Stress and uncertainty seem ever present right now. This can tap elicit and sustain powerful fears. Fears at moments overwhelm our rationality. I found this article helpful laying out how this might be and tips to cope.“When we wish to correct with advantage, and to show another that he errs, we must notice from what side he views the matter, for on that side it is usually true, and admit that truth to him, but reveal to him the side on which it is false. He is satisfied with that, for he sees that he was not mistaken, and that he only failed to see all sides. Now, no one is offended at not seeing everything; but one does not like to be mistaken, and that perhaps arises from the fact that man naturally cannot see everything, and that naturally he cannot err in the side he looks at, since the perceptions of our senses are always true.”
Blaise Pascal Social media provides so much these days: news, gossip, shopping and a way to keep up with friends. The emotional toll is becoming more clear though. I found this article takes a succinct approach in describing how social media taps into our need for connection and unintentionally fuels jealousy and envy.
Which is better for depression and anxiety: therapy or medications? Fortunately, when it comes to depression treatment what matters is that you pick the one you can say is right for you. In fact, this is not only anecdotally true but there is research to validate it.
But what happens when someone does not get better or are only part way there? A recent research paper answers this question. In the American Journal of Psychiatry, a research group asked the question of what would help people who didn't get better after starting one form of treatment for depression as part of the PReDICT study (Predictors of Remission in Depression to Individual and Combined Treatments). Their results show that people with depression can improve or get equally well with through therapy or medication for 12 weeks. However, for the people who did not get better or improve enough, the research group offered adding Cognitive Behavioral Therapy (CBT) or medication to their treatment. The additional 12 weeks of the complementary treatment made a difference for a significant number of people. Also important was the demonstration that ultimately patients were equally improved or well regardless of whether psychotherapy or medication was the added treatment. This research adds confidence that people can choose where they start to help themselves and that if they are not better it is worthwhile adding the other treatment they did not start with. I find this article useful as I already practice this way. As a psychiatrist who offers medication consultations and practices CBT I provide patients the freedom to start treatment that they think is right for them after a individualized assessment and consultation. Contact me if this approach seems right for you. When stress and anxiety have pushed our mind and body too far the most obvious manifestation is a panic attack. However, what about the person who is facing square on the demands and pressures of the day and seems on the outside to be keeping up with life just fine? While their composure might not even evidence a hair out of place inside there is a different story. If you are constantly worrying, feeling like you have to be on the move or doing something all the time, especially at night, that could be anxiety as well.
I was reminded while reading the Sunday paper about how some people live with their anxiety but more accurately might be suffering in silence. I came across this article by the psychologist, Alicia Clark. She brings up the term high functioning anxiety to describe anxiety that is severe for the individual but has not stopped them from carrying on with life. It is notable and a useful description for many because I find that it applies to many people who are feeling inside the result of stress and demands from a hectic modern life. Take a read. Regards DJean Sleep is in the news again pointing out how important it important is for our mood and cognition. In an U.K. study of almost 100,000 individuals published in Lancet Psychiatry we have a demonstration of how important it is to recognize that when it comes to sleep our bodies don't want too much variation. Our internal body clock, also know as the circadian rhythm, is sensitive to changes in time and light. So if you like find yourself with your devices and phones in bed and then realize you are not sleepy after an hour past your ideal bed time, that's your circadian rhythm thrown off by mental activity and light. The lesson? Good sleep is like any good habit: make it simple and consistent.
You read it in the news: too many people are not getting enough sleep. We take sleep for granted and unfortunately it eventually catches up to us. Will you catch up by paying to nap in midtown (see the link from the NYT about sleep pods) Why not make sure good quality sleep is in your schedule? Your mind and body will reward you with better mood and mental clarity.A debate within medicine and psychiatry for many years centered on whether antidepressants have any effectiveness for depression. Some have thought of them as merely placebos or sugar pills. Fortunately, a recent meta-analysis or a study of studies provides clear insight into the debate. The researchers were very thorough, going so far as to ask researchers for data they wouldn’t publish because they suggested that the medications did not work. Drug companies often suppress such data.
The study was just published in The Lancet and shows that all of the available antidepressants are effective and better than placebo. One interesting result of the study is that some appeared more effective than others. Now what does this study mean for each individual? In psychiatry we have the ability to craft an individualized choice for each person seeking help. So what if you are on one of the options that shows lower efficacy. Does this mean you are on the wrong medication? Not necessarily. The answer is unique to each person. It is just as unique as working with each client to devise a plan that takes into account the therapeutic benefits of medication and psychotherapy. I hope you find the blog posts helpful. Writing supportive letters or notes to yourself help counter that deluge of self criticism . It helped a former prisoner get from solitary confinement to UC Berkeley. And there is a scientific basis for it. This interview was on WNYC recently.
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My BlogHere is a selection of articles and podcasts that I have caught my attention and wanted to share. Archives
April 2020
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