generalized anxiety disorder

Short-term open-label chamomile (Matricaria chamomilla L.) therapy of moderate to severe generalized anxiety disorder

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Abstract

Background: Conventional drug treatments for Generalized Anxiety Disorder (GAD) are often accompanied by substantial side effects, dependence, and/or withdrawal syndrome. A prior controlled study of oral chamomile (Matricaria chamomilla L.) extract showed significant efficacy versus placebo, and suggested that chamomile may have anxiolytic activity for individuals with GAD.

Hypothesis: We hypothesized that treatment with chamomile extract would result in a significant reduction in GAD severity ratings, and would be associated with a favorable adverse event and tolerability profile.

Study design: We report on the open-label phase of a two-phase randomized controlled trial of chamomile versus placebo for relapse-prevention of recurrent GAD.

Methods: Subjects with moderate to severe GAD received open-label treatment with pharmaceutical-grade chamomile extract 1500mg/day for up to 8 weeks. Primary outcomes were the frequency of clinical response and change in GAD-7 symptom scores by week 8. Secondary outcomes included the change over time on the Hamilton Rating Scale for Anxiety, the Beck Anxiety Inventory, and the Psychological General Well Being Index. Frequency of treatment-emergent adverse events and premature treatment discontinuation were also examined.

Results: Of 179 subjects, 58.1% (95% CI: 50.9% to 65.5%) met criteria for response, while 15.6% prematurely discontinued treatment. Significant improvement over time was also observed on the GAD-7 rating (β=-8.4 [95% CI=-9.1 to -7.7]). A similar proportion of subjects demonstrated statistically significant and clinically meaningful reductions in secondary outcome ratings of anxiety and well-being. Adverse events occurred in 11.7% of subjects, although no serious adverse events occurred.

Conclusion: Chamomile extract produced a clinically meaningful reduction in GAD symptoms over 8 weeks, with a response rate comparable to those observed during conventional anxiolytic drug therapy and a favorable adverse event profile. Future comparative effectiveness trials between chamomile and conventional drugs may help determine the optimal risk/benefit of these therapies for patients suffering from GAD

7 Things People With Generalized Anxiety Disorder Wish Others Would Stop Saying

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i can't keep calm because i have anxiety memeGeneralized anxiety disorder (GAD) is characterized by excessive, persistent and unrealistic worry, and caused by genetic factors, brain chemistry and personality. In fact, 40 million people in the United States are affected by an anxiety disorder, according to the Anxiety and Depression Association of America. As someone with GAD, here are 7 things I’d like to ask you to stop saying.

1. “Stop thinking about it.” Don’t you think if it was that easy I would not think about it? It maybe easy for you, but as a person with GAD I have to practice the coping strategies I’ve learned in therapy. And sometimes I can’t even do that. So telling me to not worry simply does not cut it.

Instead, try asking me to go for a walk or if there is anything you can do to help me process what is happening.

2. “Everyone feels anxious.” Yes, everyone feels anxious, and it is completely natural. Anxiety actually pushes us to get things done, but when your anxiety stops you from being able to function, guess what? That’s a problem. So please do not compare GADers (yes, I created this word) with non-GADers (this word too).

Instead, acknowledge what I’m going through. Say, “I see this is really hard for you. Would you like to talk about it?”

3. “I’m stressed too.” Not to discredit your stress, but you are certainly discrediting ours. What you do not understand is that we have a hard time controlling our thoughts, and whether you realize it or not, no matter how small it may seem to you, our anxiety tends to maximize everything.

Instead, try offering some words of encouragement.

4. “I know how you feel.” Unless you have GAD you do not know how I feel, so please stop saying that you do.

Instead, say, “I don’t understand exactly how you feel, but would you be willing to help me understand?”

5. “You need to calm down.” When people suffer from GAD, there are times when his/her anxiety is through the roof and it takes me time to calm down. It is always a three-ring circus going on in our heads. That advice is like telling someone who is sick to stop coughing. So no, we cannot calm down right now.

Instead say, “Is there anything I can do to help you?”

6. “You are doing too much.” (Translation: “You are being dramatic.”) Thank you for your words of comfort. We know our thoughts can be irrational at times, but that is how our brain works. Can you imagine 1,000 tabs on your computer are opened, and you cannot stop new tabs from opening? Well, that is how we feel. Just because our disorder is invisible does not mean it is not real.

Instead, ask me about what methods I use to ease anxiety (like breathing methods and yoga), and remind me what’s worked in the past.

7. “You worry too much.” Yes, we worry too much and we know that, but if you have not figured it out by now, we cannot control it. Telling us we worry too much does not help. We were already worrying about 50 things prior to this unnecessary statement, and now we are worrying about worrying.

Instead, say, “It’s OK to feel this way. I know your anxiety can be difficult, but I’m here for you.”  

Brain Scan Changes During 4 Weeks of Treatment for Generalized Anxiety Disorder

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12 Sessions Combining Manual Acupoint Stimulation and Image Activation

1. Normal (Ideal) Profile 2. GAD Before Treatment
bscan1 bscan2
3. After 4 Tapping Sessions 4. After 8 Tapping Sessions 5. After 12 Sessions
bscan3 bscan4 bscan5
The images are digitized EEG brain scans.

The colors represent the ratio of bran frequencies (alpha, beta, and theta waves) and sub-frequencies within the given areas of the brain.
Blue normal ratio of wave frequencies (according to databases)
Turq. slightly dysfunctional ratio
Pink moderately dysfunctional ratio
Red highly dysfunctional ratio of wave frequencies

 

Image 1 depicts a normal ratio of wave frequencies according to databases. Image 2 is a scan at the outset of treatment of a patient diagnosed with generalized anxiety disorder (GAD).The profile is typical for patients diagnosed with GAD. Images 3 through 5 are taken over the course of 12 sessions during a 4-week period using the stimulation of acupoints (while anxiety-provoking imagery was activated) as the treatment. A decrease in the intensity and frequency of GAD symptoms correlated with shifts toward normal levels of wave frequency ratios in the cortex. The pattern shown in these images was typical for GAD patients in the South American study who responded positively to the stimulation of acupoints. These images were provided to Energy Psychology Interactive by Joaquín Andrade,
DISCUSSION

As the wave frequencies shifted toward normal levels (from red to blue) in the central and front areas of the brain, the symptoms of anxiety decreased in both their intensity and their frequency. Similar sequences of images and symptom reduction were also typical of other patients with generalized anxiety disorder who received energy-based treatments.

Patients who were successfully treated with what has been the standard therapy for generalized anxiety disorder (Cognitive Behavior Therapy, combined with medication as needed), showed a similar progression in their brain scans during the pilot study in South America discussed below. But it took more sessions to achieve the improvements. And more importantly, on one-year follow-up, the brain wave ratios following the Cognitive Behavior Therapy protocol were more likely to have returned to their pre-treatment levels than they were for the patients who received the energy treatments.

An interesting tangent from this study was in the comparison between patients whose primary treatment was anti-anxiety medication and patients whose primary treatment involved stimulating energy points while holding anxiety-provoking images. Both groups enjoyed a reduction of symptoms. But the brain scans for the medication group did not show noticeable changes in the wave patterns, even though the symptoms of anxiety were reduced while the drug was being taken. This suggests that the medication was suppressing the symptoms without addressing the underlying wave frequency imbalances.

Antidepressants Aren’t Taken By The Depressed; Majority Of Users Have No Disorder

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antidepressants
Flaws in access to reliable psychotherapy may lead people with mental burdens to pop pills instead.

A new study published in The Journal of Clinical Psychiatry reports some 69 percent of people taking selective serotonin reuptake inhibitors (SSRIs), the primary type of antidepressants, have never suffered from major depressive disorder (MDD). Perhaps worse, 38 percent have never in their lifetime met the criteria for MDD, obsessive compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder, yet still take the pills that accompany them.

In a society that is increasingly self-medicating itself, capsules, tablets, and pills are turning from last resorts to easily obtained quick fixes. Between 1988 and 2008, antidepressant use increased nearly 400 percent. Today, 11 percent of the American population takes a regular antidepressant, which, by the latest study’s measure, may be a severe inflation of what’s actually necessary.

“I think while psychotherapy is another option to helping people obtain better mental health, there are roadblocks,” said Dr. Howard Forman, medical director of the Addiction Consultation Service at Montefiore Medical Center. Forman, who wasn’t involved with the study, points toward cost, availability of experts, and time demands as the main reasons people may decide to pursue alternatives.

Dr. Ramin Mojtabai, of Johns Hopkins Bloomberg School of Public Health, and his colleagues relied on data from four samples, the Baltimore Epidemiologic Catchment Area Study Wave 1, which began in 1981, all the way through Wave 4, which ended in 2005. In total, they used data on 1,071 participants, including four interviews and an assessment on current antidepressant use. Similar to the national average, 13 percent of people reported using antidepressants.

Medications to offset perceived, yet undiagnosed, chemical imbalances don’t just include those targeted to mood. Amphetamines like Adderall help people find focus, and benzodiazepines like Xanax quell anxiety — or so their users claim. But when the bottom falls out on casual use, quick fixes may turn into heavy dependence. “I have no concerns about the prescription of SSRIs leading to dependence,” Forman said. Prescriptions are generally accompanied by a doctor’s oversight. “I think that any medications that are taken without the oversight of a physician, especially drugs with abuse potential, such as Xanax, are very concerning for the development of dependence.”

Solving this problem of antidepressant overuse may be partly systemic as well as personal. Mental health care is improving in the U.S., particularly as the stigma fades and people no longer feel embarrassed to seek treatment. But more can be done to give patients peace of mind, Forman says. This may help reduce their urge to unnecessarily self-medicate, as the people who don’t need medication take solace in the reassurance of their health, while those in need find the same comfort in the confirmation of an illness. The main priority is removing the element of uncertainty.

“We all experience periods of stress, periods of sadness, and periods of self-doubt,” he said. “These don’t make us mentally ill, they define us as human.”

Source: Takayanagi Y, Spira A, Bienvenu O, et al. Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study. The Journal of Clinical Psychiatry. 2015.