PTSD Articles

Facing Fear

Friday, February 17th, 2012

We have been writing this blog for a few years. When we started, we decided to call the blog Anxiety and OCD Exposed. It’s been a long time since we have discussed why we decided on that title so we thought that new readers might want some explanation.

The term “exposed” may bring up a lot of different thoughts such as:

• Finding out that a politician was cheating on his wife
• Discovering a dumping ground of toxic waste
• The feeling of your hands when you forget to wear gloves in cold weather
• A politician taking opposite positions in the same campaign
• Not noticing the piece of toilet paper stuck to your shoe
• The most effective treatment for anxiety and OCD

Research says that overall the best treatment for anxiety and OCD is a method called exposure. When people are afraid or anxious about something, they tend to avoid it. The more they avoid what they fear, the more fearful they become.

Exposure helps people face their fears in a gradual way. Most people find that after being exposed to their fear or OCD triggers, over a period of time, their anxiety decreases. The goal of exposure is not to eliminate all anxiety, but to make anxiety manageable.

One More Step Before You Decide to Get Treatment

Friday, January 13th, 2012

young manSo, Laura responded to my blog on Six Reasons for Not Treating Your Anxiety or OCD with one of her own blogs that may have helped you rethink your “treatment interfering beliefs” in a more productive way. If so, you’re ready to move ahead, right? Well, not quite.

I think it’s also wise to take one more important step. Specifically, I’d like you first to consider accepting where you’re at, problems and all. That’s right; evaluate yourself as acceptable and OK as you are.

Realize that you didn’t ask to have problems with anxiety and OCD. Rather, you have these problems for lots of good reasons. You may have had genes that tilted you in this direction. Or perhaps you experienced one or more traumas. Maybe your parents were overly critical and overbearing. On the other hand, maybe they couldn’t provide the structure you needed as a child. Perhaps you grew up in an unsafe neighborhood. People acquire anxiety and OCD for these reasons and many more. They pretty much never become anxious because they “wanted” to have these problems.

Yet, many clients judge and evaluate themselves very harshly just because they have some problems that they didn’t ask for in the first place. They see themselves as weak, incompetent, and horribly flawed. Thus, they tell themselves that they absolutely MUST overcome their problems. In addition, they should do so quickly and completely.

Anxiety: Three Messages to Avoid Giving Kids

Tuesday, November 1st, 2011

anxiety and kidsKids don’t generally develop anxiety disorders all on their own. Oh sure, genes and biology have some influence, but these factors largely just predispose kids in the direction of acquiring problems with anxiety. The wrong messages can push both anxiously disposed kids as well as otherwise normal kids in the direction of struggling with anxiety for the rest of their lives.

If you’re a parent or someone who cares about kids, you just might want to know what type of messages instill insecurity. I’ll start by laying out three common mistakes that parents make; in other words, the kinds of messages you “don’t” want to give them:

Worry About Relapse

Tuesday, August 2nd, 2011

worried womanPeople with anxiety disorders tend to get anxious (okay, duh). They even worry about getting anxious after seeking treatment for their anxiety. Sometimes they go so far as to use this concern as an excuse for not seeking treatment in the first place. In other words they think, “Why bother getting treated if the problem is likely to make a swift return after I get treatment anyway?”

If you’ve had thoughts like these, I’d like to suggest you try rethinking your viewpoint. Treatment of anxiety and obsessive compulsive disorder generally has enduring, positive effects. That’s especially the case if you obtain treatment based on cognitive behavior therapy that’s been specifically tailored for the type of anxiety or OCD you struggle with.

In fact, cognitive behavioral treatment for anxiety typically holds up far better than medication over the long haul. So even if you do take medication for anxiety or OCD, you now have one more reason to add cognitive behavior therapy to your regimen—the likely prevention of relapse as well as the possibility (for many) of successfully tapering off your medication at some point.

Nonetheless, relapse does happen. What should you do if it does?

The Downside of Protecting Our Kids

Friday, July 22nd, 2011

protecting our kidsThe New York Times recently ran an article bemoaning the ever increasing focus on safety at our nation’s playgrounds. Today, you rarely see monkey bars and tire swings. And playground surfaces feel like walking on a giant sponge. Tall, fast slides have shrunk, leveled out, and slowed down. Signs warn parents everywhere about potential dangers.

But this emphasis doesn’t stop at playgrounds. When is the last time you drove by a school bus stop and saw only children? You’re just as likely to see more parents and caretakers than children waiting for the bus. Newspapers run articles all of the time that warn of potential dangers to kids. It seems that the media can’t get enough of these stories.

Borderline Personality Disorder and Anxiety

Tuesday, March 30th, 2010

When the topic of Borderline Personality Disorder (BPD) comes up, you’ll probably hear the conversation focusing on the issue of anger and rage. Indeed, people who suffer from BPD often struggle with explosive emotional flare-ups. Those episodes capture everyone’s attention.

Other symptoms of BPD such as self-harm, impulsive actions, and unstable relationships stand out as well. However, people with BPD also suffer greatly from profound anxiety. Some people with BPD describe their anxiety as excruciatingly painful and debilitating. Quite often their anxiety centers on deep fears of abandonment. They believe that others will inevitably leave them and, once that happens, they will be left totally unable to cope.

PTSD and Evidence Based Practice

Sunday, October 18th, 2009
Like many professionals, clinical psychologists take advantage of continuing education to keep up with new advances in the profession, develop new skills, broaden their knowledge, and keep their license to practice. Frankly, after attending hundreds of hours of continuing education, I can tell you that some conferences are decidedly better than others. I can think of one conference that I sat in the back row and amused myself by counting the heads in front of me that dropped and bobbed.

Last week, I attended a well orchestrated day long conference on treating people with Post Traumatic Stress Disorder (PTSD). Organized by Dr. Rex Swanda from the New Mexico VA, the content of the conference primarily focused on therapeutic practices that have been studied and found to be effective in treating those who suffer from this disorder. Treatments that are considered evidence based have been subjected to at least several independent research studies, compared to other types of treatment, or to no treatment. Here is an abbreviated description of PTSD.

PTSD can occur when people suffer or witness a traumatic event in which they are threatened with death, injury, or physical violation. During the time of the trauma these people respond with horror, fear, or helplessness. The symptoms of PTSD include some of the following:

  • Re-experiencing the trauma: through dreams, flashbacks, unwanted thoughts, or distress when reminded of the trauma.
  • Numbing or avoiding: attempts to avoid situations, triggers, or thoughts about the trauma, feelings of detachment from others, loss of interest in activities, beliefs that their lives will be short, and restricted emotions.
  • Hyperarousal: problems with sleep, easily irritated or angry, problems concentrating, and jumpiness.

If you have concerns that you or someone you care about has PTSD, please consult with a mental health professional for a diagnosis and treatment plan.

Now, back to the conference. There were multiple sessions that mostly reviewed the effective treatments for PTSD. Not surprisingly the therapies that work are based on mixtures of cognitive and behavioral therapies. These approaches have stood the test of time and science. Cognitive Behavioral Therapy (CBT) has been used to successfully treat a wide range of emotional and behavioral problems.

It’s fun when …

When the brain sounds a false alarm

Monday, March 30th, 2009

Anxiety disorders, like most mental disorders, involve multiple causes including genetic, biological, social, and learning. And successful treatments sometimes target psychological or biological systems. Nevertheless, it is useful to consider that for most people with an anxiety disorder, there are false alarms sounding in the brain that set off a spiral of effects on the body that can lead to significant health concerns.

Let’s start at the beginning. Most people are frightened or startled by:

  • loud noises
  • sudden unexpected movements
  • dark unfamiliar places
  • large animals growling
  • suddenly appearing snakes
  • precarious heights

When scary things happen, the brain sends signals to the rest of our body to get ready to run like hell or take a stand and fight. Two areas in the brain appear to be the most crucial to fear responses: the hippocampus, which helps store verbal memories, especially those with emotional tones and the amygdala, which seems to govern and interpret fear. This circuit sends messages to the multiple brain systems that activate various stress hormones that in turn make the heart beat faster, increase blood pressure, and boost muscle power. This response evolved to keep us safe and works well when dangers are encountered.

The problem in anxiety disorders is that this system in the brain is turned on when there are no slimy snakes, roaring elephants, or dark and scary places. The fears and worries that people with anxiety have often involve anticipatory worries-or “what if?”

Being in this constant state of false alarm (imagine a fire signal blaring continuously in your brain) increases anxiety and can also damage your body. People with chronic Post Traumatic Stress Disorder have been found to have decreased volume in certain areas of the hippocampus (an area that is associated with memory). Physical costs of anxiety are far reaching, but surprisingly, so are the financial costs. One study in the Netherlands reported in the Journal of Abnormal Child Psychology found that anxious children cost society 21 times more than those children not judged anxious. Adults with anxiety disorders are more likely to have high blood pressures, diabetes, thyroid disease, gastrointestinal disorders, and cardiac disorders.

With all of the costs, including emotional, financial, and physical, treatment is …

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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