Sunday, November 29, 2009

Pharmacotherapy options in social anxiety disorder: which is the best medicine?

When you are diagnosed to have social anxiety disorder, sometimes, the doctor will persuade you to take drugs. But which one is most effective for your social anxiety disorder?

The efficiencies of benzodiazepines, monoamine oxidaseinhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs) in social anxiety disorder have been investigated in placebo-controlled clinical trials.

On the basis of the clinical evidence, an SSRI is recommended as first-line treatment for social anxiety disorder. Treatment should be initiated at a low dose (for example, paroxetine 20 mg) and then increased gradually if necessary to obtain a clinical response. Improvement can be evident after 4 weeks, but if the patient does not benefit from some improvement after 8 weeks one should consider switching to an alternative SSRI or the addition of behavioural therapy. It is important to emphasise that social anxiety disorder is a chronic condition that required long-term maintenance treatment to achieve full remission and to consolidate the response.

Pharmacotherapy should be continued for at least 1 year, to prevent relapse and allow patients to benefit from their improvement in social, education and work functioning.

According to its studies, it takes about 12 weeks for Fluvoxamine to be more effective than placebo, Paroxetine about 4 weeks to show its effectiveness.

In the future posts, I will show you if there are alternatives and treatments that have quicker effects for social anxiety disorders.

reference: Facing the challenge of social anxiety disorder
By: Herman G.M. Westenberg

Thursday, November 26, 2009

Cholesterol and cabs good for your depression?

Babeybear, From your letter I can tell you are a beautiful and thin girl suffered social anxiety and a little depression, but for diet, balance is the key. If you don't take balanced diet. It would have negative effect on your depression.

Cholesterol, good or bad for depression?

In fact it has reported that if your cholesterol below about 4.42mmol/L(170mg/dL)then you have more chance of having depression, social anxiety disorder, stroke, poor memory and more chance of attempt suicide.

Why? The reason is the cholesterol, when decomposed, would be the material to compose the transmitters of the neurons, so it would largely influence your mood and memory.

Cholesterol is rich in meat, fish, eggs etc, so take enough cholesterol each day will help you to better your depression symptoms.

Babeybear, you mentioned that you always feel fatigue and dizziness, maybe it's not the symptom of social anxiety disorder, but low pressure, because of your excessive dieting. I recommend you to have further check by your doctor.

Taking carbs, good or bad for depression?

Taking carbs would be good for you.

But please note that eating sugar is not always good for depression.
It's reported that taking sugar will improve your mood, but make you sleepy and relaxed, no motivation for working, while protein/fat meals always enable you to be awake, alert, quick thinking and acting, bright and reduce depression.

Wednesday, November 25, 2009

The world is a reflection of yourself

(time to introspection of myself, : ) )

You will feel the same way of the outside world as you feel about yourself.

Today I happened to read one article written by Hohn Dery, MD, the outer world is a projection of our own mind.
Our specific moods are reflections of the early life. If you experience neglect, abuse, emotional deprivation, you will have more chance to be low and sad. So what you experience now, is a mirror of your past.
In fact, your mood is also a mirror of what happened in the last few days or months, if you suddenly feel depressed, then there much be something happending not quite long ago that depresses you.

The way to change your mind to feel better:

(In fact it's quite like the way of "panic away" and that book I mentioned depression book)
1. Introspection of your mind, you can write dairies, you know what you are feeling like, more important is why you feel that way. (It's no use writing how you feel bad all your dairies)
2. Once you notice your negative thought, it's time to STOP it. Replace that with a positive one because everything has its advantages.
3. Connect to the outside world, feel compassion and love. But do not always connect with people who are too sad about theirselves and feel no hope about future BEFORE YOU FEEL BETTER.
4. A special way is to visualize yourself in a crown chakra, the crown glowing bright and shining like gold. Because it's said to have the highest frequency of emotional vibration.

Monday, November 23, 2009

What is cognitive behavior therapy (CBT)? Is CBT effective?

In the last post I have mentioned social anxiety disorder(SAD) and CBT.

But what is SAD, what is CBT? Does CBT really effective? Does CBT effective than simple education?

Social anxiety disorder(SAD) is also called social phobia, characterized by a persistent and marked fear and avoidance of the social situations which he/she fears being evaluated negatively or being subjected to embarrassment.

SAD is believed to be the most prevalent of psychiatric conditions. But most individuals are never identified or obtain a treatment of social anxiety disorder.

Unlike transient worries and fears that do not lead to significant impairment of functioning. SAD always result in high levels of distress and significant functional impairment. Few friends, limited extracurricular activities, underachievement. SAD may also combined with depression, anxiety and substance use disorders.

There are two cognitive-behavioral treatments:
1. Individual CBT(I-CBT)
Participants in the individual therapy met for 1 h per week. Followed the same format and covered the same content as G CBT.
2. Cognitive behavioral group therapy(G-CBT)
Met for 2h each week and coled by 2 therapists, groups ranging in size from 4-6 patients. The treatments included psycho education, breathing retraining, cognitive restructuring, simulated and in Vivo exposure to phobic stimuli, social skills training.
3. Psycho educational supportive treatment(PST) which is the control group of CBT
A group of 4-6 persons met for 2h per week led by two therapists. Including discussions each session around various topics relevant to SAD, therapists offered support but not provide specific advice, teach skills, problem solving or assign exposure exercises.

Recovery rate of all kinds of CBT for adults
Check the result above. We evaluated these three CBT treatments to the SAD in adolescents.
The treatment effect was determined by calculating percentages of patients who no longer met criteria for social phobia at post treatment and follow up.
Results revealed that all three methods are effective to reduce the symptoms and distress and increase in social performance. G-CBT was more effective for follow up.

reference: Cognitive behavior therapy for generalized social anxiety disorderin adolescents: A randomized controlled trial, by James D. Herbert

How to build your recovery? The importance of the enviroment for recovery

As in the post, social anxiety disorder, Amy was lucky. But the social service system of our society is not always work in the way to promote getting better from depression and other mental illness. That's the truth no matter that the noble goals voiced by people stresses how important to be nice to the illed ones.
In Kevin Turnquist's report, the environment to promote recovery is so important that nearly no one can fully recover if they didn't find an environment that meets sort of requirements.
1. Home, a stable place for one to recover. It must be safe enough so would smooth their feelings. But our current system seems impossible to reach this goal.
2. Find someone to communicate, only when you connect with the outside world, you have a feeling of returning to the community, friendships, hobbies, work, maybe also your pets. You must find something. Read this post if you have problem communicating with the others: social anxiety disorder.
Another point to add:
Help yourself when the others can't help you. There are quite a lot of depression treatments. Just like cold, if you have cold, no doctor, try to treat that yourself, then you will feel better.

Sunday, November 22, 2009

Social anxiety disorder: individuals unworthy?

Cognitive-behavioral therapies(CBTs) is the most well researched psychosocial treatments for social anxiety disorders. Today I want to say something about social anxiety disorder because depression is often accompanied by social anxiety disorder and social anxiety disorder always leads to depression.

But first answer a question: what is the social anxiety disorder? Or what's your problem with the social communication?

When talking about depression, doctors would give you suggestions that you should talk more to your friends and be more active in the social communities. But for many people, it's a bottleneck because you believe:

1. The others always laugh at you, they are bad and unworthy.
2. You don't know what to speak with the others
3. You feel anxious and nervous with the others

These are some of the symptoms of social anxiety disorders.
I don't want to talk too much about the theories, but only one little true story Amy told me some months ago.

Amy worked in a small company, she suffered social anxiety disorder 2 years ago, though nearly recovered, still suffered from time to time and I was trying to help her. One day she met some problems with her work and didn't get a good result. It was not her fault but she still felt a little sad and told her best friend who also in that office. One day later, she happened to hear that friend telling another one about this. At that time, she felt so depressed and sad that she just didn't want to talk to her friend any more.

When she asked me what to do, I told her to face it and talked to her friends instead.

Are you kidding? She is so unworthy!

Yes seriously I think you should talk to her. And that is the most effective way to reduce your depression and anxiety.

Surprisingly, that colleague to whom Amy's friend told went to visit her first, asked her about this, Amy barely smiled and a little self-mockery. That guy laughed, yeah it's interesting, but you are lucky because our boss nearly killed me with my current task. He then gave her some suggestions and told her to be optimistic.

Amy was moved and she suddenly knew the reason why she had social anxiety disorder.
People around you are always not as bad as you think, most of them are friendly especially when you are friendly. The reason why you have a misunderstanding to them is because lack of communication.
But social anxiety disorder varies according to people's different personality, different situations, I will talk about the other treatments of CBT later.

Why antidepressants still prevail when proved not so effective on depression?

I left a question in the older post: Why antidepressants still prevail?
Read here: Why antidepressants don't work
The fact is:

According to Dr Thomas L. Murray, Jr. in his article "The loss of client agency into the psychopharmaceutical-industrial complex"
Some of the assumptions are
1. phychiatry is part of a larger system which is called the psychopharmaceutical industrial complex(PPIC), driven by capitalism primarily.
2. power dynamics are inherent in the doctor-consumer relationship

Composition of PPIC:
1. American Psychiatric association(administrative and research psychiatry)
2. Pharmaceutical industry
3. Public relations
4. Advertising firms
5. Patient support organizations(e.g., the National alliance on mental illness[NAMI], children and adults with attention deficit/hyperactivity disorder[CHIAA])
6.The National institute of mental health(NIMH)
7. Managed care organizations
8. Flow of sources among these groups

The PPIC existed based on a simple assumption that: within a capitalistic society, mental disorders are a chronic condition resulting from a diseased brain that requires expert medial treatment in the form of mass produced pharmaceuticals.(Kuppin&Carpiano, 2006)
So pharmaceutical companies(first line of the following pic)develop a continuous flow of medications and provide funding to NIMH and patient support organizations like NAMI and CHADD. In turn, NIMH and patient support organizations endorse the disease model and its effects lobby policy makers to fund psychiatric research through NIMH.The pharmaceutical industry relies on academic psychiatrists to produce evidence that supports their medications.
Academic psychiatry depends on the pharmaceutical industry for research grants. Insurance companies rely on pharmaceuticals to contain costs.
As a capitalistic system with a drive toward greater profits, modern health care has evolved into a sickness care system. The consumers don't easily leave this system because the empowerment to overcome their emotional problems.

Saturday, November 21, 2009

Holiday season depression: how to cope with it?

Holiday season depression is a special kind of depression.

Now you have to prepare for the holidays, thanksgiving, Christmas, Chanukah's, shopping for gifts, ready to cook for your loved ones. Everyone is busy preparing for these festivals. If you feel worried and depressed about these, then you are having holiday season depression.
Do you know the reasons why you feel this way?
Reasons of holiday season depression:
1. financial stress
2. fatigue and tired
3. Alone
5.unrealistic expectations
Do not need to be depressed, here are some tactics for you to overcome this:
1. make a plan of what you should buy and the spending, do not rush around the last minute that would make you stressed. Create an easy-to-manage schedule and a clear list, ask the others around if you have any problems.
2. Get together with your family and the ones you love. It always make people feel sad and helpless when being alone.
3. Pay attention to your physical condition, a key to overcome this is to have a rest before you feel tired. Have a little rest from time to time which will keep you alight. Also you have to eat right and have good sleep at night which I will talk more in the future.
4. Always ready to help the others like being involved in charity work and help the one that has the similar feelings like you.
5. Be realistic and positive especially when you are in the financial problem, having the right attitude will bring clarity and will increase your creativity that would bring potential solutions.
One method is to think creatively to develop a new spending model that would cut back by 50%. Think about it. Like buying a reusable cards and send to your friends.

Why antidepressants don't work? A new discovery

Do you know why antidepressants don't work?
For decades, antidepressants are developed around a belief that stress is the major cause of depression which leads to the unbalance of neurotransmitters which is the direct cause of depression symptoms.
Eva Redei made a report at the Neuroscience 2009 conference that she found there was no overlap with depression related genes and stress related genes. Out of more than 30,000 genes on micro array, 254 were stress related, 1275 depression related, while only 5 were found existed in both samples.
It means, if you have stresses, those antidepressant may work for you, but if you are depressed, those antidepressant may not work. She used micro array technology which can detect all the genes at one time.
In her second part of researches, she found that the depression started back in the development of neurons instead of the neurotransmitters because there was no significant differences in her animal model in the levels of genes that control neurotransmitter functions. That means, the depressant medications works as the band-aids on the final effect rather than the treatments of the cause.
This is actually a breakthrough for studying depression.
But do you know why there was almost a 50 fold increase in antidepressants that dispensed in these 10 years?

Monday, November 16, 2009

How I cure my depression in one month with only one book?

I got depression in my college.
I didn't know where the future was, dull teacher, tedious study all day long, misunderstandings with my best friend, pressure from exams that I had to take about 8 exams in just half year...
Combined together.
I found myself in a state that I didn't want to do anything, I would rather stay in the dormitory all day long, I didn't want to talk to anyone, I felt tired and sad, I cried a lot, I lost hope to all of my interests...
It's depression sure I know because that's what I learned for quite a long time and I would remember every definition and every medicines for that.
But at that time, I had depression myself.
(It's just like doctors also have illness sometimes, lol)

It lasts for several months when I even believed I would keep that motion for all of my life.
One day, another friend gave me a book, he gave it to me and said, I think you are in depression, read it, it sure will help you.

It's a classical combined book from Dale Carnegie, called: How to stop worrying and start living and How to win friends and influence people. In some other countries, it translates into: people's weaknesses.

At that time, I didn't believe only one book can cure depression. I have read too many ebooks about how to stop worring, how to win friends, how to influence people etc. So many superior books with similar ideas. Anyhow, I randomly opened one page and began to read it.

It took me 2 days reading, and then I did what it recommended me to do then surprisingly I felt better. For the following week, the following months... I read it again and again and at the same time analyzed and about what I have experienced. I recovered. I became normal again.

Why I recommend this book?
Because unlike the others, you can see from this book(or books) that Carnegie knows people's mind very much and also he had too many experience for that.
He didn't focus on why you had depression, but he told you the most effective way of depression cure is to face it, analyze why you have that feeling, what caused it, what's your plan to do next, what's the main obstacle. This way will tackle all of your problems from origin and you will recover from your past.
It also tells you how to treat people from the point of physiology. One key point is to think what the others feel from your point of view. Then you will become more generous to your friends and gain relationships.

Read it if you are interested.
Along with

P.S If I got depression now and needed to treat it, I would not just read only one ebook, but I will combine different depression treatments together because it would be more quicker to control depression and would not easily to recur.

Depression's friends: phobia, panic disorder and the others

Do you know who are depression's friends?
Friends are always tend to be together.

Remember what I mentioned in "Why hate panic away"?
There is a fact: panic disorder, phobia like social phobia or other kind of phobia and generated anxiety disorder are depression's best friends.
It means, always you can see them together.

Why you feel so uncomfortable, why you get mad of the fact that you fear of social society or the water, dead animals etc? Why they others feel quite normal about that?
When you feel sad, anxious or other dysfunctions of daily lives about phobia or panic disorder, that means, you have depression accompanied you.
It means, if you just focus on how to treat the single disease is not enough.

You have to judge if your fear of that certain product is bigger, or that bad feeling is bigger.

If you are interested in that book some guy hates, you can read it here:
panic away
In fact, it's not that so bad as that guy said, given you need to treat panic and anxiety

Other friends of depression are:
Post-traumatic stress disorder(PTSD) It occurs when some guy experiences a horrible ordeal or events, like accident, violent assault, natural disaster or military combat. People with such experience will always re-live that event again and again.
It has other symptoms like: not willing to talk about that event, anger outbursts, guilty about oneself.
How intimate of PTSD and depression?
It's reported that 40% people experienced depression at 1-4 months intervals after that experience.

Substance abuse like Alcohol
Yes alcohol is kind of the substance that smooth your heart and make you relax. But the side effect is, if you got abused with alcohol, you will more and more tend to have mood disorder which is kind of depression.

Other medical diseases
Cancer, heart disease, HIV, stroke, diabetes, Parkinson's diseases.
When accompanied by depression, it would make more difficulty for doctors to treat your disease.
A fact is, if people are more optimistic, some disease like cancer also has the chance to be cured by itself.

Which form of depression you have? Easy examples to show you

Hello guys, long time not seeing you here because I was a little too busy in the last few weeks.
Linda wrote a letter to me and asked me if I had a depression myself those days, lol I haven't. I always have a peaceful feeling, not depression, sometimes may feel happy, but for more time just peacefulness.
(BTW, in my future post I will tell you guys a little story about my depression days and how I conquered it several years ago, I would be appreciated if you would like to share your story to me too)

Now I assume you have known much about these:
What is major depression
Why you have depression
Why hate panic away
Top 7 trustful online shops for ordering health products
Quickest way to be depression-free

Let's continue to talk about the depression forms because I know some guys don't quite know how to distinguish them.
Knowing which depression form you have is quite important because if you have made quite a clear view of your depression form you will then understand which way of treatment is the right one.
Now according to the national institute of mental health.

Here are five different depression forms.

1. Major depression disorder
Just like its name, major, you can tell its the most serious kind of depression.
It's a combination of symptoms that you will loose all the interests to your outside world, and it even prevents you from sleeping, eating, working etc. If not treated, the big chance is that the major depression will recur throughout your life.
For example: I am unable to work.

2. Dysthymic disorder (dysthymia)
Long term durance but less severe than the major depression. For example, you will still go to work or go to school, you will still eat quite a lot or less, but you always feel sad. Dysthymic disorder may also accompanied by sleeplessness, eating less but not always disable you.
For example: I can work but I feel sad about it.

Some other forms of depression like:
1. phychotic depression
It's a special kind of depression because it's accompanied by psychosis such as delusions, hallucinations etc.
For example: I can work but I always see my boss scolding me.

2. Postpartum depression
Diagnosed of a new mother that has depression within a month after delivery. It's reported that the ratio of the postpartum depression is 10%-15%. So you can see it's quite common.
For example: ... quite easy to know it right? So just skip it.

3. Seasonal affective disorder (SAD)
You mood will change according to the seasons?
Not exactly, in fact, it's the sunlight that influence your mood. Especially when you are in winter months that you can not get enough sunlight. You SAD will occur.
The treatment is to use light therapy as well as other therapies like antidepressant medication and psychotherapy.
Please note that the sunlight or other light will have positive effect on your feelings and have effect on other depressions too. Which I will talk about in my future post.