Peter H Brown Clinical Psychologist

Psychology News & Resources

Social Anxiety: Half A Dozen Research Backed Hints To Fight The Fear

Social-Anxiety-3-224x300Source Credit:

Tartakovsky, M. (2013). 6 Ways to Overcome Social AnxietyPsych Central. Retrieved on September 9, 2013, from http://psychcentral.com/lib/6-ways-to-overcome-social-anxiety/00017631

“For some people social anxiety is pretty pervasive,” said Justin Weeks, Ph.D, an assistant professor of psychology and director of the Center for Evaluation and Treatment of Anxiety at Ohio University. For others, the anxiety arises in specific social situations, he said.

The most common example is anxiety over public speaking. Making small talk, eating in front of others and using public restrooms also can trigger worry and unease for some.

Some people engage in what Weeks called “covert avoidance.” For example, they might go to parties but instead of mingling, they hang back in the kitchen, he said.

Social anxiety is defined as anxiety anticipating a social situation or anxiety during or after that situation, Weeks said. “At the heart of social anxiety is the fear of evaluation.” And it’s not just negative evaluation that people worry about; it’s positive evaluation, too.

Weeks’s research suggests that people perceive negative consequences from a social situation whether they do poorly or well. (Here’s one study.) For instance, people who do well at work might worry about the social repercussions of outshining their coworkers, he said.

In other words, people with social anxiety simply don’t want to stand out. “They want to be as inconspicuous as possible.”

Anxiety about social situations lies on a spectrum. “The consensus among the experts is that shyness and social anxiety disorder are all part of one continuum,” Weeks said. “It’s a question of severity.”

How much does social anxiety interfere with your life?

For instance, you might wish that you were more comfortable when interacting with people, Weeks said. But “you don’t feel like it’s holding you back,” in terms of your personal or professional goals.

“Social anxiety is more severe.” A person might avoid going to college because schools require passing a public speaking course and interacting with new people. They might want a romantic relationship but worry so much about rejection that they avoid potential partners.

Below, Weeks shared his suggestions for overcoming social anxiety.

1. Try a self-help manual.

Self-help manuals are designed to supplement therapy, but they’re also good tools for working on your own, Weeks said. He suggested the Managing Social Anxiety workbook. (PETER’S NOTE: For Teens I highly recommend The Shyness and Social Anxiety Workbook for Teens: CBT and ACT Skills to Help You Build Social Confidence )

2. Work with a therapist.

If social anxiety is stopping you from doing things you want or need to do, or you haven’t had much success with self-help, seek professional help. Find a therapist who specializes in anxiety disorders. You can start your search here.

The Workbook Recommended by Dr Justin Weeks

The Workbook Recommended by Dr Justin Weeks. Click Image To Read Reviews and View Content

3. Practice deep breathing every day.

It’s helpful to engage in deep breathing before an anxiety-provoking social situation, Weeks said. But practice this technique every day. This way it becomes second nature, and you don’t hyperfocus on deep breathing and miss an entire conversation, he said. Here’s more on deep breathing.

4. Create an exposure hierarchy.

An exposure hierarchy is a list – akin to a ladder – where you write down situations that cause you anxiety, in order of severity. Then you perform the easiest behavior, and keep moving up the list.

To create your own hierarchy, list 10 anxiety-provoking situations, and rate them on a 100-point scale (zero being no anxiety; 100 being severe anxiety). Your list might start with asking a stranger for directions and end with joining Toastmasters.

This website features a link to various worksheets on coping with social anxiety, and includes “the fear and avoidance hierarchy.” (Look for “managing social anxiety: workbook.”)

5. Create objective goals.

People tend to disqualify the positive when they feel anxious, Weeks said. They might do well, even great, but because of their anxious feelings, they see their performance as abysmal. That’s why therapists encourage clients to create objective behavioral goals, he said.

These are behaviors that anyone in the room would be able to observe. It doesn’t matter how you feel or whether you’re blushing or sweating (which you can’t control anyway) in a social situation.

For instance, if you’re working in a group setting, the objective behavior would be to make three comments, Weeks said.

This also gives you a good barometer for judging your progress. Again, you’re not focusing on whether you felt nervous. Rather, you’re focusing on whether you performed the actual behavior.

My Recommended Workbook for Teens

My Recommended Workbook for Teens. Click Image To Read Reviews and View Content

Also, avoid focusing on others’ reactions. It doesn’t matter how your colleagues received your idea in the meeting. What matters is that you actually spoke up. It doesn’t matter whether a girl or guy said yes to your dinner invite. What matters is that you actually asked. It doesn’t matter how your child’s teacher reacted when you declined to volunteer for yet another school trip. What matters is that you were assertive and respected your own needs.

As Weeks said, “You did what you wanted to in a situation. We can’t control what another person is going to do.”

6. Keep a rational outlook.

Dispute both bleak thoughts that undermine your performance and fuel your anxiety, and equally unrealistic thoughts that are irrationally positive, Weeks said.

For instance, if you’re giving a speech, you might initially think, “I’m going to bomb.” But if you’ve given speeches before and done well, then this isn’t a rational or realistic perspective. You might say instead, “I’ve given speeches before. I’m prepared, and I’ll give it my best shot.”

If you’re asking someone out, it’s not rational to think, “They’re definitely going to say yes.” But it is rational to consider, “They might,” according to Weeks.

If social anxiety is sabotaging your goals and stopping you from living the life you want, seek help and try the above strategies. Social anxiety is highly treatable, Weeks said. You can get better, and grow in the process.

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September 11, 2013 Posted by | Acceptance and Commitment Therapy, Adolescence, anxiety, Cognitive Behavior Therapy, Education, Health Psychology, research, therapy | , , , , , , , , , | 5 Comments

Don’t Say “Don’t Panic”: How To Help Someone With A Panic Disorder

Credit: From , former About.com Guide

The Experience of Recurring Panic Attacks

To understand panic disorder with agoraphobia, we must first talk about panic attacks. Sudden and recurring panic attacks are the hallmark symptoms of panic disorder. If you have never had recurring panic attacks, it may be hard to understand the difficulties your friend or loved one is going through. During a panic attack, the body’s alarm system is triggered without the presence of actual danger. The exact cause of why this happens is not known, but it is believed that there is a genetic and/or biological component.

Sufferers often use the terms fear, terror and horror to describe the frightening symptoms of a full-blown panic attack. But even these frightening words can’t convey the magnitude of the consuming nature of panic disorder. The fear becomes so intense that the thought of having another panic attack is never far from conscious thought. Incessant worry and feelings of overwhelming anxiety may become part of your loved one’s daily existence.

These Intense Symptoms Must Mean Something…Something Terrible

At the onset of panic disorder, your loved one may be quite certain they are suffering from a heart condition or other life-threatening illness. This may mean trips to the nearest emergency room and intensive testing to rule out physical disease. But, even when he or she is assured that these symptoms are not life-threatening, it does little to put his or her mind at ease. The feelings experienced during panic attacks are so overwhelming and uncontrollable, sufferers are convinced they are going to die or are going crazy.

A New Way of Life Emerges: Fear and Avoidance

So frightening are the symptoms of panic disorder, that your loved one may go to any and all lengths to avoid another attack from occurring. This may include many avoidant types of behavior and the development of agoraphobia. But, despite the efforts to avoid another panic episode, the attacks continue without rhyme or reason. There is no place to escape, and the sufferer becomes a prisoner of an insidious and illogical fear. Without appropriate treatment, your loved one may become so disabled that he or she is unable to leave his or her home at all.

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Self Image Is Redefined

At times, we’ve all experienced nervousness, anxiousness, fear and, perhaps, even terror or horror. But in the midst of a catastrophic event, we understand these symptoms. Once the event is over, so, too, are the symptoms. But, imagine reliving these symptoms over and over again, without any warning or explanation.

This type of fear is life-changing. As abilities become inabilities, things once taken for granted, like going to into a store, become anxiety-filled events. Some enjoyable activities, like going to concerts or movies, may be avoided altogether. It is not uncommon for sufferers to experience a sense of shame, weakness and embarrassment as their self-image is redefined by fear.

Panic disorder is not just being nervous or anxious. Panic disorder is not just about the fear, terror and horror experienced during a full-blown panic attack because it does not end when the panic subsides. It is a disorder that is quick to invade and can alter one’s very essence, redefine one’s abilities and take over every aspect of one’s life.

Your Role As A Support Person

As a support person, you can play an important role in your loved one’s recovery process. Understanding what panic disorder is, and what it is not, will help you on this journey. Author Ken Strong provides a lot of information for supporting a person with panic disorder in his book, Anxiety:The Caregivers, Third Edition.

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September 10, 2010 Posted by | anxiety, brain, Cognition, depression, research, stress | , , , , , , , , , | 10 Comments

Why Do Some Friends Disappear When The Going Gets Tough?

Image by Getty Images via @daylife

It’s a question that many of us ask when terrible things happen. Where are the people who call themselves your friends when the going gets tough?

This reposted article from Harriet Brown of the New York Times may help you understand some of the possible answers.

Over the last few years, my family has weathered our share of crises. First our younger daughter was hospitalized for a week with Kawasaki disease, a rare condition in children that involves inflammation of the blood vessels, and spent several months convalescing at home. Soon after she recovered, our older daughter landed in the hospital with anorexia, which proved to be the start of a yearlong fight for her life.

Somewhere in the middle of that process, my mother-in-law was given a diagnosis of advanced lung cancer, and died less than 11 months later.

So we’ve had plenty of opportunities to observe not only how we dealt with trauma but how our friends, family and community did, too. For the most part, we were blessed with support and love; friends ran errands for us, delivered meals, sat in hospital waiting rooms, walked, talked and cried with us.

But a couple of friends disappeared entirely. During the year we spent in eating-disorder hell, they called once or twice but otherwise behaved as though we had been transported to Mongolia with no telephones or e-mail.

At first, I barely noticed; I was overwhelmed with getting through each day. As the year wore on, though, and life settled in to a new if unpleasant version of normal, I began to wonder what had happened. Given our preoccupation with our daughter’s recovery and my husband’s mother’s illness, we were no doubt lousy company. Maybe we’d somehow offended our friends. Or maybe they were just sick of the disasters that now consumed our lives; just because we were stuck with them didn’t mean our friends had to go there, too.

Even if they were completely fed up with us, though, they had to know that my husband and I were going through the toughest year of our lives. I would have understood their defection if our friendship had been less close; as it was, I couldn’t stop wondering what had happened.

In the wake of 9/11, two wars and the seemingly ever-rising tide of natural disasters, we’ve come to understand the various ways in which people cope with crisis when it happens to them. But psychologists are just beginning to explore the ways we respond to other people’s traumas.

“We all live in some degree of terror of bad things happening to us,” said Barbara M. Sourkes, associate professor of pediatrics at the Stanford University School of Medicine. “When you’re confronted by someone else’s horror, there’s a sense that it’s close to home.”

Dr. Sourkes works with families confronted with the unfolding trauma of a child’s serious, and possibly fatal, illness. “Other people’s reactions are multifaceted,” she said. “There’s no formula, and it’ll change from person to person.” The only certainty is that traumatic events change relationships outside the family as well as within it.

Click image to read review

Often the closer one feels to the family in crisis, the harder it is to cope. “Most people cannot tolerate the feeling of helplessness,” said Jackson Rainer, a professor of psychology at Georgia Southern University who has studied grief and relationships. “And in the presence of another’s crisis, there’s always the sense of helplessness.”

Feelings of vulnerability can lead to a kind of survivor’s guilt: People are grateful that the trauma didn’t happen to them, but they feel deeply ashamed of their reactions. Such emotional discomfort often leads them to avoid the family in crisis; as Dr. Sourkes put it, “They might, for instance, make sure they’re never in a situation where they have to talk to the family directly.”

Awkwardness is another common reaction — not knowing what to say or do. Some people say nothing; others, in a rush to relieve the feelings of awkwardness, blurt out well-intentioned but thoughtless comments, like telling the parent of a child with cancer, “My grandmother went through this, so I understand.”

“We have more of a societal framework for what to say and do around bereavement than we do when you’re in the midst of it,” Dr. Sourkes said. “Families say over and over, ‘It’s such a lonely time and I don’t have the energy to educate my friends and family, yet they don’t have a clue.’ ”

The more vulnerable people feel, the harder it may be to connect. A friend whose son suffered brain damage in an accident told me that the families who dropped them afterward had children the same age as her son. They could picture all too vividly the same thing happening to their children; they felt too much empathy rather than not enough.

That was true for us, too, I realized. The friends who had disappeared had daughters exactly the same age as ours.

Dr. Rainer describes this kind of distancing as “stiff-arming” — creating as much space as possible from the possibility of trauma. It’s magical thinking in the service of denial: If bad things are happening to you and I stay away from you, then I’ll be safe.

Such people often wind up offering what Dr. Rainer calls pseudo-care, asking vaguely if there’s anything they can do but never following up. Or they might say they’re praying for the family in crisis, a response he dismisses as ineffectual at best. “A more compassionate response,” he said, “is ‘I am praying for myself to have the courage to help you.

True empathy inspires what sociologists call instrumental aid. “There are any number of tasks to be done, and they’re as personal as your thumbprint,” Dr. Rainer said. If you really want to help a family in crisis, offer to do something specific: drive the carpool, weed the garden, bring a meal, do the laundry, go for a walk.

I tested that theory recently, when a friend’s mother went through a series of medical crises and moved to an assisted-living facility in our town. Normally, I might have been guilty of pseudo-care, asking if I could do anything but never really stepping up. Instead, I e-mailed her a list of tasks I could do, and asked if any of them would be helpful.

To my surprise, my friend responded by asking if I’d visit her mother on a day she couldn’t. Her mother was glad for the company, and my friend felt reassured, knowing that her mother wasn’t alone.

And I had the chance to do something truly useful for my friend, which in turn let me show her how much I cared about her. The time I spent with her mother turned out to be a gift for me.

Thinking back to my own years of crisis, I wondered why I’d focused on the friends who didn’t come through when so many others had. In retrospect, I wished I’d taken a slightly more Zen-like attitud

“The human condition is that traumatic events occur,” said David B. Adams, a psychologist in private practice in Atlanta. “The reality is that we are equipped to deal with them. The challenge that lies before us is quite often more important than the disappointment that surrounds us.”

Harriet Brown is the author of “Brave Girl Eating: A Family’s Struggle With Anorexia,” being published next week.

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August 19, 2010 Posted by | Books, Eating Disorder, Education, Health Psychology, Intimate Relationshps, Parenting, Positive Psychology, stress | , , , , , | 2 Comments

Should I Tell Or Not? Mood Disorders & The Workplace

Credit: Therese J. Borchard via psychcentral

Just when I think our world has moved a baby step in the right direction regarding our understanding of mental illness, I get another blow that tells me otherwise. For example, awhile back I quoted an intelligent woman who wrote an article in a popular women’s magazine about dating a bipolar guy when she was bipolar herself. She recently discovered that she had jeopardized a job prospect because the article came up — as well as all those who referenced it, like Beyond Blue — when you Googled her name. So she requested everyone who picked up that article to go back and change her real name to a pseudonym.

Because talking about bipolar disorder in the workplace is pretty much like singing about AIDS at the office a hundred years ago or maybe championing civil rights in the 60s.

I totally get why this woman created a pseudonym. Trust me, I entertained that possibility when I decided to throw out my psychiatric chart to the public. It’s risky. Extremely risky. Each person’s situation is unique, so I can’t advise a general “yes ” or “no.” As much as I would love to say corporate America will embrace the person struggling with a mood disorder and wrap him around a set of loving hands, I know the reality is more like a bipolar or depressive being spit upon, blamed, and made fun of by his boss and co-workers. Because the majority of professionals today simply don’t get it.

Not at all.

They don’t get it even though the World Health Organization predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease; that major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a new study funded by the National Institute of Mental Health; that the direct cost of depression to the United States in terms of lost time at work is estimated at 172 million days yearly.

I realize every time I publish a personal blog post — one in which I describe my severe ruminations, death thoughts, and difficulty using the rational part of my brain — I jeopardize my possibilities for gainful employment in the future. I can pretty much write off all government work because, from what I’ve been told, you have to get a gaggle of people to testify that you have no history of psychiatric illnesses (and, again, all it takes is one Google search to prove I’m crazy).

It’s totally unfair.

Do we penalize diabetics for needing insulin or tell people with disabling arthritis to get over it? Do we advise cancer victims to use a pseudonym if they write about their chemo, for fear of being labeled as weak and pathetic? That they really should be able to pull themselves up by their bootstraps and heal themselves because it’s all in their heads?

But I don’t want to hide behind a pseudonym. I use my real name because, for me, the benefit of comforting someone who thinks they are all alone outweighs the risk of unemployment in the future. Kay Redfield Jamison did it. She’s okay. So is Robin Williams. And Kitty Dukasis. And Carrie Fisher. Granted all four of those people have talent agents ready to book them as speakers for a nice fee.

In their book, Living with Someone Who’s Living with Bipolar Disorder Chelsea Lowe and Bruce M. Cohen, MD, Ph.D., list the pros and the cons of going public with a mood disorder. I’m paraphrasing a little bit, but here are the pros:

  • There’s nothing disgraceful about the condition, any more than there would be about cancer or heart disease.
  • Carrying a secret is an enormous burden. Sharing it lightens it.
  • The more people who know and are looking out for you, the more likely you’ll be able to get help before the problems turn serious.
  • Sharing the information lessons the burden on your partner.
  • Lots of people have psychiatric issues; maybe your boss or family member does too.
  • Taking about the diagnosis is an opportunity to educate others.

Click image to read reviews

The authors suggest telling your employer under these circumstances:

  • If you are taking a new medication and may need time for adjustment.
  • If your schedule doesn’t allow for regular, restful sleep–which is an important factor in controlling the disorder–or if you need to request certain adjustments to your schedule, like telecommuting.
  • If you need to be hospitalized or take a leave of absence.
  • If the disorder is affecting your behavior or job performance.
  • If you need to submit benefit claims through your employer rather than the insurance company, or if your employer requires medical forms for extended absences.

And the cons:

  • Prejudice and stigma about psychiatric disorders are still common in our society. A disclosure of bipolar disorder [or any mental illness] will inevitably color your employer’s and coworkers’ perceptions of his job performance: “Did Jerry miss that meeting because the bus was late, or because he was off his meds?” Potential problems include discrimination, stigmatization, fear and actual job loss.
  • You can’t un-tell a secret.
  • Your chances for promotion could be hurt.
  • The employer is under no obligation to keep your condition secret.
  • Discrimination is illegal but difficult to prove.
  • You could be written off as “crazy.”

It’s Tricky! What are your thoughts?

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May 3, 2010 Posted by | anxiety, Books, depression, Education, General, mood | , , , , , , , , , , , , , | 2 Comments

Anxiety & Depression: Self-Help Internet Interventions Work!

A little while ago I posted a list of free interactive self-help web sites, all research based, which have been shown to effective in the treatment of anxiety & depression. A recent study adds to the body of evidence which supports web based intervention as a viable treatment option or adjunct.

Cognitive behaviour therapy (CBT) via the internet is just as effective in treating panic disorder (recurring panic attacks) as traditional group-based CBT. It is also efficacious in the treatment of mild and moderate depression. This according to a new doctoral thesis soon to be presented at Karolinska Institutet.

Read the original research thesis here (PDF)

“Internet-based CBT is also more cost-effective than group therapy,” says Jan Bergström, psychologist and doctoral student at the Center for Psychiatry Research. “The results therefore support the introduction of Internet treatment into regular psychiatry, which is also what the National Board of Health and Welfare recommends in its new guidelines for the treatment of depression and anxiety.”

It is estimated that depression affects some 15 per cent and panic disorder 4 per cent of all people during their lifetime. Depression can include a number of symptoms, such as low mood, lack of joy, guilt, lethargy, concentration difficulties, insomnia and a low zest for life. Panic disorder involves debilitating panic attacks that deter a person from entering places or situations previously associated with panic. Common symptoms include palpitations, shaking, nausea and a sense that something dangerous is about to happen (e.g. a heart attack or that one is going mad).

Click image to read reviews

It is known from previous studies that CBT is an effective treatment for both panic disorder and depression. However, there is a lack of psychologists and psychotherapists that use CBT methods, and access to them varies greatly in Sweden as well as in many other countries. Internet-based CBT has therefore been developed, in which the patient undergoes an Internet-based self-help programme and has contact with a therapist by email.

The present doctoral thesis includes a randomised clinical trial of 104 patients with panic disorder and compares the effectiveness of Internet-based CBT and group CBT within a regular healthcare service. The study shows that both treatments worked very well and that there was no significant difference between them, either immediately after treatment or at a six-month follow-up. Analyses of the results for the treatment of depression show that Internet-based CBT is most effective if it is administered as early as possible. Patients with a higher severity of depression and/or a history of more frequent depressive episodes benefited less well from the Internet treatment.

Jan Bergström works as a clinical psychologist at the Anxiety Disorders Unit of the Psychiatry Northwest division of the Stockholm County Council. This research was also financed by the Stockholm County Council.

“Thanks to our research, Internet treatment is now implemented within regular healthcare in Stockholm, at the unit Internetpsykiatri.se of Psychiatry Southwest, which probably makes the Stockholm County Council the first in the world to offer such treatment in its regular psychiatric services,” says Jan Bergström.

Read the original research thesis here (PDF)

Credit: Adapted from materials provided by Karolinska Institutet.

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April 18, 2010 Posted by | anxiety, Books, Cognitive Behavior Therapy, depression, diagnosis, Education, Internet, research, stress, Technology, therapy | , , , , , , , , , , , , , , , , , , , | 10 Comments

Mid Life – What’s The Crisis?: Why Self Esteem Peaks In The Middle-Aged

Credit: LiveScience

Read the original research article HERE (PDF)

Bad vision and other physical ailments aren’t the only things that seem to get worse as people grow old. Self-esteem also declines around the age of retirement, a new study finds.

The study involved 3,617 American men and women ranging in age from 25 to 104. Self-esteem was lowest among young adults, but increased throughout adulthood, peaking at age 60, before it started to decline.

Several factors might explain this trend, the researchers say.

“Midlife is a time of highly stable work, family and romantic relationships. People increasingly occupy positions of power and status, which might promote feelings of self-esteem,” said study author Richard Robins of the University of California, Davis. “In contrast, older adults may be experiencing a change in roles such as an empty nest, retirement and obsolete work skills in addition to declining health.”

Measuring self-esteem

The participants were surveyed four times between 1986 and 2002. They were asked to rate their level of agreement with statements such as: “I take a positive attitude toward myself,” which suggests high self-esteem; “At times I think I am no good at all,” and “All in all, I am inclined to feel that I am a failure,” which both suggest low self-esteem.

Subjects also indicated their demographics, relationship satisfaction, and whether they had experienced stressful life events, including suddenly losing a job, being the victim of a violent crime, or experiencing the death of a parent or child.

On average, women had lower self-esteem than men throughout most of adulthood, but self-esteem levels converged as men and women reached their 80s and 90s. Blacks and whites had similar self-esteem levels throughout young adulthood and middle age. In old age, average self-esteem among blacks dropped much more sharply than self-esteem among whites. This result held even after accounting for differences in income and health.

Future research should further explore these ethnic differences, which might lead to better interventions aimed at improving self-esteem, the study authors say.

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More self-esteem factors

Education, income, health and employment status all had some effect on the self-esteem trajectories, especially as people aged.

“People who have higher incomes and better health in later life tend to maintain their self-esteem as they age,” Orth said.

“We cannot know for certain that more wealth and better health directly lead to higher self-esteem, but it does appear to be linked in some way. For example, it is possible that wealth and health are related to feeling more independent and better able to contribute to one’s family and society, which in turn bolsters self-esteem.”

People of all ages in satisfying and supportive relationships tend to have higher self-esteem, according to the findings.

However, despite maintaining higher self-esteem throughout their lives, people in happy relationships experienced the same drop in self-esteem during old age as people in unhappy relationships.

“Thus, being in a happy relationship does not protect a person against the decline in self-esteem that typically occurs in old age,” said study author Kali H. Trzesniewski of the University of Western Ontario.

With medical advances, the drop in self-esteem might occur later for baby boomers, Orth said. Boomers might be healthier for longer and, therefore, able to work and earn money longer.

Read the original research article HERE (PDF)

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April 6, 2010 Posted by | Age & Ageing, Books, Cognition, depression, Education, Health Psychology, research, Resilience, Resources, Seniors | , , , , , , , , , , , , , , | 1 Comment

Exercise DOES Help Improve Mood! And Just 25 Minutes Worth Will Decrease Stress & Increase Energy

Having an Honors degree in Human Movement Studies and working in gyms in a former life while studying for my Clinical Masters degree, I have seen this to be true.  Of course it seems self evident, but these researchers have used great science with an excellent and now research-proven written program and workbook. These, along with their recent meta-analytic research review, show just how effective exercise can be in improving mood.

Credit: PhysOrg.com) — Exercise is a magic drug for many people with depression and anxiety disorders, according to researchers who analyzed numerous studies, and it should be more widely prescribed by mental health care providers.

“Exercise has been shown to have tremendous benefits for mental health,” says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. “The more therapists who are trained in exercise therapy, the better off patients will be.”

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don’t reach everyone who needs them, says Smits, an associate professor of psychology.

“Exercise can fill the gap for people who can’t receive traditional therapies because of cost or lack of access, or who don’t want to because of the perceived social stigma associated with these treatments,” he says. “Exercise also can supplement traditional treatments, helping patients become more focused and engaged.”

The Program used in the study is available from bookstores-Click Image to view description

Smits and Michael Otto, psychology professor at Boston University, presented their findings to researchers and mental health care providers March 6 at the Anxiety Disorder Association of America’s annual conference in Baltimore.

Their workshop was based on their therapist guide “Exercise for Mood and Anxiety Disorders,” with accompanying patient workbook (Oxford University Press, September 2009).

The guide draws on dozens of population-based studies, clinical studies and meta-analytic reviews that demonstrate the efficacy of exercise programs, including the authors’ meta-analysis of exercise interventions for mental health and study on reducing anxiety sensitivity with exercise.

“Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger,” Smits says. “Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing.”

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity.

At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients’ exercise guides and motivators.

The patient workbook which accompanies the program - Click image to view description

“Rather than emphasize the long-term health benefits of an exercise program — which can be difficult to sustain — we urge providers to focus with their patients on the immediate benefits,” he says. “After just 25 minutes, your mood improves, you are less stressed, you have more energy — and you’ll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise.”

Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

“Therapists can help their patients take specific, achievable steps,” he says. “This isn’t about working out five times a week for the next year. It’s about exercising for 20 or 30 minutes and feeling better today.”

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April 5, 2010 Posted by | anxiety, Books, brain, Cognitive Behavior Therapy, depression, Exercise, Health Psychology, Positive Psychology, research, Resilience, Resources, stress, therapy | , , , , , , , , , , , , , , , , , , | 4 Comments

Binge Eating: A 12 Week Self-Guided Program Gets Great Results

Kaiser Permanente Center for Health Research, Press Release

Short-Term Program for Binge Eaters Using “Overcoming Binge Eating” by Dr. Christopher Fairburn Has Long-Term Benefits

PORTLAND, Ore. — A new study finds that a self-guided, 12-week program helps binge eaters stop binging for up to a year and the program can also save money for those who participate. Recurrent binge eating is the most common eating disorder in the country, affecting more than three percent of the population, or nine million people, yet few treatment options are available.

But a first-of-a-kind study conducted by researchers at the Kaiser Permanente Center for Health Research, Wesleyan University and Rutgers University found that more than 63 percent of participants had stopped binging at the end of the program — compared to just over 28 percent of those who did not participate. The program lasted only 12 weeks, but most of the participants were still binge free a year later. A second study, also published in the April issue of the Journal of Consulting and Clinical Psychology, found that program participants saved money because they spent less on things like dietary supplements and weight loss programs.

“It is unusual to find a program like this that works well, and also saves the patient money. It’s a win-win for everyone,” said study author Frances Lynch, PhD, MSPH, a health economist at the Kaiser Permanente Center for Health Research. “This type of program is something that all health care systems should consider implementing.”

“People who binge eat more than other people do during a short period of time and they lose control of their eating during these episodes. Binge eating is often accompanied by depression, shame, weight gain, loss of self-esteem and it costs the health care system millions of extra dollars,” said the study’s principal investigator Ruth H. Striegel-Moore, PhD, a professor of psychology at Wesleyan University. “Our studies show that recurrent binge eating can be successfully treated with a brief, easily administered program, and that’s great news for patients and their providers.”

Binge eating has received a lot of media attention recently because the American Psychiatric Association is recommending that it be considered a separate, distinct eating disorder like bulimia and anorexia. This new diagnosis can be expected to focus more attention on binge eating and how best to treat it, according to the researchers. It also could influence the number of people diagnosed and how insurers will cover treatment.

This randomized controlled trial, conducted in 2004–2005, involved 123 members of the Kaiser Permanente health plan in Oregon and southwest Washington. More than 90 percent of them were women, and the average age was 37. To be included in the study, participants had to have at least one binge eating episode a week during the previous three months with no gaps of two or more weeks between episodes.

Click image to read reviews: Book helps achieve results in this research study

Half of the participants were enrolled in the intervention and asked to read the book “Overcoming Binge Eating” by Dr. Christopher Fairburn, a professor of psychiatry and expert on eating disorders. The book details scientific information about binge eating and then outlines a six-step self-help program using self-monitoring, self-control and problem-solving strategies. Participants in the study attended eight therapy sessions over the course of 12 weeks in which counselors explained the rationale for cognitive behavioral therapy and helped participants apply the strategies in the book. The first session lasted one hour, and subsequent sessions were 20–25 minutes. The average cost of the intervention was $167 per patient.

All participants were mailed fliers detailing the health plan’s offerings for healthy living and eating and encouraged to contact their primary care physician to learn about more services.

By the end of the 12-week program 63.5 percent of participants had stopped binging, compared to 28.3 percent of those who did not participate. Six months later, 74.5 percent of program participants abstained from binging, compared to 44.1 percent in usual care. At one year, 64.2 percent of participants were binge free, compared to 44.6 percent of those in usual care.

Everyone in the trial was asked to provide extensive information about their binge eating episodes, how often they missed work or were less productive at work, and the amount they spent on health care, weight-loss programs and weight loss supplements. Researchers also examined expenditures on medications, doctor visits, and other health-related services.

The researchers then compared these costs between the two groups and found that average total costs were $447 less in the intervention group. This included an average savings of $149 for the participants, who spent less on weight loss programs, over-the-counter medications and supplements. Total costs for the intervention group were $3,670 per person per year, and costs for the control group were $4,098.

“While program results are promising, we highly encourage anyone who has problems with binge eating to consult with their doctors to make sure this program is right for them,” said study co-author Lynn DeBar, PhD, clinical psychologist at the Kaiser Permanente Center for Health Research.

Study authors include: Lynn DeBar, John F. Dickerson, Frances Lynch and Nancy Perrin from the Kaiser Permanente Center for Health Research in Portland, Oregon; Ruth H. Striegel-Moore and Francine Rosselli from Wesleyan University; G. Terence Wilson from Rutgers, The State University of New Jersey; and Helena C. Kraemer from the Stanford University School of Medicine.

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April 4, 2010 Posted by | Books, Eating Disorder, Girls, Identity, Resources, therapy | , , , , , , , , , , , , , , | 5 Comments

Intimacy & Desire: David Schnarch On Sex After Marriage

Dr David Schnarch

I have just found this video which includes a rare interview with Dr David Schnarch, author of “Passionate Marriage”, “Resurrecting Sex” & his latest book released in October 2009 “Intimacy & Desire”. Anyone who knows me well knows I am an advocate of Schnarch’s personal development approach to improving intimate relationships. For more information on my personal experiences with Schnarch and his unique contributions to this field read  THIS POST.

Here are  Schnarch’s online self evaluation surveys and statistics for  the health of your sexual relationship and personal intimacy style. If you’re having issues (like 70% of couples in committed relationships) and have tried and failed to spark things up again, please watch this interview, read one of Schnarch’s books and check out his website for online resources. It will be worth your time and money.

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April 3, 2010 Posted by | Books, Intimate Relationshps, Marriage, Resources, Sex & Sexuality, video | , , , , , , , , , , , , , , , , , , , , , , , , | 1 Comment

Self Help For Anxiety & Depression: A List Of FREE Interactive Self Help Websites

Today I wanted to get around to doing what I have been meaning to do for a while and post a list of free access interactive and/or educational websites which I have come across. These sites are fantastic resources and each one offers a different way to get involved with your recovery. Please note I am not affiliated with any of these sites and they are not affiliate sites. I hope you find one or more useful as I know many of my clients have.

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Self Help / Educational Websites

Updated 27th March 2010

There you have it! Check them out and let me know what you think. Know of any others? (No affiliate sites please).

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March 24, 2010 Posted by | Acceptance and Commitment Therapy, anxiety, Cognitive Behavior Therapy, depression, Dialectical Behavior Therapy, Education, Internet, Mindfulness, Positive Psychology, Resilience, Resources, Technology, therapy | , , , , , , , , , | 8 Comments