On February 16, Dr. Andrew Rosen gave a talk to the Doctoral Program in Clinical Psychology at Nova SouthEast University on Multidisciplinary Treatment of Anxiety Disorders.
See the full presentation below.
As of this writing, 30 states, Guam, the District of Columbia, and Puerto Rico all have approved the broad use of medical marijuana. Additionally, other states allow limited medical use and 8 states (and the District of Columbia) allow recreational use of the drug. Even though the use of pot and weed is becoming more acceptable, the Drug Enforcement Administration (DEA) still considers marijuana to be a Schedule I substance, meaning it is likely to be abused and it completely lacks medical value. This classification also means there hasn’t been much research into the efficacy of the drug for medical conditions and, in particular, we lack long-term studies that would tell us whether it is safe and/or effective when used over a long period of time.
What we do know is that, in clinical practice – both in our practice and in discussions with colleagues in other practices – mental health professionals are seeing an increase in the number of incidents of anxiety, panic attacks, depression, and even psychotic reactions now that marijuana use has become more mainstream.
Did you know that:
Whether it’s used recreationally or medicinally, both forms of pot are the same product. The medical version contains cannabinoids just like recreational marijuana. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main chemicals found in the medical form.
Although medical marijuana is used for many conditions (among them: multiple sclerosis (MS), cancer, seizure disorders, and glaucoma), its efficacy hasn’t been proven. “The greatest amount of evidence for the therapeutic effects of cannabis relate to its ability to reduce chronic pain, nausea and vomiting due to chemotherapy, and spasticity [tight or stiff muscles] from MS,” says Marcel Bonn-Miller, PhD, a substance abuse specialist at the University of Pennsylvania Perelman School of Medicine.
As noted above, there aren’t many studies on the relationship between marijuana use and mental illnesses, such as anxiety, depression and bipolar disorder yet. However, research done in 2017, examined marijuana use in conjunction with the depression and anxiety symptoms of 307 psychiatry outpatients who had depression (Bahorik et al., 2017). This study found that “marijuana use worsened depression and anxiety symptoms; marijuana use led to poorer mental health functioning.” In addition, the study determined that medical marijuana was associated with reduced physical health functioning.
Part of the problem with using marijuana either recreationally or medically is that there is no way to regulate the amount of THC you’re getting, because the Food and Drug Administration (FDA) doesn’t oversee the product. This means not only the ingredients, but the strength of them can differ quite a lot. “We did a study last year  in which we purchased labeled edible products, like brownies and lollipops, in California and Washington. Then we sent them to the lab,” Bonn-Miller says. “Few of the products contained anywhere near what they said they did. That’s a problem.”
Another area of concern is that, as we know from regulated psychiatric medications, one dose may affect you differently than it affects your sibling or a friend. People are unique – each person’s reaction to a medication will vary, which is why psychiatric medications are monitored by the prescribing doctor so that the dosage can be adjusted for your specific needs.
In summary, if you choose to use marijuana either medically or recreationally, be careful. Talk to the doctor who authorized it, or speak with a mental health professional if you find yourself experiencing the symptoms of depression or anxiety, or if you have panic attacks that begin or worsen while you are using pot. Additionally, be sure your doctor knows your psychiatric history before they authorize medical marijuana for you, especially if you have been diagnosed with anxiety, depression, panic attacks, bipolar disorder, or psychosis.
We can help! The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can answer your questions about how medical or recreational marijuana use can affect your anxiety, depression, or other condition. For more information, contact us or call us today at 561-496-1094.
Resource: Bahorik, Amber L.; Leibowitz, Amy; Sterling, Stacy A.; Travis, Adam; Weisner, Constance; Satre, Derek D. (2017). Patterns of marijuana use among psychiatry patients with depression and its impact on recovery. Journal of Affective Disorders, 213, 168-171.
Most people are somewhat familiar with the term “sex addiction”, particularly because they’ve heard about the occasional movie star or entertainer who seeks treatment for their compulsion. But, while sex addiction is recognized and there are rehab centers and support groups that can provide help, its polar opposite – sex avoidance – is hardly ever discussed. And yet, sex avoidance is just as shattering – perhaps even more so, because a person with sex avoidance shuns intimacy and the enjoyment that comes with having a sincere connection to a loving partner.
Additionally, while sexual avoidance can be troubling on its own, it is also often a side effect of having an anxiety disorder. Things like performance fears, being distressed and upset, and low libido can make people even more anxious and can lead to the avoidance of sex.
In general, the aversion toward sex is a defense mechanism. When thinking of intimacy or engaging in sex, the person with sexual avoidance feels emotional distress and physical symptoms, such as nausea and tensed muscles, or they may have panic attacks. They may also experience humiliation, shame, and low self-esteem for rejecting their partner.
As with any condition, there are people who fall on either end of the spectrum. Sex avoidance can come in the form of sexual anorexia, which happens when sex and intimacy are obsessively evaded in the same way anorexics shun food. In some cases, the sexual anorexic may enjoy physical intimacy once it has been initiated, but may not be able to instigate sex. Or, they may take it a step further and turn down their spouse or partner’s desire for physical closeness more often than not.
On the other extreme, the American Psychological Association has classified an actual disorder called Sexual Aversion Disorder. With this disorder, the individual actively seeks to avoid genital sexual contact with a sexual partner. Often, the person will even avoid genital contact related to a gynecological exam or procedure. Sexual Aversion Disorder can be so traumatic that the person won’t allow any physical touch or kissing.
There are various reasons for avoiding sex. The most obvious is the case of a person who has suffered childhood sexual abuse and now dodges anything that brings the trauma back up in their mind. However, not everyone who has been abused will avoid sex, just as not every person who shuns physical intimacy has been abused.
In some cases, people with anxiety disorders also shun sexual encounters. When a person has an anxiety disorder, they suffer physical effects along with their mental stress. Physically, the Mayo Clinic reports people with an anxiety disorder may experience the symptoms of:
But, why would these symptoms cause someone to avoid the comfort of a physical relationship? One reason is that the act of intimacy raises your heart rate, induces heavier breathing, and makes you sweat. These bodily reactions mimic the physical “fight or flight” responses people experience during a panic attack, so much so that some individuals will go to great lengths to avoid feeling them at all.
Additionally, people who already suffer anxiety may choose to forego sexual encounters so they don’t have to add more fears to their list of concerns. Engaging in sexual activity can bring up worries about their attractiveness, their ability to perform, or may increase feelings of shame or guilt.
If your anxiety disorders are leading to sex avoidance, turn to the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, contact us or call us today at 561-496-1094.
Today’s women face a variety of life and family stressors. These pressures can lead to mental health concerns that can range anywhere from simple “burn out” to mood disorders and beyond. In fact, it may surprise you to know that women are almost twice as likely as men to be diagnosed with depression and anxiety.
Obviously, researchers want to know the reason for this alarming statistic. Is there a biological component at play in a women’s body that isn’t as prevalent in a male? Do females learn to worry more because they pattern themselves after a mother who worries? Or, is it simply because women are more likely than men to admit they have symptoms and seek help?
The official view of the mental health profession is that the sexes are similar in the numbers of each gender who experience psychiatric disorders. However, according to the authors of The Stressed Sex, it actually turns out that “in any given year, total rates of psychological disorder are 20-40% higher in women than men.”
Indeed, studies are beginning to show that a female’s physiology can contribute to their higher rate of physiological disorders. The Anxiety and Depression Association of America notes that women’s fight-or-flight responses are more sensitive than a man’s and the response stays activated longer in a woman. Additionally, the female brain is more sensitive to stress hormones and does not process serotonin, the neurotransmitter believed to influence psychological functions, as fast as the male brain.
Women also have a variety of external stressors that can lead to higher levels of depression and anxiety:
In addition to these external stressors, physical reasons for depression and anxiety in women can include:
If you are a woman who struggles with depression and anxiety, we can help. For more information, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.
There is no denying the fact that physician burnout is a growing problem in the United States. The statistics that support this trend are appalling:
These numbers make a strong case that physician burnout is a major issue that needs to be addressed and addressed quickly.
The symptoms of physician burnout bear a strong resemblance to those typically seen in other stress disorders, but there are also distinct differences. Dr. Dike Drummond, author of the blog, “The Happy MD“, hits the nail on the head by identifying that physician burnout occurs when stress is present and a doctor is unable to recover from it in their free time. He pinpoints three distinct burnout symptoms:
1. Physical and emotional exhaustion that leaves you worn out and unable to recover during down time.
2. The development of a cynical and negative attitude with regard to your work and your patients.
3. A reduced sense of purpose and a feeling that your work is meaningless and without value.
A variety of factors in a doctor’s work life combine to explain why burnout has become so prevalent. The most common factors that lead to this syndrome include:
It’s easy to see how the everyday challenges of being a doctor can continuously build up until the physician hits the burnout stage. The real difficulty lies in understanding how we can improve those statistics. The unfortunate reality is that many doctors will not seek assistance for physician burnout even when they realize there is a problem. There are several reasons for this:
If you or someone you know is showing signs of physician burnout, it’s important to seek help. Don’t let yourself become part of the growing statistics related to this trend. Recognizing and acknowledging this is a concern can be the biggest stepping stone toward finding a resolution.
For more information about easing the effects of physician burnout, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders at 561-496-1094. Also, you can email The Center at their Delray Beach, Florida location.
The holidays have come and gone and a new year has begun. You should be feeling inspired and happy to start working on your New Year’s resolutions and doing what you can to make this year better than the last…right? Maybe not.
Even though many people do greet the new year with excitement, there are also many who find themselves suffering from the post-holiday blues. This is understandable: the holiday season is a time of family gatherings and festive parties, which all comes to an abrupt halt right after the calendar page turns to the next year. Instead of all the merriment, we have to deal with fatigue, going back to work after taking time off, taking down those cheerful decorations, and stress from paying for all the gifts we’ve given. Additionally, the long, cold, dark days of winter, can lead some people to experience seasonal affective disorder (SAD). If you think about it, it’s no wonder many of us experience some depression after the holidays!
Symptoms of Post-Holiday Depression
The symptoms of the post-holiday blues period are similar to those of “regular” depression – headaches, insomnia and trouble sleeping, anxiety, weight gain or loss, and agitation. In general, depression related to the holidays is short-lived, though, lasting just a few weeks into the new year. For some people, however, it can be long-lasting and overwhelming: in these cases, counseling and support groups can help immensely.
Tips for Getting Over Depression after the Holidays
In order to help avoid (or climb out of) that post-Christmas depression period, many mental health professionals recommend taking a pro-active approach to the New Year. You might try:
Above all, expect to enjoy the year ahead of you. Look forward to the coming months: plan some of the things you’d like to do this year, make a list of things you’d like to accomplish, stop looking backwards at the past. Put your goals for the year down in writing or tell them to a friend, so you’ll be more likely to make them happen.
If you’ve tried some of these tips and are finding that you’re still having a hard time kicking the post-holiday blues, it might be helpful to speak with a mental health professional. Dr. Andrew Rosen and the therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida can help. For more information, call them at 561-496-1094 or Contact Dr. Rosen and The Center today.
Most all of us have had the occasional sleeplessness night for one reason or another. Maybe you have a work project on your mind or it could be that you are worried about a family issue and can’t seem to fall asleep or stay asleep. Whatever the reason, having more than a few nights of less than quality sleep can make anyone feel fatigued and more than a little depressed. That stands to reason: after all, who wouldn’t be depressed when they are totally exhausted?
But, the combination of insomnia, depression, and anxiety may mean more than just a lack of sleep. In fact, studies have shown that at least 80% of people who suffer from anxiety and depression also have chronic insomnia. This is so prevalent that researchers are now saying that chronic insomnia may actually be a predictor of the onset of depression and/or anxiety.
Chronic insomnia is defined as having trouble falling asleep or having problems staying asleep most nights during the month. Insomnia symptoms may include some or all of the following:
Is There a Link Between Insomnia and Depression/Anxiety?
If you can’t get to sleep or can’t stay asleep, it’s easy to see why you’d become depressed from fatigue or become so tired that you might become anxious about things that might not normally bother you. Current sleep research has found, however, that “insomnia and depression are two distinct but overlapping disorders,” says Michael Perlis, Ph.D., associate professor of psychiatry at the University of Pennsylvania and director of their behavioral sleep medicine program.
“Until recently, insomnia was typically seen as a symptom of depression,” says Perlis. “Treat the underlying depression, the thinking went, and sleep problems would go away.” But, recent findings show that insomnia often shows up or gets worse just before a bout of depression. “Insomnia may serve as a trigger for depression,” Perlis says. “But it also appears to perpetuate depression.”
Treating Insomnia and Depression or Anxiety
In our practice, we find that Cognitive Behavior Therapy, used in conjunction with Mindfulness Meditation, often helps the most to relieve the anxiety experienced by having insomnia. CBT teaches people healthier behaviors and helps them gain more positive and realistic thought processes regarding their sleep. This therapy encourages better sleep habits and helps reduce the fears and replace the negative thoughts that can keep them from falling asleep or staying asleep.
Research has shown that Cognitive Behavioral Therapy has longer-lasting, more sustainable effects on insomnia and depression. This is because it teaches you a skill set that you can use for the rest of your life. CBT gives you the power to cope with your situation in a healthy way and feel better about yourself and your world.
Mindfulness Meditation is also used to help the patient learn self-awareness. It teaches that our inaccurate view of the world is what triggers our negative emotions. Through practicing Mindfulness Meditation, the person trains their mind to overcome their worries and painful emotions, so they can be free of their suffering.
Other Ways to Treat Insomnia
There are also other schools of thought about ways to treat both insomnia and depression or anxiety. One idea is to specifically treat the insomnia by itself: research indicates that the treatment of sleep problems can help relieve and prevent a recurrence of depression and anxiety. In fact, several studies have found that depressed people who also had insomnia and were treated with both an antidepressant and a sleep medication did much better than those who were treated just with antidepressants. They slept better and their depression scores improved significantly over people who were just taking antidepressants alone.
Another method for treating insomnia is to actually wake a depressed insomniac early. This boosted mood in 30-60% of cases, but the cure is short-lived: the sufferer often becomes depressed again after they sleep once more.
Chronotherapy has also been used – in this type of therapy, those who have trouble falling asleep reset their internal circadian rhythm by adjusting the time they go to sleep over a period of days. Light therapy can also help: it exposes the insomniac to bright lights to help change their sleep cycles.
We Can Help
Are you or a loved one fighting chronic insomnia? It may be time to talk to a professional to see if there is an underlying condition that is contributing to your sleep problems. Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are ready to take your call and make getting help easier. Contact Dr. Rosen at 561-496-1094 or email Dr. Rosen and The Center today.
It is said that it is human nature to fear things or people who are different. For centuries, society has pointed to this as justification for judging and discriminating against people who fall into “non-traditional” categories.
Every day our society is becoming more and more accepting of the differences we see in each other. Despite this progressive acceptance, people who identify as lesbian, gay, bisexual, or transgender still face a number of social stigmas and discrimination. It’s no wonder that this can lead to stress and anxiety for those in the LGBT community.
If you are a member of the LGBT community and you’ve experienced anxiety tied to your identity, you’re not alone. Thousands of people just like you experience the same concerns every day. Let’s consider the facts:
Finding the Right Therapist for LGBT Anxiety
The ethics of professions tied to mental health, such as social work, psychology, and psychiatry require that therapists provide services to all people without discrimination. That being said, some therapists may be better than others when assisting with the specific needs of the LGBT community. Because of this, there are a few factors you may want to consider when seeking therapy for anxiety about your sexuality:
Remember, the LGBT anxiety you face on a regular basis is not a result of there being anything wrong with you. They arise because of the environmental factors that surround you. Appropriate therapy will aim to help you understand and cope with those factors to improve your daily interactions.
Are you or someone you know facing severe anxiety as a result of your sexual or gender identity? Dr. Andrew Rosen knows the best techniques for helping you work through this anxiety and cope with difficult situations that arise. For more information, contact Dr. Rosen or call The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094.
It seems like every time we turn on the news lately, we hear reports about terrorists and attacks by suicide/homicide bombers. News stories about kidnappings, beheadings, and raids by Islamic terrorism groups such as ISIS and Boko Haram are a “normal” part of the daily news now. And, even though the vast majority of these attacks take place in cities and countries on the other side of the world from us, the constant bombardment of these threatening stories can begin to make anyone feel helpless and can instill worry, stress, and fear in them. This is especially true for people who already suffer from anxiety and anxiety-related syndromes, such as generalized anxiety disorder.
Anxiety Disorder Symptoms
Even though personally experiencing an ISIS terrorist attack is unlikely, sometimes fear and anxiety over a potential threat can take on a life of its own. When you are anxious in general, you may begin having headaches, stomach problems, trouble sleeping or eating, or can even have a panic attack. And, if you have generalized anxiety disorder, your worries and fears become overwhelming. What was “normal” anxiety crosses over the line to the point that you worry:
Some of the physical symptoms of anxiety can include:
Some of the psychological symptoms of anxiety or generalized anxiety disorder can include:
What Can You Do To Help Calm Your Terror-Related Anxiety?
While it’s understandable to worry about terror threats, keeping the following in mind can help you calm your fears and lower your anxiety levels:
Keep in mind that fear pulls the enjoyment out of everything. Living in fear keeps you from taking pleasure in your life and it won’t change what happens in the world – either in another country or right down the street. Only you can choose whether you will focus on the negative or whether you will embrace the happiness that is all around you. Be kind to yourself and don’t allow yourself to get wrapped up in negative news stories and worries about terrorist threats.
If, however, you use these ideas and are still finding yourself stressed and troubled about terrorist threats, it might be time to speak with a professional to discuss more specific steps. To get more information and help for worry about terror threats and your anxiety or about generalized anxiety disorder, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.
Once again it’s that time of year for holiday music, joyful giving, and memorable parties. Unfortunately, however, holiday cheer is not always as easy to find as one would think. In fact, the holiday season is often the time of year that anxiety, stress, and depression is highest for many people.
It makes sense when you think about some of the factors that come along with most people’s holidays. Consider these triggers, which can cause a spike in anxiety and holiday stress during this festive season:
Holiday Coping Mechanisms
While it’s easy to see how this time of year can provoke anxiety and stress in a number of people, there is good news. There are a number of holiday coping mechanisms you can use to ease your way through the holiday stress:
Coping with Holiday Travel Fears
One of the most anxiety-inducing aspects of the holidays is the dreaded travel to family events. Traffic delays, crowded airports, and overflowing train stations can bring about an entirely different type of stress, especially if you already suffer from a fear of flying or of crowds. Just like with any other anxieties, however, there are ways to confront and overcome these fears:
Ultimately, if you find holiday stress is becoming overwhelming despite the recommendations listed above, don’t hesitate to reach out for help. Your holiday season does not need to be ruined because of stress, anxiety, or depression. If you or someone you know is unable to cope with the holiday burdens, it may be time to reach out to a professional.
To get more information and help for holiday stress, anxiety, or depression, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.