Chronic Fatigue Syndrom: Addiction to Worry

Carole started counseling with me because she was depressed. She had been ill with chronic fatigue syndrome for a long time and believed her depression was due to this. In the course of our work together, she became aware that her depression was actually coming from her negative thinking - Carole was a constant worrier. Many words out of her mouth centered on her concerns that something bad might happen. "What if I never get well?" "What if my husband gets sick?" "What if I run out of money?" (Carole and her husband ran a very successful business and there was no indication that it would not go on being successful). "What if my son gets into drugs?" "What if my kids don't get into good colleges?" "What if someone breaks into the house?"
Her worry was not only causing her depression, but was also contributing to her illness, if not actually causing it. Her worry caused so much stress in her body that her immune system could not do its job of keeping her well. Yet even the awareness that her worry was causing her depression and possibly even her illness did not stop Carole from worrying. She was addicted to it. She was unconsciously addicted to the sense of control that worry gave her.
I understood this well because I come from a long line of worriers. My grandmother's whole life was about worrying. She lived with us as I was growing up and I don't remember ever seeing her without a look of worry on her face. Same with my mother constant worry. Of course, I picked up on it and also became a worrier. However, unlike my mother and grandmother, who worried daily until the day they died, I decided I didn't want to live that way. The turning point came for me the day my husband and I were going to the beach and I started to worry that the house would burn down and my children would die. I became so upset from the worry that we had to turn around and come home. I knew then that I had to do something about it.
As I started to examine the cause of worry, I realized that worriers believe that worry will stop bad things from happening. My mother worried her whole life and none of the bad things she worried about ever happened. She concluded that nothing bad happened because she worried! She really believed that she could control things with her worry. My father, however, never worried about anything, and nothing bad ever happened to him either. My mother believed that nothing bad happened to my father because of her worry! She really believed until the day she died (from heart problems that may have been due to her constant worry) that if she stopped worrying, everything would fall apart. My father is still alive at 92, even without her worrying about him!
It is not easy to stop worrying when you have been practicing worrying for most of your life. In order for me to stop worrying, I needed to recognize that the belief that worry has control over outcomes is a complete illusion. I needed to see that, not only is worry a waste of time, but that it can have grave negative consequences on health and well-being. Once I understood this, I was able to notice the stomach clenching that occurred whenever I worried and stop the thought that was causing the stress.
Carole is in the process of learning this. She sees that her worry makes her feel very anxious and depressed. She sees that when she doesn't worry, she is not nearly as fatigued as when she allows her addiction to worry to take over. She sees that when she stays in the moment rather than projecting into the future, she feels much better. The key for Carole in stopping worrying is in accepting that worry does not give her control.
Giving up the illusion of control that worry gives us not easy for anyone who worries. Yet there is an interesting paradox regarding worry. I have found that when I am in the present moment, I have a much better chance of making choices that support my highest good than when I'm stuck thinking about the future. Rather than giving us control, worry prevents us from being present enough to make loving choices for others and ourselves. Worrying actually ends up giving us less control rather than more.

Georgia Ranks 11th In Depression

According to a national report recently issued by Mental Health America, Georgia ranks 11th in terms of depression, and 19th in suicide rates. %26quot;Ranking the States: An Analysis of Depression Across the States,%26quot; provides a snapshot of the level of depression, from the healthiest states to the least, in addition to suicide rankings. Among factors contributing to state rankings is availability of and access to mental health services. Depression affects more than 21 million children and adults annually and is the leading cause of disability in the United States for people 15-44. In Georgia, depression is the principal cause of roughly 900 suicides each year.
%26quot;This report provides important understanding on how we compare to the rest of the country,%26quot; said Gwen Skinner, Director for the Georgia Division of Mental Health, Developmental Disabilities and Addictive Diseases. %26quot;We will continue to build on our strengths and make necessary improvements.%26quot;
Over the last few years, Georgians with mental illness have benefitted from a 62% increase in community-based services. In addition, crisis stabilization services for adults with mental illness have increased by 30%, and Georgia is building first ever crisis stabilization beds for children and adolescents.
"Ranking the States: An Analysis of Depression Across the States" relied on four different measures to rank states including: the percentage of the adult population experiencing at least one major depressive episode in the past year; the percentage of the adolescent population (ages 12 to17) experiencing at least one major depressive episode in the past year; the percentage of the adult population experiencing serious psychological distress; and the average number of day is in the past 30 days in which the population reported that their mental health was not good.

Antidepressants Can Negatively Affect Driving Skills

People taking anti-depressants for managing depression have significantly lowered driving skills.

A team of researchers from the North Dakota University examined 60 people and gave them common driving tests to see how they can react to common driving events such as brake lights, stop signs and traffic signals. The tests were aimed at checking steering, concentration and scanning.
Participants were divided into two groups with 31 people taking at least one common depression treatment drug and with 29 people taking absolutely no drugs, with the exclusion of some of them taking oral contraceptives. Those taking drugs were also divided into two groups - patients taking high and low doses of antidepressants.
Researchers concluded, that those drivers who were not taking antidepressant drugs scored 69 points. Those drivers who were taking low doses of antidepressants scored 65 points, and those on high doses of depression treatment drugs scored 54 points.
This shows a clear evidence that depression drugs weaken driving skills.
Researchers urge more and larger scale studies to understand if it is the drugs or the health condition itself affecting concentration. Both are suspected to weaken driving skills, but it is important to better understand the situation and make sure that drivers are healthy and do not cause harm for themselves and for others.
However, there may be a lot of cases when drivers will not qualify as 'not able to drive', but they may feel discomfort and experience lack of concentration. This is why Driver and Vehicle Licensing Agency recommends - everyone who feels that his driving skills are somehow weakened because of a medical condition, must contact DVLA.

Maintenance Treatment Crucial For Teens’ Recovery From Depression

Long-term maintenance treatment is likely to sustain improvement and prevent recurrence among adolescents with major depression, according to an NIMH-funded study published in the April 2008 issue of the Archives of General Psychiatry.
The study, led by Paul Rohde, Ph.D., of Oregon Research Institute, analyzed data from the Treatment of Adolescents with Depression Study (TADS), a large, NIMH-funded trial in which depressed teens were randomized to one of three treatments for 36 weeks–fluoxetine (Prozac), cognitive behavior therapy (CBT) or a combination of both.
Teens with depression, even if they show a good initial response to treatment, are at high risk for relapse and recurrence. However, guidelines for depression maintenance treatment are based on adult needs. Rohde and colleagues aimed to identify whether the available guidelines are appropriate for depressed adolescents.
Among the 242 TADS participants analyzed for this study, 61 percent significantly improved by week 12. The combination group achieved the highest rate of sustained response (71 percent) compared to the fluoxetine-only group (68 percent) and CBT-only group (42 percent).
The majority (82 percent) of teens who reached a sustained positive response by week 12 maintained this level of recovery through week 36. Among those in combination treatment, about 89 percent maintained improvement for the full 36 weeks. Among those in the fluoxetine-only group, 74 percent maintained improvement, but among those in CBT-only treatment, 97 percent maintained their improvement.
The high long-term success rate of CBT suggests that for teens who initially respond to it, CBT may have a preventive effect that helps to sustain positive improvement and potentially avoid relapse or recurrence, even if treatment visits become infrequent, as was the case after the first 12 weeks in the TADS study. Additionally, the relatively lower sustained success rate for fluoxetine suggests that the effectiveness of fluoxetine therapy may plateau at a certain point for some responders, triggering a need for the addition of psychosocial treatment.
“For those teens who respond to fluoxetine only, adding CBT to their treatment regimen early on would likely increase their chances for continued improvement,” suggested Rohde.
The findings help guide clinicians in deciding on the best maintenance course after a teen responds to an initial treatment. They also emphasize the value of ongoing, long-term treatment, even if treatment visits are infrequent, Rohde and colleagues concluded.

Latuda is Approved by FDA to Treat Schizophrenia

Administration approved Latuda (lurasidone HCl) tablets for the treatment of adults with schizophrenia.
Latuda, an atypical antipsychotic, will be available as once-daily tablet. The drug is expected to be available in the U.S. during the first quarter of 2011.
Schizophrenia is a chronic, disabling and serious brain disorder that affects approximately 2.4 million American adults or 1 in 100 people.
Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms usually start between ages 16 and 30. Most of the time, people do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of childhood-onset schizophrenia is increasing.
The most prominent symptoms include hallucinations, delusions, disordered thinking and behavior, and suspiciousness. Hearing voices that other people don't hear is the most common type of hallucination. These experiences can make people with the disorder fearful and withdrawn.
“Schizophrenia can be a devastating illness requiring lifelong treatment,” said Thomas Laughren, M.D., director of the Division of Psychiatry Products in the FDA's Center for Drug Evaluation and Research. “Some patients do not respond well to certain types of drug therapy, so it is important to have multiple treatment options available.”
The causes of schizophrenia are still unknown, so treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments.
Four six-week controlled studies of adults with schizophrenia demonstrated the effectiveness and safety of Latuda. In the trials, patients treated with Latuda had fewer symptoms of schizophrenia than those taking an inactive pill (placebo).
The most common adverse reactions reported by those in clinical trials were drowsiness, feelings of restlessness and the urge to move (akathisia), nausea, movement abnormalities such as tremors, slow movement, or muscle stiffness (Parkinsonism), and agitation.
Other atypical antipsychotics include risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify), and paliperidone (Invega).
Latuda, as with all other atypical antipsychotics, will have a boxed warning alerting prescribers to an increased risk of death associated with off-label use of these drugs to treat behavioral problems in older people with dementia-related psychosis. No drug in this class is approved to treat patients with dementia-related psychosis.