All Posts in Category: General Anxiety

America’s germaphobes were ready for this — and have been for too long

America’s germaphobes were ready for this — and have been for too long

Health anxiety disorder is underreported, according to the Anxiety and Depression Association of America, and possibly affects 12 percent of the nation’s population. (The group’s annual conference this week was nixed due to the coronavirus.) Those who suffer from the disorder are usually thought of as hypochondriacs or germaphobes.

The current alarm about the coronavirus could be hard on OCD sufferers, prompting them to overdo it even more than usual. However, some people with health anxiety may be coping better during the pandemic than individuals who aren’t used to worrying about sneezing and coughing and handshakes and other casual physical contact, says Andrew Rosen, who runs the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Fla.

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COVID-19 banner across an image of the world

How COVID-19 Fears Can Fuel General Anxiety Disorders

COVID-19 (coronavirus) has officially been declared a pandemic. Across the globe, people are being quarantined, cruise ships are being denied entrance to ports, and social gatherings have been curtailed. This has resulted in a stock market free fall and panic buying as people hoard food and products in case of their own quarantining.

As the count of infected people rises, the unrelenting news coverage can make anyone feel helpless. It brings up worry, stress, and fear. This is even truer for those who already suffer from anxiety and its related syndromes, such as generalized anxiety disorder.

Anxiety Disorder Symptoms

In the face of a pandemic, the fear and anxiety about possible exposure to the illness can take on a life of its own.

If you are already someone who is anxious, you might find that you are having headaches or stomach problems. You may begin to have trouble sleeping or eating, or can even have a panic attack. And, if you have generalized anxiety disorder, your worries and fears can rapidly become overwhelming.

Your normal anxiety levels might ramp up to the point that you:

  • Worry about the virus on an hourly or daily basis and often find yourself consumed by fears during your day.
  • Find that your fears are significantly disrupting your work, relationships, or daily activities.
  • Automatically envision the worst-case scenario for the pandemic.

Anxiety can also manifest as physical symptoms, such as:

  • Insistent worrying or fixating about your fears
  • Being easily startled and feeling like you are constantly “on edge” or keyed up
  • Having trouble concentrating
  • Being irritable and continually on the edge of an argument with someone
  • Worrying that you are losing control

In addition to physical symptoms, there are psychological symptoms of anxiety or generalized anxiety disorder. These can include:

  • A rapid heartbeat and/or shortness of breath
  • Insomnia and problems sleeping, which leaves you fatigued
  • Headaches or an increase in migraines
  • Nausea, sweating, muscle tension

Self Care For COVID-19-Related Anxiety

While it’s understandable to worry about catching COVID-19, you may be able to calm your fears and lower your anxiety levels by doing the following:

  • First – turn off the TV and stop reading or watching online news reports and social media. Make the conscious decision to limit your exposure to distressing news. Fear is addictive, so know that if you are constantly watching world events, you’ll keep your mind focused on the negative.
  • It is good to keep in mind that news organizations prosper when people are watching and paying attention to what they are saying. If you are keeping an eye on the news right now, you’ll notice that you can hardly find any news about anything except the spread of the virus. Why is that? Because the media is making tons of money on this outbreak, so that’s what they are focusing on. Remember that we live in a safer world than ever before. Experts are working to solve this new virus and the majority of people who contract it will recover.
  • Next, try to detach – again, obsessing about germs and catching the coronavirus will not solve the problem, but it will make you more anxious and upset. Remember that your distress is only yours – worrying that you will catch COVID-19 will not change anything or protect you from getting ill. Instead, try to focus on something else – a hobby, exercise, your loved ones – so you aren’t constantly preoccupied with the news.
  • Take care of yourself by eating nutritious foods, exercising regularly to help relieve stress, and trying to get enough sleep. In addition, meditation can help to calm your mind, as can something as simple as deep, rhythmic breathing.
  • As much as possible, try to continue doing the things you enjoy so that you feel more in control of the world around you. While we are working from home and avoiding public places, we can catch up on the movies we have missed (or watch favorites again), read the books on our list, clean out clutter, or start an online class in something we are interested in (classes can be found on websites such as Udemy). All these things will help to distract from the virus.

It’s also good to remember that fear sucks the pleasure out of everything. Living in fear keeps you from enjoying your life – and it won’t change what happens in the world.

However, you are the only one who can choose whether to focus on the negative or whether you will look for ways to turn this into a “positive”. Be kind to yourself and don’t permit yourself to get wrapped up in negative news stories and worries about COIVD-19.

If, however, you use these ideas and are still stressed and fearful about the coronavirus, it might be time to speak with a professional to discuss more specific steps. Many offices, including ours, now have virtual options available, so that you can speak to someone without having to leave your home.

Virtual Options For Anxiety Treatment

For more information on our virtual (or in-office) help for your anxiety about COVID-19 or for a 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.

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Mindfulness Therapy Can Help With Anxiety Disorders

Mindfulness – The Secret To Being Happier Throughout Your Day

Most people go through their lives in reaction-mode. They respond to something that happens in their environment – a conversation, a changing traffic light, the boss calling a meeting – but they often aren’t truly aware of the world around them. They can be so focused on the distractions of life that they aren’t actually experiencing life.

You’ve probably heard the phrase “be more mindful” or “be present in your day,” but do you know what that really means? Is it simply paying attention to your surroundings or is there some deeper concept to be explored? Are there benefits to being mindful?

What Does It Mean To Be More Mindful?

Strictly speaking, mindfulness is defined by the Merriam-Webster dictionary as, “the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis.”

In practice, being mindful does encompass an awareness of your surroundings, but being present also means to stay focused on the here and now. For example, worrying about a work trip that will happen next week distracts from the joy you might take in playing catch with your son right this minute. Because you are absorbed by something other than playing with your child, you are denying yourself the full experience of being with him.

To be mindful, you might focus on the sound of the ball hitting your glove when you catch a ball he has thrown. You may enjoy the warmth of the sun on your skin or hearing your son exclaim, “yes!” when he catches a difficult toss of the ball. Or, you might listen to a bird chirping in the tree or smell your neighbor’s freshly mown lawn.

When you choose to be mindful, you experience your life more richly instead of just cruising through it.

Benefits Of Staying Present

In today’s high-paced, digital world, slowing down and just taking in the world around you can be challenging. Not many of us are able to fully relax: we’re always thinking of the next task we have to do, checking texts and emails, or planning the next activity. This stressful way of living can lead to health concerns, as well as to emotional and psychological issues.

Mindfulness, however, can:

  • Make you happier and feel more peaceful – According to a study by Keng, et al, “mindfulness brings about various positive psychological effects, including increased subjective well-being, reduced psychological symptoms and emotional reactivity, and improved behavioral regulation.”
  • Help you stay healthier – In a study of HIV-positive patients, an 8-week study on the effects of mindfulness meditation training showed that mindfulness “can buffer CD4+ T lymphocyte declines in HIV-1 infected adults.” Further, a study by Hughes, et al, on the effects of mindfulness in pre-hypertension patients showed a reduction in both diastolic and systolic blood pressure readings as compared with those who only did progressive muscle relaxation exercises.
  • Minimize the negative impact of illness – A study by Davidson, et al, showed that an 8-week mindfulness meditation program caused “significant increases in antibody titers to influenza vaccine among subjects in the meditation compared with those in the wait-list control group.”
  • Teach you how to regulate emotions through experiencing thoughts as they happen. This allows us to label and categorize these thoughts and emotions instead of letting them become overpowering.
  • Improve relationships – A 2016 meta-analysis by McGill, et al, (published in the Journal of Human Sciences and Extension) found that “the association between mindfulness and relationship satisfaction is statistically significant, indicating when an individual is more mindful they are more satisfied in their romantic relationship.”
  • Enhance the quality of your sleep – “Sleep disturbances pose a significant medical and public health concern for our nation’s aging population. An estimated 50% of persons 55 years and older have some form of sleep problem, including initiating and maintaining sleep,” according to a 2015 study by Black, et al. This study showed that mindfulness meditation promoted better sleep quality and reduced daytime impairment in older adults who had sleep disturbances.
  • Help you eat healthier – Instead of rushing through a fast food lunch at your desk, being mindful of how your food contributes to your health will allow you to reach for more nutritious foods. In fact, choosing to take small bites, chewing your food thoroughly, and savoring the flavors not only reduces stress, a study from the American Journal of Clinical Nutrition says it can also help you lose weight without counting calories.

What Are Some Ways To Be Mindful?

Mindfulness is done by keeping your attention on the present – on what you are experiencing in that particular moment. It doesn’t matter where you are or what you are doing, you simply tune in to the experience of the here and now.

An article from HelpGuide.org says, “You can choose any task or moment to practice informal mindfulness, whether you are eating, showering, walking, touching a partner, or playing with a child or grandchild. Attending to these points will help:

  • Start by bringing your attention to the sensations in your body
  • Breathe in through your nose, allowing the air downward into your lower belly. Let your abdomen expand fully.
  • Now breathe out through your mouth
  • Notice the sensations of each inhalation and exhalation
  • Proceed with the task at hand slowly and with full deliberation
  • Engage your senses fully. Notice each sight, touch, and sound so that you savor every sensation.
  • When you notice that your mind has wandered from the task at hand, gently bring your attention back to the sensations of the moment.”

Mindfulness can also be done as part of practices such as yoga, aikido, and tai chi training, as well as being a form of meditation in its own right.

How To Practice Mindfulness For Anxiety

Anxiety is connected to our thoughts and triggered by our reaction to them.

By being mindful, we can learn to calm the emotion behind these thoughts and begin to stop reacting to them.

  • Start with focusing on your breathing.
  • Zero in on the sensations you feel. Notice the sensation of your breath flowing through your nose and lungs as you inhale and exhale. Feel your chest expand and contract with each breath.
  • Notice the room’s temperature, the sounds around you, any smells or fragrances, and your physical reactions (sweating, pulse rate, etc).
  • If you have an anxious thought, label it, but don’t get caught up in it or reject it. Instead, think “that is a fearful thought” or “that is a sad thought,” then take 3 deep breaths.
  • After taking these breaths, try to gain perspective about the anxious thought. Ask yourself if the worry or fear was valid? Or, was it actually something you might be making bigger than it deserves? Or, could it be that you are jumping to conclusions? 
  • Experiencing those few seconds of calm as you gain perspective allows you to release the anxious thought, so let it go and focus on your next breath.
  • Don’t judge yourself for having anxious thoughts. Once you notice them, simply return your attention to your breathing and repeat these mindfulness steps.

“Practice makes perfect,” as the saying goes. You probably won’t experience a total release of anxiety the first time you try mindfulness, but you should get some relief from your concerns.

If you keep practicing, you will improve over time. Each time you focus on the present, your mind gets a chance to relax so you can see things from a new perspective.

Learn More About Mindfulness Here

If you or a loved one are struggling with 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.

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Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation: High Tech Help For Treatment Resistant Mood Disorders

Despite therapy and the use of medications, we occasionally find that the effects of a mental health disorder persist in some people. For these individuals, brain stimulation therapies like transcranial magnetic stimulation (TMS) may provide relief from their symptoms. TMS may also be an alternative for those who cannot tolerate mood stabilizing medications.

The National Institute of Mental Health (NIMH) reports that TMS and other brain stimulation therapies “involve activating or inhibiting the brain directly with electricity.” TMS is the most noninvasive of these treatments and is given via energy pulses that are generated by an electromagnetic coil held near or against the person’s head.

Because these magnetic pulses are given over and over in a repetitive rhythm, the most technically correct term for TMS is repetitive transcranial magnetic stimulation (rTMS).

What Is Transcranial Magnetic Stimulation Used For?

In 2008, the Food and Drug Administration (FDA) approved repetitive transcranial magnetic stimulation to treat major depressive disorders and their associated cases of severe depression and anxiety. It has also been studied as a therapy for psychosis and researchers are looking into how it may help conditions like post traumatic stress disorder (PTSD). Additionally, another form of rTMS, called deep transcranial magnetic stimulation (dTMS), has been FDA-approved for the treatment of obsessive compulsive disorder (OCD).

In 2010, the NIMH funded a clinical trial on the effectiveness of transcranial magnetic stimulation. Initial results showed that the effectiveness of rTMS was around 14 percent compared with a placebo-type procedure, which was only 5 percent effective. However, when participants were put into a second-phase trial, the remission rate of rTMS increased to 30 percent.

How Does A TMS Work?

When you go through a session of rTMS, you will be fully awake. Each session lasts between 40 and 60 minutes and no anesthesia is required. It is an outpatient procedure so you can drive yourself to the appointment and back home again. Typically, a person is treated four to five times per week for between four and six weeks.

During the rTMS session, an electromagnetic coil, which is about the size of your hand, will be passed over your forehead and scalp along the region of the brain thought to regulate mood. This coil produces short electromagnetic pulses similar in strength to the ones generated by a magnetic resonance imaging (MRI) machine. According to the Anxiety and Depression Association of America (ADAA), “The magnetic pulses cause small electrical currents that stimulate nerve cells in the targeted region of the brain.”

As scientists gain more knowledge about how rTMS can help people, they are developing new treatment methods. In fact, the FDA has sanctioned the use of theta burst stimulation, which is a variation of rTMS. In the theta burst procedure, the person only receives transcranial stimulation for about 10 minutes per session, however they still need to have daily sessions for several weeks.

In addition, another form of rTBS, called iTBS or intermittent theta burst stimulation, is now being given in 3 minute treatments. iTBS (also FDA-approved) gives intensive bursts of high frequency stimulation and has shown results comparable to the customary rTMS therapy.

Does TMS Therapy Hurt?

While rTMS therapy doesn’t hurt, the person may feel some mild sensations as the electromagnetic pulses are administered. These sensations might include:

  • A light knocking or a mild tapping feeling on their skull.
  • The muscles in their face, jaw, or scalp tingling when the magnet is applied.
  • These same muscles contracting while the magnet is in use.

Is Transcranial Magnetic Stimulation Safe?

Although most people do very well with it, rTMS does have some temporary, mild side effects for a small number of people. They can include:

  • Mild headaches
  • Lightheadedness
  • Scalp discomfort

Rare, but possible, is the chance of a seizure, however no seizures were reported during the two large studies that have been done on the safety of rTMS, according to the NIMH.

Additionally, Johns Hopkins reports that people who have non-removable metal objects in their head (for example: stents or aneurysm clips) should not receive rTMS. This is because the magnets can cause these objects to move or heat up, which could produce a serious injury or even death.

It’s worth noting that because transcranial magnetic stimulation is relatively new, we haven’t been able to study its long term effects. That said, treatment data has been compiled and studied since the mid-1990s and there have been no long term complications from its use, to date.

We Can Help

If you are struggling with anxiety, depression, or other mental health concerns, consider speaking with the professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information on how we can help, contact us or call us today at 561-496-1094.

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Intensive Outpatient Therapy For Depression And Anxiety Help

We all have our anxious moments or times when we are depressed. It’s normal to feel these emotions when we are in stressful situations. Generally, this anxiety or depression goes away once conditions improve and life becomes less hectic again. For millions of people, however, anxiety or depression can drag on and on. It may get worse over time and might even start to interfere with their work, school, or relationships. When it reaches this point, it is likely that the person has an anxiety or mood disorder that requires treatment.

While about 20 million to 40 million Americans suffer from these disorders, only about a third will seek help – yet these conditions are highly treatable.

People who have depression or other mood disorders often do best with a combination of psychotherapy and medication. Anxiety help and relief comes through therapies like cognitive behavioral therapy (CBT) and mindfulness.

Most of the time, someone who is undergoing treatment for depression or anxiety will see their therapist once or twice a week for 30-60 minute sessions. These sessions often continue for three to four months, but could go on much longer depending on the severity of the person’s disorder. However, a relatively new concept in psychotherapy, called intensive outpatient therapy, is showing promise for helping patients get better faster.

What Is Intensive Outpatient Therapy?

Intensive outpatient therapy is focused therapy that is given over longer treatment sessions. For example, intensive treatment might be concentrated into daily, three-hour sessions given five days in a row over a two to four week period.

Just as with a traditional psychotherapy session, intensive treatment uses methods like CBT, mindfulness, and exposure response and prevention (ERP). The idea behind the intensive sessions is to teach strategies to decrease the person’s symptoms and provide support, but to do it within a framework that allows them to live at home and continue family or personal activities.

An intensive outpatient therapy program includes:

  • Comprehensive treatment planning
  • Learning to recognize unhealthy behaviors
  • Methods and practice to aid in asking for and getting support
  • Learning coping strategies and skills
  • Building successful problem solving abilities
  • Follow up sessions to reinforce these new skills

Although intensive therapy is fairly new, research is showing that it is just as beneficial as long term therapy or in-patient centered therapy. A 2012 study by Ritschel, Cheavens, and Nelson at the Emory University School of Medicine reported that, “Depression and anxiety scores decreased significantly and hope scores increased significantly over the course of treatment.“

If you are looking for an intensive program, be sure that whichever one you choose utilizes therapists who have been highly trained in treating anxiety and depression. Also, you want the program to be individualized to you. You should feel a connection with the therapist and they should work with you to develop a plan specifically for your needs in order to maximize the outcome of your treatment.

Who Would Benefit From Intensive Outpatient Therapy?

Sometimes a person can struggle with depression or anxiety symptoms while still being able to function in their daily life. At other times, someone may need more focused therapy and support. Intensive outpatient treatment would work for both people.

Intensive therapy also benefits those who either don’t find it practical to see a therapist over several months or those who have tried traditional therapy but haven’t been as successful as they’d hoped. It also can provide rapid and effective management in someone with severe symptoms who has taken time away from work or school for their recovery.

To be most effective, those who participate in intensive therapy should:

  • Be sure they attend every session. This can be difficult if they are having bad days, but they will get the most benefit by coming to every appointment.
  • Allow themselves time to process what they are learning.
  • Treat themselves gently while they learn that it’s okay to make mistakes
  • Trust in the therapy and therapist.

Learning coping skills and effective management of symptoms may continue on and off during one’s life. Sometimes people need a “booster” even after intensive therapy, but trusting that the psychotherapists and treatment will help can aid in quickly reducing and managing moderate to severe anxiety and depression.

Learn More About Our Upcoming Intensive Outpatient Therapy Sessions – Starting Soon!

If you have depression or need anxiety help, consider our upcoming summer intensive therapy sessions. For more information, talk to the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. Contact us or call us today at 561-496-1094.

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Why We Dread Bedtime When We’re Anxious

Why We Dread Bedtime When We’re Anxious

For those who struggle with anxiety and insomnia, lying in bed at night can be dreadful. Before getting into bed for the night, many will describe allowing themselves to have a nice, relaxing evening. They may feel relatively low stress or little to no anxiety. But, as soon as the lights turn off for the night, the brain turns on with a vengeance. Now you’re in bed, wide awake, worrying about any and every possible negative outcome in the days, weeks, months and even years ahead.

What’s more, anxiety at bedtime often becomes anxiety about sleep. The focus then shifts to trying to sleep, which puts us in a frustrating paradox because sleep is an automatic process that we cannot force.

What’s really keeping us awake at night? Why does our anxiety have such a propensity to attack us when we try to sleep?

Read the full post by our very own Dr. Brand here.

Let Us Help

If you are suffering from anxiety, get help from our mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. To get answers to your questions or for more information, contact us or call us today at 561-496-1094.

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