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All Depression and Anxiety Alerts
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What Is Social Phobia and Do You Have It?
A reader from Seattle, Washington asks: Where do you draw the line between shyness and social phobia? I get overwhelmed with anxiety in many social situations. It has affected my career and my ability to socialize and date. I am wondering whether medication could help me. I'd appreciate your input. More...
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Knowing When It’s Time to End Therapy
Most people think of psychotherapy simply as counseling. In fact, the term psychotherapy is used to describe a variety of different talk therapies that treat emotional, behavioral, personality, and psychiatric disorders. Psychotherapy involves a commitment to a series of appointments with a licensed mental health professional, enabling a relationship to form between the therapist and the individual. More...
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Gender and the Stigma of Mental Illness
Individuals with mental disorders are poorly understood by the general public and often seen as violent or incompetent. People may also assume that mental health conditions are character defects rather than illnesses. Now a study reported in Psychological Science (volume 20, page 169) suggests that people may have differing views of men and women with the same mental health condition. More...
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Conquering Your Phobia With Virtual Reality Treatments
In moderation, fear is actually a good thing. It's a survival instinct that helps us avoid activities and creatures that can harm us. But sometimes that fear increases out of proportion to the actual danger. While most of us eventually get past our fears -- or at least learn to live with them -- people with phobias are held prisoner by an irrational sense of panic. More...
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How Mood Disorders Affect Your Body
Most people think of depression and anxiety as conditions of the mind, influencing one's mood and outlook on life. But that's only part of the story. For many people, the more common manifestations of depression and anxiety are physical, not mental, and they can have long-term consequences as well. Here is an overview of some common (and serious) mood disorder-related conditions … More...
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Antidepressant Medication: How Long Is Enough?
When doctors first began prescribing antidepressant medications in the 1950s, the prevailing belief was that a short course of medication could cure depression -- much like antibiotics wipe out an infection. But over time, physicians began to realize that depression required longer treatment regimens than originally thought. More...
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Insomnia and Mood Disorders
Insomnia is an enormous burden in itself, but when combined with a mood disorder, the hardship it causes is multiplied and complicated through a feedback loop of suffering. Sleeping less, or poorly, worsens mood, which interferes with sleep, which heightens anxiety … and so on. And so you might ask: “Do sleep disorders cause mood disorders or vice versa?” Dr. David N. Neubaurer, associate director of the Johns Hopkins Sleep Disorders Center, replies. More...
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Do You Need a PAD?
In many health emergencies, such as heart attacks and strokes, doctors make all the decisions. The same is often true of mental health crises as well. But if you have a psychiatric condition that could lead to hospitalization -- such as bipolar disorder, schizophrenia, or severe depression -- you may have strong feelings about various treatment options. This is when a psychiatric advance directive (PAD) can be just what the patient ordered. More...
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Antidepressant Medication “Poop Out”
A reader from Roswell, Georgia asks: “I have been taking 20 mg/day of Celexa (citalopram) for about a year and a half for depression. It was the first medication I tried, and it worked great. For the past two months or so, however, I haven't been feeling great. I have been sleeping a lot, crying a lot, and feeling antisocial. Is it possible for Celexa to 'poop out' and just stop working over time? Should I talk to my doctor about increasing my dosage or changing medications? Or maybe this bout with depression is just extra bad and I should tough it out?” Here’s our advice. More...
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Exercise is Medicine for the Brain
Just 20 minutes a week of physical activity can make a difference in your mood. No one seems able to agree on how much exercise, or what type, is best for mental health. But a Scottish study, reported in the British Journal of Sports Medicine, has found that just 20 minutes of any physical activity, including housework, in a week is enough to boost mental health. … More...
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Electroconvulsive Therapy Update
Some 100,000 Americans undergo electroconvulsive therapy (ECT) treatments for depression each year. Deciding whether ECT is a good treatment option for you or a loved one can be a difficult decision. But it is an option worth exploring when depression is severe. In this Health Alert, Johns Hopkins provides a primer on ECT. More...
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Insomnia: Nature or Nurture?
According to the American Academy of Sleep Medicine, about one-third of adults have symptoms of insomnia, the most common sleep disorder. In fact, insomnia is so common that many sufferers wonder if it could be inherited. Here’s what the research on insomnia and family ties shows. More...
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Pristiq: A New SNRI for Depression
Dr. Karen L. Swartz, Director of the Johns Hopkins Mood Disorders Center, answers a reader’s question about the therapeutic benefits of Pristiq, a new antidepressant: I am currently on Effexor (venlafaxine), which has a similar generic name, so I'm wondering how Pristiq differs from Effexor and other SNRIs? More...
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How Pets Comfort Us
Pets are more than just furry friends and loyal companions. Yes, they tug at our heartstrings, but they also improve our health, both mental and physical, helping us to live longer and happier lives. More...
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Depression and Your Health
Depression clearly has a harmful effect on physical health, although the biological reasons for the link between body and mind are unclear. Whatever the reasons, over the past 20 years, it has become evident that depression after a heart attack is much more than an 'understandable emotional reaction' to a stressful, life-changing event -- it is profoundly dangerous, raising a person's chances of having a second, fatal heart attack. More...
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How We Grieve
Sometimes we experience huge changes in our lives, such as the death of a loved one. These events can cause intense emotional anguish, and grieving during such life changes is a normal and healthy, if painful, process. A recent study from the Journal of the American Medical Association sheds new light on the grieving process. … More...
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What is PTSD?
In a recent issue of The Johns Hopkins Depression and Anxiety Bulletin, Dr. O. J. Bienvenu, associate professor of psychiatry at Johns Hopkins, talked about post-traumatic stress disorder or PTSD – an increasingly common condition. More...
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Men and the Blues
Is depression really less common in men than in women? Researchers are beginning to wonder. In fact, some experts believe that depression may actually be just as common in men as in women but is often overlooked because of its different symptoms. More...
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Spinning Out of Control With GAD
Generalized anxiety disorder (GAD) is characterized by excessive, recurrent, and prolonged anxiety and worrying. People with generalized anxiety disorder typically agonize over everyday concerns, such as job responsibilities, finances, health, or family well-being or even such minor matters as household chores, car repairs, being late for appointments, or personal appearance. The focus of anxiety may shift frequently from one concern to another, and sensations may vary from mild tension and nervousness to feelings of dread. More...
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Managing Your Weight on Antidepressants
While recovery from mood disorders such as anxiety and depression can be lifesaving, weight gain often can be an unwanted side effect of treatment for many people. In this Health Alert, Johns Hopkins provides nine practical strategies to head off unwanted weight gain.
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Antidepressants and Personality Changes
If you take antidepressant medication, you may wonder: Will medication change my personality or who I am? In this Health Alert, Dr. Karen L. Swartz, Director of the Mood Disorders Clinic at Johns Hopkins, answers this important question that's on the minds of many patients.
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Can Taking an Antidepressant Make Me Suicidal?
Suicide attempts or suicidal thoughts are common symptoms of depression, and the risk of suicide may increase as depression begins to respond to treatment because the person might regain just enough energy and motivation to follow through on a suicidal urge. This discussion addresses the question: Can Taking an Antidepressant Make Me Suicidal? … More...
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Talking About Social Phobia
In this excerpt from a recent Depression and Anxiety Bulletin, psychiatrist Emily A. Bost-Baxeter, M.D. explains social phobia and discusses treatments.
Q. Where do you draw the line between shyness and social phobia? I get overwhelmed with anxiety in many social situations. It has affected my career and my ability to socialize and date. I am wondering whether medication could help me. I'd appreciate your input. Seattle, WA … More...
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Research Update on Depression and Anxiety
Which comes first: depression or anxiety? This is the question researchers have begun to answer in a new study reported in the Archives of General Psychiatry.
It has been believed that generalized anxiety disorder (GAD) typically precedes the development of depression. However, researchers now assert that depression occurs before anxiety as frequently as anxiety manifests before depression, and that the two disorders often develop at the same time. … More...
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14 Signs of Bipolar Disorder
When properly diagnosed, bipolar disorder can be managed effectively with medications and therapy. In this excerpt from a recent Depression and Anxiety Bulletin, medical editor Karen L. Swartz, M.D. reviews 14 symptoms of bipolar disorder.
Formerly known as manic-depressive illness, bipolar disorder is a mental illness characterized by alternating periods of mania and major depression. Typically, the mood of a person with bipolar disorder will swing from overly 'high' and irritable to sad and hopeless, and… More...
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What To Do When Your Antidepressant Doesn’t Work
If you're on an antidepressant and it's not working, don't give up on it: You may need a higher dose, a longer duration of therapy, a different antidepressant altogether, or a combination of medications. That's the important lesson to learn from a large, six-year, four-step government study called the Sequenced Treatment Alternatives to Relieve Depression trial, or STAR*D. In fact, the researchers found that systematically trying these treatment options can lead to a remission in… More...
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Linking Obesity and Depression
Does depression lead to poor health … or is it the other way around? Recent research explores the relationship between obesity and mood disorders, including depression, bipolar disorder, panic disorder, and agoraphobia.
Depression clearly has a harmful effect on physical health, although the biological reasons for the link between body and mind are unclear. It may be that depression affects health because people develop a fatalistic attitude and stop taking care of themselves. … More...
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Finding the Courage To Seek Help for Depression or Anxiety
Are you feeling down, sad, or anxious? For many people the biggest obstacle to recovery is the perceived stigma of appearing weak or vulnerable and needing professional help. Johns Hopkins discusses this common concern and offers advice.
Being clinically depressed or anxious is not a sign of mental weakness. Nor is it a normal part of aging or an inevitable consequence of having other health problems such as heart disease or diabetes. Rather, depression and anxiety… More...
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Mixing Wine With Antidepressants
Is it safe to drink wine or another alcoholic beverage if you take antidepressant medication? In this Q and A from a recent issue of the Depression and Anxiety Bulletin, Dr. Karen L. Swartz responds to a reader's question.
Q. I have been drinking wine with my dinner for more than 30 years. Now that I am taking an antidepressant for the first time, my wife has told me that I should not drink any more… More...
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Light Therapy and Wellbutrin XL for SAD
Now patients with seasonal affective disorder have two effective therapies to relieve depression in the winter months – light therapy and the antidepressant, Wellbutrin XL.
At this time of year, changes in the amount of daily sunlight cause changes in the body's internal biological clock, known as circadian rhythm. This rhythm is a 24-hour cycle that affects our eating and sleeping patterns, brain wave activity, hormone production, and other biological activities. In some people, less daily… More...
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Religion and Panic Disorder
For patients with phobias or panic disorder, strong religious belief may help to quell symptoms.
The treatment of panic disorder often involves both psychotherapy and medication. Now a study reported in the journal Depression and Anxiety (Volume 23, page 266) shows that people with panic disorder who perceive themselves as being religious are more likely to experience improvements in their panic symptoms than people who rank religion or spirituality as unimportant to them. … More...
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Trends in Psychotherapy
In the place of Freudian psychoanalysis is a trend toward short-term cognitive-behavioral therapy and a new kind of therapy, called acceptance and commitment therapy.
One of the newest therapies to emerge -- acceptance and commitment therapy (ACT) -- is considered a third-generation behavioral therapy (traditional behavioral therapy being the first generation and cognitive-behavior therapy the second). … More...
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Is Electroconvulsive Therapy The Right Choice?
Electroconvulsive therapy (ECT) is hands-down the most controversial treatment in modern psychiatry. No other treatment has generated such a fierce and polarized public debate. Critics of ECT say it’s a crude tool of psychiatric coercion; advocates say it is the most effective, lifesaving psychiatric treatment that exists today.
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Anxiety and Older Adults
Anxiety is a common, normal, and often useful response to life's challenges and dangers. But in people who suffer from an anxiety disorder, anxiety levels spin out of control, causing psychological and physical symptoms that interfere with normal functioning, appear even in the absence of obvious external stressors, or are clearly excessive in the face of the stressors More...
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Research on Depression
People who recover from major depression may experience marked sensitivity to emotional stress, raising the risk of falling back into dysfunctional and depressive thought patterns, according to a Canadian study. Even mild negative moods can reactivate the thinking styles associated with depression and may predict the recurrence of major depression.
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Depression and Older Adults
Researchers explore the link between depression and nursing home admissions among adults aged 65 and older.
Depression and aging do not necessarily go hand in hand. A survey of Californians age 50-95 found that factors such as chronic illness, physical disabilities, and social isolation -- which often coincide with increasing age -- were stronger predictors of depression than age itself. That said, the incidence of depression is clearly higher in older adults. The National Institute of… More...
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Compulsive Hoarding -- Clutter Out of Control
Many people are closet clutterers. But what if you've taken saving and collecting to such an extreme that it’s difficult to move around your home or you’re embarrassed to invite people in because of all the clutter? In that case, you may have crossed the line from a bad habit into a mental disorder known as compulsive hoarding. More...
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The Many Benefits of Pets
Pets are more than just furry friends and loyal companions. Yes, pets tug at our heartstrings, but they also improve our health, both mental and physical, helping us to live longer and happier lives. Studies over the past 25 years have shown that stroking a dog or cat can lower blood pressure and heart rate and boost levels of the mood-related brain chemicals serotonin and dopamine. Heart attack sufferers recover more quickly and survive longer when they have a pet at home, and children who are exposed to pets early in life may have a reduced risk of allergies and asthma. More...
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Qs & As on Insomnia
Melatonin, antihistamines, and bright light therapy for insomnia
Q. What do you think about melatonin and valerian as treatments for insomnia?
A. Melatonin is a hormone produced in the body by the pineal gland in response to darkness and as a cue for sleep. Valerian is an herb promoted as a mild sedative. Both melatonin and valerian are sold as dietary supplements in the United States and are marketed as sleep aids. The National Institutes of… More...
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Alleviating Dry Mouth
Dry mouth is a common side effect of many psychiatric medications. Dry mouth occurs when a drug blocks the receptor sites of the neurotransmitter acetylcholine, which controls saliva production. There are several simple, helpful remedies to help you relieve dry mouth. More...
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Insomnia and Mood Disorders
David N. Neubauer, M.D, associate director of the Johns Hopkins Sleep Disorders Center, answers patients’ questions about the interrelationship between insomnia and mood disorders. He begins with the chicken-and-egg question… More...
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Results from the STAR*D Study
After failure on an antidepressant, the next step you and your doctor decide to take is largely a matter of trial and error based on your doctor’s experience with other patients, your medical history, and your doctor’s consultation with other mental health professionals. This trial-and-error approach may soon be a thing of the past, however. More...
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First Drug Approved for Seasonal Depression
Feeling SAD? Wellbutrin XL may help.
The Food and Drug Administration (FDA) recently approved Wellbutrin XL (bupropion HCL extended-release tablets) for the prevention of major depressive episodes in people with a history of seasonal affective disorder (SAD). Wellbutrin XL is the first drug officially approved for seasonal affective disorder, which is characterized by recurrent bouts of major depression that coincide with the shorter daylight hours of autumn and winter (thus the nickname 'winter depression”). … More...
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Bipolar Disorder and Older Adults -- When Symptoms Strike for the First Time in Late Life
Just as depression is not a normal and natural side of aging, neither are extreme irritability, angry outbursts, paranoia, or irrationally hyper behavior.
One of the myths associated with bipolar disorder is that it follows a predictable pattern, with cycles of mania and depression following one another as neatly and symmetrically as day follows night. Not true. Bipolar disorder is an unpredictable disease. And while bipolar disorder usually makes its first appearance during adolescence or young adulthood, another, often unexpected, feature is that bipolar disorder can show up for the first time in late adulthood.
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Don't Overlook Dysthymia
Left untreated, dysthymia can lead to major depression, or worse.
It is far better to treat dysthymia (recurrent, mild depression; also called subclinical depression) than to think of it as a minor condition. That reminder comes from a seven-year prospective study of more than 1,000 young people in New Zealand, reported in the Archives of General Psychiatry.
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The Genetics of Depression
Why do some people bounce back from stressful events while other fall into depression?
Genetic factors play a role in the development of depression and other mood disorders. For example, a gene that may be linked to bipolar disorder has been identified and one study showed that a common family gene mutation could predict whether a person will experience clinical depression when faced with traumatic events in his or her life.
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Taking Care of the Caregiver
If you’re a caregiver for a chronically ill relative or friend and are feeling overwhelmed, even depressed, this advice can help.
Being a caregiver for a chronically ill family member is a 24-hour job. With all the attention you give to others, it’s understandable that you may feel tired, unhappy, or irritable. But you may be beyond feeling just “worn down.” The strain of being a caregiver can eventually lead to diagnosable mental distress. A recent… More...
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Is it a Panic (Anxiety) Attack or a Heart Attack?
Roger S. Blumenthal, M.D., Professor of Medicine at Johns Hopkins, explains the important difference between a panic attack and a heart attack. An acute anxiety attack, or panic attack, is a terrifying ordeal to experience. During a panic attack, a surge of fear overcomes the individual, often without any clear provocation. Many patients truly believe they are going to die, and some experience syncope, or fainting, as a reaction to this stressor. More...
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Men and Depression
Men often experience nontraditional symptoms of depression, which can keep them from recognizing the problem and seeking help.
If you’re a man and suffer from depression, you’re not alone! Nearly six million men in the United States are diagnosed with depression each year. But because men are less likely than women to recognize their symptoms and seek treatment, many more men probably suffer from this condition. … More...
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Is it Normal Grief or Depression?
A good sign that grieving is successful is a shift to positive and realistic plans for the future.
The loss of a loved one can cause intense mental anguish. Occasionally, this anguish triggers a major depressive episode, but few people in mourning experience true clinical depression.
Grieving may produce a wide range of feelings. The grieving process is considered successful when it permits the mind to adjust to the acute sorrow of a loss. The end… More...
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Natural--but not Always Harmless--Remedies for Depression and Anxiety
Recent reports have illustrated that St. John's wort, used by many people to relieve depression, may not be as benign as it appears.
Despite the availability of a full arsenal of medications proven to be effective for treating depression and anxiety, many people have turned to herbal remedies—which are classified as dietary supplements in the United States and so have not been tested or approved by the U.S. Food and Drug Administration (FDA). No one is… More...
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