july 11 2005
High-Tech Hypercondriac Machine
Paranoia can strike the heart of the best of families, which is why I say it's best not to leave your house, eat only foodstuff you've made yourself, and never - ever - watch the news! On sale in Tokyo from today, this high-tech phobia machine comes with a blood pressure monitor, computer software for health management and tracking of the main vital statistics, and a wireless connection kit which transmits the readings from your blood pressure monitor to your PC. Does it matter how the device costs? We're all gonna die anyway!
July 8 2005
All of us have psychological fears called phobia. What makes phobias totally different from ordinary fears is that these are marked by truly intense and often indescribable anxiety. Some have fears of enclosed areas called claustrophobia. Others have fears of water called hydrophobia (don't you wonder how these people take a bath or drink water?). There are so many phobias that exist in human beings that there are not enough words by which to label them.
I have a phobia for heights. I was once told that the scientific name for this type of phobia is called acrophobia. I however think that the word "height-o-phobia" is more appropriate. And this phobia is not a rare one either, which makes it rather common until...
One is invited by environmentalists to scale the heights of a mountain. And by no means just any mountain, but the highest peak in the country--the majestic Mt. Apo!
A few years before I had decided to finally move to Davao City, I had been traveling to this city of blooms to work with real environmentalists. While I am one who is sincerely concerned with the state and fate of our environment, I cannot say that I am a diehard environmentalist's environmentalist.
But I loved working with these gentle people, not only because I was able to travel to Davao often, but because it fascinated me to witness their passion for the preservation, conservation and development of the environment. Such passion I can empathize with!
Unaware of my debilitating height-o-phobia (I cannot even scale the stairway to the third floor of SM Davao without palpitating and profusely sweating), these friends invited me to climb Mt. Apo with them. And stupid boastful me accepted the invitation with aplomb.
Getting to the foot of the mountain was no big deal. One would not even be aware of climbing. It was more of trekking with friends. Carrying backpacks was no big deal either. A climber of the female gender (and from Manila, to boot!), such as myself, were given preferential treatment. There were local guides to carry most everything I had on my back, except for my shirt.
I recall one of the environmentalists bringing a bottle or two of red wine, with (take note) matching wine glasses. On the first night, some five of us lay on top of this huge boulder, watching the stars pop out of the sky, one by one-- until there were more stars in the dark canvas of a sky than there was sky. Then we opened the wine bottle and paid tribute to the gods who created such glorious wonders on earth!
By Sandy Gi
July 7 2005
Detecting a phobia
Tony Shalhoub has spent so much time in Monk's head that the obsessive-compulsive detective has gotten into the actor's head. "I never had a problem shaking hands," Shalhoub said. "Now I do."
As the USA series enters its fourth season, it hasn't quite gotten to the stage where Shalhoub whips out a tissue to wipe his hands after shaking someone else's, Shalhoub said. "But I do have the ugly thoughts."
Monk's ugly thoughts, a product of every conceivable phobia, make for some of the most beautifully unconventional detective work this side of Columbo.
Not only is Monk one of the most successful series in basic-cable history, but also the character has become a folk hero to people afflicted with OCD. "People who have this problem have taken him as their hero," Shalhoub said. "He has de-stigmatized the illness."
This hasn't prevented less sensitive souls from making sport of Adrian Monk's demons. "People have made drinking games out of Monk's phobias," Shalhoub said. "I've heard some fans talk about having Monk moments or Monking out."
Monk moments again will be doled out in two blocks: nine episodes this summer, seven more during the winter. The split season annoys some, since the show seems to have just arrived when it disappears again. Shalhoub has heard the complaints but says these viewers fail to see the bright side. "They don't have to wait so long between seasons."
The fourth season gets off to a rousing start with Monk seemingly meeting his match, a disheveled loser of a private eye with an uncanny knack for uncovering clues. Jason Alexander, doing his finest work since Seinfeld, plays Monk's rival.
Before the season is out, Shalhoub said, fans will be provided insights into what made Monk the person he is. "We'll get a glimpse of Monk in junior high and see him with his mother. There will be a glimpse of that dynamic. There also will be a lot revealed about Monk's father and a peek into the relationship of Adrian and [his brother] Ambrose."
What there won't be is any romance between Monk and his new assistant Natalie, played by Traylor Howard. "We've talked about it," Shalhoub said. "I won't rule anything out but I think it's better to keep a certain amount of tension between Monk and Natalie." For the time being, Shalhoub said, it's more interesting to have both of them insinuating themselves into one another's personal life.
The one thing Shalhoub remains less than forthcoming about is the true Hollywood story about what led to the departure of Bitty Schram, who played Monk's original assistant, Sharona Fleming. One version had Schram wanting her part enhanced. Another had Shalhoub unhappy that Schram had already become too big a presence.
Shalhoub hinted it was more the former. He complimented Schram for doing a great job, then said she had become disenchanted with her place in the series. Of course, that's his side of the story. Schram has yet to tell hers.
So what really happened remains a mystery. Alas, it's one even a crack detective like Monk wants no part of.
c Tom Jicha
Tom Jicha can be reached at firstname.lastname@example.org
March 22 2005
HIV phobia linked to misinformation
A combination of factors has lead to a decline in the number of blood donors in Africa. Religious and cultural issues have long played a large role in impeding donations. Some people have chosen not to donate because they fear their blood will help criminals, while others fear donation will make them weak. The National Blood Transfusion Centre of Africa has discovered that donors' fear of discovering their HIV status is a factor that has lead to a recent blood shortage. Public education regarding the importance of blood donation has been poor, and officials hope to improve this with better management of The National Blood Transfusion Center.
March 18 2005
Tricyclic antidepressants are a class of antidepressant drugs first used in the 1950s. They are named after the drugs' molecular structure, which contains three rings of atoms (compare tetracyclic antidepressant). The term 'tricyclic antidepressant' is sometimes abbreviated to TCA.
Most tricylic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. They are not considered addictive and have many fewer side-effects and restrictions than the MAOIs. For many years they were the first choice for pharmacological treatment of depression. Although they remain effective, they have been increasingly replaced by SSRIs and other newer drugs. These newer antidepressants are thought to have fewer side effects and are also thought to be less effective if used in a suicide attempt, as the treatment and lethal doses are much further apart than with the tricyclic antidepressants.
side effects tricyclic antipressants – clomipramine
The side effects of tricyclic antidepressant may include drowsiness, anxiety, restlessness, dry mouth, constipation, urinary retention or difficulty with urination, cognitive and memory difficulties, weight gain, sweating, dizziness, decrease in sexual ability and desire, muscle twitches, weakness, nausea, increased heart rate and irregular heart rhythms (rare). Some of these side effects relate to their anticholinergic properties.
It is worth noting that many people suffer few, if any, side effects from taking tricyclic antidepressants. However, as with any medication, it is always worth reporting any problems you encounter to your health care provider.
March 15 2005
High-Intensity Exercise Best Way To Reduce Anxiety
University Of Missouri Study Finds
COLUMBIA, Mo Cardiovascular disease is the leading cause of death in the United States. The amount of stress and anxiety a person experiences is a major factor in cardiovascular disease. For the past three decades experts have vacillated in their recommendations concerning the amount and intensity of exercise required to alleviate stress and anxiety.
Recently, most experts have agreed that a moderate to low amount of regular exercise can ease personal tension and stress. However, a new study by researchers at the University of Missouri-Columbia shows that a relatively high-intensity exercise is superior in reducing stress and anxiety that may lead to heart disease. Moreover, the researchers found that high-intensity exercise especially benefits women.
Conventional wisdom says that exercising for 30 minutes at a moderate exercise intensity is more effective in reducing anxiety than either a low or high intensity dose, said Richard Cox, professor of educational and counseling psychology and leader of the study. This conclusion, however, is deceptively simple because reductions in anxiety are not always observed immediately following a high intensity bout of exercise.?
In the study, female participants, ages 18 to 20 and 35 to 45, completed three experimental sessions. Each session started with a test to determine the anxiety level of the participant. Following the test, the women either did not exercise (control condition) or exercised at a moderate or high-intensity level for 33 minutes. After the session, Cox measured anxiety levels at 5, 30, 60 and 90 minutes post-exercise.
Although all three exercise conditions, including the control condition, showed a decline in anxiety over time, Cox found the high-intensity level experienced the sharpest decline. Cox said the intensity of exercise conditions did not differ in anxiety levels at baseline or immediately after exercise, but a difference favoring the high intensity level emerged at 30, 60 and 90 minutes post-exercise.
Results also showed that when the iron status of the women was taken into consideration, the beneficial effect of high-intensity exercise was greater for the older women.
This is a relationship that needs to be further explored, Cox said. It appears to suggest that after controlling for iron status, the beneficial effects of exercise on anxiety may only apply to older women and not to younger women.
Cox believes this study, which is scheduled for publication in the Research Quarterly for Exercise and Sport, will prove beneficial to medical practitioners in the fight against heart disease.
March 15 2005:
Specific Phobia SYMPTOMS
Many people experience specific phobias, intense, irrational fears of certain things or situations--dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren't just extreme fear; they are irrational fear. You may be able to ski the world's tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
Specific phobias strike more than 1 in 10 people. No one knows just what causes them, though they seem to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias; only about 20 percent of adult phobias vanish on their own. When children have specific phobias--for example, a fear of animals--those fears usually disappear over time, though they may continue into adulthood. No one knows why they hang on in some people and disappear in others.
Specific Phobia Symptoms:
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack.
Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.
The person recognizes that the fear is excessive or unreasonable.
Note: In children, this feature may be absent.
The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
In individuals under age 18 years, the duration is at least 6 months.
The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879 (1995)
March 14 2005
Specific Symptoms of Social Phobia:
A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing.
Note: In children, there must be evidence of the capacity for age-appropriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults.
Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pred
isposed Panic Attack.
Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or shrinking from social situations with unfamiliar people.
The person recognizes that the fear is excessive or unreasonable.
Note: In children, this feature may be absent.
The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
In individuals under age 18 years, the duration is at least 6 months.
The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder.
If a general medical condition or another mental disorder is present, the fear in the first criteria is unrelated to it, e.g., the fear is not of Stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa.
American Psychiatric Association. (. Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.
National Institutes of Health, National Institute of Mental Health, NIH Publication No. 95-3879
March 11 2005
Specific Phobia- American Description
(Formerly Simple Phobia)
A. Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).
B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. Note: In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.
C. The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent.
D. The phobic situation(s) is avoided or else is endured with intense anxiety or distress.
E. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder, such as Obsessive-Compulsive Disorder (e.g., fear of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), Separation Anxiety Disorder (e.g., avoidance of school), Social Phobia (e.g., avoidance of social situations because of fear of embarrassment), Panic Disorder With Agoraphobia, or Agoraphobia Without History of Panic Disorder.
• Animal Type
• Natural Environment Type (e.g., heights, storms, water)
• Blood-Injection-Injury Type
• Situational Type (e.g., airplanes, elevators, enclosed places)
• Other Type (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting an illness; in children, avoidance of loud sounds or costumed characters)
copyright © 1995-2005 by Phillip W. Long, M.D.
March 8 2005
Facts about Social Phobia
Social phobia, also called social anxiety, is a disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work or school—and other ordinary activities. While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation.
Social phobia can be limited to only one type of situation—such as a fear of speaking in formal or informal situations, or eating or drinking in front of others—or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people. Social phobia can be very debilitating—it may even keep people from going to work or school on some days. Many people with this illness have a hard time making and keeping friends.
Physical symptoms often accompany the intense anxiety of social phobia and include blushing, profuse sweating, trembling, and other symptoms of anxiety, including difficulty talking and nausea or other stomach discomfort. These visible symptoms heighten the fear of disapproval and the symptoms themselves can become an additional focus of fear. Fear of symptoms can create a vicious cycle: as people with social phobia worry about experiencing the symptoms, the greater their chances of developing the symptoms. Social phobia often runs in families and may be accompanied by depression or alcohol dependence.
How Common Is Social Phobia?
• About 3.7 percent of the U.S. population ages 18 to 54—approximately 5.3 million Americans—has social phobia in any given year.
• Social phobia occurs in women twice as often as in men, although a higher proportion of men seeks help for this disorder.
• The disorder typically begins in childhood or early adolescence and rarely develops after age 25.
What Causes Social Phobia?
Research to define causes of social phobia is ongoing.
• Some investigations implicate a small structure in the brain called the amygdala in the symptoms of social phobia. The amygdala is believed to be a central site in the brain that controls fear responses.
• Animal studies are adding to the evidence that suggests social phobia can be inherited. In fact, researchers supported by the National Institute of Mental Health (NIMH) recently identified the site of a gene in mice that affects learned fearfulness.
• One line of research is investigating a biochemical basis for the disorder. Scientists are exploring the idea that heightened sensitivity to disapproval may be physiologically or hormonally based.
• Other researchers are investigating the environment's influence on the development of social phobia. People with social phobia may acquire their fear from observing the behavior and consequences of others, a process called observational learning or social modeling.
What Treatments Are Available for Social Phobia?
Research supported by NIMH and by industry has shown that there are two effective forms of treatment available for social phobia: certain medications and a specific form of short-term psychotherapy called cognitive-behavioral therapy. Medications include antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as well as drugs known as high-potency benzodiazepenes. Some people with a form of social phobia called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure.
Cognitive-behavior therapy is also very useful in treating social phobia. The central component of this treatment is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. The exposure process often involves three stages. The first involves introducing people to the feared situation. The second level is to increase the risk for disapproval in that situation so people build confidence that they can handle rejection or criticism. The third stage involves teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.
Cognitive-behavior therapy for social phobia also includes anxiety management training—for example, teaching people techniques such as deep breathing to control their levels of anxiety. Another important aspect of treatment is called cognitive restructuring, which involves helping individuals identify their misjudgments and develop more realistic expectations of the likelihood of danger in social situations.
Supportive therapy such as group therapy, or couples or family therapy to educate significant others about the disorder, is also helpful. Sometimes people with social phobia also benefit from social skills training.
What Other Illnesses Co-Occur With Social Phobia?
Social phobia can cause lowered self-esteem and depression. To try to reduce their anxiety and alleviate depression, people with social phobia may use alcohol or other drugs, which can lead to addiction. Some people with social phobia may also have other anxiety disorders, such as panic disorder and obsessive-compulsive disorder.
Publication No. OM-99 4171 (Revised)
Printed September 1999
Copyright National Institute of Mental Health
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