Health Guidance

In my ongoing quest for knowledge pertaining to the contributors to panic attacks and anxiety, as well as treatment strategies and techniques, I came upon some very cool stuff several years ago. It’s called Somatic Experiencing (SE) and it’s the amazing work of Peter A. Levine, Ph.D. This will be the first in a series of two articles. Here we’ll have a look at SE within the context of a contributor to panic and anxiety. The article that follows will approach SE from a treatment perspective. Well, tune-in because I know you’re going to find the information fascinating, hopeful, and helpful.

SE came to life as Dr. Levine observed that though wild animals of prey are under constant threat and siege, they’re rarely traumatized. Well, I never really gave that much thought, but I suppose it’s true. So, just how in the heck do they pull that off? Well, credit is given to an innate regulating mechanism that very efficiently manages and discharges the energy that accumulates in their bodies as a result of self-preservation behaviors. Levine observed that when an animal of prey survives a potentially deadly chase, it actually takes time to physically shake-off unused energy before moving on with the herd. Well, Levine posits we humans are equipped with essentially the same mechanism; however, ours is greatly inhibited by our more advanced cognitive capabilities. Man, how many times does thinking mess things up for us? By the way, isn’t it interesting that we so often use the phrase, “Just shake it off,” when someone takes a relatively minor hit of some kind. Continue reading ‘Panic Attacks, Anxiety, and Somatic Experiencing: Part I’ »

In a previous article I discussed the importance of including balance issues in any discussion of the contributors to panic attacks and anxiety. Amazingly, this connection hasn’t received much attention, but it appears as though that’s changing. Yes, children with balance issues are being assessed for signs and symptoms of anxiety, and intervention strategies and techniques are being developed and implemented. This is great news, as it holds the potential to save millions from life-long suffering.

As you may know, in addition to our sense of hearing the inner ear is the headquarters of balance and equilibrium. Within the membranous labyrinth, a fluid-filled structure deep within the inner ear, is a relatively large area known as the vestibule. And it’s the “vestibular system” that monitors and manages balance and equilibrium by receiving and integrating input from the eyes, ears, and muscles of the trunk, neck, and limbs. Of course, the vestibular system gets a little help from its friends, one of which is the brain’s cerebellum. I guess it would make sense that the cerebellum is a major player in the integration of sensory perception, as well as motor control.

Continue reading ‘Panic Attacks and Anxiety: Treatment of Balance Issues In Childhood’ »

The human brain is absolutely amazing. And as much as we’ve learned about it, it remains one incredibly mysterious three-pound mass of tissue and fluid. The brain’s functioning has certainly been a puzzle to me over the many years, as it’s facilitated a long bout with panic disorder, as well as dances with other distressing mental, emotional, and physical phenomena. Lately, I’ve become more and more fascinated with how a panic sufferer’s assorted pathological challenges present and interact. Here are just some of my thoughts.

I was nine-years-old when an episode of derealization struck me like a lightening bolt while I was sitting at a kitchen table with my parents and their friends. I panicked and ran from the scene. During that same timeframe it was often written on my report cards that I was seemingly unable to sit still and would occasionally wander around the classroom. As a junior in college intrusive thoughts entered my airspace. I was walking down the sidewalk in downtown East Lansing, MI. and saw a woman coming toward me pushing a stroller. Out of nowhere I wondered what would happen if I punched her baby right in the face. Wow!

Continue reading ‘Panic Attacks and Assorted Mind Variances: Pieces of a Greater Whole’ »

One could write and talk for days about the potential contributors to panic attacks. So much so that I choose to use the term “contributors,” not “causes.” And that’s because I believe using the term “causes” throws a very unnecessary roadblock in the path toward relief, as it attempts to find solid and defined explanations for why panic attacks occur. Ultimately, that’s great; however, I find it limiting in the immediate. At any rate, I want to discuss a very common psychological contributor to panic attacks that I refer to as the “We Do It Intentionally Paradox.”

First, just what is a paradox? Well, it’s something that may appear to be incongruent with what’s accepted as common sense, yet it’s very likely true. That said, it’s my observation that many panic sufferers may consciously and/or unconsciously intentionally trigger their panic attacks. Is that paradoxical enough for you? Geez, don’t get angry at me now. If this notion is true, and it applies to you, it can serve to provide a lot of direction. So think about it. Before I go into detail, could it at least be possible?

Continue reading ‘Panic Attacks: The “We Do It Intentionally Pardox”’ »

1. This is hard work, you are going to have to deal with it! This is probably not what you want to hear but this is the way it is. There will be no magic bullet, no rescue squad. No one will swoop down and take your client off your hands. Even if there are mental health services that recognise that your client has a psychiatric problem, what do you genuinely think they can do? The first step to working with a DD client is accepting that your intervention, done properly, is probably the best and most significant intervention your client will get. You may feel that you lack the skills but the truth is so does everyone else – there is no super-magical skill set for working with chaotic clients, psychiatric services rarely have any greater expertise in working with these kinds of clients than you do (and they most likely will have less experience than your common or garden outreach worker or drugs worker). So, knowing that there is no rescue (and when it comes to DD clients most of us would like to be rescued from what seems an impossible task) it’s time to steel yourself for this extra work you will be doing. Get good supervision in place, you will need it. If it isn’t forthcoming, find it – the most important thing is that you don’t burn out, so do what you have to do (in dialogue with your line manager), take breaks if you need to, go for coffee with colleagues, anything that works. The client needs a consistent worker and for the time being just accept that that worker is you.

2. Know what you are talking about. The DD label is bandied around a lot. But let’s be clear that we are dealing with two different categories: (1) Clients that have formal diagnoses who also use substances, and (2) Clients who use drugs who just seem that extra bit difficult to work with because their baseline mental capacities (though there is no easy way of judging this) seem more inhibited or affected than their peers. The former tend not to worry us too much, the care pathways seem fairly clear, the latter are the real meat of our anxiety as workers. Be careful not to overuse the term dual diagnosis or knowingly equivocate between lower level DD and more concerning DD. If your substance using client has mental health issues but your capacity to communicate with them and their capacity to understand and relate to the world seems by and large intact then only in certain clear circumstances is it useful to employ the term DD. We could quite easily make the point that all substance misusers have mental health issues but that won’t help us. Save the term DD for clients that illicit genuine concern, for whom the prognosis seems particularly bleak and your capacity to communicate effectively with them is genuinely hampered.

3. Know what matters. If you are working to get additional support for your client from psychiatric services then what matters is not what your client feels or even their level of distress. Of course these things are deeply important (obviously to your client) but what matters when making assessments of need is what your client is prevented from doing because of their mental illness. Mental illness is a barrier and you should be clear about what it is a barrier to. It is one thing to say a client is schizophrenic, but much more powerful to be able to say that the client’s schizophrenia means they are unable to feed themselves, or care for themselves – these are the things that count in mental health assessments. Someone can be unwell but be judged to be coping, no noticeable deterioration in their circumstances over a given period, whilst the most concerning clients will stop being able to look after themselves. If you are making a referral to psychiatric services this is what you must be able to detail.

Continue reading ‘Pointers on Working With Dual Diagnosis’ »

2009 is a critical year. Promised economic recovery and healthcare reform legislation are opportunities for meaningful financial commitments to mental health and addictions services and mental healthcare organizations are offering a practical actionable agenda:

- The integration of primary care services in behavioral health settings: The Healthcare Collaborative Project brings together behavioral health and primary care organizations offering a bi-directional approach for care. The need for behavioral health services in primary care is widely accepted. But the integration of primary care services in behavioral health settings remains controversial despite the fact that individuals with serious mental illness appear to have the worst mortality rates in the public health system. Therefore, mental healthcare organizations are actively pursuing single points of accountability to enhance continuity of care for this underserved population.

- Cost-based-plus financing that supports service excellence: People want and deserve quality services but quality services depend on skilled staff. Low salaries have created – and are perpetuating – a recruitment, retention, and quality crisis for behavioral healthcare. We need a workforce of skilled staff delivering nationally recognized practices within organizations that live by the rule “If you don?t measure it, you can?t improve it.”For mental healthcare organizations, healthcare reform is an opportunity to bring “parity” to public mental health services by ending the second class status of community mental health and addiction providers in America?s safety net.

Continue reading ‘Economic Recovery and Healthcare Reform – Opportunities for Mental Health and Addictions’ »

Anger is a perfectly normal emotion. We feel angry when we have been hurt physically or emotionally, have been wronged by someone or when we feel really frustrated. Anger is a normal human expression in response to an event or person.

We all have been angry at some time or another. Like of our other emotions: love, sadness, happiness, desire, pride and fear; we can experience anger at different levels of intensity, depending on the experience that triggered the emotion.

Continue reading ‘Anger is a Normal Emotion, but Sometimes Needs to be Controlled’ »

It is rare when someone can achieve anxiety mental health without knowing how to manage this natural feeling of worry and/or nervous tension. Notice I didn’t say eliminate, since anxiety is part of our genetic makeup which has allowed human beings to survive for thousands of years. This uncomfortable defense mechanism is known as our fight or flight mechanism.

When fight or flight occurs our bodies are flooded with hormones such as adrenaline which are produced in our endocrine glands leading to a narrowing of focus, breathing to shallow, heart rate to increase, sweating to occur, and so on and so forth. So from a pure physiological perspective a couple of ways to achieve anxiety mental health are to either burn off those excess hormones or figure out a way to deflect the nervous tension in a way that cuts the flight or flight response short, before it really has a chance to do any serious damage. Continue reading ‘Five Simple Steps For Achieving Anxiety Mental Health’ »

Today, the trend is to remain sexually active as long as possible because sexual pleasure contributes to both physical and mental health.

Research indicates that many men face erectile dysfunction as they grow older. This is because of lowered testosterone levels, as well as cardiovascular disease, diabetes, and prostrate issues. Smoking, lack of exercise, and stress are other contributory factors.

Similarly, women face lowered sexual desire and lubrication problems as they age. They often require increased sexual stimulation to get aroused. Both older men and women find it embarrassing to discuss sexual issues with their doctor. Therefore, they can simply make some changes to their sexual routine for better sex without much effort. Continue reading ‘Forget Old Age Sex Woes With Natural Sex Enhancement’ »

Hans Eysenck, a Brit born in Germany in 1916, may not be one of the more widely known personality theorists; however, he was one of the finest. And his work is important to panic attack sufferers.

Eysenck believed temperament, a characteristic mode of emotional response, is the featured component of personality. And he believed it was up and running at birth. Now, that isn’t to say he didn’t believe in the influence of environment, it’s just that he reasoned nature, as opposed to nurture, merited top billing with regard to how we think, feel, and behave.

Now, in his PEN (Psychoticism, Extraversion, Neuroticism) model, Eysenck submitted there are three dimensions of temperament; what he called “superfactors.” Within the context of panic, I’d like to limit our chat to neuroticism and extraversion.

Neuroticism
People that fall into this dimension are generally fairly calm to very nervous. According to Eysenck, these folks are prone to what he called “neurotic” problems, issues of a mental or emotional nature that result in stress. Interestingly enough, Uncle Hans focused upon the sympathetic nervous system. Well, panic sufferers know this system well, as under the direction of our fear and emotion circuitry, the sympathetic nervous system launches our physical fight/flight response. According to Eysenck, neuroticism involves, shall we say, a “hyperactive” sympathetic nervous system.

Continue reading ‘Panic Attacks, Temperament, and Uncle Hans: It's a Matter of Engineering?’ »