Anxiety

Anxious? Activate Your Anterior Cingulate Cortex With a Little Meditation

Practicing mindful meditation lights up the parts of the brain that control thinking emotions such as worry are activated. Anxiety levels are reduced.

June 4, 2013 — Scientists, like Buddhist monks and Zen masters, have known for years that meditation can reduce anxiety, but not how. Scientists at Wake Forest Baptist Medical Center, however, have succeeded in identifying the brain functions involved.

"Although we've known that meditation can reduce anxiety, we hadn't identified the specific brain mechanisms involved in relieving anxiety in healthy individuals," said Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. "In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief."

The study is published in the current edition of the journal Social Cognitive and Affective Neuroscience.

For the study, 15 healthy volunteers with normal levels of everyday anxiety were recruited for the study. These individuals had no previous meditation experience or anxiety disorders. All subjects participated in four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.

Both before and after meditation training, the study participants' brain activity was examined using a special type of imaging -- arterial spin labeling magnetic resonance imaging -- that is very effective at imaging brain processes, such as meditation. In addition, anxiety reports were measured before and after brain scanning.

The majority of study participants reported decreases in anxiety. Researchers found that meditation reduced anxiety ratings by as much as 39 percent.

"This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety," Zeidan said.

The study revealed that meditation-related anxiety relief is associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex, areas of the brain involved with executive-level function. During meditation, there was more activity in the ventromedial prefrontal cortex, the area of the brain that controls worrying. In addition, when activity increased in the anterior cingulate cortex -- the area that governs thinking and emotion -- anxiety decreased.

"Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings," Zeidan said. "Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful."

Research at other institutions has shown that meditation can significantly reduce anxiety in patients with generalized anxiety and depression disorders. The results of this neuroimaging experiment complement that body of knowledge by showing the brain mechanisms associated with meditation-related anxiety relief in healthy people, he said.

Support for the study was provided by the Mind and Life Institute's Francisco J. Varela Grant, the National Institutes of Health grant NS3926 and the Biomolecular Imaging Center at Wake Forest Baptist.

Co-authors are Katherine Martucci, Ph.D., Robert Kraft, Ph.D., John McHaffie, Ph.D., and Robert Coghill, Ph.D., of Wake Forest Baptist.

 

Link to article

Young Adults Are The Most Stressed Generation: Survey

Being young does not mean carefree.  Survey finds young Americans, aged 18-33, are among the most stressed. By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 7 (HealthDay News) -- Young Americans between 18 and 33 years old -- the so-called millennials -- are more stressed than the rest of the population, according to a new report from the American Psychological Association.

What's stressing them out? Jobs and money mostly, said Norman Anderson, CEO of the American Psychological Association, during a Thursday morning press conference.

On a scale of 1 to 10, the millennial generation stands at 5.4 stress-wise, significantly higher than the national average of 4.9, the association found after surveying more than 2,000 Americans.

"Clearly there are a number of pressures facing young people that might account for this increase in stress," Anderson said. "These individuals are growing up in an era of unprecedented economic upheaval. This coincides with the time they are finishing school and trying to establish themselves in society."

Getting a job, starting a family and repaying student loans are all stressful, he added. "They have great difficulty finding jobs because of the higher unemployment and underemployment rates," Anderson said.

These young adults also don't feel they're getting support from the health system. Only 25 percent of millennials give the health care system an A grade, compared with 32 percent of the rest of the population, according to the report, Stress in America: Missing the Health Care Connection.

In addition, 49 percent said they aren't managing their stress well, and only 23 percent think their doctor helps them make healthy lifestyle and behavior changes "a lot or a great deal." Only 17 percent think their doctor helps them manage their stress.

"When people receive professional help to manage stress and make healthy behavior changes, they do better at achieving their health goals," Anderson said.

On that measure, the United States falls short, he said. To lower the rates of chronic illnesses and reduce the nation's health costs, "we need to improve how we view and treat stress and unhealthy behaviors that are contributing to the high incidence of disease in the United States."

Those who get support for stress from their doctor fare much better than those who don't, the researchers said.

People suffering from chronic illnesses report even less support for stress and lifestyle management than Americans without a chronic condition, according to the survey.

Despite seeing their doctor more often than most people, only 25 percent of those with a chronic illness say they get "a great deal or a lot" of stress management support from their doctor. And 41 percent of these chronically ill people said their stress level had increased in the past year, the researchers found.

The disconnect between what people need to manage stress and what the health care system delivers is evident at all ages, the survey found.

For example, 32 percent of respondents said it is extremely important to talk with their doctor about stress management, but only 17 percent said that happens often or always.

Fifty-three percent said they get little or no help with stress management from their doctor, and 39 percent said they have little or no support for other lifestyle issues. Those who felt unsupported were more likely than others to say their stress had increased during the previous year.

This problem is worse for the 20 percent of Americans who consider themselves extremely stressed, the researchers said. Among these people, 69 percent say their stress increased in the past year. Thirty-three percent, however, never discussed their increasing stress with their doctor, according to the report.

The report did find that many people know that controlling stress is important for good health. But for more than one-third of Americans, stress levels are on the rise, they noted.

More information

For more information on stress, visit the U.S. National Library of Medicine.

 

Link to article

How to Use Social Jujitsu To Snag New Business

How do you grow your client base? I was recently quoted in an article on expanding your business with confidence.

By: ANN BROWN
Monday, January 7, 2013

Jujitsu philosophy in the workplace Some executive leaders are born with it; other develop it. “Social Jujitsu” is the charisma that draws people and potential clients to you like a magnet. In the martial arts world, at its base the Japanese martial art of Jiujitsu is a method of defeating an opponent without a weapon. "Ju" is usually translated as "gentle, supple, flexible, pliable." And "Jitsu" is translated to mean "art" or "technique." Some experts say you can use the philosophy of jujitsu in the business world as the way to woo and win over colleagues and new business. But as with any art form, you have to develop and master the techniques.

Become more of who you are

The worse thing is to pretend to be someone you aren´t. So don´t fake it. “You don't develop a winning personality. You have one. Don't try to be someone you're not. The trick is letting it out,” says Mike Schultz, president and founder of RAIN, who is also a second degree black belt in Seirenkai Jujitsu. Adds Shari Goldsmith of Shari- Life Coach for Women, “Be you; true-to-you-authenticity is attractive. People can spot dishonesty a mile away.” The basics matter

Don´t throw common courtesy out of the window. Be polite and engaging. “Smile, offer a firm but not death grip handshake and open body language. Light touch is an HR no-no, but it's connecting,” Schultz points out. Do your homework

All clients appreciate knowing you have taken the time to study their company and their needs. They will be more attracted to you and what you are offering. “Know that you are offering your client something they need. Be aware of how you perceive your product or services. You are not simply asking for something from them but potentially solving a problem they have. Inquire about what they want to improve in their lives or business and explain how you can help them,” says Licensed Clinical Psychologist Dr. Nerina Garcia-Arcement, Clinical Assistant Professor at Dept. of Psychiatry, NYU School of Medicine and of the Williamsburg Therapy and Wellness.

Be all ears

Merely rattling off a sales pitch is an empty gesture. Listen to what is being said to you, what is being asked of you. “Listen more than you talk, but don't make it all listening,” says Schultz.

Apply the personal touch

You don´t need to tell a complete stranger or a potential client your life story, but sprinkle in personal bits into your conversation. “Don't be afraid to talk about personal things,” advises Schultz. “When you let your personality and personal life shine through, it can be very comforting to people who care about the same things. You have to find mutual areas of connection to build rapport.” Goldsmith agrees. “People want to do business with people that they like and trust. Focus on letting others see the real you and be consistently kind and honest,” she adds.

And, when you share, seek out information about your client. “Don't see people as just potential clients, see them as individuals you can get to know on a personal basis. Be friendly, look for potential connections and common interests.  This will help everyone feel more comfortable. For example, you both might have small children or enjoy the same sport,” stresses Dr. Garcia-Arcement. “Once you know your clients on a more personal level, this aids in breaking the ice at the next meeting. Inquire about their family, their favorite sport or recent trip. This will help everyone feel like they are doing business with a friend instead of a stranger.”

Throw out bias and discriminatory tendences

Never make assumptions. Not only is it a good rule in life but business as well. “Treat everyone the same, no matter what their station in life. You never know where your future business is going to come from. Don't judge,” says Goldsmith. Dare to be different

Being cookie cutter is boring. You want people to be excited about doing business with you, about having you around. “Be unique--know what makes you different and play it up,” says Goldsmith.

Do unto others..

The “me” generation has come and gone. When possible, help someone on a project. “Help others succeed. Focus on helping others succeed at their goals, and it will come back to you,” says Goldsmith. Confidence is dynamic

If you're timid about or unsure of yourself, your product/services, then how can you expect a customer to be eager to do business with you? “Feel confident in your product or service. Know why the product is worth selling. If you know the virtues of the product or services, it will show in your sales pitch,” advises Dr. Garcia-Arcement.

On call As a small business owner, you´re always on call. You have to be ready to tell someone about your product at a moment´s notice—and with passion. People tend to respond to this approach just because of the sheer enthusiasm. “Prepare the proverbial elevator speech. This speech is best if you don't have a lot of time and want to get the client's attention. What would you say about the product you are selling if you only had a few moments with a client? If you have that prepared and memorized, it will reduce your anxiety the next time you approach a client,” says Dr.  Garcia-Arcement.

Martial arts mindset

Martial arts philosophies can easily be applied to business and business situations. “As far as jujitsu, the best conversation and connection application is a concept called kuzushi. Kuzushi literally means unbalancing, and it's applied as a redirecting of energy from one direction gently but specifically to another,” explains Schultz, author of the bestseller Rainmaking Conversations. “If you know where you want to go in a conversation, you can gently move it down to that path from wherever it's going. But do it subtly. For example, if you want to talk about an exciting project you're working on, don't just start talking..Just ask the other person, 'What's the most exciting thing you're working on.' They'll share, and then they'll ask you. At the same time, they're thinking 'what a great conversationalist,' and you got them to do what you wanted without forcing it.”

Link to article

Yoga Helps Ease Stress Related Medical and Psychological Conditions, Study Suggests

Yoga might increase GABA activity, low GABA (neurotransmitter) is linked to anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. So practicing yoga might reduce distress from these disorders. Mar. 6, 2012 — An article by researchers from Boston University School of Medicine (BUSM), New York Medical College (NYMC), and the Columbia College of Physicians and Surgeons (CCPS) reviews evidence that yoga may be effective in treating patients with stress-related psychological and medical conditions such as depression, anxiety, high blood pressure and cardiac disease. Their theory, which currently appears online in Medical Hypotheses, could be used to develop specific mind-body practices for the prevention and treatment of these conditions in conjunction with standard treatments.

It is hypothesized that stress causes an imbalance in the autonomic nervous system (parasympathetic under-activity and sympathetic over-activity) as well as under-activity of the inhibitory neurotransmitter, gamma amino-butyric acid (GABA). Low GABA activity occurs in anxiety disorders, post-traumatic stress disorder, depression, epilepsy, and chronic pain. According to the researchers, the hypothesis advanced in this paper could explain why vagal nerve stimulation (VNS) works to decrease both seizure frequency and the symptoms of depression.

"Western and Eastern medicine complement one another. Yoga is known to improve stress-related nervous system imbalances," said Chris Streeter, MD, associate professor of psychiatry at BUSM and Boston Medical Center, who is the study's lead author. Streeter believes that "This paper provides a theory, based on neurophysiology and neuroanatomy, to understand how yoga helps patients feel better by relieving symptoms in many common disorders."

An earlier study by BUSM researchers comparing a walking group and a yoga group over a 12-week period found no increase in GABA levels in the walking group, whereas the yoga group showed increased GABA levels and decreased anxiety. In another 12-week BUSM study, patients with chronic low back pain responded to a yoga intervention with increased GABA levels and significant reduction in pain compared to a group receiving standard care alone.

In crafting this neurophysiological theory of how yoga affects the nervous system, Streeter collaborated with Patricia Gerbarg, MD, assistant clinical professor of psychiatry at NYMC, Domenic A. Ciraulo, MD, chairman of psychiatry at BUSM, Robert Saper, MD MPH, associate professor of family medicine at BUSM, and Richard P. Brown, MD, associate clinical professor of psychiatry at CCPS. They are beginning test these theories by incorporating mind-body therapies such as yoga in their clinical studies of a wide range of stress-related medical and psychological conditions.

Link to article

Tuning in to psychology

Can't get to a lecture room, but curious about the latest research in psychology.  Here is a simple and free way to access lectures through iTunes U. Thanks to iTunes U, free psychology lectures are pumping through the earbuds of thousands of students, professionals and curious laypeople around the world.

By Anna Miller

Monitor Staff

January 2013, Vol 44, No. 1

Print version: page 28

Tuning in to psychology

Last spring, Daniel Stokols, PhD, of the University of California–Irvine, video recorded his environmental psychology lectures as a first foray into developing an online course. A proponent of face-to-face interactions with students, Stokols saw the videos as a useful supplement to classroom-based learning, not a substitute for it. He uploaded the videos to iTunes U, a component of the iTunes music store that features free academic content, and proceeded with his course as usual. "I thought maybe 100 people would view the course," he says. Fast forward a few months. Apple had featured Stokols's course on its iTunes U homepage. By late July, the course had more student enrollments per week than any other. By September, it had reached 100,000 subscribers and, for months, it remained one of iTunes U's top 10 courses. In November, subscriptions topped 170,000 students.

"It's mind-boggling," says Stokols, who has taught at UCI for nearly 40 years and has "never come close" to reaching that many students. Now, he's heard from a photographer in Germany who says the course has changed the way she interprets her photos; a nurse anesthesia student in Pittsburgh who learned that surgical patients require less pain medication if their beds face windows; and a professor in China who had never heard of environmental psychology before.

"The gratifying part is the feedback from people around the world who are enjoying the material and finding it useful," he says.

Stokols is just one of a growing number of professors turning to iTunes U to host content for their students and share high-quality educational material with the public. Apple launched the platform in 2007; Stanford, UC-Berkeley, MIT and Duke were among the first to sign on. Professors can upload syllabi, handouts, quizzes, slides and links to online resources in addition to audio and video lectures. Students, professionals and curious laypeople can access the courses for free via their computers (PCs included) or with an iPod, iPhone or iPad. The iOS application, which launched in January 2012, had been downloaded more than 14 million times by the end of the year.

"What's really heartening is … how hungry people are for good science," says Dacher Keltner, PhD, of UC Berkeley, whose "Psychology of Emotion" course was listed as one of the top five educational downloads in Wired magazine. He regularly gets feedback from listeners, including an employee at a cardboard box-making factory who's found that the lectures make his job bearable and a retired attorney who said that if he had known about the science of emotion earlier, his professional life and marriage would have been different.

Many universities don't appear to have a problem with providing the public with the same content –– but not the credits –– that students pay big bucks for. At Yale, for example, Fred Volkmar's course on autism serves as a reliable source in an Internet pool diluted with millions of websites selling cures for autism. "It's very consistent with Yale's vision of wanting to get quality product out there," he says.

Below is a sampling of some of the psychology courses available on iTunes U. To access the courses, download the iTunes app or go to the iTunes store.

Tuning in to psychology

Thanks to iTunes U, free psychology lectures are pumping through the earbuds of thousands of students, professionals and curious laypeople around the world.

By Anna Miller

Monitor Staff

January 2013, Vol 44, No. 1

Print version: page 28

Tuning in to psychology

Last spring, Daniel Stokols, PhD, of the University of California–Irvine, video recorded his environmental psychology lectures as a first foray into developing an online course. A proponent of face-to-face interactions with students, Stokols saw the videos as a useful supplement to classroom-based learning, not a substitute for it. He uploaded the videos to iTunes U, a component of the iTunes music store that features free academic content, and proceeded with his course as usual. "I thought maybe 100 people would view the course," he says. Fast forward a few months. Apple had featured Stokols's course on its iTunes U homepage. By late July, the course had more student enrollments per week than any other. By September, it had reached 100,000 subscribers and, for months, it remained one of iTunes U's top 10 courses. In November, subscriptions topped 170,000 students.

"It's mind-boggling," says Stokols, who has taught at UCI for nearly 40 years and has "never come close" to reaching that many students. Now, he's heard from a photographer in Germany who says the course has changed the way she interprets her photos; a nurse anesthesia student in Pittsburgh who learned that surgical patients require less pain medication if their beds face windows; and a professor in China who had never heard of environmental psychology before.

"The gratifying part is the feedback from people around the world who are enjoying the material and finding it useful," he says.

Stokols is just one of a growing number of professors turning to iTunes U to host content for their students and share high-quality educational material with the public. Apple launched the platform in 2007; Stanford, UC-Berkeley, MIT and Duke were among the first to sign on. Professors can upload syllabi, handouts, quizzes, slides and links to online resources in addition to audio and video lectures. Students, professionals and curious laypeople can access the courses for free via their computers (PCs included) or with an iPod, iPhone or iPad. The iOS application, which launched in January 2012, had been downloaded more than 14 million times by the end of the year.

"What's really heartening is … how hungry people are for good science," says Dacher Keltner, PhD, of UC Berkeley, whose "Psychology of Emotion" course was listed as one of the top five educational downloads in Wired magazine. He regularly gets feedback from listeners, including an employee at a cardboard box-making factory who's found that the lectures make his job bearable and a retired attorney who said that if he had known about the science of emotion earlier, his professional life and marriage would have been different.

Many universities don't appear to have a problem with providing the public with the same content –– but not the credits –– that students pay big bucks for. At Yale, for example, Fred Volkmar's course on autism serves as a reliable source in an Internet pool diluted with millions of websites selling cures for autism. "It's very consistent with Yale's vision of wanting to get quality product out there," he says.

Below is a sampling of some of the psychology courses available on iTunes U. To access the courses, download the iTunes app or go to the iTunes store.

"Environmental psychology"

University of California, Irvine

Instructor: Daniel Stokols, PhD, chancellor's professor of social ecology in the departments of psychology and social behavior, and planning, policy and design

Why tune in? Environmental psychology is about how we're influenced by our everyday surroundings, including our offices, dorm rooms, commutes and exposures to nature. Stokols's course addresses a variety of issues, including how the design of an apartment influences the formation of friendships, why people litter and the consequences of a society suffering from information overload. "Today, there's so much concern about issues of sustainability, public health, pollution and population growth that viewing the world as a system and in ecological terms … is very timely," says Stokols.

Fun fact from the course: People are more likely to throw away trash in a garbage can that's painted decoratively than one that's plain.

"Health psychology"

American University

Instructor: Brian Yates, PhD, professor of psychology

Why tune in? Yates originally intended iTunes U to serve as a resource for his own students, who are challenged to evaluate and change their own habits to promote health. They assess their personal risks, identify what they want to change and maintain, and set up a system of "triggers and flags" that will signal when it's time to seek professional help in the future. The material has caught on — his course is consistently one of the top 10 downloaded from iTunes U and had more than 35,000 enrollees in October. "The field is very exciting. It's young, dynamic, it affects every one of us," says Yates. "That's what psychology is supposed to do."

Surprising fact from the course: One study of HIV-positive men found that those who tended to blame themselves for negative outside events experienced a significantly faster decline in helper T cells, important for maintaining immune function.

"Human emotion"

University of California, Berkeley

Instructor: Dacher Keltner, PhD, professor of psychology and director of Berkeley's Social Interaction Laboratory

Why tune in? Keltner's course has always been well-attended, so it was Berkeley's idea to make it available to the public through iTunes U. The course details fascinating research on art and emotional expression, cultural similarities and differences in non-verbal expressions, and emotion's neurobiological and hormonal underpinnings. "The study of human emotion is new, it's growing and it's relevant to people around the world," says Keltner.

Interesting fact from the course: People can usually accurately convey — and interpret — emotion through nothing more than a brief touch. But in a study conducted by Keltner and his team, there were two instances in which the "touchee" was clueless: When women tried to convey anger to men, and when men tried to communicate sympathy to women. "That fits how emotions are gendered, and how families socialize women into the ways of sympathy and men into the ways of anger that might account for these differences," he says.

"Autism and related disorders"

Yale University

Instructor: Fred Volkmar, MD, chief of child psychiatry at Yale-New Haven Children's Hospital

Why tune in? A rotating panel of mental health experts lead this course on the latest autism research, including a lecture by Volkmar's co-instructor, James McPartland, PhD, that details how brain electrophysiology is informing researchers' understanding of social perception in autism. "This is a happy story in the sense that outcomes seem to be getting better with early intervention and protection," says Volkmar, who estimates the course's first lecture has gotten about 21,000 views on iTunes.

Interesting fact from the course: One of the early theories of autism speculated that intelligent parents were more likely to have autistic children. But the idea was likely a selection bias: The people who knew about what's now known as autism were predominantly researchers or other academics. "Now," he says, "you see children with autism everywhere … from all social classes, from every continent on the globe — and it looks remarkably the same. What's different is how people respond to it."

"Great ideas in psychology"

Missouri State University

Instructor: Todd Daniel, professor of psychology and director of Missouri State's RStats (Research, Statistical Training, Analysis and Technical Support) Institute

Why tune in? Daniel is a former radio producer who uses his storytelling skills to bring psychology to life in this introductory course. The course, which is Missouri State's most downloaded podcast, begins with the "Myth of Psyche" and takes the listener through an engaging overview of psychology including lectures on dreaming and hypnosis, a health course dubbed "Why College Is Bad for You" and the truth about Freud. "After I do a lecture in front of a seated class, when it's over, it's gone like a vapor," says Daniel. "I wanted to create something more permanent."

Surprising fact from the course: In 1964, a man named Randy Gardner went 264 hours, or about 11 days, without sleep. He was trying to prove that sleep wasn't all that important, but the changes noted in his cognitive and behavioral functioning proved otherwise — a lesson Daniel tries to impart on his students. "Your best strategy is to get a good night's sleep," he says.

Link to article

 

New Year, New Tips To Handle Work Stress

By Nerina Garcia-Arcement, Ph.D. Stress is on the rise in the United States. In a recent APA survey, Americans reported a 44% increase in their stress over the past five years. What are people worried about?  Money, relationships, work and the economy are at the top of the list.  Work is a popular concern. Not only are individuals worried about losing their jobs in this down economy but also about increased job responsibilities and difficult interpersonal relationships.  All this worry impacts your sleep, physical and mental health, and productivity. It also erodes your ability to be patient when dealing with others—all things that can make working more difficult and put your job at risk.

If this sounds familiar, you are not alone. The good news is you can change this. There are simple steps you can take that will help you manage your stress and improve your quality of life. Below are proven stress reduction suggestions you can use at work and at home.

While at work build into your day these three tips.

1. Walk away from what is stressing you and take regular breaks. Time-outs are not just for toddlers. They are an effective coping strategy that will allow you to clear your mind and refocus, as well as be more productive and creative.

2. Take deep breaths. Shallow breathing increases anxiety, while deep, slow breathing helps calm your mind and body.

3. Stretch your tense muscles. For example, progressive muscle relaxation sends your brain a message that you are safe and relaxed which helps reduce stress and anxiety.

While at home, try these habits regularly to decrease your stress.

1. Practice yoga. Even a few minutes will help calm your mind and relax your body.

2. Use imagery. Imagine yourself in a safe place, such as the beach or a cabin in the mountains. If imagining a peaceful place is difficult, you can use memories from a favorite vacation spot or familiar personal sanctuary (even if it’s just your favorite bench in Central Park).  Your memories will trigger positive feelings and distract you from your stress at the same time.

3. Speak to a trusted friend or family member. Share what is upsetting you, whether in person or over the phone. Social support is a great stress reducer and mood enhancer.

Preventing stress before you feel it is even better. Follow these suggestions to stop the stress before it hits.

1. Have open communication with your supervisors/bosses about what projects you are working on and their status.

2. Ask for help when you need it. We all require assistance at some point. Don't be afraid to ask for what you need.

3. Create a detailed list of work requirements and deadlines. This way you don't waste mental energy keeping track of what needs to get done and instead focus on how to accomplish those tasks.

If these tips are not enough, consider talking to a mental health provider that specializes in stress management.

Visit http://www.apapracticecentral.org for more information about stress.

Mental Illness and Marriage

I was interviewed on how mental illness affects marriage and how to cope. Listen to the podcast.

What kind of impact does mental illness have on a marriage?

In today’s society, it’s becoming more and more common for individuals to be living with some sort of mental health condition or illness like anxiety or depression. And while there are many issues and conditions that present themselves in different, unique ways, oftentimes the effects on a marriage are very similar.

In addition to anxiety and depression, some people suffer from more extreme conditions like post-traumatic stress disorder and substance abuse problems. When these issues creep in without the proper treatment, their impact on a marriage and the individual can be fundamentally problematic. In some situations, the partner without the condition will have to pick up the slack for the other. And in many cases, couples will begin to suffer from tension and exhaustion within their marriage.

Our guest today is Dr. Nerina Garcia, a clinical psychologist with Williamsburg Therapy and Wellness in Brooklyn, NY. Nerina is here to give us some advice about how couples and individuals can learn to cope with mental illnesses within marriages while building a network of support.

To find out more about Nerina and her practice, visit her website or call (917) 816-4449.

Podcast: Play in new window | Download

Link to podcast

To Drink or Not To Drink At Holiday Work Parties: Easy Steps to Managing The Stress

By Nerina Garcia-Arcement, Ph.D.

Work place holiday parties can be a time to connect with co-workers in a different friendlier setting. Yet for many it can also be stressful and awkward. Stressful because individuals are familiar with their workplace expectations, they have scripts or rules they follow on a regular basis, yet holiday parties create the opportunity for a different social interactions that does not follow familiar rules.  It is a blending of expectations that can create stress and uncertainty about how to behave. One common way to cope with stress or anxiety is drinking alcohol, sometimes to excess.  Some drink as a way to numb or avoid feeling uncomfortable emotions, yet it can lead to problems if done at work. Over drinking at the holiday party can create problems in the workplace if you behaved inappropriately while drunk. Although this is a "party" it is still work related and those rules of conduct still apply. Sober and drunk behavior reflects upon who you are as an employee.

If you tend to over drink at holiday work parties, here are a few steps you can take to protect yourself from overindulging.

1. Explore what triggers you to drink. Such as: Do you feel anxious when you walk into the party alone? Do you worry about having to speak to certain co-workers? Do you find it difficult to say “no” when encouraged to have another drink by coworkers?

2. Prepare yourself before the event by engaging in stress reduction activities. If you know that interacting socially with co-workers is stressful or anxiety provoking try activities such as deep breathing, imagining yourself in a peaceful place, reading a chapter of a favorite book, and/or progressive muscle relaxation.

3. Create a plan to managing your feelings and triggers before and during the party. Recognize your triggers and walk away from them or surround yourself with positive supportive coworkers that don't encourage excessive drinking.

4. Stick to your specific plan regarding drinking. If you are not going to drink at all then remove yourself from that temptation by holding a cup with soda throughout the party or staying away from the beverage area. Take steps to succeed with the plan, such as letting your coworker friends know you are not drinking at the party. If you decide to set a limit to your drinking, remember that once you start drinking inhibitions lower and you might be tempted to alter your original plan and it becomes more difficult to keep track of how many drinks you had.

5. Invite a friend to attend with you or shorten the length of time you stay at the party if you know the party is a trigger and difficult to manage by yourself. You are not expected to stay for the entire time.

If you are concerned about how stressed and anxious you feel when faced with an invitation to a social gathering or that you over drink when at parties, then you ought to consider speaking to your primary care physician or a mental health provider to evaluate if these actions are a sign of a more serious problem such as depression, an anxiety disorder, or substance abuse disorder.

Childhood Trauma Leaves Mark On DNA of Some Victims: Gene-Environment Interaction Causes Lifelong Dysregulation of Stress Hormones

How we live and what happens to us changes our genes. Trauma in early childhood can change DNA and lead to PTSD, anxiety and depression.

Dec. 2, 2012 from Sciencedaily.com— Abused children are at high risk of anxiety and mood disorders, as traumatic experience induces lasting changes to their gene regulation. Scientists from the Max Planck Institute of Psychiatry in Munich have now documented for the first time that genetic variants of the FKBP5 gene can influence epigenetic alterations in this gene induced by early trauma.

In individuals with a genetic predisposition, trauma causes long-term changes in DNA methylation leading to a lasting dysregulation of the stress hormone system. As a result, those affected find themselves less able to cope with stressful situations throughout their lives, frequently leading to depression, post-traumatic stress disorder or anxiety disorders in adulthood. Doctors and scientists hope these discoveries will yield new treatment strategies tailored to individual patients, as well as increased public awareness of the importance of protecting children from trauma and its consequences.

Many human illnesses arise from the interaction of individual genes and environmental influences. Traumatic events, especially in childhood, constitute high risk factors for the emergence of psychiatric illnesses in later life. However, whether early stress actually leads to a psychiatric disorder depends largely on his or her genetic predisposition.

Research Group Leader Elisabeth Binder of the Max Planck Institute of Psychiatry examined the DNA of almost 2000 Afro-Americans who had been repeatedly and severely traumatised as adults or in childhood. One-third of trauma victims had become ill and was now suffering from post-traumatic stress disorder. The risk of developing post-traumatic stress disorder rose with increasing severity of abuse only in the carriers of a specific genetic variant in the FKBP5 gene. FKPB5 determines how effectively the organism can react to stress, and by this regulates the entire stress hormone system. The scientists hoped to cast light on the mechanisms of this gene-environment interaction by comparing modifications of the DNA sequence of victims who had not become ill with that of those who had.

The Munich-based Max Planck scientists were then able to demonstrate that the genetic FKBP5 variant does make a physiological difference to those affected, also in nerve cells. Extreme stress and the associated high concentrations of stress hormones bring about what is called an epigenetic change. A methyl group is broken off the DNA at this point, causing a marked increase in FKBP5 activity. This lasting epigenetic change is generated primarily through childhood traumatisation. Consequently, no disease-related demethylation of the FKBP5 gene was detected in participants who were traumatised in adulthood only.

Torsten Klengel, a scientist at the Max Planck Institute of Psychiatry, explains the findings of the study as follows: "Depending on genetic predisposition, childhood trauma can leave permanent epigenetic marks on the DNA, further de-repressing FKBP5 transcription. The consequence is a permanent dysregulation of the victim's stress hormone system, which can ultimately lead to psychiatric illness. Decisive for victims of childhood abuse, however, is that the stress-induced epigenetic changes can only occur if their DNA has a specific sequence."

This recent study improves our understanding of psychiatric illnesses which arise from the interaction of environmental and genetic factors. The results will help tailor treatment particularly for patients who were exposed to trauma in early childhood, thereby greatly increasing their risk of illness.

Story Source:

The above story is reprinted from materials provided by Max-Planck-Gesellschaft (2012, December 2). Childhood trauma leaves mark on DNA of some victims: Gene-environment interaction causes lifelong dysregulation of stress hormones. ScienceDaily. Retrieved December 10, 2012, from http://www.sciencedaily.com­ /releases/2012/12/121202164057.htm

Link to article

El Huracán Sandy: Como Lidiar con las Secuelas Emocionales

Por Nerina Garcia,-Arcement Ph.D. Traducción por Carla Saad, B.A.

Los desastres naturales, como el Huracán Sandy, nos recuerdan que tan vulnerables somos.  Entre más cercano haya sido la experiencia de uno con el huracán, la reacción que uno sentirá después podrá ser más intensa.  Al sobrevivir un desastre natural como el Huracán Sandy, uno puede sentir estrés, ansiedad, depresión y síntomas del trastorno de estrés postraumático.  Si usted ha sufrido de problemas emocionales en el pasado, el enfrentarse con un evento estresante, como el Huracán Sandy, puede exacerbar éstas condiciones pre-existentes.

Algunas de las reacciones emocionales típicas que uno puede sentir tras vivir un desastre natural incluyen sentimientos de incredulidad, sentirse confundido o indefenso, irritabilidad, tristeza, miedo, dificultad para concentrarse y para tomar decisiones, sentirse preocupado y pensar constantemente acerca de lo que paso durante/después de la tormenta, sentir preocupación por consecuencias negativas que puedan llegar a ocurrir, y sentir que uno está volviendo a vivir los eventos del desastre.  Algunas de las reacciones físicas comunes que uno puede tener incluyen: dificultad para dormir, tener pesadillas, sentirse nervioso y sobresaltarse con facilidad, latidos rápidos del corazón, problemas para respirar, dolor de cabeza y sentirse tembloroso.

Hay varias cosas que usted puede hacer para sentirse mejor si ha notado que está teniendo éstos problemas:

  1. No se aísle: Busque apoyo de gente querida, amigos y vecinos que entiendan lo que usted está viviendo. Esto le ayudará a darse cuenta que no está solo, y no es el único que siente éste dolor.
  2. Hable con amigos y gente querida acerca de como se siente: El expresar sus preocupaciones, miedos, ansiedades, tristeza, sentimientos de incredulidad y confusión puede ser un proceso curativo y catártico.
  3. Limite ver noticieros: Ver las imágenes de destrucción únicamente recuerdan la experiencia traumática y reafirman los sentimientos de miedo y vulnerabilidad.
  4. Participe en actividades de recursos de socorro: El ser voluntario y donar su tiempo en esfuerzos de ayuda humanitaria le ayudará a sentir mayor control y sentir que puede causar un impacto positivo. Ayudar a otras personas a sentir menos dolor, le puede ayudar a aliviar su propio dolor.
  5. Participe en pasatiempos o en actividades positivas: El participar en actividades que uno disfruta le ayuda a distraerse y en no pensar en su aflicción, y le recordará que aún existe belleza y creatividad en el mundo, y no solamente destrucción.
  6. 6.      Manténgase activo: Haga ejercicio, o salga a dar caminatas. Estas actividades le ayudarán a no pensar en sus problemas. El mantener el cuerpo activo le ayuda a liberar hormonas que reducen el estrés.

Si después de intentar éstos consejos usted todavía se siento afligido, considere hablar con un experto en problemas de salud mental o con un consejero espiritual.  El sobrevivir un desastre natural puede tener impactos negativos y duraderos en la manera en que nos sentimos y en la que vemos el mundo.  El enfrentar el dolor emocional lo antes posible reduce las probabilidades de que los síntomas de estrés, ansiedad, depresión y del trastorno de estrés postraumático sean duraderos, y persistan en los años por venir.

Trauma and Disaster: Helping Teens Manage the Impact of Hurricane Sandy

Listen to my interview on The Mary Waldon Show on the emotional impact and how to cope with Hurricane Sandy. Hurricane Sandy has had a tremendous impact on countless families up and down the east coast of the United States. Such an event can leave even the most well-informed parent with questions and concerns.What is the potential impact of natural disasters and other traumas on teenagers? What can parents do to help mitigate the impact of Hurricane Sandy? What is an expected reaction to such extreme events, and what kinds of reactions indicate a need for professional intervention? For answers to these and other related questions, please tune in to The Mary Waldon Show to hear the insight and expertise of Dr. Nerina Garcia-Arcement, an expert in the treatment of Post Traumatic Stress Disorder.

Link to radio show

Hurricane Sandy: Coping with the Emotional Aftermath

By Nerina Garcia-Arcement, Ph.D. Natural disasters, such as Hurricane Sandy, remind us of our vulnerability. The closer the impact of the hurricane to you the more intense your reaction can be. Surviving a natural disaster such as Hurricane Sandy can bring about stress, anxiety, depression and post traumatic stress symptoms. If you have experienced emotional distress in the past, then a major stressor such as Hurricane Sandy is likely to exacerbate a pre-existing condition.

Typical emotional reactions include disbelief, feeling confused or helpless, irritability, sadness, fear, difficulty focusing and making decisions, feeling preoccupied and ruminating about what happened during/after the storm, worrying about what future negative things could occur, and re-experiencing events from the disaster. Common physical reactions are sleep problems, nightmares, feeling jumpy and being easily startled, racing heart, trouble breathing, headaches and trembling.

If you notice you are experiencing these problems there are actions you can take to feel better:

  1. Do not isolate yourself: Seek out support from loved ones, friends and neighbors that know what you are going through.  This will help you realize you are not alone in your pain.
  2. Talk to friends and loved ones about how you are feeling: Expressing your worries, fears, anxieties, sadness, disbelief and confusion can be healing and cathartic.
  3. Limit your news watching: Seeing the images of destruction simply reminds you of your traumatic experience and reinforces your feelings of fear and vulnerability.
  4. Donate or volunteer your time through relief efforts: This will help you feel more in control and that you can make a difference. Aiding others through their pain helps reduce your own.
  5. Engage in hobbies or life affirming activities: Doing things you enjoy will help distract you from your distress and remind you that there is beauty and creativity in the world, not just destruction.
  6. Stay Active: Exercise or go outside for walks. These activities will get your mind off of your problems.  Getting your body moving will help release hormones that relieve stress.

If you find you are still distressed after trying these suggestions, consider talking to a mental health professional or a faith based adviser. Surviving a natural disaster can have a lasting negative impact on how you see the world and how you feel. Addressing your emotional pain now can reduce the chances of your stress, anxiety, depression or PTSD symptoms lasting for years into the future.

 

Naming the Shame that Can Cripple

I was quoted on the causes of shame, how to cope and treatment options. By Marcia G. Yerman

When Amy Ferris asked me to contribute an essay to Dancing at the Shame Prom: Sharing the Stories That Kept Us Small, I wasn't sure that I had any shame. Then, when I thought about it, I realized that I did. I just hadn't framed it that way. I agreed to participate. After I handed in my essay, I heard back from co-editor Hollye Dexter. "I think you are holding back," she said. "Can you go a little deeper?" So I did. Along with twenty-six other women, I wrote openly about issues that had impacted my life.

Now that the book is out, I have taken off my memoirist hat and am writing as health journalist. Reading the stories that encompassed familial alcoholism, sexual abuse, parental suicide, distorted body images, hoarding, alienation, and racial identity anxiety - I wanted to get to the psychological root of how shame shapes who we are and how we live our lives.

I interviewed four practitioners who shared insights that were both clinical and revelatory. We focused on how shame specifically impacts girls and women. Many of their observations and verbiage overlapped. To a person, they all began the conversation by drawing a distinction between shame and guilt.

Shame is a feeling or belief that screams, "I am bad." Guilt is evidenced as, "I did something bad." Shame is feeling worthless. Guilt is external; you can fix it. Specifically, shame is, "I am damaged."

Amber Lewter, EdS., LAPC, whose background includes working as a survivor advocate at a rape crisis center, told me, "When women define themselves as being bad, it creates low self-esteem and a poor sense of self-worth." Treating those who have experienced childhood sexual trauma, Lewter sees women coming in for counseling with a lot of "shoulds" ("I should have told someone.").

She conducts an exploration of shame through expanding awareness of external factors, pointing out that what happened "was beyond the control" of the patient. She believes that shame is more of an issue for women because they are "relationship-centric" and therefore bring childhood shame and a "less than" mindset into their adult relationships.

Ph.D. and Licensed Clinical Psychologist, Nerina Garcia-Arcement, qualifies shame as "an insidious emotion, often at the root of mental health problems like depression and anxiety." She sees shame as creating "a sense of isolation which poisons an individual's self-esteem."

She told me, "My patients feel silenced due to their shame. Often, they can't even speak out loud what they feel ashamed about." Garcia-Arcement defines shame as a reflection of a "core value." Therefore, what results is a need to cover up what we feel ashamed about.

She related, "The power of shame is that it silences us and creates internal negative dialogue, such as, 'I wasn't good enough. I deserved it.' So we want to stay invisible. We don't want to feel vulnerable. This stunts our ability to grow." Garcia-Arcement explained how the fallout of shame translates into a "fear of takings risks."

"A silent killer," is how Lori Freson, Licensed Marriage and Family Therapist, describes shame. Her practice specializes in women's issues and self-esteem.

"Women don't always acknowledge shame as a presenting problem," she said. "Women can have body image problems and not realize it is shame."

She spelled out, "Shame about our bodies can lead to isolation, depression, and eating disorders." Shame about sexual abuse can lead to "avoidance of intimacy, relationships, sexual problems, and self-harm." Shame about an addiction "can delay or sabotage" efforts to recover.

Finally, she added the key observation, "Shame is connected to self-perception and how you think people perceive you."

Founder of the Critical Therapy Center, Silvia M. Dutchevici, spoke at length about how our culture "plays into our perceptions." Her philosophy embraces a holistic approach. "Psychology is not in a vacuum," she emphasized. She referenced the issue of race, class, gender, ideology, and economic status. Her point of view is that "society has issues as well," forcing people to "adapt to a false criteria rather than challenging that criteria."

Dutchevici was crystal clear in her assessment. "For women in particular, depending on the trauma, feelings of shame may arise from our culture's imposition of gender roles and the way women have been socially conditioned regarding their view of themselves. The more a society demands perfectionism," Dutchevici continued, "the more we have shame."

Both Freson and Garcia-Arcement addressed this element as well.

"A lot of shame comes from external societal factors," Freson said. "People want to be accepted. People are afraid of being different. Shame among women and girls is more prevalent because of cultural standards."

Freson pointed to celebrity media and fashion magazines. "People shut shame down because they want to have the perfect image." Her message about shame to young girls is, "You don't have to be perfect. Be your best self."

"The core expectation for women," said Garcia-Arcement, "is that we can do it all. Be beautiful and be everything to everybody." When girls and women buy into cultural norms they "learn to hate their bodies and themselves." It all comes back to not being "good enough." Garcia-Arcement illustrated shame from the ground level of family dynamics, up and outward toward group identification.

"Our family is a reflection of who we are," she said. "So if there is a family behavior [alcoholism, suicide, sexual abuse, domestic violence], it's still a part of us." Treatment by Garcia-Arcement entails the challenges faced by people of color. She identified that if a person from a minority community does something that the rest of the group is not proud of - it is seen as a "personal reflection on who they are."

In tandem, Dutchevici - a political refugee from Romania - touched on the use of shame as a tool of control in promoting a specific ideology. Shame also operates by keeping group memberships and affiliations intact.

So what can be done? All four women I spoke with communicated the need to explore an individual's experience through expanding consciousness.

Lewter articulated about introducing an awareness of "external factors." Freson, who maintains that if "shame is not exposed and dealt with it can destroy your relationships and your life," believes the more exposure the topic gets the more taboos are broken down.

Applauding the premise of the book, Freson sees it functioning as a tool for dialogue while enabling readers to discover, "Oh. It's not just me. I'm not the only one."

Dutchevici agreed. "The more people come out and talk about shame, the less power it has." She reiterated that it was important to "name the emotion."

"The first step is to realize that you are not alone," Garcia-Arcement reiterated. She uses a combination of talk therapy, cognitive behavior therapy, and insight-oriented work. She suggested mindfulness exercises, trying to connect the mind and body, sitting with your feelings, and being in the moment. Garcia-Arcement stressed the power of stories, advising the importance of sharing one's story.

"Empathy is essential to healing. If you can't say it out loud yet, write it down. Excise it from yourself. Writing is a useful tool, as there is no witness to the shame." An important element of eventually sharing the narrative is that it helps individuals "normalize their experience," through a realization that they are not alone and not to blame.

(The Shame Prom has a Tumblr blog where anyone can post a shame narrative, either with her name or anonymously).

Garcia-Arcement said definitively, "Everyone has shame. We just don't want to look at it."

In her essay, Elizabeth Geitz wrote, "I've learned letting go of shame is one of the most freeing things I've ever done. I've learned that I don't have to dance at the Shame Prom forever. The dress, the shoes, the long-wilted corsage are now gone.

"The music has finally stopped."

Link to article

When Your Kid's Sick at School How to help (and calm your own anxiety) when a college kid gets ill

Life transitions are difficult for all involved. This article addresses the struggle of letting your child grow and become independent, while still being a concerned parent.  I am quoted on common illnesses college students experience and how to help while letting your child gain independence. By Vanessa McGrady

So your baby’s grown up and gone away to college. You’ve packed her full of good advice and loaded her up with enough technology so that you could find her at the bottom of the sea, if it came to that. But no matter how independent college students become, nearly every parent gets that call home at some point: “Mom, I’m so sick.”

It’s a helpless feeling, and you might wrestle with a decision to go visit or bring your child back. Typical ailments for college students include viruses, gastrointestinal infections or "stomach flu,” mononucleosis and food poisoning. A university health service also fields cases of sexually transmitted diseases and injuries from accidents—some which involve alcohol. (These of course, happen only to other people’s children.)

You can’t drop everything to tend to each new boo-boo, but there are things you can do to help prevent trips to the clinic.

“It is very common for college students to get colds and the flu. This happens most often around midterms and finals season. Stress lowers the immune system and makes it easier to ‘catch bugs,’” says Nerina Garcia-Arcement, a licensed clinical psychologist at New York University School of Medicine.

RELATED: College Prep: Communication

You can’t drop everything to tend to each new boo-boo, but there are things you can do to help prevent trips to the clinic and, in the worst-case-scenario, the emergency room.

“Parents can help by offering support, reminding their kids to practice stress management, socialize to reduce isolation and increase social support, eat well and exercise. Care packages that encourage this are encouraged,” says Arcement.

A big part of preparation for college is to make sure your kids have the basics of self-care down, says Dr. Claudia Borzutzky, Lead Physician at University Park Health Center for University of Southern California’s Keck School of Medicine. That includes:

  • Regular exercise, healthy diet, adequate sleep (at least six to seven hours a night for most people)
  • Frequent hand washing during cold and flu season
  • Responsible use of alcohol and avoidance of binge drinking
  • Safe sexual practices
  • Use of bicycle helmets and respect for traffic and safety regulations on college campuses.
  • A primer on over-the-counter medications, most of which will suffice for the following: regular coughs, colds and flus that last less than a week or do not cause fevers over 100.5 degrees, shortness of breath or dizziness.

RELATED: Coping With College—as a Parent

Borzutzky says it’s also important to make sure kids understand their new campus's student health center hours and what kind of care they can access there. They should have a copy of their health insurance card and know what to do in an urgent medical situation.

You’ll also want to ensure that your kids' vaccinations are all up to date, including meningococcal vaccination, HPV vaccination (now recommended for both women and men), and annual influenza vaccination or the “flu shot,” especially for those with asthma or other chronic medical conditions.

One thing that may frustrate you, as your college student grows into adulthood, is that while you can always provide information about your child’s health to his doctor, you no longer can request information without your child’s written permission. If your child is under 18, privacy laws for issues such as mental health, drug use and reproductive health vary depending on the state.

“Learning to deal with minor illnesses without a parent close by is part of the separation and maturation process older adolescents need to go through as they approach young adulthood,” Borzutzky says, “However, in the case of more significant or prolonged injuries or illnesses, students will need to use their own best judgment about their ability to cope on their own without extra support, and parents and family are, of course, an essential part of their care and recovery when that is not the case.”

Link to article

Why a cancer diagnosis can turn a loved one into a fair-weather friend

This article discusses the unexpected reactions of loved ones to a cancer diagnosis.  I share insights into why people might not react as expected.
2 0 1 2Aug20

Why a Cancer Diagnosis Can Turn a Loved One into a Fair-Weather Friend

Posted by Staff

Cancer and PsychologyIn difficult times, people tend to lean on their family and friends for support, care, and love. Receiving a cancer diagnosis is certainly a time when the support of loved ones is especially important. However, what if, instead of support, a patient received a narcissistic attitude from a loved one? Instead of care, a loved one retreated from the patient’s life? How should someone in a situation like this react to their loved one’s attention-seeking and negative attitudes and what explains the behavior?

Stress, Sickness and Relationships

“I have very little contact with [my mother],” says Rebecca Cagel, whose cancer diagnosis caused an extremely negative attitude from her mother and, ultimately, the end of their relationship. “Since my diagnosis my mother continuously insults me and tells me I am going to be a "bag lady" because I am unable to work a forty hour week.”

Extreme negativity, especially from parents, can be hardest to deal with and can only be partially explained by stress.

“When stress levels are lower, people can cover up their fears, think more rationally,” says Elizabeth Lombardo, Ph.D., Physical Therapist, Psychiatrist, and author of ‘A Happy You: Your Ultimate Prescription for Happiness’. “But when the imminent death of a loved one is thrown at them, calling to mind their own mortality and helplessness regarding death, stress levels can skyrocket.”

According to Lombardo, extreme stress can lead to feelings of anger, fear, and anxiety, all of which can manifest into negative behaviors and feelings towards the patient. In the case of Rebecca Cagel, her mother’s fear for her daughter’s life may have led to this negative behavior. This negativity is not healthy for a cancer patient, however, and can be cause for the severing of the relationship.

“It is sad but I have to distance myself from her because it would be too frustrating and depressing to be around her,” says Cagel. “I have to take care of myself and get her negativity out of my life.”

Can a Relationship be Salvaged?

There is a way, however, to potentially save a relationship that has been hurt by extreme negativity-- empathy might be the key.

“You might say something like, I know my cancer is tough on all of us, and it is not uncommon to feel scared, sad or even angry about it,” says Lombardo. “When you empathize, then the person will be more likely to be able to hear the rest of what you have to say.”

Expressing your concerns in an understanding, non-threatening way will help alleviate tension and could play a big part in maintaining relationships through tragedy.

Negativity By Any Other Name

Negativity can appear in a less obvious way than outright insult and rude commentary. Some people begin to seek attention or behave selfishly in response to a loved one’s diagnosis. In these instances, ego is most likely to blame.

“Those who utilize narcissistic traits...are usually those with poor egos,” says John Lops, an adult, child, and adolescent psychiatrist from Brooklyn, NY. “Events such as tragedies can be a platform to display how important they can be, as well as a wonderful opportunity to fulfill their narcissistic urges.”

Many times these people will go over the top in their attempts to support and care for the patient, defining their doing as how special they are and showing others how appreciative they should be of him or her. But according to Lops, a poor ego is injured further when the acknowledgment of these “nice gestures” from other family and friends moves to the past. Then these narcissistic traits reveal themselves as selfish and attention-seeking.

Carla Ulbrich, who suffered from a severe and chronic, but not terminal, illness was faced with these behaviors when a close relative made a comment about needing to get sick in order to get any attention from the family. Ulbrich remembers her next thought: “You can think that, and I suppose you can even whisper it to somebody, but do you really have to shout it to the person who is already suffering kidney failure?”

There is a way to deal with this type of behavior while still keeping this person’s fragile ego in mind.

“Due to the fragility of folks who displays these behaviors, confronting, for the most part, will not be helpful,” says Lops. “I would probably thank them and make them aware to what extent I appreciate their efforts.”

It is important for a patient to, in some cases, completely remove this person and their negative behavior for some time, and Lops suggests expressing appreciation, but also telling him or her that they need not take further responsibility of aiding in getting through whatever tragedy occurred.

Radical Reactions

Other radical behavior, such as denial or withdrawal, can also be caused by stress. Loved ones may gradually withdraw from a recently diagnosed friend out of discomfort or fear. Avoidance is the only way they can deal with such serious news.

“They can't let in or accept that their loved one is sick or dying. Instead they focus on themselves and deny that extreme changes such as a difficult treatment or even death is in their friend and family's future,” says Nerina Garcia-Arcement, Ph.D. Licensed Clinical Psychologist, Clinical Assistant Professor, Dept. of Psychiatry, NYU School of Medicine.

Avoiding the patient and denial of the situation can increase as the patient’s health deteriorates. Walter Meyers of San Diego, CA remembers how a friendship ended before a terminal diagnosis took a close friend’s life.

“Suzy, Scott and I all...worked together for years. When Suzy was diagnosed with cancer, I tried to be there for her, visiting her often in the hospital, even donating blood platelets for an [experimental treatment],” recalls Meyers. “As Suzy got sicker, Scott drifted further away...and when things got to the point that it was apparent nothing more could be done, Suzy called Scott to tell him goodbye. He said: “You think you’ve got problems? I went bowling last night and couldn’t break 100!”

Scott never made it to see Suzy and did not attend the memorial service. Meyers says he has not spoken to him since.

In all cases and at all levels of severity, negative behavior and attitudes in light of a loved one’s tragedy is serious and personal. However, it is important for both the patient and his or her loved ones to remember that a severe illness can affect everyone involved, both negatively and positively. By remembering this, it is easier to react empathetically and rationally in the face of such a life-changing event.

Link to article

 

Organizing Your Life

I was recently on the Colin Lively Show, discussing how to declutter your mind.  The entire show was filled with helpful tips on how to better organize your home, office and mind. The description for the show is below:

Oh lord, if this show wasn’t sent from on-high, than it was Hildamae’s dying wish coming true: get Colin to clean his room! So, there it is, the cat is out of my Birkin bag: I can be rather messy. But aren’t we all? Whether it be in mind, life, schedule, desk, purse, closet, or your inbox, somewhere you are a little messy; and a little messy can lead to a great deal of stress. It is, as Dawn Falcone put it, “stuck energy.” For me, Consuelo un-sticks my stuck energy four times a week, but that doesn’t cover all my bases: I still need to go to Dr. Feldheim, my therapist, and Dr. Koplowitz, my psychiatrist, to get my mind in order.

I was stunned to learn that our outer world is very much a reflection of our inner world. For instance, a messy desk can be a sign of a stressful work environment or chronic work overload. It is important to create systems that keep our lives orderly and neat. We do not need to be neat freaks, but organization is one of the keys to happiness. Growing up, we polished the silver under the iron fist of Hildamae, she said the harder we scrubbed the more we would feel her love. Boy was she right! Three hours of polishing spoons made my wrist feel so loved that they were practically stuck in an arthritic state until my mid-40s. “Sheets tight enough on which to bounce a quarter,” she would demand. By the time I went to college, I had had enough Old Dutch Cleanser, Clorox and Bon-Ami running through my blood that I vowed never to clean again. And I have not touched a mop since!

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

This week I will be speaking with three personal organizers and a psychologist, and we are going see how we can change our state of mind with a Swiffer, or two, or forty-seven.

Dawn Falcone is not only passionate about organization, she knows it has a HUGE impact on personal sanity, success, and overall stress level. She emphasizes the point that reducing clutter and chaos will ultimately bring reward in the form of clarity, serenity, and time. She works closely with her clients to design spaces that reflect their personality and spirit. Dawn is a proud member of the (National Association of Professional Organizers) and is a certified interior environmental coach. Her work has appeared in many publications including: Real Simple, Woman’s World, Home And Garden Television, and Apartment Therapy.

Bonnie Joy Dewkett is the founder of The Joyful Organizer and is an organizing expert, author, motivational speaker, and radio personality – oh and she is an expert in time management! Boy oh boy does she know how to block-out a day!

Andrea Brundage of Simple Organized Solutions (S.O.S.) offers personalized hands-on organizational solutions to help small-to-medium sized business owners and homeowners function in efficient and organized environments. In partnership with its clients, S.O.S. creates “sensible solutions for your organizational needs.”

Dr. Nerina Garcia-Arcement is a licensed Clinical Psychologist and a Clinical Assistant Professor, in the Dept. of Psychiatry, at NYU School of Medicine. She specializes in challenges associated with life transitions, stress, anxiety, and depression.She provides a holistic therapeutic session by using a combination of Cognitive Behavioral Therapy and insight oriented/psychodynamic techniques to identify current problems, develop individualized strategies to ease stress, and gain insight into understanding one’s patterns in behavior. Dr. Garcia strongly advocates the act of self exploration, which helps us understand the way we think and act, it will also help shed light on our behaviors that worked in the past but are not effective any longer.

Link to podcast/show

Organizing Your Life

Can Social Anxiety Be Caused by a Nutritional Deficiency?

I was quoted on the topic of social anxiety and its causes. by Rheyanne Weaver |

If you don’t get the right nutrients, your body won’t function to the best of its ability. Some general health conditions can be linked to nutritional deficiency, but it’s up for debate whether the same applies to specific mental health conditions. Some nutrition experts do claim that unique cases of social anxiety can actually be caused by a nutritional deficiency. In the condition several experts refer to as pyroluria, once the nutritional deficiency is taken care of, the social anxiety is relieved. Other experts are quick to dismiss the validity of this diagnosis.

Trudy Scott, a food-and-mood expert who said in an email that she has suffered from pyroluria, is a certified nutritionist, immediate past president of the National Association of Nutrition Professionals, and author of The Antianxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood and End Cravings.

“The person experiences shyness, inner tension, and social anxiety,” Scott said in regard to symptoms of pyroluria. “Symptoms usually start in childhood and are made worse under stressful situations. The wonderful thing is that the symptoms can be completely alleviated with taking these supplements: zinc, vitamin B6, and evening primrose oil. People typically start to feel less anxious, less shy, and more social within a week. The important thing is that if you do have pyroluria, you do need to take the supplements always.”

Generally only zinc and Vitamin B6 are recommended for pyroluria, but “gamma-linolenic acid (GLA), found in evening primrose oil and borage oil, is also beneficial for those with pyroluria because its levels are often low, and supplementing with GLA improves zinc absorption,” she added. In her book about anxiety, mood, and food, she wrote a whole chapter about pyroluria.

“I am … very passionate about the subject because I have pyroluria myself and used to suffer terribly from social phobia and shyness, anxiety, unexplained fears, waking with a sense of doom and even panic attacks,” Scott said. “I have used the amazing healing powers of foods and nutrients to completely heal. I now help women find natural solutions for anxiety and other mood disorders.”

She has posted a questionnaire on her website for pyroluria. It includes a long list of symptoms, and if 15 or more items are checked on the list, it is likely a person has pyroluria: http://www.everywomanover29.com/blog/pyroluria-questionnaire-from-the-antianxiety-food-solution/

She said that in research studies, pyroluria is also called “the mauve factor.” “Much of what we know about pyroluria is based on the work of Humphrey Osmond, Abram Hoffer, and Carl Pfeiffer,” Scott said. “Much of the original work was done with schizophrenic patients in psychiatric hospital settings. Although pyroluria was first identified in the 1960s, the medical and mental health communities have been slow to recognize it, and many mental health practitioners and physicians remain unfamiliar with this condition.”

She said she learned about the condition mainly from reading the following books: The Mood Cure by Julia Ross Depression-Free Naturally by Joan Mathews-Larson Nutrition and Mental Illness (1988) by Carl Pfeiffer

Her own book goes into the specific details and biological/chemical/genetic aspects of pyroluria. In her book, she cites research prevalence rates from Joan Mathews-Larson, the author of Depression-Free Naturally. Pyroluria is thought to exist in “11 percent of the healthy population” and “40 percent of adults with psychiatric disorders,” according to Scott’s book. For people with alcohol addiction, pyroluria is thought to have a 40% prevalence rate. However, the prevalence rates do depend on the source. In her own experience as a nutritionist, Scott said about 80% of her clients who have moderate to severe anxiety have symptoms associated with pyroluria.

She added that stress can be a major factor for what age pyroluria develops and that it is a genetic condition that seems to affect more women than men. In addition, people who have pyroluria tend to also have gluten sensitivity, especially if they also are dealing with other issues like depression, anxiety, autism, alcoholism, bipolar disorder, and schizophrenia, according to the book. People with pyroluria may also have digestive problems, and they need to make sure to balance out an increased Vitamin B intake with a higher intake of magnesium.

In the book The Mood Cure by Julia Ross, the author includes a discussion of the prevalence, testing, and treatment of pyroluria, as well as a checklist similar to that offered by Trudy Scott. Ross states that the questionnaire was developed by Dr. Carl Pfeiffer, a clinician and researcher. He wrote the book Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry in 1988.

Ross states in her book that pyroluria is fairly uncommon in the general public, but in certain groups of people (like those who have experienced alcohol addiction), it is more common. “I am just getting familiar with this condition, but I can see that it is an important one for certain people, affecting stress levels and mood generally and preventing full response to nutrient therapy until it is addressed,” Ross wrote in her book.

There are a plethora of articles dedicated to nutrition, diet, and mental health in general, as well as multiple research studies suggesting that certain mental health issues can be improved through natural supplements and a healthy overall diet. “Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries and are exceptionally deficient in patients suffering from mental disorders,” according to an abstract from a research study in Nutrition Journal. “Studies have shown that daily supplements of vital nutrients often effectively reduce patients’ symptoms.”

Another abstract from a research article in the journal Alternative Therapies in Health and Medicine concludes the following: “Many patients will benefit from the use of specific dietary supplements, such as a multivitamin-mineral high in B vitamins and omega-3 fatty acid,” according to the abstract. “And no matter what the underlying cause of the mood disorder, patients should be counseled about the relationship between food and mood, for the evidence now substantiates what laypeople and medical professionals have long known intuitively: the way we eat affects the way we feel.”

The research, authored by Tieraona Low Dog, director of the fellowship at Arizona Center for Integrative Medicine at University of Arizona, added in the research abstract that the healthiest diet for improving mental health is a “low-glycemic, modified Mediterranean diet rich in fruits, vegetables, whole grains, and seafood (if not vegetarian) and low in processed, refined foods.”

Other experts remain unaware of the condition and are skeptical of its legitimacy. Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said in an email that he is not accustomed to pyroluria and had to look it up on Google to find out what it was.

“Once I saw that it is connected to orthomolecular psychiatry, which I have heard of, I knew it was in the pseudoscience realm,” said Carroll, who is also an assistant professor at the University of New Mexico School of Medicine. “Not surprisingly, it claims to be the cause of a number of unrelated psychiatric disorders, which is typical of pseudoscience disorders. Like so many ‘cure-alls,’ it sounds plausible, but there is no scientific basis to it, and it allows dubious practitioners to prey on desperate, suffering people.”

He said there are certain cases where nutrition can play a part in mood and mental disorders. “Inadequate amounts of Omega 3 fatty acids, especially from fish or krill oil, have been shown to affect mood and anxiety in a broad way of which social anxiety can be a part,” Carroll said. “Also, low folate, low Vitamin D, and low B12 have all been associated with negative effects on mood and anxiety.”

“However, in people with low folate, it is more often a case of a genetic inability to transport the folate molecule into the brain rather than a low blood level,” he added. “In those cases, which often present with chronic depression and anxiety that has never responded to antidepressants, there are folate precursors that are more lipophilic and can diffuse into the brain without use of a transport mechanism.”

Nerina Garcia-Arcement, a licensed clinical psychologist and clinical assistant professor at the NYU School of Medicine, said in an email that she didn’t study pyroluria in school and hasn’t read about it in any research studies after graduating from her doctorate program.

“Based on current knowledge it does not appear to be a legitimate health condition,” Garcia-Arcement said. “Further research is required to further explore and understand whether social anxiety or any other mental health condition could be related to improper synthesis in the blood.  Although this theory seems appealing, being able to ‘cure’ a mental disorder with vitamins or supplements … is unlikely.”

“Causes of social anxiety that have been substantiated by research include chemical imbalances in the brain (i.e., serotonin, a neurotransmitter), inherited traits (genetic and through observing anxious family members), negative life events or experiences, and an overactive amygdala (a part of the brain that controls emotions, including fear response),” she added.

She said that good nutrition is important for overall health, but it’s not necessarily linked to mental disorders. “In my experience, the social anxiety could be traced to other causes, not nutritional deficiencies,” Garcia-Arcement said. “Having a healthy and balanced diet is overall beneficial, but it won’t cure social anxiety or a mood disorder. I am more likely to recommend my clients get enough sun exposure to improve their moods (seasonal affective disorder) than recommend diet changes.”

Link to article

How Are You Coping With the Recent Mass Shootings?

I was quoted on the important topic of PTSD and typical reactions to mass shootings and trauma. In this I share tips on how to cope after a trauma.

By Rheyanne Weaver  |

The two mass shootings in the last couple of months have been on the minds of many Americans, especially because they took place in seemingly safe places -- a movie theater and a temple. Experts have suggestions for how the general public and victims can cope with such saddening and scary events.

Nerina Garcia-Arcement, a licensed clinical psychologist, said in an email that she previously worked with 9/11 survivors. “Unfortunately many people do not seek help for mental health problems following a trauma and most people wait an average of 10 years to seek mental help,” Garcia-Arcement said.

“A majority of my 9/11 clients sought help six to 10 years after 9/11. By this point many were isolated from all social support, had difficulties working as they avoided public transportation and public spaces, and suffered from chronic stress due to fear of the ‘next terrorist attack.’"

She hopes that victims of recent shootings get help from mental health professionals sooner in order to cope with trauma. There are a plethora of mental health issues that could result from being a victim of a shooting.

“The closer the person was to the event, the more emotionally impacted they are likely to be,” Garcia-Arcement said.

“For people directly affected by the recent shootings, it is common to experience Post Traumatic Stress Disorder (PTSD), anxiety (including panic attacks, generalized anxiety and phobias related to the attack, such as social phobias or fear of the dark) and depression symptoms.”

“It is a normal reaction for people to re-experience or remember the event, have nightmares, feel sad and scared, be hypervigilant, avoid reminders of their trauma and isolate from people,” she added. “This is the mind trying to process and make sense of what happened.”

“Survivors of the [Colorado] shooting will find that things like the smell of popcorn, popping sounds, the dark, being in crowded spaces or watching a movies might trigger reminders of their experience,” Garcia-Arcement said.

“These are normal reactions that can be managed with deep breathing, relaxation exercises and positive self talk (i.e., ‘this is just a reminder, it is not happening again. I am okay. I am safe.’). For many survivors, those in the theaters and injured, survivor's guilt is common.”

People who were not directly involved in the shooting can still suffer from slight mental health issues as well, such as “sadness, horror and anxiety,” and avoidance of reminders of the shootings.

Here are some tips from Garcia-Arcement to help people cope with the recent shootings:

1) “Offer each other social support, as individuals and as a community.”

2) “Remind yourselves that this was an isolated horrible event that happened to good people. It was not their fault.”

3) “My strongest recommendation is that survivors and the general public do not avoid reminders of the trauma and do not isolate. It is instinctive for people to avoid things that remind them of their trauma. Unfortunately once they begin avoiding going to movies or spending time in crowded spaces, it often escalates to avoiding more and more things. They begin to misinterpret the fact that they are safe simply because they avoided going to the movies, instead of forcing themselves to go to the movie and realizing they are safe.”

4) “A person should seek mental health support if they are feeling overwhelmed by their reactions to the shooting. If after a few months they find they are still experiencing PTSD, anxiety or depression symptoms, they ought to seek a therapist that could help them process their normal reactions.”

Robin Zagurski, a licensed clinical social worker, works with adults and teens who have gone though traumatic experiences. She said in an email that a major indicator that professional mental health is needed after a mass shooting is if people are unable to function in their daily lives.

She suggested keeping the same daily routine in order to distract from thinking about the recent shooting, and taking care of one’s overall health and well being.

She said that it’s difficult to plan for rare shooting situations, but to be aware of any “leakage” statements, where a future shooter may tell someone or post on the Internet what their plans are.

Don’t assume these statements are merely threats. Reporting this to authorities could potentially save lives.

“Think ... of maintaining your safety in all environments, especially for hazards that have a higher likelihood,” Zagurski said.

“For example, always know where the exits are in any building in case of fire. Practice evacuations so that you know how to get out safely. If someone talks to you about hurting themselves or others, report it to authorities immediately.”

 

Link to article

Mental Health Issues to Be Aware of in Your 20s

I was quoted in this article regarding typical mental health issues for people in their 20s. I discuss the impact of stressful transitions and how to cope. by Rheyanne Weaver |

People in their 20s seem to have it all: youth, energy, health, and looks. But they are also still figuring themselves out, and this time of change can bring certain mental health concerns as well. Experts have information on these issues that tend to impact people in their 20s, and provide some solutions for addressing and coping with these problems.

Clinical psychologist Dean Haddock, a marriage, family, and child counselor and the executive director and founder of Community Counseling and Psychological Services, points to a fairly common activity of 20-somethings that can lead to mental health issues if it’s not checked: alcohol and drug use.

“The first problem that leads to many others is alcohol and chemical abuse, which often leads to dependency,” Haddock said in an email. “The mental disorders that follow are often depression, anxiety, and brain injury. Of course, self-esteem and body-image problems often lead to eating disorders.”

Haddock gives three tips to help people in their 20s prevent and get through some common mental health concerns:

  1. Know your genetic history of mental disorders. Knowing is half the battle to avoid those disorders in yourself.
  2. Be choosey about your friends, as they will influence your decisions. Healthy friends lead to healthier decisions.
  3. Self-esteem is often the result of the people who matter to you. If they do not esteem you, then you will not esteem yourself.

Nerina Garcia-Arcement, a clinical psychologist and clinical assistant professor at NYU School of Medicine, suggests that the many life changes people experience in their 20s can cause mental health issues at times.

“Your 20s are filled with life transitions that can be stressful,” Garcia-Arcement said. “This is a time when young adults are solidifying their personalities, developing their independence from family, starting or finishing college, beginning new jobs, developing a career, forming romantic relationships, and learning to manage their existing family relationships and friendships within these context.”

“Individuals in their 20s don’t have a lifetime of experience to draw on when managing multiple life transitions at once,” she added. “When someone experiences these transitions, anxiety and depressive disorders can occur.”

Here are six of Garcia-Arcement’s tips to help people in their 20s cope with mental health issues more common to that age group:

  1. Seek out and form strong support networks.
  2. Seek out others who are going through similar experiences and share your feelings, whether you are feeling worried, nervous, scared, sad, confused, or excited.
  3. Know that you are not alone in your confusion about your career and relationships.
  4. Seek out mentors who have achieved their goals, and ask for advice.
  5. If you are feeling stress, sadness, or anxiety, engage in activities that will help you manage those feelings such as yoga, meditation, exercise, hobbies, social activities, relaxation exercises, and deep breathing.
  6. If you feel you are not getting the necessary support and feel overwhelmed or depressed, seek out mental health professionals who can help you manage the feelings related to your life transitions.

Stephanie Sarkis, a licensed mental health counselor, said in an email that anxiety and depression are some of the main mental health issues 20-somethings face.

“We have seen an increase in these issues due to the lagging economy and difficulties finding employment,” Sarkis said. “Many people in their 20s have moved back in with their parents, which can trigger feelings of failure and frustration.”

Dr. Maiysha Clairborne, a family physician and wellness and stress management coach, added in an email that eating disorders associated with body dysmorphic disorder and body-image issues are also common for people in their 20s. She has three overall tips for people in this age group:

  1. Talk to someone. The worst thing that a person can do when they are feeling depressed, anxious, or alone is to isolate more. Many times when we talk with someone we trust about what’s going on, we come to realize that we are not the only ones experiencing it and then we can get support.
  2. Get active. Staying physically active not only helps to keep the body fit but also helps release endorphins and serotonin in the brain, which help keep the mood elevated. Physical activity is also a good release for stress and anxiety.
  3. Minimize sugar and junk food. Sugar and processed junk foods can worsen the emotions of stress, anxiety, and depression because they cause erratic changes in your body’s blood sugars. This can disrupt the normal release of hormones in the brain that keep your moods stable.

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said there are many issues specific to people in their 20s, including problems associated with medication use.

“Many people were on stimulants/meds for their ADHD when they were younger, but they thought it was okay to stop their meds when they were done with school,” Carroll said. “Now they are struggling at work and don’t know why. I’ve also seen young adults stop all kinds of meds like their thyroid meds because they didn’t know why they were even on it, and then they have all kinds of problems.”

Bad habits involving drug and alcohol use can start to become a major substance abuse issue when people are in their 20s, and other mental health issues start coming to the forefront at this time in peoples’ lives. Examples include bipolar disorder and schizophrenia. Also, panic attacks can start for people who have a genetic predisposition and who have higher amounts of stress associated with newfound adulthood.

“The 20s are an important time of social/emotional development,” Carroll said. “Unlike previous generations, identity formation often takes the entire 20s due to the complexity of modern society. It could be said that adolescence lasts until the early 30s in today’s society due to [prolonged] periods of education (grad school, law school, med school, etc.), lack of stable job options, and delays in getting married and starting families.”

Carroll, who is also an assistant professor at the University of New Mexico School of Medicine, suggests that when it comes to serious relationships and marriage, people in their 20s should consider how their choices could eventually affect their mental health and how their brain plays a part in their decision.

“Many 20-somethings are tempted to get married, but it is generally a bad idea because the brain in not done developing until about 25 [years old] … which leaves young adults vulnerable to having their rational mind be overwhelmed by their feelings or stress,” Carroll said. “Relationship choices often dramatically change from the early 20s to the late 20s, so many people find that the person that was perfect at 22 is a disaster at 27.  This can be an incredibly hard transition, to have to break up with your former soul mate that you thought you’d love for life because you’ve changed so much over the last several years.”

Link to article

Social Anxiety Can Be a Hidden Problem in College

I was quoted on the topic of social anxiety, its causes and how to cope or treat the symptoms. by Rheyanne Weaver |

Public speaking is generally not a favorite activity of most people—in fact many people seem to fear public speaking or at least avoid it when they can. But most people are also not crippled with embarrassment or anxiety when they have to present in front of a class or when they are called on to answer a question. For students with social anxiety, being put into the spotlight occasionally during class presentations or participation is enough to make them avoid those classes altogether.

New research from the University of Plymouth and University of the West of England (UWE) Bristol looked at the impact of social anxiety in higher education, and psychologist Phil Topham estimates that “10 percent of university students experience significant social anxiety,” according to a news release from UWE Bristol.

Social anxiety disorder or social phobia is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as “a marked and persistent fear of social or performance situations in which embarrassment may occur.” There are several other diagnostic criteria, including that “the social or performance situation is avoided, although it is sometimes endured with dread.” People are only diagnosed with the disorder if their life is significantly negatively impacted.

Out of over 1,500 students who were surveyed, some students experienced “frequent anxiety in learning situations that involved interacting with students and staff.” To cope with this anxiety, students would not participate in lectures and presentations or would even skip class. Other students wouldn’t take any classes that involved presenting at some point, according to the news release.

The researchers conclude that students who experience social anxiety “could be missing out on learning opportunities and may be distracted from attending to academic information by excessively focusing on their anxieties.”

Although the researchers don’t believe students should be treated as potentially fragile and coddled, there needs to be more support available for students with social anxiety without further stigmatizing these students or making them feel like their “flaws” are exposed. The researchers even give some suggestions for support in the university, including “not singling out students for questioning in lectures or setting assessed presentations in their first term,” and “sensitive appreciation of the shame and conflict caused in students by the desire to succeed and the fear of failure.”

Basically, college professors need to take into consideration the styles of all college students—some love the spotlight, others have social anxiety, so it’s best to ease students into participating and presenting during class.

Mental health experts have some tips on how to succeed in high school and college despite having social anxiety.

Nerina Garcia-Arcement, a clinical assistant professor at NYU School of Medicine and a licensed clinical psychologist, gave one major suggestion in an email to help students who are experiencing social anxiety.

“Do not avoid what you fear,” Garcia-Arcement said. “The more you avoid, you are creating evidence that it is more comfortable to not do something. Instead, if you face what you fear you can slowly prove that your worst fears will not be realized.”

She also suggests that students follow these four steps to take control of their anxiety:

  1. Stop and evaluate what you are feeling (i.e., butterflies in your stomach, sweating, trouble breathing, heart racing).
  2. Stop and evaluate what are you thinking (i.e., “people will laugh at me,” “I will fail,” “I will look ridiculous.”)
  3. Practice activities that will reduce the physical symptoms, such as deep breathing, muscle relaxation exercises and imagining yourself in a safe place.
  4. Challenge your negative thoughts by stopping the critical belief and instead replace it with a positive thought such as “people have never laughed before,” “I can do this,” “looking silly is the point of this activity, and if I do look silly so what.”

There are effective treatment options for students who have access to a mental health professional.

“Talk therapy is extremely effective for social anxiety, especially cognitive behavioral therapy. Medication can be taken in severe cases, Garcia-Arcement said. “Learning to manage the physical anxiety symptoms and stopping and controlling the negative thoughts is essential to controlling social anxiety. Sometimes people can do it on their own, sometimes they need help with monitoring thoughts and feelings and figuring out what gets in the way of using these new skills.”

She has three other tips for students who are trying to decrease their social anxiety:

  1. Practice deep breathing, meditation, yoga, and exercise. These help manage and control anxiety.
  2. Ease into social activities, first with smaller groups and eventually, as you feel comfortable, with larger groups.
  3. Practice what you fear in a controlled environment. First practice the presentation or talking to a stranger in front of a mirror, later practice in front of someone you trust such as a friend or parent, then go into the real situation.

Scott Carroll, a child psychiatrist who works at the University of New Mexico, said that part of the problem can be that some students don’t realize they have an issue that needs to be worked on.

“Many people with social phobia … often just think they are shy and don’t realize they may have a treatable condition,” Carroll said. “Also, if someone has been anxious their whole life, they may not realize they are significantly more anxious than other people.”

Once students do realize they have a disorder, they have a variety of treatment options available to them, including individual psychotherapy (such as cognitive behavioral therapy), social skills therapy groups, and multiple types of medications.

Carroll has two other coping methods for college students who have social anxiety disorder: positive self-talk, in which you reassure yourself that it’s okay to talk or say hello, can be helpful with milder forms; and repeated exposure, which leads to decreased anxiety, like joining Toastmasters to get comfortable with public speaking.

Jeffrey Gardere, a contributing psychologist at Healthguru.com, said in an email that it’s beneficial for students with social anxiety to have friends they can rely on to come along with them in situations that could cause more anxiety.  Sometimes self-help books can be useful as well.

“The young person with social anxiety may also want to stay away from stimulants such as energy drinks and caffeine in order to avoid becoming even more nervous,” Gardere said. “And certainly [try] to avoid liquor, marijuana or any other chemical that is a self medication in order to feel relaxed, simply because they may be more at risk for possible addiction.”

Link to article