Category: Anxiety

Articles about Anxiety from Lori Calabrese, M.D. | The Ketamine Blog

When you feel that sense of dread or uneasiness about something in the present or in the future, that’s anxiety. Everybody feels that way at some point. An interview for a job, meeting your fiancee’s family, a major exam…. But for some people, the unpleasant dread can be overly intense and ongoing. When it’s so intense that it interferes with your life, causing you to miss work, or miss social opportunities…  then it may be a disorder. These articles about anxiety shed light on the difference between moments of anxiety, and a lifetime with a severe, debilitating disorder.
Anxiety can be as mild as a transient feeling of butterflies, or so intense and overpowering you think you’re having a heart attack so you call 911.

Types of anxiety disorders:

1. Social anxiety

is the overpowering and relentless fear of being watched and judged by others. It can cause you to feel afraid to meet new people, to believe everyone in the room is talking about you, and to feel intensely self conscious in the presence of others. This is a serious mental health condition that can prevent you from interviewing for jobs or excelling at the one you have, or from meeting new people and building relationships.

2. Postpartum anxiety

This is emerging as a serious disorder in woman, at least as prevalent as postpartum depression. It can express symptoms like panic, fear of harming the baby, poor bonding with baby, obsessive worrying, inability to eat, sleep, or relax. Also, it can include the obsessive fear the panic will never resolve.

3. General anxiety disorder

obsessive and continuous worry about one’s health, work, social contacts and interactions, as well as daily routine circumstances and experiences…that repeat almost every day for at least six months.

4. Panic Disorder

Characterized by repeated and overwhelming panic attacks with accelerated pounding heart rate, sweating, trembling, shortness of breath, and feelings of impending doom. Often brought on by triggers, but not always. The attacks lead to a fear of the attacks, and a driving desire to avoid them, which can often lead to agoraphobia.

5. Test anxiety

Irrational dread of testing in spite of being well prepared. The anxiety can rise until the person’s displaying symptoms of panic like accelerated heart rate, headache, nausea and sweating. Can result in the mind going blank, and general functioning shuts down.

6. Phobia-related disorder

Agoraphobia – fear of enclosed public spaces, fear of open spaces
Arachnophobia – fear of spiders
Acrophobia – fear of heights
Dentophobia – fear of dentists
Claustrophobia – fear of enclosed, confined spaces
Aerophobia – fear of flying
Aquaphobia – fear of water
Zoophobia – fear of animals
Coulrophobia – fear of clowns – (not officially recognized but widely claimed)

7. Separation anxiety

Occurs in children and adults, and expresses as fear of being apart from people to whom they’re attached. They often worry that something terrible will happen to the person they’re connected to, and so avoid separation from that person as well as avoid being alone.

8. Selective mutism

A rare disorder in both children and adults where people don’t speak in specific situations, even though they have well developed language skills. It’s often associated with extreme shyness and fear of social embarrassment, and usually begins before the age of five.

9. Obsessive -Compulsive Disorder (OCD)

Considered to be connected to anxiety disorders, but there is controversy as to whether it belongs here. At the very least, that person who suffers from OCD has feelings of anxiety and usually feels powerless to control the intrusive thoughts they have, or their reaction to them.
This is not an exhaustive list, but rather examples of anxiety disorders.

Treatment of Anxiety Disorders

Some people suffer from a cluster of anxiety disorders and mood disorders combined, while some struggle with only one.  Since anxiety disorders are best treated for the specific diagnosis, the more complex a person’s condition is, the more complex it may be to treat.

Transcranial Magnetic Stimulation (TMS)

demonstrates promising outcomes for some types of anxiety.  Cognitive behavioral therapy shows the most promising outcomes as a form of psychotherapy. Psychotherapy combined with anxiolytic medicines, serotonin reuptake inhibitors (SRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) can be helpful, as well.

IV ketamine treatment has demonstrated favorable outcomes in some patients with some types of anxiety. Social anxiety can be debilitating and interfere with the desire to build life, family, and career. Ketamine treatment is one of the most effective treatments for social anxiety. There is exciting work being done with OCD patients and ketamine treatment also.
We invite you to continue reading the following articles about anxiety by Lori Calabrese, M.D.

  • Attitude of Gratitude: How to Rise Above Tragedy

    Attitude of Gratitude: How to Rise Above Tragedy

    Grateful woman with arms upraised, overcoming tragedy with attitude of gratitude

    WHAT DOES GRATITUDE HAVE TO DO WITH HAPPINESS?

    We’ve been talking about the science of happiness. The things researchers have been learning about what actually make us happy, as well as what doesn’t make us as happy as we think they will.

    The funny thing about happiness is that it’s sort of counter-intuitive. For instance, if we only think of ourselves and what we want, we begin to sink, and grow less and less happy.

    Even if we get EVERYTHING we want! The richest men in the history of humanity who were focused on accumulating for themselves and got everything they wanted…were usually miserable. The ancient king Nebuchadnezzar, for one. And Howard Hughes might be another example.

    SELFISHNESS HURTS

    Another dramatic example is King Solomon, who lived around 970 BC. He had it all…wealth, fame, and 700 wives. But… he was miserable. The more he gathered for himself, the more miserable he became. (Since building a healthy relationship with one spouse is pretty challenging already, it’s probably not that surprising he was overwhelmed and stressed out trying to do it with 700!)

    Solomon wrote three books in his lifetime, and the final one was about the misery of trying to make yourself happy by getting everything want.

    GIVING FREELY COMPOUNDS JOY

    On the other hand, men who used their wealth and power to improve the lives of people, and make the world a better place, have often been much happier. Men like John D. Rockefeller, who began giving 6% of his paycheck to charity at the age of 16, and lived his life not only building his wealth, but also perfecting systems of giving his money away to improve the lives of others. He has often been called the wealthiest man in the world, but he was also one of the most generous. John enjoyed his wife and family–a strong pillar of happiness.

    But then there was also his contemporary, Andrew Carnegie, who may really have been the wealthiest with the equivalent of $374 billion. In addition to building his massive steel company, he spent the last 20 years of his life traveling to see friends, and helping others. Mr. Carnegie enjoyed his visits with friends like Mark Twain, Teddy Roosevelt, and so many others. He had humility, and valued his friendships.

    These are just two examples of generous wealthy men who found happiness in giving and valuing their relationships. But it’s not hard to think of more from early times to the present. Genghis Kahn for instance (huge surprise!) and of course Bill Gates, among a host of others.

    GENEROSITY AND AN ATTITUDE OF GRATITUDE

    The fact stands that it’s not wealth that brings happiness, but generosity, strong relationships, and a passion for something.

    So…we talked about in our post last week about the science of happiness, we learned that it isn’t getting that brings us joy, but giving. Not taking advantage of someone else to our own ends, but serving and caring for the welfare of others.

    A huge study that included 200,000 people in 136 countries found that being generous had a positive effect on a person’s happiness in 93% of the countries involved. Another study conducted at Notre Dame found that the more people gave of themselves and their money, the happier they were.

    As humans, we need to have something bigger than ourselves to live for.

    We humans actually like to sacrifice for the good of others. How’s that for a surprise…?!

    Another pretty important factor is having an attitude of gratitude.  Rather than taking credit for everything we accomplish, and for all the good in our lives, we’re happier putting humility to work and expressing our gratefulness for the good in our lives and the potential for good even in the toughest situations. 

    Is that because we know we don’t have power to control everything?

    [Because if we think we can, the burden of controlling all things in the world around us to ensure safety, prosperity, friendship, and happiness, is a big truckload to pull around…but let’s save that for a future post.]

    SILVER LININGS

    The beauty of gratitude is that it acknowledges we can’t do it all ourselves. It also says that there’s good to be found in every circumstance of life, no matter what it is. By choosing to be grateful in a difficult circumstance, we open the door to solutions.

    There’s a man who is a world-class expert at finding silver linings. An expert at choosing gratitude.

    His name is Jon Morrow, and if you haven’t learned about him or met him up till now, you may want to connect with him before you forget.

    Jon was born with muscular dystrophy, and is unable to move anything but his lips and his eyes.

    Yes, he’s paralyzed. He can’t move any other part of his body. But he’s not numb. He feels pain just like you do. In fact, pain and struggle is part of every single day of his life.

    And yet, you know what? He’s developed, through decades of suffering, an overcoming approach to every challenge. He looks for the silver lining no matter how bad the circumstances, and he always determines to turn every difficulty into something in his favor.

    GRATITUDE EXPERT

    He’s grateful. Grateful for his life. He admits it’s not been an easy way to live, but he also knows if it had all been easy for him, he might have done nothing with his life.Person holds a beautiful flower in both palms showing that even in darkness gratitude for beauty brings happiness

    Ten years ago he was in poverty, in a hospital bed, and completely dependent on Medicaid to support him and his $120,000/year medical bills. He felt trapped. If he earned more than $700/month, Medicaid would drop him. So he couldn’t build a business…because he needed medical care.

    Jon hadn’t found his flow. Remember how in our science of happiness post we talked about how finding your flow motivates you to live with passion and purpose?  Jon hadn’t found his yet…he felt pretty much stuck.

    But, since the rules of Medicaid had him stuck, he set out to change the rules. It took courage, but the flow was beginning to trickle. He invested two years of his life writing for a successful online publication for free, because he couldn’t make more than $700/month anyway. 

    PUT GRATITUDE ON THE OTHER FOOT

    He told the publisher there was one stipulation…he’d write for them awhile for no pay, but eventually there would come a time he’d need some favors in return.

    Now, Jon is a guy who was accepted into MIT…but he couldn’t afford to go. Jon is no slouch, in fact, he’s a pretty sharp guy. So his writing was received with enthusiasm by this organization. This continued until 2 years later, when he was ready to take the next step.

    He told them it was time, and he needed some favors. He needed to move to Mexico where medical care costs far less. (That $120,000 bill per year in the US only cost $18,000 in Mexico!)

    He told them he needed to start a consulting business and asked for help reaching some people through their mailing list to market his services.

    They happily agreed, and in 30 days, this guy had a full-time consulting business that supported him with $10,000 per month. Now, ten years later, he’s a millionaire, and he can live wherever he wants to.

    Now, let’s talk about what makes happiness in light of Jon’s story.

    It’s human nature to feel sorry for ourselves when things don’t go well. We all know that. But Jon Morrow will quickly tell you he may be tempted to feel sorry for himself…but he can’t afford a single second of it without being defeated.

    JON MORROW’S ATTITUDE OF GRATITUDE

    To overcome whatever he’s faced with, he looks for a way to find benefit in his circumstances – to seek out that silver lining – and he looks for ways to make it better than if it had never happened.

    If you’re angry, bitter, or tied in knots of self-pity, you can’t think that way. When all thoughts are turned inward, it’s tough…really tough…to get them turned outward again.

    And like we said before, happiness relies on counter-intuitive responses. Focusing on ourselves snuffs out the joy. But looking for ways to help others, well, that fills us with power.  And happiness.

    I encourage you to read more of Jon Morrow’s writings. He’s learned some profound lessons about happiness, success, and giving of himself through his 34 years of struggle. He’s started a new blog to give back by teaching the world these principles that have brought him so much richness in life.

    So learn from his story the lessons of gratitude and generosity, of finding your flow, and always finding a way to turn every negative circumstance to your favor. When you do, your garden of happiness will be fertilized, nourished, and will grow so full you’ll have to give some of it away.

    And…if your own struggle makes happiness seem beyond reach, schedule an appointment to see if you’re a candidate for innovative psychiatric treatments like  IV ketamine therapy or transcranial magnetic stimulation. We’ll learn so much after a comprehensive evaluation.

    We’re here to help you live a more fulfilling and rewarding life, and look forward to hearing from you.

    To your increasing happiness within your best self,

    Dr. Lori Calabrese, MD

    Lori Calabrese, MD offers innovative psychiatric treatment

  • How Curcumin Relieves Depression

    How Curcumin Relieves Depression

    This woman is enjoying her friends at a dinner party because curcumin alleviated her depression

    In the search for alternatives to help those patients who suffer from treatment-resistant depression, or who can’t tolerate the side effects of some antidepressant medications, a shining star rises — curcumin.

    Curcumin is the potent anti-inflammatory ingredient found in the spice turmeric. The wonderful aromatic spice that makes mustard and curry yellow, turmeric is a delicious ingredient used in Indian and other eastern foods. Its flavorful qualities are second only to its healing characteristics.

    Curcumin Protects Almost Every Part of Your Body

    As a result, it provides anti-inflammatory benefits to nearly every part of the body. A single curcumin molecule possesses anti-inflammatory, antimicrobial, chemotherapeutic,  anti-thrombotic, anti-hepatotoxic, antiparasitic, anti-diabetic, anti-psoriasis, and wound healing properties…but that just scratches the surface.

    Today though, we’re focused on how it can help depression. And that brings into focus its neuroprotective properties…and…that it penetrates the blood-brain barrier carrying its healing properties to the brain. It’s also been discovered through animal studies that curcumin enhances neurogenesis in the adult hippocampus by proliferating the numbers of newly generated cells there. (more…)

  • IV Ketamine Therapy for Postpartum Depression

    IV Ketamine Therapy for Postpartum Depression

    postpartum depression

    Postpartum depression affects 1 in 7 women and can last for months if not treated. The symptoms of pervasive depressed mood, feelings of inadequacy and being overwhelmed are often accompanied by anxiety, irritability, inability to sleep despite exhaustion, inconsistent appetite, and intense isolation and guilt about experiencing these symptoms during what should be a joyful time. Some women have thoughts of harming themselves or intrusive thoughts of intentionally or unintentionally harming the baby.

    Treatment for postpartum depression includes support for the mother and baby, omega 3 fatty acids, bright light therapy, and acupuncture. Data on the effectiveness of these is limited, but some women have found them helpful. Multiple studies have found that postpartum depression responds to psychotherapy and to traditional antidepressant medications. However, psychotherapy can take weeks or months to help ease symptoms; antidepressants often take weeks to work and are transmitted to the baby if the mom is breastfeeding.

    Breastfeeding mothers with postpartum depression often agonize about whether or not to use antidepressants to treat their symptoms because they often don’t want to expose the baby to medication and don’t want to stop nursing in order to take a daily medication.  Yet they need rapid and effective relief–for their own health and the health and development of their babies. Multiple studies show that untreated postpartum depression affects mother-baby interactions and are associated with lower cognitive functioning and adverse emotional development in the baby. In these instances, IV Ketamine Therapy for Postpartum Depression can help.

    Explore IV Ketamine Therapy for Postpartum Depression Safely and Affordably

    If you have postpartum depression or know someone who does, IV ketamine can treat it within hours without requiring that you stop breastfeeding.

    IV ketamine is an extremely rapid, effective treatment for depression and 75-80% of patients respond quickly and dramatically to very low dose IV infusions. Although more research needs to be done, this makes IV ketamine therapy an exciting treatment option for postpartum depression, where getting better quickly is what every mom hopes for, and where restoring the health of the mother positively impacts the whole family.  Mood, negativity, hopelessness, anxiety and distractibility can improve within hours, and hopelessness and suicidal thoughts can evaporate. A series of low dose infusions over about 2 weeks can result in dramatic and complete remission of symptoms.

    Most women experience a mild floating feeling during the 45 minute infusion and lightheadedness, which clears within about 10 minutes.  Although other side effects are possible, they are rare, and have not occurred in our postpartum patients. We are careful to discuss and review these in depth with our patients, as well as the breadth of research that supports the use of IV ketamine in the treatment of depression.

    We Prioritize IV Ketamine Therapy for Postpartum Depression with Flexible Scheduling

    We offer IV ketamine infusions, called IV Ketamine Therapy, for depression and for postpartum depression, and we make it a priority to see postpartum moms.  We offer flexible scheduling in the late afternoon and evenings so that a breastfeeding mom can come in for her treatment and resume breastfeeding when the medication has cleared from her system so that her baby is not exposed to it.  We carefully calculate the time that it takes for ketamine to clear and work with our patients to plan breastfeeding or pumping around their treatments.

    This is dramatic and life-changing for new moms and their families and can be easily added to support, non-pharmacologic approaches and psychotherapy for the most robust and sustained result.

    If you or a loved one would like to learn more about IV Ketamine Therapy for Postpartum Depression, please reach out to our office. We are here to help restore you back to your best self.

    To getting you back to your best self,
    Lori Calabrese, MD
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  • 3 Ways to Stop Repetitive Thoughts

    3 Ways to Stop Repetitive Thoughts

    repetitive thoughtsHave you ever had fast, recurring thoughts about a particular topic that you just couldn’t shake? You may be experiencing repetitive thoughts, which is a common symptom of anxiety. Psychiatrists sometimes refer to these as “ruminative thoughts.” Here are 3 ways to stop them.

    1. Write

    When you find yourself having repetitive thoughts, stop for a minute and write them down. Getting your thoughts on paper frees up your mind, allowing you to feel less anxious. Writing actually engages your mind and helps to reduce the power of your repetitive thoughts. You don’t have to forget about these thoughts entirely. Writing them down allows you to revisit them when you’re mind isn’t moving so quickly.

    2. Breathe

    You may find that your breathing changes during your bouts of repetitive thoughts. When your mind is racing, be aware and work to slow your breathing. Slowly breathe in through your nose, counting to 3, and breathe out through your mouth, slowly counting to 5. You’ll start to notice that your mind and body will be more relaxed.

    3. Focus

    When your mind is racing, it may be difficult to focus on anything but your thoughts. However, it’s important to focus on the present especially during times like this. Focusing on the present allows you to accept what you can’t change and let it go. As much as you may like to, you can’t change the past so it only encourages your anxiety to constantly think about it.

    Remember, it takes time to change old habits or develop new ones. Start slowly by choosing one of these tips to use the next time you find yourself dealing with repetitive thoughts. For more tips or to schedule an appointment, contact our office today.

    To getting you back to your best self,
    Lori Calabrese, MD
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  • 4 Strategies to Overcome Test Anxiety

    4 Strategies to Overcome Test Anxiety

    test anxietyIt’s that time of year when thoughts turn to beginning a new school year and thinking about how things may go. As a student, you may already be experiencing some anxiety about taking tests. Take these last few weeks to master these 4 strategies to overcome text anxiety!

    Plan Your Time

    You have a lot of material to study in a short amount of time, and that could make anyone anxious. How are you going to remember it all? The best course of action here is to make and keep a study plan. List out the tasks you need to accomplish and then break them into smaller, more manageable sub-tasks. This will keep you from feeling overwhelmed, and will keep you on task and focused on the material you need to know.

    Change Your Perspective

    Sometimes a change in perspective is all we need. See the test as your friend instead of your enemy. Embrace it and you’ll notice that the stress you usually experience may be a thing of the past. Stop all negative self-talk and focus on what needs to be done.

    Be Mindful

    It’s important to take time to regroup and collect your thoughts throughout the day. Being mindful of right here, right now is a great way to decrease your stress and anxiety. If the test you’re studying for is in a week, your mind may be flooded with thoughts on how you’re going to pass, when to study, how you’re going to retain the information you’ve learned, and so on. The practice of mindfulness doesn’t take that away; it just brings your thoughts and focus back to the present.

    Cover the Basics

    The basics consist of taking care of your basic needs; diet, sleep, and exercise. Eating a balanced diet will keep your body fueled with the nutrition it needs to stay focused and ready for anything that comes your way. Getting enough sleep is also essential as it calms your mind and body, which decreases stress and anxiety. Lastly, exercise gives you more energy and decreases stress.

    Education can be stressful for a number of reasons, but taking tests no longer has to be. Follow these 4 strategies to conquer test anxiety once and for all! For more information on conquering anxiety or to schedule an appointment, please contact our office today.

    To getting you back to your best self,
    Lori Calabrese, MD
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  • 4 Ways to Overcome Mental Exhaustion

    4 Ways to Overcome Mental Exhaustion

    mental exhaustionMental exhaustion often disguises itself as overwhelm and stress. If you’ve ever complained about not having enough time in the day, you may be suffering from mental exhaustion. Here are 4 ways to overcome it!

    1. Relax

    Relaxation is often elusive to many of us for one reason or another. It’s not enough to relax; you need to give yourself permission to relax. Don’t feel guilty about doing nothing. Your mind, body, and spirit need the rest so sit back and enjoy it!

    2. Be Realistic

    For many of us, our to do list is full of tasks we know we’re not going to accomplish that day. It’s time to start being realistic about how much you can get done during the day. Don’t overextend yourself with a full to do list. Leave some room for more enjoyable things, like taking a walk or reading.

    3. Practice Prioritization

    At the beginning of each day, choose the three tasks that must be completed that day. These are the most important tasks you should be focusing on, which help you prioritize your day. It’s also helpful to find more efficient ways of handling your tasks. For example, setting up your bills on auto-pay will take the stress off of you each month because you don’t have to manually pay them.

    4. Seek Rest Opportunities

    Rest opportunities are all around us but many of us are too exhausted to see them. While you’re waiting in line, try some mindfulness techniques or breathing exercises. Some mindfulness techniques include paying close attention to physical feelings, such as how your feet feel on the floor or in your shoes, how your shoulders feel (i.e. are they tense, back, hunched forward). These can be used in public, making it a perfect option while standing in line at the supermarket.

    Relaxing your mind and recovering from mental exhaustion is essential for good mental health. It’s important to take time for yourself, even if it’s just 20 minutes a day, to help you unwind and feel better.

    To getting you back to your best self,
    Lori Calabrese, MD
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  • Do I have Social Anxiety?

    Do I have Social Anxiety?

    social anxietyOur society is a social one. But what happens when you feel nervous in social situations? There could be a number of reasons why this happens, including social anxiety.

    Social anxiety, formerly known as social phobia, is the fear of interaction with others that often brings about self-consciousness, feelings of being judged and negatively evaluated, and tends to lead to avoidance of social situations. It is the third largest psychiatric condition in the country, and it is estimated that about 7% of the population is affected. For example, a fear of public speaking is considered a specific form of social anxiety. Those with generalized social anxiety are nervous and uncomfortable in almost all social situations.

    What are the Symptoms of Social Anxiety?

    There are a number of physiological symptoms including, but not limited to:

    • Racing heart
    • Blushing
    • Intense fear
    • Dry mouth
    • Trembling
    • Excessive sweating
    • Twitching of the facial muscles

    These symptoms manifest due to an increased fear of certain social situations, such as being watched while doing something or meeting new people. If you were teased or heavily criticized as a child, you may have social anxiety disorder. It’s not uncommon for teasing and bullying to be a catalyst for this condition, as those actions tend to make people shy away from social situations (avoidance).

    Treatment Options

    It’s important to note that you can overcome social anxiety with the proper treatment. Cognitive‐behavioral therapy has been very successful in the treatment of social anxiety. There are also several medications which can be used to treat severe social anxiety.

    Experiencing anxiety in social situations is no fun and can make you want to avoid them entirely. It’s time to seek treatment for your social anxiety so that you can enjoy life once again.

    To getting you back to your best self,
    Lori Calabrese, MD
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