Overcoming Anxiety Showcased at Virtual Bookcase

With seven days to go until the official launch of Overcoming Anxiety, we begin the launch party with a showcase at the Virtual Book Case. Here is the link; Click here to visit the Virtual Bookcase.

The Virtual Bookcase showcases select books that the owner, Glynis Smye deems worthwhile. She is very personable and lives in the UK, at the seaside town of Dovercourt-Harwhich. She is author of the Ripper Romance Series and while she tends to favor historical fiction, especially from the Victorian era, she has some interests in Mind, Body and Sprit topics and was gracious to include a showcase for Overcoming Anxiety.

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PTSD Overdiagnosed in Soldiers?

No way.

An article in NY times tried to argue that PTSD in returning soldiers is really just lack of home support, because more are being diagnosed than actually saw enemy fire. Obviously misguided.

If you sit in a hostile foreign land where your companions are being killed, you do not have to be shot at to be traumatized. One client I had, for example, had PTSD from the Panama Canal zone even though he was never shot at. It was nevertheless disturbing on a daily basis, since his job was to go up and down the canal in the body barge collecting bodies. That picture in his head was still traumatic.

While it is true that in cultures where there is more affluence there is greater alienation and social supports are low for any problems one has, that does not account for these numbers. Some people get trauma from a car accident, or even seeing one. Should not up close and personal experience of war count as much as how many bullets one dodges? My definition of trauma is rather broad : any event(s) that exceed(s) your resources.

 

There are a few misdiagnoses, such as TBS being mistaken for PTSD. Not nearly so many as there were when the VA tried to mislabel for economic reasons..

Published in: on May 7, 2015 at 8:01 am  Comments (1)  
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Aspergers Syndrome, Can we Save it?

Persons diagnosed with Asperger’s Syndrome learned recently that the psychiatric community in the USA has determined that this disorder is so much like Autism that it should be diagnosed instead as a mild form of Autism. While there has been some overlap and similarities in Asperger’s Syndrome and Autism, I am one psychologist who would have prefered that the two be more clearly separated, an outcome almost diametrically opposite from the one chosen by American psychiatry in its DSM-5 version (due out later this year).

While there are some advantages for these children to be seen as Autistic (access to research funds, better access to society’s supportive programs), these are outweighed by the negatives. It is less likely that adult and adolescent children with Aspergers will want to be identified as autistic. More important than the greater likelihood of stigmatization, is the prospect that the etiology and treatment of Aspergers will become hopelessly muddled and confused. Understanding of the disorder will be set back decades as will treatment and diagnostic issues. So what can be done?

There is a realistic prospect that US Psychiatry will change this decision the next time around, if advocacy groups apply pressure, however that prospect would require a wait of several years. A better approach is for the various advocacy groups tied to the disorder to develop a new institutional groundwork- one in which the funding for research, education and all things nonmedical are addressed outside the purview of mental health, and away from the insurance industry. While therapy may still need to rely on the medical establishment, the ICD-10 still can be used, at least for the near future, to capture the correct diagnosis (F-84.5).

Published in: on January 21, 2013 at 6:52 pm  Comments (2)  
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New Mental Health Procedure Codes- Reimbursement Cuts

The mental health procedure codes used by insurance companies are being revised, and will be reimbursed at a different rate. While some codes stay the same, one of the changes that will lead to a cut in pay for most therapists, and a cut in service for most mental health patients, is the code for outpatient psychotherapy.

The old code of 90806 was used by most therapists and was reimbursed for the typical 50 or 55 minute therapy session. However the way the new codes are set up, if a 50 minute session is preauthorized (and that is the way blue cross and many other insurers do it), then you are expected to round down to 45 minutes, and that session is equivalent to the old 90804, paid at a much lower rate of reimbursement.

This is a hidden pay cut and service cut, for therapists and clients respectively. If therapist usually takes the whole hour (adding time at the end for record keeping), then the new rules will try to force them to do 45 minute session, (or donate the time) seeing three patients over a little over two hours, if they plan to make as much or more money as in the previous system, when they saw two patients in that time.

So far the actual reimbursement rates have yet to be published although they were due in November. Hopefully that will include an increase, but the projection is for a cut in reimbursement, when both are taken into account. I still make less from an insurance company now than I did in the 1980’s, and that is one reason many of my colleagues do not fool with insurance.

 

Published in: on November 28, 2012 at 5:23 pm  Comments (1)  
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Emily Dickenson

I think this quote can be helpful. It’s kind of the opposite of anxiety, don’t you think? Psychologists have long understood that we typically find what we look for.

Published in: on June 17, 2012 at 8:53 am  Comments (1)  
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More DSM-5 changes: Facebook or Droid Addiction?

The APA Diagnostic DSM-5  which is dues out next year, is likely going to result in a boom industry in addictions treatments.  It may even mean there will be a mental health diagnosis to accompany your Droid or Facebook  addiction.

The changes that are planned will generally relax the criteria to qualify for drug and alcohol  addiction while expanding the number of symptoms that will help qualify. 

In addition, gambling would be more easily diagnosed as an addiction. 

But the most interesting thing for all the Facebook, Twitter and Droid lovers is the new section on behavioral addictions.  What kind of behaviors are they meaning?  Can you think of any behaviors that more clearly seem to be addicted than online excesses?

Psychiatrists who are revising the manual have indicated that the broader language will be helpful in promoting accurate diagnoses,  and providing for earlier intervention and better outcomes.

They failed to add that it would likely pad their wallets, but I guess that goes without saying.

All that being said, I suspect that some people really could use some help with getting away from the their Droids especially. I wonder how bad the withdrawal symptoms would be? If everyone had a no cell phone day (or week?) organized online, would the homicide rates go up? Or the pregnancy rates? 

I wonder what the difference is between a workaholic and a geek?

April is Child Abuse Month

April is child abuse monthApril is child abuse month, so I wanted to give a shout out to all the children (often now grown) who have survived monstrously terrifying adult parental figures  and the families who failed to adequately protect them. If you made it this far, chances are you are a brave, creative and noble soul with a lot of personal resources going for you that helped you make it.

In case you don’t already know it, I want to be clear it was not your fault.

There are a lot of trained clinicians who know how to help you reclaim your life and piece together a solution that can transend the things that happened to you. If you can harness these experiences and build a better today the world will be a better place and you will be able to use your wisdom gained to help others find thier own best solutions.

David J Berndt

Phot credit: by Brean

Published in: on April 5, 2012 at 8:54 am  Comments (1)  

The Big Sleep- Insomnia Treatments are Dangerous

If you have been using sleeping pills to help with insomnia, the news from the most recent issue of the Brittish Medical Journal is going to give you some sleepless nights. Using these medications adds little to your amount of sleep, but the use of sleeping pills may have been associated with as many as 500,000 deaths.

The study looked at over 10,000 patients in the USA, sho were using drugs like Ambien, Lunesta, Sonata, and Resterol, and found that even infrequent use was associated with a 3.5 times greater risk of death, and if you used it often, you had a 5 times greater likelihood of dying. It was associated with deaths by cancer, as well, and it was associated more strongly with lung cancer than smoking.

The study only lasted for a two-and-a-half-year follow-up, and did not demonstrate a causal connection, just the association. Each of the 10,000+ patients, all of whom were using the sleeping pills, were matched with 2 control patients of the same age and gender, and similar overall health.

These results point to the need for more use of Cognitive Behavioral and otheranxiety management techniques to manage sleep and improve  insomnia treatment. For patients who have trouble sleeping because of anxiety or depression, a psychologist may be more effective not to mentionless risky than these sleeping pills.  The study also looked at other medications besides Ambien, Lunesta, Resterol and Sonata, but these pills that are among the 20  most frequently prescribed medications in the USA.

Between 6 and 10% of all adults in the USA have tried one of these sleeping pills.

Hemispheric Brain Differences From a New Perspective

I wanted to share with my readers a memorable video by a brain researcher, Jill Bolte Taylor, who was able to use her own scientific skills to observe her experiences with a left hemisphere stroke, as it took over her mind, and as she recovered from it.

As a clinical psychologist who also likes to stay on the cutting edge, I am a big fan of TED, (technology, entertainment and design) in my opinion the most innovative group of people you can conference with. Ms. Taylor gave this gift of a lecture/video during a TED conference in the spring of 2008.

The right hemsiphere and left hemisphere have very different functions, as many of you know, and she likens the non-dominant right hemisphere to a parallel processor, concerned not only with creativity, and connections, but with the here and now.

The left hemisphere, the dominant one, she likens to a parallel processor, and it is involved with linear, methodical thinking and language. These are not new concepts, but she is able to vividly describe how they feel, as she experiences one side or the other as her stroke progressed.

Her most unique contribution was, however, was to note that the non-dominant hemisphere feels connected to the whole universe, and fails to distinguish us as separate from our surroundings. It is all about the present, and in that moment, we are all one.

The dominant hemisphere — in contrast –sees us as separate. It is focused on the past and future, and be seeing us as disconnected from our surroundings and the present, it narrows our sense of self.

Of course both sides are useful, for different kinds of tasks, but I think you may well enjoy, as much as I did, her vivid and inspiring descriptions of her stroke and recovery. I strongly recommend TED conferences to anyone who likes this video.

Girls and Boys Preference for Pink

In a recent child development study, on gender-based preferences, there is new evidence that girls develop a preference for pink at about age 2, and while their prefernce may fade somewhat by age 5, the aversion to pink by boys stays steady  between ages 2 and 5.

The study, by Lobue and Deloache in the Brittish Journal of Developmental Psychology , casts doubt on recent speculation that the preference has to do with an innate preference for louder colors, like pink. Indeed if there was such an innate preference we would likely see it reflected sooner.

In the study, toddlers indicated their preference by a paired choice of otherwise identical items, differing only in color. While this choice seems to overlap with a developmental phase that includes verbalization of some ability to distinguish genders verbally, it is still a long way from showing that these changes reflect acculturation.

The study did not look at a preference for blue, a preference that has not been shown to be very robust.

An interesting approach would be to control for language development, and look at the children of parents who themselves have differing views of gender equality, to see if these results are independent of these two factors.