To bring awareness and create venues for public education about anxiety and depressive illnesses, Freedom From Fear has created National Anxiety and Depression Awareness Week, May 3 – 9, 2009. This program, which began in 1994, is now celebrating its 15th successful year. Each year more than 40 million Americans will suffer with an anxiety disorder and over 20 million will suffer from some type of depressive illness. The cost to the economy of these terrible diseases is billions of dollars each year; the cost in human suffering is immeasurable.

We need your help. Register to be a part of our public education campaign. In order to receive a free promotional kit, you agree to promote and sponsor an event during National Anxiety and Depression Awareness Week (May 3 – 9). Some suggestions are:

o Link your website to Freedom From Fear’s screening room where people can be screened for anxiety and depression Screening Room.
o Organize a free screening day open to those in your community.

o Have a film showing and lecture at your facility or within your community.
o Give a talk at a community organization.

For more suggestions and ideas on how to hold a successful event, contact Heather at 718-351-1717 ext. 19.

There is a $5.00 shipping and handling fee for this promotional kit. Payment can be made through Paypal or by sending a check to:

Anthony Santoro

Love and marriage may go together like a horse and carriage, but what happens when the love fizzles out and that horse dies? The carriage problem is simple; just buy a new horse. The marriage problem is a little more difficult. Divorce is a major problem in the United States today being that, statistically speaking, 40 to 50 percent of all marriages will end in divorce. Splitting up is usually extremely difficult for any couple, however divorce gets even more complicated when instead of just involving two people, a third is added to the situation. Although couples without children have a slightly higher rate of divorce, approximately 40 percent of all divorces involve children. Since such a large portion of all divorces involve children, it is necessary to identify the effects of divorce on children, as well as the main causes of those effects.

When a couple with children decides to divorce, many questions arise: What will happen to the children? Who gets them? How much time will each child stay with one parent? Fortunately, a large majority of divorcing parents can amicably negotiate a compromise regarding child custody issues without legal assistance, and only six to 20 percent of all divorce cases involving children do need the courts to intervene. Throughout the decades there have been different custody decision trends exhibited by the courts. In past years child custody decisions seemed usually to follow the Tender Years Doctrine. This meant that most of the time the mother would gain custody over younger children, especially young girls. Although this trend lasted a number of years, recently the courts began utilizing the Least Detrimental Alternative Standard. This standard is concerned with granting custody to the parent who will negatively affect that child the least. In this circumstance, both of the child’s parents are evaluated by a psychologist or social worker, and are equally considered contenders for primary guardian.

Regardless of whether raised by their fathers or mothers, certain traits and prevalent characteristics seem to frequently transpire in children of divorce. These children may experience feelings of powerlessness and depression. It is important to note that these traits are seen in small children as irritability. The child may also store feelings of anger and act out violently. Sleeping problems can be associated with these children, as well as a decline in their schoolwork. Concerning children of divorce, self-esteem levels seem to be low and suicidal tendencies seem to be high compared to other children.

Although it might seem appropriate to blame all of the difficulties these children experience on the divorce itself, there is another aspect that probably affects these children more than the actual divorce. The child may take the initial separation hard, but the behaviors of each parent towards the child after the divorce are what will impact the child the most. Often times, the parents become preoccupied by their own problems and quarrels and lose focus on the child. Parents forget that they are the most important people in their child’s life. Instead of compromising their own anger and problems for the well being of their child, they often cause additional stress.

In 2005, Elizabeth Marquardt published her research on children of divorce. She surveyed 1,500 adults, half of who were from divorced households. She found that a large number of adults who were raised by divorced parents reported that, as children, they did not feel physically or mentally safe in their homes. Also, 44 percent of them felt that they were often alone as children. This percentage is drastically higher than those children whose parents did not divorce. Longer custody battles seem to negatively affect children during this delicate time. Parents speaking badly about each other in front of their children, or the parent negatively comparing the child to the other parent appears to be especially detrimental. Phrases such as, “You’re just like you mother/father,” lead to issues regarding both parents, as well as may make the child want to reject his or her own identity.

Handling the situation with ease and care, however, can alleviate the hardships of divorce on a child. If both parents plan on being involved in the child’s life after the divorce, then both parents should tell the child about the divorce together. The parents need to make sure the child is aware that both parents are here for him or her and still love them. If one parent can not or will not be involved in the child’s life after the divorce, the remaining parent needs to address this to the child from the start in a straightforward, simple and clear manner.

When two parents are actively involved in the child’s life after a divorce, it is necessary that parents act cooperatively in making decisions regarding their child. In other words, they should talk to each other before telling their child that they can or cannot do something. Doing this makes the child realize that if one parent says no, the other parent won’t give in. This way the child is unable to play both parents off of one another. Two active parents are seen as strongest when both parents are in accord. Parents should always let their children know that they can be honest, as well as making their children aware that their parents are always by their side, looking out for their best interests.

Divorce will never disappear. What can disappear is the negative impact on children that is caused by parents during divorce. During this time it is easy for a parent to drown in their own worries and emotions, however they should never forget that their children are also suffering. In fact, they are most likely dealing with the most painful experience of their lives so far. Sacrificing some of their own personal concern for the betterment of their child undoubtedly shows that the parent cares. Fueled by unwavering love, this selflessness will not only greatly lessen the negative effects of divorce on the child, but also benefit the child. Being that children already have abundant love and admiration for their parent, they mirror their parents. Seeing a parent handling divorce positively may help a child grow up to be a well-adjusted, adaptable, and level headed individual. The negative effects of divorce on a child can best be remedied by a parent’s love.

Further information about this topic:

The Truth About Children and Divorce: Dealing with the Emotions So You and Your Children Can Thrive by Robert Emery

Helping Your Kids Cope with Divorce the Sandcastles Way by M. Gary Neuman

Making Divorce Easier on Your Child: 50 Effective Ways to Help Children Adjust by Nicholas Long and Rex L. Forehand

Christina Jones

Bipolar disorder, also known as manic-depression, causes a person to have severely fluctuating moods, energy, and level of functioning. A person with bipolar disorder can go from an extreme high called mania to an extreme low called depression. In between manic and depressive episodes, a person with bipolar disorder may have mild or no symptoms at all. Bipolar disorder is not an uncommon disorder. A statistic shows that 5.2 million American adults, aged 18 and older, are currently diagnosed with bipolar disorder.

One of the major symptoms of bipolar disorder is irritability, which is defined as an excessive response to stimuli. Irritability is characterized by excessive feelings of annoyance or frustration with a person or situation. It can be experienced during both manic and depressive episodes. A manic episode may last for a few days or a few weeks and during this manic episode a person usually feels extremely elevated moods and behaviors causing them to become easily irritated. During a depressive episode a person usually feels sad, hopeless and empty. A person can also feel irritable during a depressive episode because they may be having problems concentrating and may be experiencing fatigue, making them easily frustrated and annoyed.

Irritability is not only a symptom in diagnosing adults, it is also a common symptom among children with bipolar disorder. Bipolar disorder is usually diagnosed during late adolescence or early adulthood, but there have been cases of children being diagnosed. A study shows that seven percent of children seen at psychiatric facilities have bipolar disorder. More recently, studies have found that children who show symptoms of bipolar disorder have been misdiagnosed with ADHD (Attention Deficit Hyperactivity Disorder). In a study, it was shown that in children, irritability was not sufficient enough to determine a bipolar disorder diagnosis. It is still a relevant symptom because many of the children with bipolar disorder did show increased frustration during a hard and emotionally demanding task. Irritability cannot sufficiently determine bipolar disorder because this is also a common symptom of ADHD. If it is in addition to elevated moods, grandiose behavior and decreased need for sleep, it can help secure a diagnosis for bipolar disorder because these other symptoms are uncommon in ADHD. Another problem with diagnosing bipolar disorder in children is that people assume the child has behavioral issues and they do not seek outside help. Also, diagnosing bipolar disorder in children is fairly new and the DSM-IV guidelines outline classic adult symptoms, not symptoms children might express. Some symptoms children might express in addition to irritability are explosive temper tantrums, distractibility, separation anxiety, sensitivity to emotional or environmental triggers, bed-wetting (especially in boys), and night terrors.

Bipolar disorder is a serious mental illness that can impact a person’s daily life. One of the main symptoms, irritability, can appear in manic episodes and also during depressive episodes. Diagnosis of bipolar disorder does mainly occur with people in late adolescence and early adulthood, though cases have been found to appear in childhood. Irritability cannot determine a diagnosis of bipolar disorder alone. There are many other symptoms of bipolar disorder, and if you are experiencing those symptoms, you should try to seek help for treatment.

By: Nora D. Volkow, M.D., NIDA (National Institute on Drug Abuse) Director

Since the first vaccine, for smallpox, was developed more than 200 years ago, immunization has proven to be a powerful weapon in the fight against infectious disease. Today, NIDA-supported researchers are using modern molecular biology to create vaccines against another deadly disease – addiction to drugs such as cocaine, nicotine, phencyclidine (PCP), and methamphetamine.

Immunization against drugs provides a different sort of protection than do the shots routinely given to prevent measles, hepatitis, and the flu. Those vaccines stimulate the immune system to produce antibodies that destroy or deactivate viruses or bacteria. Anti-drug vaccines also stimulate the immune system to produce antibodies, but these antibodies do not destroy drug molecules. Instead, they attached to drug molecules, forming a compound molecule that is too big to cross the blood-brain barrier easily. By slowing drugs’ entry into the brain, the vaccines reduce or prevent the euphoria that promotes addiction. The higher the level of antibodies in the body, the more effective the vaccine in preventing euphoria.

Preliminary research on snit-drug vaccines is encouraging. NicVAX is a nicotine vaccine being developed, with NIDA support, by Nabi Biopharmaceuticals of Rockville, Maryland. In early studies, antibody levels rose with vaccine dose, and smokers receiving the vaccine did not smoke more to compensate for the reduced nicotine levels. In a 12-month trial, 16 percent of the NicVAX recipients quit smoking and remained abstinent, compared with the 6 percent of recipients of an inactive substance.

In tests of TA-CD, a cocaine vaccine produced by Bermuda-based Celtic Pharma, investigators found that cocaine-dependent users who received high doses produced more antibodies against the drug than did those who were given less. High-dose recipients were also more likely to abstain from cocaine during the 12-week study.

To counter methamphetamine and PCP, researchers are exploring an approach called passive immunization. Injections of antibodies specifically targeted to these drugs quickly reduced the drug concentrations in the brains of laboratory animals. If this approach proves to be safe and effective for people, it could be a lifesaving treatment for overdose. Periodic antibody injections might also serve as a treatment for addiction to these and other drugs.

As drug vaccines emerge, researchers will need to learn the most effective ways to use them, perhaps combining them with behavioral therapy. Just as protection against infectious illness often requires “booster shots,” drug vaccines will probably need to be administered more than once to have a long-term effect.

Judith S. Beck, Ph.D.

With over twenty-five years experience as a psychologist and diet coach Dr. Judith S. Beck, Director of the Beck Institute for Cognitive Therapy and Research and New York Times best-selling author of The Beck Diet Solution is back with THE COMPLETE BECK DIET FOR LIFE: The Five Step Program for Permanent Weight Loss which includes the Think Thin Eating Plan (Oxmoor House; $24.95; January 2009). A must have for anyone who hungers to train their brain to think thin and learn how to eat like those who have not simply lost weight, but who have conquered the battle to keep weight off for years. Dr. Beck states, “Cognitive therapy—the most highly researched and effective form of talk therapy—teaches dieters how to identify, and effectively talk back to their self-defeating, sabotaging thoughts such as “It’s okay if I eat this food I hadn’t planned because I’m happy/ I’m sad/ I’m stressed/ I’m busy/ it’s a special occasion/ no one is watching/ I’ve been good all day/ I’ll make up for it later” and dozens of other excuses.

THE COMPLETE BECK DIET FOR LIFE is the only program that teaches dieters how to overcome universal problems such as feeling deprived, disappointed, overwhelmed, apathetic, or discouraged—by changing their thinking. No wonder so few dieters have been able to lose weight permanently. They never knew how to change their thinking so they could make permanent changes in their lifestyle habits. Dr. Beck points out that with other weight-loss programs, dieters are not permitted room for error—to “cheat” on their diets. Thankfully, Dr. Beck respects that dieters are human; she expects mistakes. THE COMPLETE BECK DIET FOR LIFE teaches dieters exactly what to do immediately following mistakes, and how to solve and prevent tem in the future.

Based on the eating choices of the most successful dieters she has counseled and with the assistance of a registered dietician, Dr. Beck has created a comprehensive lifetime food plan. With THE COMPLETEL BECK DIET FOR LIFE dieters will discover the 5 Stages of successful dieting and maintenance. Dieters learn how to motivate themselves every day, how to give themselves credit for every change they make, how to create time and energy for dieting, and how to handle hunger and ravings. Dr. Beck eases dieters into changing their eating, one step at a time. They master one task (such as eating slowly) before they move on to the next. And they learn how to develop plans for coping with challenging situations such as holiday celebrations and people who “push food”. By practicing the skills in Dr. Beck’s 5 Stages, dieters will achieve a lifetime of healthful eating and lifelong motivation. “To be a successful dieter and maintainer, you have to learn to follow a highly nutritious diet, use good eating habits, and respond to sabotaging thinking that can get you off track. Change you thinking and you will make permanent changes in you eating, your weight, your self-esteem, and your health.”

With THE COMPLETE BECK DIET FOR LIFE dieters will:

•Learn to think differently and overcome common dieting pitfalls and sabotaging thoughts

•Learn how to eat favorite foods while steadily losing an average of one-half to two pounds per week

•Feel in control in the most challenging situations—no matter what

•Build confidence in their ability to follow a healthy diet and exercise plan

•Remain motivated to maintain weight loss for life

Dr. Judith S. Beck is the daughter of the influential found of Cognitive Therapy, Aaron T. Beck, M.D. She received her doctorate from the University of Pennsylvania where she is currently a Clinical Associate Professor of Psychology in Psychiatry. Director of the Beck Institute of Cognitive Therapy, she is also the past president of the Academy of Cognitive Therapy. She has published many articles and books about Cognitive Therapy, including The Beck Diet Solution and Cognitive Therapy: Basics and Beyond, and she lectures worldwide on the topic.

Marcia Pinck

In the minds of some people, the word hypnosis has connotations of “magic”, “brainwashing” or “hocus pocus.” The fictional image of Svengali using hypnotism to cast his spell on innocent, unwilling victims and the curious antics of people hypnotized by a nightclub performer, have kept hypnosis from achieving full medical acceptance despite a long, fully-documented record of success.

Finally in 1958, the American Medical Association lifted this aura of mysticism and recognized hypnosis as a safe, efficient and effective therapy. It continues to take time for the general public to realize the great value of hypnotherapy.

People from all walks of life are now benefiting from hypnotic techniques. Still there are many people who, although they have read or heard of wonderful results and have a need for it, are afraid to use hypnosis. Fear of the unknown is the most common cause of failing to use hypnosis when it is recommended.

There is no loss of awareness or control; in fact, there is much greater awareness during hypnosis. You hear outside sounds and voices but the focus of your attention is directed to suggestions given rather than outside distractions. The subconscious mind becomes receptive to ideas and suggestions that specifically relate to your goal. The hypnotist cannot make you say or do things against your will nor can you become hypnotized against your will. It requires cooperation between subject and hypnotist and an average intelligence on the part of the subject. Therefore it is another misconception that only weak-willed and unintelligent people can be hypnotized. There is no need to fear you might not come out of the hypnosis; anytime you want to, you can simply open your eyes and emerge from hypnosis. You will feel completely refreshed and rested and completely alert in a few seconds.

The key to hypnosis is the communication directly with the subconscious. The mind is like a computer that can be programmed. Unfortunately the subconscious mind is more like a tape recorder that simply takes in messages and feeds them out the same way; it cannot reason and will accept either negative or positive conditioning or programming. Therefore unwanted and undesirable habits are easily formed.

Hypnotherapy is used for the achievement of many goals including weight control and smoking cessation. More than 40 percent of the population is overweight; severe obesity affects at least 15 percent of adults. Excess weight is hazardous to one’s health. It is a significant factor in heart disease, high blood pressure, diabetes, lower back pain and many other disorders. It also adversely affects emotional health causing low self-esteem and even depression. Diets are usually ineffective. Successful weight control is more likely to occur when the individual adjusts his or her attitude about dieting. Permanent weight loss requires establishing a new eating lifestyle that allows the individual to socialize without any need for special foods or preparations.

For many years smoking was a strictly male vice. Few women of fine reputation smoked. In the 1920s however, mass advertising was directed to women as much as men and it promoted a massive spread of the habit. Tobacco consumption continued to increase well into the 1960s when the fist authoritative reports about the true dangers of smoking began to appear. Since then, we have seen how many illnesses are directly attributable to the habit. Yet people, and particularly mental health consumers, continue to smoke. The smoking habit is a complex mixture of physical drug dependence (brought on by the pharmacological action of nicotine on the body) and psychological and social factors.

 There are hundreds of methods available today to help people quit smoking. However, after reviewing 160 “stop smoking” methods. Dr. Jerome Schwartz, former Health Care Research Specialist for the California Department of Health concluded: “The highest success rates for smoking cessation were achieved through professionally controlled hypnotherapy sessions.”

Hypnosis is extremely effective because it can “short-circuit” habits on the subconscious level where they are formed rather than fight them with will power alone. Even people with strong motivation find it difficult to quit smoking or lose weight permanently on their own. Skillful use of post-hypnotic suggestion can build up and strengthen the determination and desire to lose weight or quit smoking. The individual is trained to become more aware of their emotions that had previously triggered a desire for large portions of fattening foods, in-between meal snacks or late night eating, or cigarette smoking. There is no feeling of deprivation, but instead the individual begins to feel more confident and healthier.

A trained hypnotherapist can also help you to decrease stress and anxiety; increase motivation and self-confidence; relieve pain or insomnia; improve memory or concentration or athletic skills; overcome fears or phobias; control bad habits; and generally take charge of your life. Every person possesses the power for performance far beyond his or her level of achievement. Yet for most, this power remains unused throughout their life. It is a store of inner strength that is rarely utilized simply because few know how to use or even know it is there. Hypnosis can unlock your hidden potential and help you achieve person success.

Heather Lauria

You’ve been diagnosed with a mental illness. Now what? The idea of telling friends and family your misfortune is daunting. How will they react? Will they too succumb to the social stigma of mental disorders or will they stand up and help you fight to get well again? In a world where finding out you have a mental illness can almost seem traumatizing in itself, it helps to know that you are not alone. There are so many others out there going through exactly what you are dealing with. There are people who have taken on what life has thrown at them and who have succeeded. But just who are these people and where do you find them?

Lately, more and more celebrities have begun speaking out about mental illnesses. Many of the Hollywood population know firsthand the suffering that comes with mental illness. All of America watched as Britney melted down under the hot lights of Hollywood scrutiny and we all remember Brooke Shields battle against Postpartum Depression and Tom Cruise.

A mental illness does not mean that your life has to stop. There are many people, both in history and still living, who have managed to accomplish unbelievable things in spite of (or in some cases, due to) their mental disorders. The failure of the brain to function correctly is no one’s fault and can be overcome. But while you are working on recovery, it is possible to strive for the extraordinary. Take a look at the following list to see what some very famous people have achieved while struggling with a mental illness.

President Abraham Lincoln and his wife, Mary Todd Lincoln both suffered from mental illness. The President was plagued by severe depression but this in no way stopped him from becoming the man who held our country together during a civil war. During his presidency, Mary Todd stood by her husband while suffering from bipolar disorder.

Winston Churchill, another great leader of the world also suffered from bipolar disorder. It is written by author Any Storr, “Had he been a stable and equable man, he could never have inspired the nation. In 1940, when all the odds were against Britain, a leader of sober judgment might well have concluded that we were finished.”

Literary greats Ernest Hemingway, Sylvia Plath, Charles Dickens, Virginia Woolf, Leo Tolstoy, John Keats, Edgar Allen Poe, and Tennessee Williams all suffered from depression. Geniuses in their own mediums, Vincent Van Gogh, Michelangelo and Ludwig van Beethoven were all tormented by illness of the mind. Mental illness has even made it to the moon when Buzz Aldrin shuttle there. He did not let his battle against clinical depression stop him from being the second man to walk on the moon.

It is also important to remember that even the saintly and those who have dedicated their lives to God and charity work were not spared the pain and suffering of illnesses of the mind. Both Saint Ignatius of Loyola and Saint Francis of Assisi suffered from depression. Saint Ignatius also suffered from Obsessive Compulsive Disorder (OCD), as did Saint Therese the Little Flower.

The next time you get discouraged and think that you will never be able to have a normal life because of your mental illness, embrace that idea and strive for a life of extraordinary proportions. Most famous people with mental disorders had the illness before their fame. They learned that a mental illness did not mean their life was over, but they had the chance to achieve what “normal” people could not!

Marty Garfinkle Ph.D.

Board of Directors

Freedom From Fear

“What if My Boss Doesn’t Like Her Grab Bag Gift?”

“What if My Kid’s Think I Skimped on Their Presents?”

“What if My Wife Isn’t Happy with Her Gift?”

Sounds Like Gift Giving Anxiety!

• Keep sentimentality in mind when making your gift choices, create something that is meaningful and will warm the recipient’s heart for years to come.

• Make gift choices that are useful and have mileage (avoid giving gifts that will be discarded and forgotten within a few weeks).

• Give the greatest gift, one self. Keep in mind there is no gift more precious than the gift of ones time.

• Lastly, do not over spend. In these hard financial times, pay with cash and spend only what you can afford, otherwise you may have the January blues when it is time to pay those credit card bills.

Carol Sonnenblick, Ed.D.

Board of Directors

Freedom Fom Fear

Chubby Santa’s, twinkling lights, parties, the aroma of pies and cookies baking in the kitchen, champagne bubbles, family feasts and gifts piled high greet each year’s holiday season.  Holidays are happy times, right?  Not necessarily.  The advent of the holiday season is not always a time of joy.  It is a time when we mourn those whose presence is missed.  It is a time when frenzied activity adds to the burden of life’s already hectic schedules.  It is a time of excess—spending too much, eating too much and drinking too much. How can we put in the obligatory time with family which may prove toxic as old habits and unresolved issues resurface?   How can we enjoy the holiday season when coping with our usual stressors requires us to use all of our inner resources?  Here are some.

• Develop a shopping list and spending plan.  Resist impulse buying and extravagance.
• Remember that there is no reason to expect that difficult relationships will have improved since last year—so why get aggravated.

• Pace your activities.  Accept invitations to those events that will not overburden your life and cause next day exhaustion.  Feeling tired and frantic is not good for your physical and mental health.
• If food and drink are an issue—try moderation (more easily said than done—think  January when you will want to undo the results of binge indulging)
• Choose parties and events you really care about, avoid day after day of obligatory activities. 
• Set aside some time just for yourself—do something that you enjoy, makes you smile and reduces your sense of being on a treadmill.
• Chose someone you really care about and spend some quality time, even if it’s only a quick lunch somewhere. 
• Make plans for January and February to do something special—give yourself something to look forward to during the coldest, darkest winter months.
• Buy yourself a gift, something that you really want that no one else is going to get for you. 

Put the holiday into perspective—the excitement, the scenery, the parties, friends and family.  Recognize that changes in routine can be stressful but that’s just part of the season—enjoy and happy holidays. 

“Remember that our expectations will create our reactions, and expectations are often too idealistic if guided by the hallmark holiday image.”  

-Mark Sisti, Ph.D

“Have the freedom to change traditions, based on what works and what no longer works.”

-Constance Salhany, Ph.D.

Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each of the treatments alone is also effective, according to a new study funded by National Institutes of Health’s National Institute of Mental Health (NIMH). The study was published online Oct. 30, 2008, in the New England Journal of Medicine.

“Anxiety disorders are among the most common mental disorders affecting children and adolescents. Untreated anxiety can undermine a child’s success in school, jeopardize his or her relationships with family, and inhibit social functioning,” said NIMH Director Thomas R. Insel, M.D. “This study provides strong evidence and reassurance to parents that a well-designed, two-pronged treatment approach is the gold standard, while a single line of treatment is still effective.”

The Child/Adolescent Anxiety Multimodal Study (CAMS) randomly assigned 488 children ages 7 years to 17 years to one of four treatment options for a 12-week period:

            Cognitive behavioral therapy (CBT), a specific type of therapy that, for

this study, taught children about anxiety and helped them face and

master their fears by guiding  them through structured tasks;

The antidepressant sertraline (Zoloft), a selective serotonin reuptake

inhibitor (SSRI);

CBT contained with sertraline;

pill placebo (sugar pill).

The children, recruited from six regionally dispersed sites throughout the United States, all had moderate to severe separation anxiety disorder, generalized anxiety disorder or phobia. Many also had coexisting disorders, including other anxiety disorders, attention deficit hyperactivity disorder, and behavior problems.

John Walkup, M.D., of John Hopkins Medical Institutions, and colleagues found that among those in combination treatment, 81 percent improved. Sixty percent in the CBT-only group improved, and 55 percent in the sertraline-only group improved. Among those on placebo, 24 percent improved. A second phase of the study will monitor the children for an additional six months.

“CAMS clearly showed that combination treatment is the most effective for these children. But sertraline alone or CBT alone showed a good response rate as well. This suggests that clinicians and families have three good options to consider for young people with anxiety disorders, depending on treatment availability and costs,” said Walkup.

Results also showed that the treatments were safe. Children taking sertraline alone showed no more side effects than the children taking the placebo and few children discontinued the trial due to side effects. In addition, no child attempted suicide, a rare side effect sometimes associated with antidepressant medication in children.

CAMS findings echo previous studies in which sertraline and other SSRIs were found to be effective in treating childhood anxiety disorder. The study’s results also add more evidence that high-quality CBT, with or without medication, can effectively treat anxiety disorders in children, according to the researchers.

“Further analyses of the CAMS data may help us predict who is likely to respond to which treatment, and develop more personalized treatment approaches for children with anxiety disorders,” concluded Philip C. Kendall, Ph.D., of Temple University, a senior investigator of the study. “But in the meantime, we can be assured that we already have good treatments at our disposal.”

The six CAMS sites were Duke University; New York State Psychiatric Institute/Columbia University Medical Center; Johns Hopkins University; Temple University/University of Pennsylvania; University of California, Los Angeles; and the Western Psychiatric Institute and Clinic/University of Pittsburgh Medical Center.

Reference

Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill J, Ginsburg GS, Rynn MA, McCraken J, Waslick B, Iyengar S, March JS, Kendall PC. Cognitive-behavioral therapy, sertraline and their combination for children and adolescents with anxiety disorders: acute phase efficacy and safety. New England Journal of Medicine. Online ahead of print 30 Oct 2008.

The National Institute of Mental Health (NIMH) mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website.

The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit the NIH website.

Pignoli Cookies

Christine Guerriero

Christine¡¯s grandmother, Angelina Guerriero, passed this recipe down to her. Making pignoli cookies is a tradition in Christine¡¯s family which she has graciously shared with us. Christine¡¯s passion for baking and pastries led her to the French Culinary Institute in NYC where she graduated. She now has her own business. To view and purchase some of Christine¡¯s delicious creations, please visit www.sweetlorrainesonline.com.

Ingredients

¨ö cup granulated sugar

¨ö cup confectioner¡¯s sugar

¨ù cup AP flour

Dash of salt

18 oz. almond paste

2 egg white¡¯s (lightly beaten)

¨ö tsp almond extract

¨ö tsp vanilla extract

1 lb. pignoli nuts

Confectioner¡¯s sugar for dusting

Procedure

1.      Break up almond paste w/ fingers and beat in mixer in paddle attachment until smooth.

2.      Add granulated sugar and confectioners sugar and beat into almond paste, scraping down bowl as needed.

3.      Add egg whites and extracts and beat until emulsified.

4.      Add flour and salt and beat just until combined.

5.      Scoop out of bowl and press into pignoli nuts.

6.      Place on sheet pan lined w/ parchment paper and bake in oven set at 300¢ªF for approx 25 min. or until tops are light golden brown.

7.      Let completely cool before taking off parchment otherwise cookie will stick.

Potato Pancakes (Latkes)

Helene Schonbuch

Helene shared her favorite traditional Potato Pancake recipe with us. Every year she makes this recipe for Hanukkah. Helene is the wife of Stanley Schonbuch, Ph.D., an associate of Freedom From Fear for over 20 years.

Ingredients

8 medium potatoes (not baking)

1 medium yellow onion

2 eggs

2 tsp. salt

Dash of white pepper

1/3 cup matzo meal or flour

Vegetable oil

Procedure

1. Scrub potatoes well.
2. Cut into pieces (leave skin on).
3. Add all ingredients, except oil, into food processor on grate cycle.
4. Heat griddle or large frying pan with oil to cover.
5. Drop large spoonfuls onto heated griddle.
6. Turn once when golden brown on one side.
7. Serve hot, with sour cream or applesauce.

Sharon Davies

September 29, 1950 - November 30, 2002

Sharon Davies was a psychiatric nurse, a researcher and a staunch advocate for those who suffer from mental illnesses. She loved her profession, and she loved people. She also realized that stigmatization and ignorance about mental illnesses can enslave individuals and their families who suffer with these diseases. She was determined to help change this.

In 1985, she became actively involved with Freedom From Fear, a non-profit mental illness advocacy organization, during its early development. She was a primary source of advice and encouragement. Sharon volunteered each month for many years to counsel individuals who sought help for their mental health problems. She also visited schools and civic groups giving lectures and assisted in the development of community outreach programs.

In her professional career as a nurse, Sharon had a diverse and interesting background. She volunteered for a year as a nurse on a Hopi Indian Reservation and held a variety of other nursing positions. However, her primary work was as a researcher and Special Projects Coordinator of the Anxiety Disorders Unit at the New York State Psychiatric Institute where she was employed for 27 years.

Sharon's kind and caring way was a source of strength to all who came to know her. She always made herself available to help others, whether they were a patient, coworker or a resident struggling to write their first research grant. She generously gave of her time and asked nothing in return but the satisfaction of seeing her colleagues and friends achieve their goals.

Sharon was greatly loved and will be greatly remembered by her friends and colleagues. Her memory, goals and aspirations will live on through the Sharon Davies Memorial Awards Program created by her family, friends and colleagues at Freedom From Fear.

Sharon Davies Memorial Awards Program

Why has this program been created?
The family, friends and colleagues of Sharon created this program to provide grants to individuals to assist them in the area of mental health research. The program is particularly interested in novice researchers but all eligible candidates are encouraged to apply.

What is the amount of funding available for a research grant?
In 2007 a maximum of $20,000 will be awarded. Grant requests cannot exceed $10,000. What is the deadline for submitting a grant application? Grants must be received by October 4, 2007. Late or incomplete applications will not be accepted.

Who is eligible to apply for a grant?
Applicants must be a Registered Nurse or a Nurse Practitioner employed in either a research, clinical or academic setting.

Can more than one grant application be submitted?
Candidates can submit only one grant application per grant cycle.

Is previous research experience required?
No previous research experience is necessary to apply for a grant.

Does the research have to be done in a research or academic institution?
No. It doesn't have to take place at a research or academic institution, but applicants are required to submit the name of individuals that have experience in research. These individuals must provide a letter that they are mentoring the applicant.

What types of projects are eligible for funding?
The program will fund grants that facilitate innovative research in the field of mental health.

Applications have been submitted for the grant with diverse research projects ranging from "Effects of Lavender Aromatherapy on Dementia Patients in the Acute Psychiatric Setting" to "A Pilot Study Using rTMS (Transcranial Magnetic Stimulation) in the Treatment of Panic Disorder".

2003 Winners

Michelle Choi, MS, BS, BSN, (PhD Candidate)
Barriers to Seeking Mental Health Care Among Korean American Women

Judy Parker, RN
The Impact of Social & Non-Social Rewards on the Elopement of Psychiatric Inpatients

2004 Winners

Jessica Gill, MSN, RN, (PhD Candidate)
Bio-behavioral Exploration of PTSD in Women

Ginette G. Ferszt, PhD, RN, CS, CT
A Group Intervention with Women in Prison

Pamela Adamshick, MSN, (PhD Candidate)
A Nursing Exploration of the Experiences of Female Peer-to-Peer Aggression in Girls in Marginalized Groups

2005 Winners

Berry Anderson,BSN
Patients’ Perceptions of Living, Adapting, and Coping with a New Treatment, Vagus Nerve Stimulation for Depression

Janice H. Goodman, Ph.D.
Identification and Treatment of Depression in Pregnancy

2006 Winners

Cheryl Anderson, RN, Ph.D., CNS Ph.D.
Pyschological Impact of Childbirth among Adolescents

Margaret Governo, EdD, APRN
Is the Classroom Character Education Program Intervention effective in increasing positive self-esteem, enhancing leadership behaviors, while decreasing the prevalence of bullying behaviors in fifth grade elementary students

2007 Winners

Monika Eckfield, RN, MSN, PhD Student Ph.D.
Hoarding and Cluttering Behaviors in Older Adults

Linda Paradiso, RN
Is the Classroom Character Education Program Intervention effective in increasing positive self-esteem, enhancing leadership behaviors, while decreasing the prevalence of bullying behaviors in fifth grade elementary students

Heather Lauria

For years mental health advocates have been trying to equalize mental health and addiction treatment in the United States. While many people, including senators and representatives from different parties, have lobbied for the Parity Bill to be signed into law, time and time again it has failed, always due to different, and sometimes unrelated, reasons. On October 3, 2008, the Americans with mental health concerns finally got what they needed most. It might seem unusual that the Parity Bill was tacked on to the massive economic bailout package, but it was done as a bargaining tool of the Democrats to ensure Republican Senate members would vote in favor of the government bailout.

What good news this brings for people suffering from mental illnesses and addictions! The parity bill calls for equality from the insurance companies. Mental health co-payments and deductibles can no longer be higher than those for physical illnesses. The bill does away with limits on the number of outpatient therapy sessions or inpatient treatment days. Also, insurance companies must offer out of network benefits for mental health if they provide the same service for physical treatments.

The bill does, of course, have shortcomings. While it equalizes the treatment of mental illness and addiction to the treatments of physical problems, this only applies to insurance companies who were already covering mental health. If your insurance did not cover mental health, or any out of network benefits before, then you will not see any changes in your mental health coverage. Also, the new Parity law does not go into effect until January 1, 2010 and it only covers businesses with fifty or more employees.

While there are still limitations on mental health coverage, this bill is a step in the right direction for our nation. Mental illness is finally being recognized as legitimate, medical problem. The passing of this bill is expected to relieve some of the stigma associated with mental illnesses and addiction problems. “With approval of this bill, we will tear down the walls of stigma and discrimination and the open the doors to the power and promise of treatment and recovery.  It recognizes that mental health disorders are every bit as debilitating, and just as treatable, as cancer and diabetes.” said David Shern, Ph.D., president and CEO of Mental Health America.

Congratulations to everyone who worked so hard and so long to pass such an important piece of legislation!

Jennifer Leslie

Electroconvulsive Therapy (also known as Electroshock or ECT) was introduced in the 1930s.  Today, it is estimated that about one million people worldwide receive the safe and effective treatment.  ECT is most often used to help those suffering from severe depression, acute mania, catatonia and occasional cases of schizophrenia.  ECT is approved by the American Psychiatric Association when administered under specific guidelines, including written and informed consent from the patient, as well as an overview of possible side effects explained by the doctor.  While administering treatment, an anesthesiologist, psychiatrist and recovery nurse must be present. 

ECT is performed in a hospital setting.  Clients are normally inpatients receiving treatment three times per week; however outpatient ECT may also be an option.  A patient may receive as little as three treatments, or as many as 15, depending on his/her personal situation.  A patient undergoing ECT is unable to eat eight to12 hours prior to the procedure.  Once the anesthesia is administered, the muscles are temporarily paralyzed to prevent the patient from moving throughout the procedure.  Electrodes are placed on the head and an electric current is applied (for a second or less) and passes through the brain, inducing a grand mal seizure.  During the seizure, the patient does not experience pain.  The seizure causes chemicals, called neurotransmitters, to be released into the brain and allows the cells to work better with one another. 

Though researchers are still not sure how ECT works, there are many hypotheses.  Some researchers believe that treatment changes the receptors in the brain that receive chemicals (for example, serotonin). Another theory is that ECT is able to stabilize a person’s mood by teaching the brain to resist seizures. A third is that ECT releases chemicals which increases metabolism and blood flow through the brain.  Meanwhile, the patient’s seizure activity and heart rhythm are constantly being monitored and an oxygen mask is also used.  A clinically effective seizure usually lasts from about 30 seconds to a minute and the patient is awake again within 15-20 minutes.

ECT is most often used to treat clients suffering from major depression who have been unresponsive to therapy or prescription drugs.  ECT is also administered to patients who have severe thoughts of suicide, those who refuse to eat, drink or take prescribed medication or present immediate danger to themselves.   The treatment has quicker results than many medications and therapy and many patients see changes in mood after just two to three treatments.  A study conducted in 2006 at Wake Forest University School of Medicine in North Carolina showed that ECT improved the quality of life for nearly 80 percent of their participants.

After receiving Electroshock Therapy, the patient may experience some confusion, nausea, short term memory loss, the inability to concentrate, back pain, muscle stiffness or headaches.  There also may be a brief drop in blood pressure, an increase in heart rate or heart rhythm disturbances.  Symptoms usually last for about 20-60 minutes following treatment and may be helped with aspirin.  Some patients may experience longer-term memory problems. 

Recent studies indicate that ECT has a very low mortality rate (4.5 deaths per 100,000 treatments).  Most risk is due to anesthesia, however, it is no more of a risk to undergo anesthesia for ECT than it is for a minor surgery. Electroshock Therapy is not recommended for children, elderly patients or those with heart conditions.

Heather Lauria

Every year throughout the world, October 10^th is celebrated as World Mental Health Day (WMHD). This year, the founder of Freedom From Fear (FFF), Mary Guardino, was asked to speak at the United Nations Briefing for WMHD, held on October 9, 2008 at the United Nations. Ms. Guardino’s presentation was entitled, “Advocacy, Empowerment and Awareness: A Journey of Understanding and Commitment.”

Ms. Guardino shared her personal experiences with anxiety and a depressive illness with the more than 300 attendees. She told her story about her own triumph over mental illness and how it led to the founding of the national advocacy organization, Freedom From Fear. She told her story that as a child and adolescent, she always felt an “unexplainable difference” in herself from her friends. She described it as being “fear sensitive.” The thought of taking a roller coaster ride, a favorite among teenagers, was “like a near death experience” to her. After more than 40 years, Ms. Guardino was finally diagnosed with agoraphobia and depression and began receiving treatment for her illness. The experience of not being able to find help for so long made Ms. Guardino want to do something. She started Freedom From Fear as a small, local support group. Over the 25 years since its founding, FFF has grown into a national advocacy organization which helps people throughout the United States.

 During her presentation, Ms. Guardino emphasized the difficulty in making people aware of mental illnesses and that effective treatments can offer help and hope for a better life. Ms. Guardino spoke of her disappointment that mental health advocacy still remains so small even though mental disorders affect on average one in four Americans over 18 years old.

She referenced the larger advocacy groups of the American Association of Retired Persons (AARP) and the American Breast Cancer Association calling their ability to spread awareness for their causes as “remarkable.” She hopes that mental illness advocacy will someday reach the same heights. “I was very honored to be asked to speak at the UN,” says Ms. Guardino of the experience. “I hope my presentation brought new recruits to the mental health army.”

Sleep in America Poll, 2008  

            Long work days that often extend late into the night are causing Americans to doze on the job, at the wheel, and on their spouses, according to NSF's 2008 Sleep in America poll. Among the poll respondents, 29% fell asleep or became very sleepy at work in the past month, 36% have fallen asleep or nodded off while driving in the past year, and 20% have lost interest in sex because they are too sleepy. (1)

Common Sleep Disorders

            Is it hard for you to fall asleep or stay asleep though the night? Do you wake up feeling tired or feel very sleepy during the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are:

Insomnia - a hard time falling or staying asleep

Sleep apnea - breathing interruptions during sleep

Restless legs syndrome - a tingling or prickly sensation in the legs

Narcolepsy - daytime "sleep attacks"

            Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help. (2)

Sleep Facts

       (1) Your brain stays active throughout sleep.

       (2) Not getting enough sleep increases the risk of having high blood pressure, heart disease, and other medical conditions.

       (3) Insomnia—trouble sleeping at night—is more common in females, people with depression, and people older than 60.

Source: National Heart, Lung, and Blood Institute (Ref. 3)

How Much Sleep is Enough?

       (1) Most adults need 7–8 hours of sleep each night.

       (2) Newborns sleep between 16 and 18 hours a day.

       (3) Preschool children sleep between 10 and 12 hours
a day.

       (4) School-aged children and teens need at least 9 hours of sleep a night.

Source: National Heart, Lung, and Blood Institute (Ref. 3)

Why Do You Need Sleep ?

            Sleep is not merely a “time out” from our busy routines; it is essential for good health, mental and emotional functioning and safety. For instance, researchers have found that people with chronic insomnia are more likely than others to develop several kinds of psychiatric problems, and are also likely to make greater use of healthcare services.

            People suffering from a sleep disorder called sleep apnea are at risk for high blood pressure, heart attacks, stroke and motor vehicle crashes if left untreated. Even occasional sleeping problems can make daily life feel more stressful or cause you to be less productive. In the NSF survey, those who said they had trouble getting enough sleep reported a greater difficulty concentrating, accomplishing required tasks and handling minor irritations. Overall, sleep loss has been found to impair the ability to perform tasks involving memory, learning, and logical reasoning. This may contribute to mistakes or unfulfilled potential at school or on the job and strained relationships at home. In fact, sleeplessness has been found to be a significant predictor of absenteeism. The direct and indirect impact of daytime sleepiness and sleep disorders on the national economy is estimated to be $100 billion annually.

            Insufficient sleep can also be extremely dangerous, leading to serious or even fatal accidents. The National Highway Traffic Safety Administration has estimated more than 100,000 auto crashes annually are fatigue related. These drowsy driving crashes cause more than 1,500 deaths and tens of thousands of injuries and lasting disabilities. This problem has been found to affect drivers aged 25 or under more than any other age group. (4)

What Is Insomnia?

            Insomnia is a condition in which you have trouble falling or staying asleep. Some people with insomnia may fall asleep easily but wake up too soon. Other people may have the opposite problem, or they have trouble with both falling asleep and staying asleep. The end result is poor-quality sleep that doesn’t leave you feeling refreshed when you wake up.

- Types of Insomnia

            There are two types of insomnia. The most common type is called secondary insomnia. More than 8 out of 10 people with insomnia are believed to have secondary insomnia. Secondary means that the insomnia is a symptom or a side-effect of some other problem. Some of the problems that can cause secondary insomnia include:

Certain illnesses, such as some heart and lung diseases

Pain, anxiety, and depression

Medicines that delay or disrupt sleep as a side-effect

Caffeine, tobacco, alcohol, and other substances that affect sleep

Another sleep disorder, such as restless legs syndrome; a poor sleep environment; or a change in sleep routine

            In contrast, primary insomnia is not a side-effect of medicines or another medical problem. It is its own disorder, and generally persists for least 1 month or longer.

            Insomnia is a common health problem. It can cause excessive daytime sleepiness and a lack of energy. Long-term insomnia can cause you to feel depressed or irritable; have trouble paying attention, learning, and remembering; and not do your best on the job or at school. Insomnia also can limit the energy you have to spend with friends or family.

Insomnia can be mild to severe depending on how often it occurs and for how long. Chronic insomnia means having symptoms at least 3 nights per week for more than a month. Insomnia that lasts for less time is known as short-term or acute insomnia. (4)

-Outlook

            Secondary insomnia often resolves or improves without treatment if you can eliminate its cause. This is especially true if the problem can be corrected soon after it starts. Better sleep habits and lifestyle changes often help relieve insomnia. You may need to see a doctor or sleep specialist to get the best relief for insomnia that is persistent or for which the cause of the sleep problem is unclear. (5)

The Effect of Caffeine

            Caffeine has been called the most popular drug in the world. It is found naturally in over 60 plants including the coffee bean, tea leaf, kola nut and cacao pod. All over the world people consume caffeine on a daily basis in coffee, tea, cocoa, chocolate, some soft drinks, and some drugs.

            Because caffeine is a stimulant, most people use it after waking up in the morning or to remain alert during the day. While it is important to note that caffeine cannot replace sleep, it can temporarily make us feel more alert by blocking sleep-inducing chemicals in the brain and increasing adrenaline production. (6)

How are sleep and depression linked?

            An inability to sleep, or insomnia, is one of the signs of depression. (A small percentage of depressed people, approximately 15 percent, oversleep, or sleep too much.) Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone might be depressed. (7)

Anxiety and depression

            Anxiety, depression and other emotional problems can make it harder to sleep at night. At the same time, not sleeping at night can add to your anxiety and depression. Understand that anxiety and depression can be serious conditions. Don't hesitate to tell your doctor if you have feelings of sadness or anxiousness that keep you up at night. These feelings can be treated. (8)

 References

(1) 2008 Sleep in America Poll; The Sleep Foundation http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2417353/k.6764/Sleep_in_America_Polls.htm)

(2) Medline Plus; http://www.nlm.nih.gov/medlineplus/sleepdisorders.html#cat8

(3) Source: National Heart, Lung, and Blood Institute; http://www.fda.gov/consumer/features/sleepdrugs073107.html#facts

(4) Medline Plus; http://www.nlm.nih.gov/medlineplus/sleepdisorders.html#cat8; ABCs of ZZZZs -- When you Can't Sleep; http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2419181/k.3D71/ABCs_of_ZZZZs__When_you_Cant_Sleep.htm

(5) http://www.nhlbi.nih.gov/health/dci/Diseases/inso/inso_whatis.html

(6) National Sleep Foundation; http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2465369/apps/nl/content3.asp?content_id={5B9531C4-FAC0-48D9-B46C-B24F705A04CC}&notoc=1

(7) The Cleveland Clinic Foundation; http://www.clevelandclinic.org/health/health-info/docs/3700/3721.asp?index=12124

(8) The Mayo Clinic; http://www.mayoclinic.com/print/insomnia/HA00056/METHOD=print

Jason Edwards

Author of Will Allen and the Great Monster Detective

To purchase a copy of his book, please visit our bookstore: http://www.freedomfromfear.org/ftp/BOOKSTORE/children.html

It Happens To Everyone

Every parent has seen it happen one time or other: in an otherwise placid situation, your child suddenly stiffens, and his or her eyes grow wide with terror.  The child’s breathing may become fast and shallow, and he or she may get shivers, begin sweating, cry, or act dizzy.  Then they might scream and run away.  If something causes your child to feel this way over and over again, the child may be suffering from a phobia.  A phobia is an intense and irrational fear of certain objects or situations.  These fears can produce painful anxiety for children, cause them to become isolated and irritable, interfere with schoolwork or social interactions, and restrict them from many activities.  For a parent, witnessing your child suffering this way can be very upsetting, and we wish we could just make it go away.  Thankfully, phobias can be overcome.  With appropriate treatment, it is possible to reduce or even eliminate the effects of phobias.

Discovery May Lead to Better Treatments

Researchers have pinpointed a mechanism in the brains of mice that could explain why some human mothers become depressed following childbirth. The discovery could lead to improved treatment for postpartum depression. Supported in part by the National Institute of Mental Health, of the National Institute of Health, the study used genetically engineered mice lacking a protein critical for adapting to the sex hormone fluctuations of pregnancy and the postpartum period.

“For the first time, we may have a highly useful model of postpartum depression,” said NIMH Director Thomas R. Insel, M.D. “The new research also points to a specific potential new target in the brain for medication to treat this disorder that affects 15 percent of women after they give birth.”

“After giving birth, female mice deficient in the suspect protein showed depression-like behaviors and neglected their newborn pups,” explained Istvan Mody, Ph.D., of the University of California at Los Angeles (UCLA), who led the research. “Giving a drug that restored the protein’s function improved maternal behavior and reduced pup mortality.”

Mody and Jamie Maguire, Ph.D. UCLA, report on their findings in the July 31, 2008 issue of Neuron.

Researchers had suspected that postpartum depression stemmed from the marked fluctuations in the reproductive hormones estrogen and progesterone that accompany pregnancy and childbirth. Yet manipulating the hormones experimentally triggers depression only in women with a history of the disorder. The roots of their vulnerability remain a mystery.

Evidence suggested that the hormones exert their effect on mood through the brian’s major inhibitory chemical messenger system, called GABA, which dampens neural activity, helping the regulate when a neuron fires.

Mody and Maguire discovered that a GABA receptor component, called the delta subunit, subunit fluctuated conspicuously during pregnancy and postpartum in the brains of female mice, hinting that it might have pivotal behavioral effects. To find out, they used mice lacking the gene for this subunit and studied them in situations that can elicit responses similar to human depression and anxiety.

Muck like human mothers suffering from postpartum depression, the genetically altered mouse mothers were more lethargic and less pleasure seeking than normal mice. They also shunned their pups and failed to make proper nests for them.

This abnormal maternal behavior was reversed and pup survival increased after the researchers gave the animals a drug called THIP that acts on the receptor in a way that specifically restores its function in spite of the reduced number of subunits.

“Improper functioning of the delta subunit could impair the GABA system’s ability to adapt to hormone fluctuations during the highly vulnerable port partum period,” explained Maguire. “Targeting this subunit might be a promising strategy in developing new treatments for postpartum depression.”

Reference

Maguire J, Mody I. GABAAR plasticity during pregnancy: relevance to postpartum depression. Neuron. 2008 Jul 31; 59

Anjuli Chikara

Seasonal Affective Disorder (SAD) is a cyclic mood disorder that causes recurring major depressive episodes based on the changes of the environmental light, usually occurring during the fall and winter months. This period of depression is then followed by a season of relatively emotional stability.

SAD typically occurs during the fall or winter months when the days are shorter, and there is less natural light. There is a higher report rate of SAD cases in northern regions. This could be connected to the fact that northern regions receive fewer hours of sunlight than southern regions. Some individuals also report that their depression will increase on overcast or rainy periods during the summer months (if they suffer from winter-onset SAD). Although it is more typical for people to experience winter-onset SAD, some have what is called Reverse-SAD or summer-onset SAD. In this case individuals experience depressive episodes in the summer months, and have symptoms disappear during the winter months.

Individuals who suffer from SAD may experience some or all of the following symptoms during the season: increased depression, anxiety, negative automatic thoughts, hopelessness, social withdrawal, fatigue and an increase or decrease in appetite, among other symptoms. In the opposite season, individuals who suffer from SAD often experience normal emotional functioning.

Although there is still research being conducted on the causes of SAD, many scientists believe that it is linked to biochemical reactions in the brain. Dr. Jeffery Meyers and his team at the Centre for Addiction and Mental Health found a correlation between SAD and increased serotonin transporters, which remove serotonin. Serotonin is a chemical that moderates emotional and physical functions, such as appetite, mood, and energy levels in the nervous system and brain.

Meyers and his team discovered significantly higher levels of serotonin transporters in the brain during fall and winter months of individuals who suffer from winter-onset SAD. This correlation indicates that there is more serotonin removal occurring in individuals who are affected by winter-onset SAD during periods of less sunlight which could mean sunlight influences serotonin removal. Meyers expressed the desire for more research to be done confirming this connection between sunlight and serotonin levels saying, “We intend to determine the specifics of the environment… so as to determine the optimal environment to prevent illness.”

            There are various types of treatment for SAD, the two most common are Light Box Therapy and Cognitive Behavioral Therapy. Light Box Therapy was created after finding the correlation between periods of depression and changes in the environmental light. It uses certain types of light bulbs to simulate environmental light. This is done by placing a white fluorescent light bulb in a box containing an ultra-violet shield and diffusing lens. The lens and shield decrease the glare of the white light providing a more natural light. By varying the temperature of the light bulb, different times of day can be simulated. For instance higher temperatures give more of a natural sky hue, while lower temperatures are more reminiscent of softer, evening light. The box should be eye level or higher to help further the appearance of natural light and to reduce glare and discomfort to the eyes. To be effective, the individual must be exposed to the light box often two or three times a day for anywhere between 20-60 minutes at a time depending on the light intensity being used.

Cognitive Behavioral Therapy (CBT) is a type of talk therapy that uses homework assignments to reinforce helpful techniques and behaviors that decrease emotional stress.

Although SAD is believed to be a biochemical reaction, CBT has been shown to be effective in the treatment of SAD. Therapists focus on ways to decrease stress, negative thoughts and other emotional symptoms of depression.

You may want to speak to your doctor or mental health professional about SAD if you have experienced intense feelings of depression during certain seasons for longer than two years and the period of depression is followed by a disappearance of symptoms, and there is no other explanation for your change in moods.

Citations:

Mayo Clinic

NAMI.org

Psychcentral.com

Wikipedia.com

Rohan, et al. (2007) A Randomized Controlled Trial of Cognitive-Behavioral Therapy,

Light Therapy and Their Combination for Seasonal Affective Disorder. Journal of

Counseling and Clinical Psychology, 75, 489-500.

Stacey Chen

Jennifer Opromalla

I remember the day so clearly. I was a discouraged psychology major sitting at my desk in my dorm room at Wagner College. It was my second semester of sophomore year. Frustration began to fill me as I searched the web looking for a hands on summer internship in the mental health field. Everything I stumbled upon required credentials. I knew that in order to reach my goal, a psychologist with a Psy D, I needed field experience and I could not waste another minute.

Since I am an impatient and eager person, I started to worry. In my panicked state, I turned to my best friends and sorority sisters. One of my senior sorority sisters, Maria (also a psychology major), came to my rescue. She turned over to me a sky high packet of papers filled with hospitals, schools, and clinics all in my area that greeted volunteers with open arms. The only one that caught my attention was Freedom From Fear on Seaview Avenue, Staten Island. I read the overview and immediately knew that this place would be perfect for me to gain experience. It said that the staff at Freedom From Fear helps patients tackle anxiety and depression. This was exactly what I wanted to learn more about. I was also impressed that Freedom From Fear allows their interns to sit in on actual therapy sessions with the patients consent. Not many organizations permit this. In my opinion, this is the only way to pick up techniques and learn how to counsel others.

I quickly phoned Mary Guardino, the founder and executive director of Freedom From Fear. She was eager to know how I found out about Freedom From Fear and why I wanted to work there. She quickly said, “There will be no money provided, just so you know.” I laughed and said I understood. I felt lucky enough to have found a summer internship. I told her my background information and my goal for the future and we set up an interview.

On my first day at Freedom From Fear, I had butterflies in my stomach. I was not sure what to expect and if I would even be successful at completing my assigned tasks. Most of all, I was afraid of finding out that a career in the mental health field was not for me. My fears quickly abated when I was allowed to sit in on my very first therapy session. I was introduced to Chris Guardino, the therapist I would be working with for the summer. I sat down and began to listen intently to the one on one conversation between the therapist and patient. My mind began to race. I began taking many notes from Chris, analyzing the patient, writing down advice I would have given the patient, and thinking of things that the patient could do to improve his/her life.

I acquired so much knowledge about the mental health field from Freedom From Fear. As I sat in on session after session, I tried to assess what disorder or illness the patient was struggling with since it was usually not stated during the session. This is a very challenging skill to pick up and that is why anxiety, depression and other mental health illnesses are often misdiagnosed today. I was happy I had the opportunity to be taught by the professionals at Freedom From Fear about how people can improve their lives.

I also learned about Cognitive Behavioral Therapy, which is a form of psychotherapy that focuses on thinking in how we feel and what we do. It was wonderful to be able to witness patients improve and feel better. I  learned one of the hardest things of all, which is that it is ok to feel the sorrow and pain of the patients but never bring it home with you.

Freedom From Fear’s mission states that they have been improving lives since 1984. I quickly learned this is true.  Freedom From Fear was unlike any place I have ever volunteered. I was never given busy work. I never had to answer a phone or stamp envelopes. I was able to listen to patient’s stories and experiences. Each patient impacted me greatly. I felt a strong need to help these people and to let them know that I was there for them. I began to realize that this is what I was meant to do. I began to feel that becoming a psychologist was more than my future career. It was my calling.

I will always remember this experience and the amazing work done by Freedom From Fear and the committed staff who taught me so much. As Mary Guardino often told me, “Jennifer, you have to study hard and listen carefully to the patients stories so you will be prepared to join the Mental Health Army.”

Heather Lauria

You’ve heard it all before, fish hailed as the miracle food one week only to be stricken down the next week for its high mercury content. The only question that remains is to eat the fish or not to eat the fish? According to several different studies, the answer is eat the fish, but make sure you eat the right kind. What’s even more exciting, is the omega-3 fatty acids found in fish can help raise serotonin levels in the brain much like the effects of modern drugs used to treat depression.   

Picking the Right Fish.

            Fish with low levels of mercury are the best to consume. These include shrimp, sardines and salmon. Fish that feed on other fish are an unsafe bet. When fish eat other fish, their mercury levels build up making them not a smart choice. Researchers at Ohio State University in Columbus also found that cold-water fish are good sources of omega-3 fatty acids. The best cold water fish are trout and salmon (that’s two votes for salmon, if you’re keeping track). A couple of other fish high in omega-3 fatty acids are mackerel and herring. If you don’t already have a favorite, try them all.

What Can Fish Really Do for Me?

          The beneficial effects of eating fish can start even before we are born. A study published in the American Journal of Epidemiology found that women who ate fish while pregnant had babies with better cognitive and fine-motor skills than those whose mothers had not eaten fish while pregnant. Researchers in another study, published in the journal, Pediatrics, gave premature infants milk supplemented with essential fatty acids. These infants preformed better six months later than premature infants without the supplemented milk. Pregnant women must make sure they stay away from those fish containing high levels of mercury, as they could have damaging effects on their infants developing brains.

            So if your mother did not eat enough fish while she was pregnant with you, are you done for? No, not by a long shot. Eating fish regularly can produce so many other long lasting benefits. Studies have suggested that fish can cut the risk of death from a heart disease by a third, reduce blood clotting by reducing the stickiness of blood, and consuming oily fish or fish oil can reduce total mortality by 17 percent. A diet rich in salmon can also smooth out age lines. Selenium, found is fish, is also thought to have cancer-fighting properties.          

Still not convinced fish has healing powers?

In a study done in Sweden of 6,000 men over a course of 30 years, those who did not eat fish nearly doubled or tripled their rate of developing prostate cancer than those who consumed fish. Omega-3 fatty acids have the ability to regulate your body’s inflammation cycle. What does this mean? Ingesting more fish can prevent and/or relieve painful conditions such as arthritis, prostatitis and cystitis. Dr. Floyd H. Chilton, author of Inflammation Nation, argues in his book that a diet lower in omega-6 and higher in omega-3 fatty acids would lessen inflammation and the risk of developing heart disease, diabetes, irritable bowel syndrome and Alzheimer’s disease.

Martha Belury, an associate professor at Ohio State University, and a co-author of the study done there says, “Maybe just a little bit more omega-3 could help reduce [the] markers for both stress and depression.” Omega-3 fatty acids found in fish are believed to raise levels of the brain chemical serotonin. Serotonin is as a chemical messenger that transmits nerve signals between nerve cells and that causes blood vessels to narrow. Changes in the serotonin levels in the brain can alter the mood. Raising serotonin levels has been found to reduce depression. This is how common medications, prescribed for depressive illnesses, work. By raising the serotonin levels in your brain you also raise your mood. If you have depression, regular fish consumption may help to easy symptoms. If you do not have depression, eating fish can be used as a preventative measure.    

Alaina Kovalsky

What do some people today and the ancient Mazatec’s have in common? They may be smoking Salvia to achieve hallucinogenic visions. Salvia or Salvia divinorum is a psychoactive hallucinogenic herb in the mint family, used in traditional spiritual and healing practices by the Mazatec people of Mexico. The plant, which has large green leaves, hollow square stems and white flowers with purple calyces, can grow to over three feet tall. The active ingredient responsible for the hallucinogenic effects is Salvinorin A, which is the most potent naturally occurring hallucinogen.

Salvia is also known as Sally-D, Sage of the Seers, Diviner’s Mint, Magic Mint, and Leaves of Mary, the Shepherdess. Many of Salvia’s nicknames stem from the religious connotation that is believed to go along with the herb and how the Mazatecs honor it. The Mazatecs believe that Salvia has healing and divination qualities. They consider it is the incarnation of the Virgin Mary. The genus name, Salvia, comes from the Latin word, salvare, which means “to save.” The specific name, divinorum, means “of the seers.” Salvia can be ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves can be smoked like marijuana, in a bong, pipe or as a joint. It can also be consumed in water pipes, vaporized and inhaled, or brewed and ingested as a tea.  

People who abuse Salvia generally experience hallucinations or delusional episodes that mimic psychosis. Subjective effects have been described as intense but short-lived. They appear in less than one minute and last less than 30 minutes. The effects of Salvia include psychedelic-like changes in visual perception, mood and body sensations, emotional swings, feelings of detachment, and a highly modified perception of external reality and the self which leads to a decreased ability to interact with one’s surroundings. Some physical effects include dizziness, nausea, lack of coordination, slurred speech, decreased heart rate, and chills.

Salvia, for the most part, is legal in the United States. It is not currently being regulated by the Controlled Substances Act; however, because of an increase in usage and related dangers, the Drug Enforcement Agency has listed Salvia as a drug of concern and is considering classifying it as a Schedule I drug, like LSD or marijuana. Some states have placed Salvia into Schedule I of state law. Others have enacted different forms of legislation restricting the distribution of Salvia.

People can purchase Salvia via the Internet and at some “head shops” throughout the country. A head shop is a retail outlet specializing in paraphernalia related to consumption of cannabis, other recreational drugs, and New Age herbs. This allows easy access to a “drug” which may be extremely damaging to those who use it.

With a better understanding of the neurochemistry of the brain today, drug experts have strong concerns about the damaging effects, even long term effects, when hallucinogenic substances are used.

Eve Bender

Successful treatment of maternal depression can be a "twofer" where children are concerned, according to new data from a large clinical trial.

Successful treatment of maternal depression may have benefits that extend to the youngest family members, according to data posted online in the June 16 AJP in Advance. (The report will appear in print in the September American Journal of Psychiatry.)

Kathryn Tristan

Fear is an unseen enemy that can emotionally cripple and quickly erode your life unless you learn, as I did, how to stage your own “Anxiety Rescue.” That’s what I called my journey out of fear and the title to a book that I wrote about it. 

I suffered from anxiety, panic and fear for most of my adult life. Too afraid to leave my home city for more than 20 years, scared of bridges, traffic, shopping centers…the list was long and convoluted. Although I am a scientist at one of the top medical schools in the country, my analytical brain hurt me more than helped me.  Like most people with this problem, my first instinct was to look for external solutions to overcome anxiety and panicky feelings. What could I not do so that I wouldn’t feel this way? Avoidance is often our first strategy. But, my list only grew longer, my life more restricted, and it really didn’t help much anyway.  How could I avoid feeling scared in the middle of the night or on a cloudy day or a host of other things?

But, here’s the good news…what I found out was that when you want to make deep and lasting changes, recovery begins first on the inside.  This is where your true source of power and healing lies.

I also discovered that our two most powerful tools in the process out of fear and into recovery are “Awareness” and “Choice.”  You cannot fix a problem of which you are unaware and you cannot choose to direct your life differently until you do.

“Awareness” simply means learning to hear the negative inner chatter that plays in the background all the time.  I considered myself an optimistic person at least to others. For the most part I was kind, cheerful, and helped others.  But the negative chatter came quickly and often unknowingly to me. I wasn’t as kind and cheerful to MYSELF. For example, I might awaken in the morning, glance into the mirror and think “Oh no, is that a new wrinkle? Am I gaining weight? I hate this hair-do!” This hidden chatterbox was incessant, negative and my own emotional and thinking “Auto-pilot.” I wasn’t even aware of it. That same chatterbox fed me dialogues filled with fear. “This might be frightening, don’t do it…that could be a problem, tense up!”

I finally realized that to heal, I needed to disengage those automatic thinking/reacting gears.  But how? By digging within I identified two inner characters that seemed to direct most of my life.  I called these EARL and PEARL.

EARL is “Easy Angered, Rigid and Limiting.”  EARL isn’t evil; EARL is only my voice of “protection.”  EARL remembers anything that ever hurt or scared me and doesn’t want that to happen again.  EARL is like my own personal police force, whose motto is to ‘serve and protect.’  EARL blares and has a loud voice.  I mostly heeded those thoughts and automatic reactions.

But, I also identified a much quieter and peaceful energy.  I called that “PEARL.”  This inner energy is “Peaceful, Earnest, Adventurous, Resilient, and Loving.” PEARL is the quiet voice and feeling I have when I see a newborn baby, a puppy, a beautiful sunset or when I look into the eyes of someone I love. PEARL whispers, while EARL shouts.

Both are valid and a necessary parts of life.  Yet, when I only paid attention to the voice of fear, the voice that was trying unnecessarily to only protect me, the net result was that my world began to shrink and so did my happiness.

Learning to hear EARL but CHOOSING to disagree and respond differently than by anxiety and fear, allowed me to connect to my true sense of power, my inner spirit that knew ‘all is well’ and that ‘whatever comes along, I’ll handle it.’ 

Awareness and Choice are YOUR two most powerful tools.  When you learn you are so much more than the voice of fear that restricts you, you begin the journey out of fear and into freedom. When you realize you have all the strength you’ll ever need and it is inside of you right now, you start to re-connect with your life and happiness. Keep working toward your recovery. You can do the things you think you cannot, and you do it one small step at a time!

After overcoming my own fears, I wrote a book to help others called “Anxiety Rescue – Simple Strategies to Stop Fear from Ruling Your Life.” It’s received some great praise from best-selling authors (such as frequent Oprah guest, Dr. Christiane Northrup) and expert psychotherapists.  It’s available on Freedom from Fear’s website bookstore.

Lynn Min

Spirituality can make a significant difference in sufferers of anxiety. There exist numerous studies indicating that religious people are less likely to become anxious than their nonreligious counterparts.

Heather Lauria

Americans live in an over-stimulated environment. Television, video games and other electronic devices are the culprits. According to an A.C. Nielsen Co. study conducted in 2007, the average American will watch over four hours of television per day. That statistic translates to nine years of television watching for a person who lives to 65 years old or 250 billion hours a year watched in America alone. A.C. Nielsen Co. also reports that children average 1,680 minutes of television per week versus the three and a half minutes they spend per week in meaningful conversation with their parents.

Over the course of a year, a child will spend over 1,000 hours in school and approximately 1,500 hours sitting in front of the television. With 99 percent of households owning one television set and 66 percent with three or more sets, it’s no wonder that a parent’s natural instinct has become putting their child in front of the television from a very early age. But have parents seriously thought or understood what effect this television watching will have on their children?

Researchers agree that the unsuspectingly harmless television set sitting in the living room may lead to increased aggression in children, but research has also found that television watching is connected to Attention-Deficit Hyperactivity Disorder (ADHD) cases in children. ADHD is a neurobehavioral developmental disorder. It is usually diagnosed during childhood, but may also reveal its symptoms in adolescence and adulthood. Symptoms can include, but are not limited to, inattention and concentration problems, hyperactivity, forgetfulness and short-term memory loss, procrastination, and poor impulse control. People with ADHD do not necessarily exhibit all symptoms.

 A study, done at Children’s Hospital and Regional Medical Center in Seattle, on more than 2,000 children revealed that for every hour watched at ages one and three, the children had an almost 10 percent higher chance of developing attention problems that could become ADHD by the time the child reached seven years old. Toddlers who watched three hours daily tripled their risk to 30 percent more likely to be diagnosed with ADHD.

Children between the ages of one and three are developing neural pathways in their brains in a completely unique way. When babies and toddlers are exposed to the over stimulation of television, the forming of these pathways is interfered with. These babies’ minds are wired differently than a normal baby’s mind. “TV can cause the developing mind to experience unnatural levels of stimulation,” says Dr. Dimitri Christakis, lead researcher and director of the Child Health Institute at Children’s Hospital and Regional Medical Center and associate professor at the University of Washington School of Medicine. The quick scene shifts of video images seem normal to TV tots. Such a fast-paced world is not reality. As these children grow they expect the same rapidity from school as they found earlier in life from the television.

In a world where parents are constantly over-stressed and overworked, sitting a child in front of a television for a couple hours a day can almost seem like a vacation for mommy and daddy, but at what cost? Baby Einstein and Teletubbies do their jobs at keeping children occupied but that’s about it. Not even these shows and videos, produced solely for entertaining and educating young children, are safe. “Each hour has an additional risk. You might say there’s no safe level since there’s a small but increased risk with each hour,” says Frederick Zimmerman of the University of Washington, Seattle.

Researchers agree television for babies and toddlers may be detrimental to their development but for now, the decision as to whether or not these young children will sit in front of a TV screen remains with their parents. “Things are a trade-off. Some parents might want to take that risk. We didn’t find a safe level in that sense,” says Zimmerman.

Aaron Levin

Hoarding may be a psychiatric symptom, but is it just one part of obsessive-compulsive disorder or does it stand alone?

Since the dawn of hunting and gathering, some people have always gathered more than others and just couldn't bear to part with it.

When such behavior crosses the line from the eccentric into the DSM-IV realm, it becomes a symptom—hoarding—the compulsion to acquire objects coupled with an unwillingness to discard them.

Hoarding may occur in connection with a number of psychiatric disorders, but it is most commonly associated with obsessive-compulsive disorder (OCD). Perhaps 30 percent to 40 percent of people with OCD have hoarding symptoms. Specialists argue over the relationship between OCD and hoarding. Is the latter merely a symptom of the former, or should the two be considered separate syndromes?

What Causes Dysthymia?

Experts are not sure what causes dysthymia. This form of chronic depression is thought to be related to brain changes that involve serotonin, a chemical or neurotransmitter that aids your brain in coping with emotions. Major life stressors, chronic illness, medications, and relationship or work problems may also increase the chances of dysthymia.

What Are the Signs and Symptoms of Dysthymia?

The symptoms of dysthymia are the same as those of major depression but not as intense and include the following:

The Voice Awards honor writers and producers who have given a voice to people with mental health problems by incorporating dignified, respectful, and accurate portrayals of these people into film and television productions.

Sponsored by the Substance Abuse and Mental Health Services Administration, the Voice Awards also acknowledge the tireless efforts of advocates who are working to reduce the stigma and discrimination associated with mental illnesses.

ÐThe Pain of Depression: A Journey through the Darknessî explores the physical and psychological challenges of depression, whose symptoms range from insomnia to debilitating fatigue. Compelling stories from depression sufferers capture the illness� devastating impact on their families, friends and communities.

This informative documentary was produced and written by Mary Guardino, Founder and Executive Director of Freedom From Fear and sponsored by the organization. It has aired on over 250 television stations nationwide and takes viewers on a journey to understand depression through the first-hand experiences of three people. Their family members and friends express their early misconceptions about the illness and recall how their loved ones fought depression with counseling, medication and lifestyle changes.

Throughout the film, nationally recognized experts from the University of Pennsylvania, Columbia University, New York State�s Psychiatric Institute and the Hispanic Treatment Program at New York State�s Psychiatric Institute discuss the cutting-edge research and theories about depression: its neurophysiology, symptoms, treatments and the role of family and friends in an individual's recovery. The documentary also touches upon the stigma of mental illness within various ethnic communities, including Latinos, and details the need for a customized treatment plans for these populations.

For more information and to view clips from the film, please visit http://w ww.painofdepression.org

Do you experience.....

·        Sudden feelings of dread

·        Heart palpitations

·        Shortness of breath

·        Fear of losing control

      You may have Panic Disorder

·        Fear of public speaking

·        Afraid to meet new people

·        Fear of being scrutinized

·        Fear of social situations

You may have Social Anxiety Disorder

·  Persistent unwanted thoughts

·  Rigid routines and rituals

·  Fear of germs

·  Checking things repeatedly

You may have Obsessive Compulsive Disorder

·  Flashbacks

·  Nightmares

·  Inability to trust or feel

·  Avoiding reminders of the ordeal

You may have Post-traumatic Stress Disorder

·        Chronic worrying

·        Inability to trust or feel

·        Difficulty sleeping and headaches

·        Persistent sense that something is wrong

You may have Generalized Anxiety Disorder

To learn if you may be suffering from an anxiety disorder you can screen yourself at http://www.freedomfromfear.org/screenrm.asp.

To find a referral in your area visit our referral foom http://www.freedomfromfear.org/refroom.asp .

Often people don’t understand the physical symptoms of depression. Knowing all the signs and symptoms can greatly improve your health.

Do you suffer from any of the following physical symptoms?

• Headaches
• Back Pain
• Trouble Concentrating
• Restlessness, Irritability
• Sleeplessness, Fatigue
• Joint or Muscle Pains
• Digestive Problems
• Feeling Sad or Blue

 Did you know?

• Anxiety disorders and depression manifest themselves in individuals with symptoms of pain. The most common symptoms are joint and back pain, fatigue, insomnia, headaches and dizziness.
• 80% of people suffering from anxiety or depression complain of physical symptoms.
• The mind and body work together, when they are not in sync difficulties can develop.
• When seeking help it is important to inform your healthcare provider about your emotional state.
• Often x-rays, blood work or diagnostic procedures cannot diagnose some types of pain. But the pain is real, impairing and distressing to both body and mind.

To learn if you may be suffering from symptoms of depression screen yourself at http://www.freedomfromfear.org/screenrm.asp or to find a referral in your area visit our referral room http://www.freedomfromfear.org/refroom.asp .

Researchers Say Merely Anticipating a Laugh Can Jump-Start Healthy Changes in Body

By Kelley Colihan
WebMD Medical News

OK, take a deep breath. Now put your hand on your belly. Imagine your stomach jiggling, as if you were starting to laugh. You may have just taken a step toward reducing stress hormone levels.

The findings come from a small study, made up of 16 healthy men. The men were divided into two groups. The experimental group was told to anticipate something funny. The other group was used as a comparison.

Researchers then tested the levels of three stress hormones participants had in their blood and compared that to the control group, which did not expect a laugh was on the way.

Researchers found that the group anticipating the laughs had reduced levels of three stress hormones compared to the other group.

Here's the breakdown from the experimental group.

Cortisol levels dipped 39%. Cortisol is known as a major stress hormone.

Adrenaline levels dropped 70%. Adrenaline is also known as epinephrine.

Dopac levels dropped 38%. Dopac is a chemical related to the "feel-good" chemical known as dopamine.

Persistently elevated stress hormone levels in the blood, as happens under chronic stressful situations, has been linked to a weakened immune system.

"Our findings lead us to believe that by seeking out positive experiences that make us laugh we can do a lot with our physiology to stay well," says researcher Lee Berk in a news release.

The researchers were following up on a similar study they did two years ago in which they found that anticipating laughter led to an increase in healthful chemicals such as beta-endorphins.

Visit our bookstore to order a copy of Healing Through Humor: a book containing fabulous jokes, anecdotes, and mind twisters to speed healing to your heart and soul.

http://www.freedomfromfear.org/ftp/BOOKSTORE/amazon%20books%20inspirational.html

-WHAT IS BDD?

    Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a severe preoccupation with a perceived defect in one’s appearance. Any body part can be the focus of one’s concern. Individuals with BDD frequently have face-related preoccupations (e.g., their nose is too big or their eyes are too small). Some patients may worry about their hair or skin (e.g., that their hair is thinning or that their skin is scarred). Often, people with facial or skin concerns pick at their skin. Some BDD sufferers have concerns involving body symmetry. Others have muscle dysmorphia, where they worry that they are not muscular enough or that they are small and weak. Most of these concerns are imaginary, but if a slight “defect” is in fact present the concern is regarded as overly excessive.
    Individuals with BDD spend a great deal of time – at least one hour a day - thinking about their perceived appearance flaws. Commonly, BDD patients will repetitively check their minor or imagined flaw in mirrors. In other cases, patients will often go to great lengths to avoid mirrors. Individuals with BDD may attempt to gain reassurance from others or try to convince them of their imperfections. They often have difficulty controlling the negative thoughts about their appearance and often have poor insight or awareness of their problem. Individuals with BDD frequently try to hide their defect with make-up, sunglasses, clothing, etc. Some engage in excessive grooming behaviors (e.g., combing hair or picking at their skin) to remove imperfections. These rituals may take several hours per day and usually only provide temporary relief. Some BDD patients will seek cosmetic surgery or dermatological treatment for their perceived defects but will usually find only temporary relief, as BDD patients are typically dissatisfied with the outcome of their procedures.
    BDD can result in significant distress (e.g., anxiety or depression) and impairment in one’s social life, relationships, employment, schoolwork, and overall functioning. People with BDD often avoid dating, miss school or work, and feel overly self-conscious in social situations. Though the severity of BDD varies, in general, patients have a very poor quality of life. While some BDD sufferers experience manageable distress, others find the disorder to be tormenting. Left untreated, such torment can lead to hospitalizations and suicide.

-HOW TO DETERMINE IF YOU HAVE BDD?
 
    If you answer yes to several of the following questions you may have BDD. Please note that the questions cannot provide you with a final diagnosis of BDD.
 
•Do you worry a lot about your appearance?
•Do you consider any part or parts of your body especially unattractive?
•Do you spend a lot of time thinking about your defect(s)? At least one hour per day?
•Do your appearance concerns interfere with your work or social life?
•Do you repetitively check your appearance in mirrors or go to great lengths to avoid mirrors?
•Do you often ask people for reassurance about how you look?
•Do you spend a lot of money on make-up, cosmetics, etc., to camouflage your flaws?
•Do you often compare your appearance to that of others?
•Do you pick at your skin?
•Have you had repeated cosmetic surgeries?
 
    BDD usually begins during adolescence and tends to be chronic. Though the disorder is currently diagnosed equally among men and women, it is frequently misdiagnosed or undiagnosed for a number of reasons. Many BDD sufferers are embarrassed by and ashamed of their symptoms and, therefore, have difficulty revealing them to others. There is also a lack of familiarity with BDD among healthcare professionals. The majority of physicians are unaware of the disorder. Misdiagnosis can also occur because BDD produces symptoms similar to those of a number of other psychiatric problems, including anorexia, obsessive-compulsive disorder, trichotillomania (compulsive hair pulling), social phobia, and others. In addition, several BDD patients see dermatologists, plastic surgeons, and other physicians rather than mental health professionals and, therefore, do not receive proper treatment.
 
-HOPE

    There is hope for BDD sufferers. Studies have shown that when treated with cognitive-behavioral therapy and/or medication patients have shown a significant improvement in symptoms and overall functioning.

From Website of Massachusettes General Hospital, Link: http://www.massgeneral.org/bdd/pages/bddInfo.htm

-WHAT IS BDD?

     Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a severe preoccupation with a perceived defect in one’s appearance. Any body part can be the focus of one’s concern. Individuals with BDD frequently have face-related preoccupations (e.g., their nose is too big or their eyes are too small). Some patients may worry about their hair or skin (e.g., that their hair is thinning or that their skin is scarred). Often, people with facial or skin concerns pick at their skin. Some BDD sufferers have concerns involving body symmetry. Others have muscle dysmorphia, where they worry that they are not muscular enough or that they are small and weak. Most of these concerns are imaginary, but if a slight “defect” is in fact present the concern is regarded as overly excessive.
     Individuals with BDD spend a great deal of time – at least one hour a day - thinking about their perceived appearance flaws. Commonly, BDD patients will repetitively check their minor or imagined flaw in mirrors. In other cases, patients will often go to great lengths to avoid mirrors. Individuals with BDD may attempt to gain reassurance from others or try to convince them of their imperfections. They often have difficulty controlling the negative thoughts about their appearance and often have poor insight or awareness of their problem. Individuals with BDD frequently try to hide their defect with make-up, sunglasses, clothing, etc. Some engage in excessive grooming behaviors (e.g., combing hair or picking at their skin) to remove imperfections. These rituals may take several hours per day and usually only provide temporary relief. Some BDD patients will seek cosmetic surgery or dermatological treatment for their perceived defects but will usually find only temporary relief, as BDD patients are typically dissatisfied with the outcome of their procedures.
     BDD can result in significant distress (e.g., anxiety or depression) and impairment in one’s social life, relationships, employment, schoolwork, and overall functioning. People with BDD often avoid dating, miss school or work, and feel overly self-conscious in social situations. Though the severity of BDD varies, in general, patients have a very poor quality of life. While some BDD sufferers experience manageable distress, others find the disorder to be tormenting. Left untreated, such torment can lead to hospitalizations and suicide.

-HOW TO DETERMINE IF YOU HAVE BDD?
 
    If you answer yes to several of the following questions you may have BDD. Please note that the questions cannot provide you with a final diagnosis of BDD.
 
•Do you worry a lot about your appearance?
•Do you consider any part or parts of your body especially unattractive?
•Do you spend a lot of time thinking about your defect(s)? At least one hour per day?
•Do your appearance concerns interfere with your work or social life?
•Do you repetitively check your appearance in mirrors or go to great lengths to avoid mirrors?
•Do you often ask people for reassurance about how you look?
•Do you spend a lot of money on make-up, cosmetics, etc., to camouflage your flaws?
•Do you often compare your appearance to that of others?
•Do you pick at your skin?
•Have you had repeated cosmetic surgeries?
 
    BDD usually begins during adolescence and tends to be chronic. Though the disorder is currently diagnosed equally among men and women, it is frequently misdiagnosed or undiagnosed for a number of reasons. Many BDD sufferers are embarrassed by and ashamed of their symptoms and, therefore, have difficulty revealing them to others. There is also a lack of familiarity with BDD among healthcare professionals. The majority of physicians are unaware of the disorder. Misdiagnosis can also occur because BDD produces symptoms similar to those of a number of other psychiatric problems, including anorexia, obsessive-compulsive disorder, trichotillomania (compulsive hair pulling), social phobia, and others. In addition, several BDD patients see dermatologists, plastic surgeons, and other physicians rather than mental health professionals and, therefore, do not receive proper treatment.
 
-HOPE

    There is hope for BDD sufferers. Studies have shown that when treated with cognitive-behavioral therapy and/or medication patients have shown a significant improvement in symptoms and overall functioning.

Vermont leads the United States in marijuana use, while Utah has the highest number of people reporting mental health problems, U.S. government researchers said on Thursday, based on a new state-by-state report.

They said substance abuse and mental health issues vary widely by state, but all struggle with these problems to some degree.

"This report shows that although states may be uniquely affected by serious public health problems like underage drinking, every state and region must confront these issues," said Terry Cline, chief of the U.S. Substance Abuse and Mental Health Services Administration, which compiled the study.

The report found rates of underage drinking in 2005 and 2006 ranged from a low of 21.5 percent in Utah to a high of 38.3 percent in Vermont.

Yet Utah had the highest rate of adults reporting serious psychological problems at 14.4 percent in the same period, compared with Hawaii, which had the lowest at 8.8 percent.

The report takes a state-by-state look at 23 measures of substance use or mental health problems, based on combined data from national surveys done in 2005 and 2006.

It includes data from 136,110 people and offers the most recent and most comprehensive look at individual state issues to date, said Dr. Westley Clark, a substance abuse expert at SAMHSA, a part of the U.S. Department of Health and Human Services.

"Our hope is this report will allow people to do strategic planning to address specific issues," Clark said in a telephone interview.

Drug Use Varies Strongly

The study shows a contrast in the use of illicit drugs by state.

In North Dakota, just 5.7 percent of people aged 12 and older used an illicit drug in the month prior to being surveyed, compared with a high of 11.2 percent in Rhode Island.

Vermont led the nation in marijuana use by a number of measures. Among those 12 and older, 15.5 percent of those in Vermont said they had used marijuana in the prior 12 months, and 41.9 percent of young adults aged 18 to 25 said they had used marijuana in the prior year.

Utah, by contrast, had the lowest rates of marijuana use among young adults, with 18.9 percent of those 18-25 saying they had used it in the past year. Just 4.3 percent of those 12 and older in Utah said they had used marijuana in the prior month.

Cocaine use was highest in the District of Columbia during the combined survey years of 2005-2006 at 2.4 percent of those 12 and older. It was lowest in North Dakota at 1.6 percent.

Georgia had the lowest level of underage binge drinking of alcohol, with 15.2 percent reporting a binge episode in the prior month, compared with a high of 28.5 percent in North Dakota.

Clark said the report should help states make the best use of limited funding. "The better data we have, the better decisions and choices we can make and exercise," he said.

Teens with difficult-to-treat depression who do not respond to a first antidepressant medication are more likely to get well if they switch to another antidepressant medication and add psychotherapy rather than just switching to another antidepressant, according to a large, multi-site trial funded by the National Institutes of Health’s National Institute of Mental Health (NIMH). The results of the Treatment of SSRI-resistant Depression in Adolescents (TORDIA) trial were published February 27, 2008, in the Journal of the American Medical Association (JAMA).

“The findings should be encouraging for families with a teen who has been struggling with depression for some time,” said lead researcher David Brent, M.D., of the University of Pittsburgh. “Even if a first attempt at treatment is unsuccessful, persistence will pay off. Being open to trying new evidence-based medications or treatment combinations is likely to result in improvement.”

Adolescents with treatment-resistant depression have unique needs, for which standard treatments do not always work.

“About 40 percent of adolescents with depression do not adequately respond to a first treatment course with an antidepressant medication, and clinicians have no solid guidelines on how to choose subsequent treatments for these patients,” said NIMH Director Thomas R. Insel, M.D. “The results from TORDIA bring us closer to personalizing treatment for teens who have chronic and difficult-to-treat depression.”

Brent and colleagues conducted TORDIA at six regionally dispersed clinics with 334 adolescents ages 12 to 18. The teens in the study all had major depression and had not responded to a previous two-month course of a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant. The teens were randomly assigned to one of four interventions for 12 weeks:

• Switch to another SSRI—paroxetine (Paxil), citalopram (Celexa) or fluoxetine (Prozac)
• Switch to a different SSRI plus cognitive behavioral therapy (CBT), a type of psychotherapy that emphasizes problem-solving and behavior change
• Switch to venlafaxine (Effexor)—another type of antidepressant called a serotonin and norepinephrine reuptake inhibitor (SNRI)
• Switch to venlafaxine plus CBT

The researchers chose to compare SSRIs with an SNRI because some studies on adults have found that venlafaxine is more effective than an SSRI in managing treatment-resistant depression.

About 55 percent of those who switched to either type of medication and added CBT responded, while 41 percent of those who switched to another medication alone responded. There were no differences in response between those who switched to an SSRI and those who switched to an SNRI, nor were there differences in response among the three SSRIs tested. 

Unlike similar studies on adolescent depression, TORDIA did not exclude teens who were thinking about suicide or had attempted suicide. They were included so that TORDIA would mirror real-world treatment situations, and its findings would be readily applicable to community settings.  

More than half of the participants expressed suicidal thinking and behavior (suicidality) before treatment began, and all teens were monitored weekly for side effects related to suicidality and predictive symptoms like hostility and irritability.   

None of the TORDIA treatment groups, however, showed any measurable effects on suicidality, a finding consistent with other studies that have discovered suicidality does not necessarily subside when the depression does. The researchers reiterated the need for new treatments that specifically prevent or alleviate suicidality.

Although none of the medications seemed to be superior over the others, venlafaxine was associated with more adverse effects, such as skin infections and cardiovascular side effects. The researchers concluded that because venlafaxine had a greater potential for side effects, switching to another SSRI should be considered first.

The findings echo those of the NIMH-funded Treatment for Adolescents with Depression Study (TADS), which concluded that depressed teens benefited most from a combination of medication and psychotherapy over both the short and long terms. They are also consistent with results from the NIMH-funded Systematic Treatment Alternatives to Relieve Depression (STAR*D) study, which showed that adults with persistent depression can get well after trying several treatment strategies.

TORDIA was conducted at the University of Pittsburgh, University of Texas at Galveston, University of Texas at Dallas, UCLA, Brown University, and Kaiser Permanente Center for Health Research in Portland, Ore.

Reference

Brent D, et al. The treatment of adolescents with SSRI-resistant depression (TORDIA): A comparison of switch to venlafaxine or to another SSRI, with or without additional cognitive behavioral therapy. Journal of the American Medical Association. 2008 Feb 27.

Sharon Davies was a psychiatric nurse, a researcher and a staunch advocate for those who suffer from mental illnesses. She loved her profession, and she loved people. She also realized that stigmatization and ignorance about mental illnesses can enslave individuals and their families who suffer with these diseases. She was determined to help change this. Sharon was greatly loved and will be greatly remembered by her friends and colleagues. Her memory, goals and aspirations will live on through the Sharon Davies Memorial Awards Program created by her family, friends and colleagues at Freedom From Fear.

Freedom From Fear is pleased to announce the recipients of the 2007 Sharon Davies Memorial Awards Grant program.

Monika Eckfield, RN, MSN, PhD Student – University of California, San Francisco

Hoarding and Cluttering Behaviors in Older Adults – Grant $9115

Approximately 2-4 million people in the US are affected by hoarding behaviors. Hoarding can create difficulties in the home as well as public health issues. Most studies on hoarding have looked at adults between 20 – 50 years old and little is known about the behavior in older adults. The purpose of this study is to better understand the experience of older individuals with hoarding behaviors. Findings from this study will help advance our knowledge about the behavior and mental health conditions, such as anxiety, associated with it.

Linda Paradiso, RN – Richmond University Medical Center, New York

The Effectiveness of Cognitive Behavior Interventions to help adolescent psychiatric inpatients gain a more positive attitude toward treatment – Grant $5000

Medication compliance is an obstacle to effective treatment that is particularly challenging when working with the adolescent psychiatric population. Because medication adherence is associated with a reduction in relapses and better patient outcomes, providing adolescents with a collaborative approach to their care, by using compliance therapy techniques, may have the potential to enhance treatment adherence. This study will explore the role that compliance therapy can play in assisting adolescents in gaining understanding and insight about their illness, improve attitudes toward treatment, enhance compliance, and prevent relapse.

Tom Olson, PhD – University of Texas at El Paso

Multifamily Behavioral Treatment to address OCD & Health Disparities at the US-Mexico Border: A Pilot Project – Grant $5,000

OCD is a neurobiological disorder that ranks among the World Health Organization’s ten leading causes of disability. At present, there are severely limited resources in the border region for addressing this major health concern, and those resources that exist tend to exclude low income persons. The purpose of this project is to pilot a culturally sensitive, cost-effective multifamily behavioral treatment intervention (MFBT). This intervention is designed to improve health outcomes and to decrease health disparities involving Mexican origin adults with OCD and their families living in the border region.

WASHINGTON (AP) -- People who tend to the elderly, change diapers and serve up food and drinks have the highest rates of depression among U.S. workers.

Overall, 7 percent of full-time workers battled depression in the past year, according to a government report available Saturday. Women were more likely than men to have had a major bout of depression, and younger workers had higher rates of depression than their older colleagues.

Almost 11 percent of personal care workers -- which includes child care and helping the elderly and severely disabled with their daily needs -- reported depression lasting two weeks or longer.

During such episodes there is loss of interest and pleasure, and at least four other symptoms surface, including problems with sleep, eating, energy, concentration and self-image.

Workers who prepare and serve food -- cooks, bartenders, waiters and waitresses -- had the second highest rate of depression among full-time employees at 10.3 percent.

In a tie for third were health care workers and social workers at 9.6 percent.

The lowest rate of depression, 4.3 percent, occurred in the job category that covers engineers, architects and surveyors.

Government officials tracked depression within 21 major occupational categories. They combined data from 2004 through 2006 to estimate episodes of depression within the past year. That information came from the National Survey on Drug Use and Health, which registers lifetime and past-year depression bouts.

Depression leads to $30 billion to $44 billion in lost productivity annually, said the report from the Substance Abuse and Mental Health Services Administration. The report was available Saturday on the agency's website at http://oas.samhsa.gov.

The various job categories tracked could be quite broad, with employees grouped in the same category seemingly having little in common.

For example, one category included workers in the arts, media, entertainment and sports. In the personal care category, a worker caring for toddlers at a daycare center would have quite a different job from a nursing aide who helps an older person live at home rather than in a nursing home.

Just working full-time would appear to be beneficial in preventing depression. The overall rate of depression for full-time workers, 7 percent, compares with the 12.7 percent rate registered by those who are unemployed.

Copyright 2007 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Top 21 -- Most Depressing Jobs