not every child outgrows separation anxiety without some treatment. Usually, the school counselor or teacher will have some helpful hints. Some children will benefit from …


Contest Winners For AA (Acronym Addiction)

Monday, August 10th, 2009

Our contest is over. We had many correct and almost correct responses. The winners are based on number correct and speed of answering. We had some postings on the blog and others to our emails. Again, recall that there were numerous “correct” possibilities, but we used the “correct” responses that lived in our heads. Unfair? To be sure. Here are the “correct” answers:

CT Cognitive Therapy
OCD Obsessive Compulsive Disorder
ABCT Association for Behavioral and Cognitive Therapies
ERP Exposure and Response Prevention
EXP Exposure and Response Prevention
(okay, this was a tricky one and we decided in this one case to be unexpectedly “fair” and give credit for Experimental Psychology)

ACT Acceptance and Commitment Therapy
DBT Dialectical Behavior Therapy
FGU Fielding Graduate University (how did this one get in here?)
BT Behavior Therapy
IPT Interpersonal Therapy
PD Personality Disorder
PDD Pervasive Developmental Disorder
ADD Attention Deficit Disorder (if you want to follow the DSM IV, it should be ADHD)
MDD Major Depressive Disorder
BPD Borderline Personality Disorder
AN Anorexia Nervosa
PTSD Post Traumatic Stress Disorder
ASD Autism Spectrum Disorder
ODD Oppositional Defiant Disorder
APA American Psychological Disorder (oops, that should have been American Psychological “Association”)

If you are one of our winners, please email us ( anxietyocd@psychcentral.com ) with your street address and we will send you the book you asked for. Here are the winners:

1. Jessica M.
2. “croak”
3. Gwen A.
4. Kristi R.
5. Angela B.

 

Thanks to all who participated and especially to Bonnie for bringing us some laughs. And Laurie S., if you’d like a book, please email us with your address–we went crazy and declared a sixth winner!


Warning: The Vast Majority of Psychologists Suffer from Serious Addiction Problem (& a Contest for You)!

Monday, August 3rd, 2009

This addiction causes a variety of problematic symptoms such as confusion, difficulty in communicating, laziness, and loss of memory. Very few psychologists have sought treatment for this issue and most don’t even have a desire to do so. The major psychological associations and organizations have yet to issue warnings about this problem; indeed we doubt that they ever will. AA (Alcoholics Anonymous) offers little hope for those who have this disorder and in fact, may actually contribute to the problem itself. DSM IV (the Diagnostic and Statistical Manual) used by most psychologists also adds fuel to the fire and has completely failed to consider its inclusion in the next edition. Even our esteemed colleague’s book,  Addicted? Recognizing Destructive Behaviors Before It’s Too Late (by Marilyn Freimuth, Ph.D.) failed to deal with this issue, representing the lone omission of an otherwise fine piece of work.

We ourselves have fallen prey to this pernicious issue in spite of having written six (and counting) For Dummies books. Of all people, we should have addressed this concern before now. Well, we feel strongly that it’s time to call attention to this addiction and do something about it! Unless we act, we fear that most of the general public will become so disgusted with psychologists’ behavior that they will abandon seeking their services entirely.

The problem is AA itself. No, not Alcoholics Anonymous, but Acronym Addiction (AA)! Yes my friends, AA may be the worst, un-dealt with issue psychologists face today–except that they are not facing it. In order to draw attention to this disorder, we have decided to hold a contest. Below we list 20 of our personal, favorite acronyms. This list is far from all inclusive. For the first five people who respond with the greatest number of “correct” answers, we will you send your choice of a free copy of one of our FDBs (For Dummies Books) listed below.

You may find yourself objecting …


Anxiety & OCD Exposed



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Laura L. Smith, Ph.D. and Charles H. Elliott, Ph.D. are authors of many books, including Overcoming Anxiety for Dummies and Child Psychology & Development for Dummies.

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