All Posts in Category: Health Anxiety

Is There a Connection Between Vaccines and Autism?

Is there a link between vaccines and autism? This question has been at the center of an ongoing debate ever since the Centers for Disease Control (CDC) began reporting that autism was on the rise in the United States and around the world.

Currently, about 1 child out of every 68 will be diagnosed with Autism Spectrum Disorder (ASD), which is classified as a developmental disability. Whenever there is an increase in a disorder or disability, people start looking for reasons for the change. Since ASD can be seen in a child as young as the age of two, research has focused on the factors early in life that might contribute to an autism diagnosis. From birth, children receive many immunizations, so fears have been raised of a possible connection between these vaccines and autism.

In particular, there have been concerns about the measles, mumps, and rubella (MMR) vaccine and thimerosal, a mercury-based preservative that had been used in MMR and other inoculations. Since 2003, nine studies have been conducted into the relationship between thimerosal and ASD, however the Institute of Medicine has determined there is no link between the vaccine and the development of autism.

In reaction to concerns about whether thimerosal in vaccines and autism were related, the preservative was either removed from vaccines or reduced to negligible amounts between 1999 and 2001. Today, this preservative has been limited to use only in multi-dose vials found in some flu vaccines. If you are still worried, however, you can request your child receive a thimerosal-free vaccine.

Additionally, a 2013 study by the CDC determined there is no link between vaccines and autism. It looked at the number of antigens (they help the body’s immune system fight disease) and found no difference between children with ASD and children without the disorder.

What Causes Autism?

The CDC is currently conducting research to find out if autism has an environmental, biological, or genetic cause. There are many categories of disability along the autism spectrum and, at this time, specialists haven’t found any one specific reason for the development of the disorder.

We do know, however, that there are factors which can indicate a higher chance that a child will develop autism. These components are:

  • Children with autistic siblings are more likely to develop the disability.
  • Children born to older parents are more likely to be at risk.
  • It is thought that the critical developmental time for ASD is in utero, or in the period during or immediately after birth.
  • The prescription medicines valproic acid and thalidomide have been linked to a higher ASD risk in the infant, when these medications were taken during the pregnancy.
  • ASD occurs more often in people who have certain chromosomal or genetic conditions (for example: Fragile X Syndrome).

What are the Early Signs of Autism?

Although autism can affect either gender, the disorder occurs about 4.5 times more often in males than in females. It is found in every socioeconomic, racial, and cultural background, although it is more prevalent in white children than in African-American or Hispanic children.

People with ASD may have problems communicating or interacting with others, or may have difficulty focusing or learning. Additionally, early signs of Autism Spectrum Disorder may include:

  • Lack of interest in objects or in relating to people
  • Avoiding eye contact
  • Preferring to spend time by themselves
  • Becoming upset if routines change
  • Unusual reactions to stimuli, such as smells, tastes, textures, or sounds
  • Repeating words or phrases or repeating actions over and over

Diagnosis, Evaluation, and ASD Treatment

Although there is no cure for ASD, early intercession can reduce the severity of a child’s developmental delays and can teach them important skills. The earlier a child is diagnosed and begins treatment, the better their chances of reaching their full potential. ASD treatment and early intervention can begin as soon as 3 months of age.

If you are concerned about your child and the way they interact with you or others, the way they speak or act, or the way they learn, the first step is to call your child’s pediatrician and discuss your worries. Your child’s doctor can help answer your questions and, if alarmed, should refer you to specialists for further evaluation. Psychologists, psychiatrists, developmental pediatricians, and/or pediatric neurologists are specially trained to assess and diagnose Autism Spectrum Disorder.

Additionally, if you need a free assessment, you can contact your state’s early intervention programs. To find out more about your particular state’s Child Find evaluation, visit the Early Childhood Technical Assistance Center.

Our Children’s Center Can Help

If you have questions about the early signs of autism, treatment and intervention, or have other autism-related concerns, the professionals at our child-focused department, The Children’s Center, can help. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Emetophobia: The Fear of Vomiting

There are a number of mental health anxieties out there that most people are familiar with: panic disorder and post-traumatic stress disorder are great examples. In general, many people have at least heard of these conditions and most could somewhat understand them if they came up as a topic of conversation. That being said, however, there are a number of fears or anxieties that you’ve probably never heard of before. And, because you don’t know they exist, you may believe you’re struggling alone through concerns no one else will understand.

If you’re one of these people and you suffer with a fear of vomiting, first know that you are not alone. In fact, the fear of vomiting, officially known as emetophobia, is a phobia that affects millions of people. And, the good news is that help is available.

Understanding Emetophobia

It might be helpful to understand a little of what emetophobia entails. The fear of vomiting can present itself in a number of different ways:

  • Fear that you will throw up.
  • Fear that you will see someone else vomit.
  • Fear of the loss of control that can come with getting sick.
  • Fear that if you begin to vomit you won’t be able to stop.
  • Fear of death from throwing up.

It is interesting that most people who struggle with emetophobia do not actively worry about throwing up. Instead, the phobia rears up when they are put in a position where they feel like vomiting may occur. Here are a few examples of triggers that can exacerbate this fear:

  • Someone else vomiting: seeing this in person, watching it in a movie, or even hearing about it can have a negative effect and trigger their fears.
  • Hearing that a coworker is home with the flu.
  • Thinking of food or seeing or smelling a food item that has made them vomit before.
  • Seeing or hearing things that can be associated with throwing up, like a toilet or the sound of someone gagging.

Life Impact

The truth about vomiting is that none of us are very happy to talk about it or think about it. In fact, most of us will also do whatever it takes to avoid throwing up, just the same as someone who struggles with emetophobia. The difference between these types of people comes in two important areas: the level of worry involved and the impact that worry has on one’s life. When faced with the triggers noted above, the average person might flinch or groan, unhappy to be hearing about them. On the other hand, someone who struggles with emetophobia may have the following reactions:

  • They may do an analysis of themselves and how they’re feeling: Is my stomach hurting? Could that gas lead to something worse.
  • They may begin digging into the details of someone else’s illness to determine their own risk of getting sick.
  • They may search for signs of impending trouble: Did that coworker cough or gag? Did they (or I) eat the same thing as someone else who just got sick?

When a person has convinced themselves that their risk of throwing up is high, there are a number of ways it can impact their life. They may find themselves avoiding:

  • People they know are sick or who look sick.
  • Food they think could lead to vomiting
  • Eating in restaurants.
  • Drinking alcoholic beverages.
  • Friend’s babies or even their own baby, based on a concern that the baby is bound to throw up at some point.

Seeking Help

Though a fear of vomiting would seem to be a part of Health anxiety disorder (hypochondria), emetophobia is not the same thing. Treatment for emetophobia can even be a little more challenging at times, mostly because everyone who struggles with this type of anxiety has thrown up before or has been around their triggers without having their worst fears confirmed. Despite this, their anxieties continue and often strengthen over time.

That being said, there are plenty of ways that a psychotherapist can help sufferers learn to cope with this fear and reduce its impact on their life. As an example, Cognitive Behavior Therapy can help them recognize and understand the false beliefs that are triggering their phobia and anxiety. Exposure Therapy can also be useful to reduce the fears associated with their triggers.

Could you or someone you know benefit from professional assistance with emetophobia? Take action today to overcome your fears! For more information on treatment for emetophobia, Contact Dr. 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.

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How to Overcome Extreme Fear of Doctors

When the thought of getting health care makes you sick.

Scared patient in the waiting room.

Not knowing what will happen at the doctor can frighten some anxious patients.

By July 1, 2014 | 8:57 a.m. EDT

If you’re like most people, you don’t exactly love visiting the doctor. But for some, the anxiety they experience is so overwhelming they avoid any form of health care whatsoever – in some cases for decades.

Beyond Reluctance

David Yusko, clinical director at the University of Pennsylvania‘s Center for the Treatment and Study of Anxiety, treats patients with iatrophobia ​– the medical name for fear of doctors. He says the phobia probably affects about 3 percent of the population.

Such people can be helped by exposure therapy – in which they’re gradually confronted with medically related images, items and scenarios in rising order of fear-provoking power.

When Yusko treats these patients, he says their anxiety is obvious: “They’ll wring their hands; they’ll cross their arms or legs; or they’ll try to turn their body away from the image or hide their eyes from it. They’ll talk about their heart beating quickly, their hands getting sweaty and feeling dizzy or nauseous.”

Cascade of Fear

The biggest fear for many patients is fear of the unknown, says Andrew Rosen,​ director of The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Needle phobia is also common, Rosen says, above and beyond the distaste most people have when faced with an injection or blood draw. When he talks patients through exaggerated fears, it often turns out they’ve imagined excruciating pain that could last for hours.​

“The person doesn’t know what’s going to happen to them once they step in the door. Usually a person who’s anxious fills in the blanks with bad things: ‘I’ll be hurt.’ ‘I’ll be mistreated.’ ‘I’ll be diagnosed with some terrible disease,’” Rosen says. “It’s the fear of pain, bad news, cancer, the hospital.” It’s a cascade in which a patient could go “from A to Z in two seconds,” he adds.

Anticipation Equals Dread

Doctor anxiety wasn’t an issue for Virginia Lounsbury​, of Gulf Stream, Florida, until 2009, when she was hit with a debilitating illness at age 38. She underwent a barrage of treatments and multiple hospitalizations until the life-changing diagnosis – postural orthostatic tachycardia syndrome, or POTS, a rare genetic condition – came 2.5 years later.

By then, she had developed a full-blown fear of doctors and health care facilities. It reached the point where she needed help managing her anxiety, which brought her to Rosen’s center.

Rosen walks Lounsbury through scenarios in advance, starting with her rising anxiety as the car enters the parking lot and she approaches a medical center. “It’s a building – it’s concrete,” she recalls him saying. “You can’t be afraid of concrete.”

Because she’s claustrophobic, spending 90 minutes in an MRI tube is among her least favorite experiences. But for Lounsbury, the waiting room is the hardest part. “All those TVs [are] on – any doctor you go to,” she says. “And it’s all this medical news, which is never good.” She describes hearing dire cancer statistics emanating from a TV as she once waited her turn for a mammogram.

​To cope with future visits, she and Rosen came up with a plan: Pack a bag with items for distraction, find a quiet waiting room corner away from the intrusive TV and read, do needlepoint or check email.

Ah, the Dentist

One underlying cause of doctor fear is the increasingly impersonal nature of health care, according to Rosen. But when it comes to dental care, the experience may be too personal.

“If I’m going to work on you as a dentist, I’m going to get pretty close,” says Matthew Messina,​ consumer advisor for the American Dental Association. “There’s kind of that invasion of personal space aspect. So I have to respect that in patients.”

With extremely phobic patients, he says, most have had some bad experience recently or in the past, perhaps with a dentist or while in the hospital, and the memory could be long repressed. “They may have been restrained in the emergency room,” he says. “Those kinds of things can create very deep-seated fears where dentistry and medicine all sort of get lumped together.”

Messina, who has a private practice in Fairview Park, Ohio, says he wishes dentist avoiders would put aside their fear long enough to sit down in his office – just to talk. “We have to confront the fear and name it,” he says. “Then we can have a chance at overcoming it.’”

Motivation to Change

Getting someone with extreme fear back into the health care system is a hard sell. Rosen recalls a patient in her 50s who hadn’t had a breast cancer screening or seen a gynecologist in 25 years.

For some patients, it takes a crisis like a heart attack or appendicitis to accept treatment. Others finally acknowledge the need for preventive care and routine screening. Yusko says he’s had several cases of women whose plans to eventually have children motivated them to overcome their medical fears.

Exposure Therapy in Action

With exposure therapy, Yusko says patients confront a hierarchy of anxiety in the safe, supportive environment of his center. Images – of stethoscopes or syringes, for instance – would be lower-hierarchy items. From there, therapy could move on to viewing videos or TV shows like “Grey’s Anatomy” that feature medical procedures.

Next, the patient might stand outside the hospital in the parking lot. Actually seeing a needle, or being in the same room as a needle, would be another step. And because a nurse works in the center, Yusko says patients get a chance to come face to face with a medical professional.

Other Treatment Options

Different types of talk therapy and relaxation techniques may also help. While medications can ease short-term anxiety, they don’t address the root of the doctor phobia and most often aren’t needed, physicians say.

With dentistry, the situation is somewhat different. Messina says some patients may benefit from techniques including medication, biofeedback and hypnosis. For procedures like wisdom-tooth removal, sedation may be warranted, he says, but there is a risk-benefit ratio involved, and “using sedation to clean someone’s teeth [is] probably a higher level of medical risk than we’d like to take on.”

Dealing With It

Of their patients who’ve gone through exposure therapy, the vast majority can now manage their anxiety and receive medical care, Yusko and Rosen say.

Lounsbury, who’s started a foundation to help others with her condition, says she’s coping better with her anxiety. Acupuncture works for her (for those scared of needles, laser acupuncture or acupressure are alternatives). To people who share her fears, she offers these words of encouragement: “The main point is, wherever you are, it’s only temporary. Nobody’s ever gone to the doctor forever.”

Reference: http://health.usnews.com/health-news/patient-advice/articles/2014/07/01/how-to-overcome-extreme-fear-of-doctors

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Fear of the Doctor and of Medical Tests – Get Help in South Florida

We all know someone who may be sicker than a dog and yet still refuses to go to the doctor. Maybe this person hasn’t crossed the threshold of a physician’s office for years, even decades. Other people may have troubling symptoms but they put off doctor visits or medical tests that could help them. While it could be that the person is just being stubborn, often those who refuse to seek medical help are experiencing iatrophobia or fear of the doctor or of medical tests.

Iatrophobic people often ignore symptoms until it is too late: maybe their cold progresses into pneumonia or their troubling symptoms are signs of a serious disease such as diabetes or cancer.

When people who suffer from a fear of medical tests or a fear of the doctor consider seeking medical help, they often experience symptoms such as:

  • Fear of dying
  • Fear of loss of control
  • Nausea and dry mouth
  • Heart palpitations and breathlessness
  • Excessive sweating and shaking
  • Obsessive worry about visiting the doctor or hospital

What are the reasons someone may have a fear of the doctor? Iatrophobia can be the result of many things, among them:

  • Fear of hearing bad news or getting negative results from a medical test or exam
  • Anxiety about catching an illness or disease from someone else in the office or hospital
  • A traumatic event that occurred at the doctor’s office as a child
  • Sights and smells in a hospital or doctor’s office
  • Fear of blood or of claustrophobia (during an MRI, for example)
  • Fear of pain from undergoing a test or examination or from shots and needles
  • Impersonal doctors or staff, making people feel like they are just a “number”

If you suffer from fear of the doctor, have been avoiding medical tests, or haven’t been to a doctor in years, there are several things you can do to help:

  • For a mild case of iatrophobia, try to schedule your appointments early in the morning or late in the day to avoid waiting too long in the reception area. Take a book or something distracting with you to help you relax while waiting. If you have claustrophobia, ask if your MRI can be done using an “open MRI” machine or if the facility uses distractions, such as music, when you are undergoing the procedure. Additionally, it can be helpful to bring a close friend or family member along with you for support.
  • For a more moderate or severe form of iatrophobia, cognitive behavior therapy can help you gain a better understanding of your condition and assist you in finding ways to cope with your fears. This therapy helps you replace negative, inaccurate thoughts with ones that are positive and more realistic.
  • In some cases, in vivo exposure therapy can be used to reduce the triggers that drive a fear of the doctor. This type of therapy helps to redirect the negative signals into positive ones through gradual exposure coupled with relaxation exercises when anxiety levels become too great.
  • If your doctor–based anxiety also includes a fear of the mental health professional who may treat you, know that some therapists offer their services via email, Skype or Facetime, or over the phone. This can be a great way to begin treatment while still remaining in a safe and comfortable environment and recent studies have shown you can achieve the same therapy benefits from online treatment as you can from being physically present in an office setting.
  • In severe cases, medication may be combined with cognitive behavior therapy or other supportive therapies.

Don’t put off examinations and medical tests due to a fear of the doctor any longer! Supportive therapies can make all the difference in your health and wellbeing. For more information, call Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

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Carcinophobia or Fear of Getting Cancer

You see it everywhere – articles and news reports that feature experts who talk about how they’ve just discovered that a particular environmental factor causes cancer or that exposure to particular sweeteners or preservatives will give you cancer. Additionally, celebrities keep cancer in the public eye by candidly discussing their cancer diagnoses or treatments in magazines and newspapers across the country. Did you ever get the idea that it is almost impossible to walk out the door without coming in contact with something that’s sure to cause a tumor? Even though it is said jokingly, people often remark that everything causes cancer nowadays. It’s no wonder, then, that people are beginning to fear getting cancer before they even develop it.

Carcinophobia, or the fear of getting cancer, typically affects those who have had the disease or have known people afflicted with it. Of course, it’s normal to experience fear of any kind but people with carcinophobia often take their fear to the extreme and when that fear impacts their everyday life it becomes a source for concern.

Of all the phobias that exist, the fear of getting cancer can be one of the most debilitating. Take a fear of heights in comparison: the person afflicted with this fear can avoid heights and continue about their day. But a person who suffers from carcinophobia carries their fear with them. For them, the slightest pain or the appearance of new mole or lump on the body is a guarantee of cancer. What follows is anxiety about everything associated with cancer: the possibility of painful treatments, loss of hair, spreading of the cancer, and death. They’re also bound to worry about how it will impact their personal lives. Who will take care of them while they’re sick? Who will take care of their family and children if they succumb to the disease? These concerns and many others often arise before they’ve even visited a doctor. Eventually, the fear can become so overwhelming that the person may refuse to leave their safe environment and may shun people because they might be “carrying” carcinogens.

The good news is that this fear of getting cancer, like any other phobia, is treatable. Like most things, we often fear what we don’t understand and it can be helpful for the person who is afraid of getting cancer to research the latest advancements in cancer treatment technologies. Cognitive behavioral therapy can help the person become aware of their unreasonable thoughts and fears so they can view the situation more realistically and react in a healthier way. If all else fails, psychological counseling combined with the use of anxiety disorders medications has shown great results in many people.

If you or someone you know suffers from a fear of getting cancer, please seek professional help before it impacts your life. Left untreated, carcinophobia can become a debilitating condition that can affect every aspect of the sufferer’s work, social, and home life.

For more information on carcinophobia and treatment for the fear of getting cancer, contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. They can be reached by calling 561-496-1094 or by emailing Dr. Rosen and The Center today.

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Health Anxiety Disorder

Across the country, millions of people are plagued by a persistent fear that they are suffering, or will suffer, from a disease or other serious medical condition. This is known as health anxiety disorder, or hypochondria. Every year, as many as 14 percent of patients who are examined for health problems are actually experiencing hypochondria. Sufferers of this disorder tend to feel very real physical symptoms, such as:

  • Tenderness
  • Dizziness
  • Swelling
  • Palpitations
  • Pain

Fortunately, when these people visit a doctor with their concerns, tests reveal that there is nothing wrong. Unfortunately, as a result, they’re usually told the symptoms are imagined. Doctors don’t take them seriously and often consider them to be “difficult patients” rather than genuinely concerned individuals. On the other hand, some doctors are more likely to run unnecessary tests just to appease the patient. In fact, more than $20 billion a year is spent on unnecessary procedures and examinations. This can have the adverse effect of increasing the patient’s anxiety since it can provoke their concern while still not producing results.

People who are extreme worriers are more likely to develop health anxiety disorder. The fear that arises with this disorder can be paralyzing. To make things worse, about two-thirds of hypochondriacs suffer from a co-existing psychiatric disorder, such as major depression or panic disorder.

Treatments for health anxiety disorder can include:

  • Sessions with a mental health professional to assist with the stress associated with the disorder.
  • Regular doctor visits with a trusted physician. If the visits occur regularly rather than on an as-needed basis the patient has a better chance of distinguishing between the seriousness of the symptoms they experience.
  • Working to recognize that the physical signs each person experiences are not a symptom of something sinister and are, instead, their mind making their normal bodily sensations seem more threatening than they actually are.

If you or someone you know is suffering from health anxiety disorder it is important to seek help immediately. Health anxiety is a debilitating condition that can severely affect the lives of the people who suffer from it. Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida specialize in helping those who are fearful that they may have a serious medical condition. Take the first step toward getting help by calling 561-496-1094 or by emailing Dr. Rosen and The Center today.

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