OUR CONSCIOUS CHOICES CAN IMPROVE OUR GENETICS

Anxiety, depression, ADD are problem people often inherit genetically. The genes are responsible, more often than not, for the predisposition to these problems. Often my patients ask me if it is possible to influence and change that predisposition. I believe people can do that. The environment we live in and the choices we make, which ultimately influence our environment, will influence the way we react to it.

This is an article that challenges the belief that the IQ is genetically determined and there is nothing anyone can do to change that--old school type of thinking. Recent studies are saying that we can influence our IQ by influencing the environment we live in, by expanding the cultural information our brain gets, by adapting, understanding and learning new concepts about life, ourselves and the Universe that surrounds us. We are not simply the involuntary recipients of a genetic code. The power to improve our lives stays with us.

I have discovered this article through http://twitter.com/iopsychology. Check it out.

Here is the article: "RICHARD NISBETT SAYS CULTURE, NOT HEREDITY, GUIDES OUR INTELLECT (http://ow.ly/roMA)

RICHARD NISBETT is Professor of Psychology and Co-Director of the Culture and Cognition Program at the University of Michigan and author of The Geography of Thought: How Asians and Westerners Think Differently... And Why, and Intelligence and How to Get It.

CREATING NEW CONNECTIONS IN THE BRAIN...ONE DENDRITE AT THE TIME

Sandra, a new patient, came in recently because of anxiety. She worked as a physician assistant and she worked hard for her degree, as she was the only one in her family with college education. She built her life through her own efforts and she was proud of that. At a closer look, there were more layers to her anxiety. She was regarded by her family as the "strong one" and now, paralyzed by fear and panic attacks, she was ashamed of herself for being unable to "beat it." She was indeed very harsh on herself.

Her anxiety started six months ago when she suddenly lost her voice. She was diagnosed with a condition called spasmodic dysphonia, in which the larynx's muscles contracted in a sudden spasm. That rendered her vocal chords practically unable to function, hence she was unable to speak. She had, at that time, a procedure that injects a tiny amount of botox, which blocks the nervous impulse that makes the muscle in the larynx contract. The larynx's muscles then relax, and the vocal chords become functional again. Usually, this treatment works for only three to six months at the time and it is likely she will need more injections after that. But for now she was able to speak. Her voice returned, but her anxiety was just starting.

Since then, she started living in fear that at any moment she will loose her voice again. Her fear was paralyzing her every action. Gradually, she couldn't work because she was afraid to talk and by doing that, lose her voice. She stopped going shopping because she was having panic attacks about going in front of the cashier and not being able to speak. She would not go out with her friends and became more and more isolated.

Eventually, her Ear, Nose and Throat doctor suggested that she sees a psychiatrist. He didn't know what else to do for her. From his point of view, she was cured.

As we were talking, I noticed that she was a bright, ambitious person. "I thought I was a strong person," she said. "I don't understand how come I am unable to handle this. I live in constant fear that someday soon, when I open my mouth to talk, no sound will come out. We communicate by talking, right? What am I going to do when I loose my voice again. I will not be able to function!" she ended, in a panic stricken voice.

I gently pointed out that she is already unable to function right now, not because she can not talk but because of the fear she will be unable to. I also pointed out that language is not the only form of communication. We communicate with all our senses. For example, if indeed she is unexpectedly unable to speak, she can carry a note book in her purse and she can write down what she wants to say. This could be her plan B.

She looked at me with disbelieve saying she didn't want people to think she is "stupid."

Then I tried a different tactic. She was a physician assistant so she knew anatomy. I asked her to imagine that within the brain, there are billions of neuronal connections--highways on which the information, or thoughts, travel at incredible speed. Engaging her brain with same sort of thoughts repeatedly, her neurons will form connections with each other that will facilitate faster transmission of those exact thoughts to the entire gray matter of the brain carrying one message--fear of going mute. If she thinks over and over that she is afraid of being unable to speak, the neurons in the brain will lined up in a way that will facilitate the "fear thoughts" to travel through the brain with great ease until the whole brain vibrates with fear. Every time she thinks about this fear, she emphasizes this path, reinforcing it again and again. Whereas if she thinks of her fears in a different way, there will be different neuronal connections that will be formed and gradually she will stop being afraid.

"How can I do that?" she asked.

"Realistically," I said, "do you know what to do if you loose your voice again?"

"Yes, I call my ENT doctor. I have his number programed in my phone on speed dial."

"OK. If you want to change the way your neurons are lined up in the "fear direction", you need to change the way you think. Every time the thought of "Oh, my God! What happens to me if I loose my voice again?" comes to your mind, instead of thinking "I will be crippled for life, everyone will look at me thinking I am stupid and weak and incapable of handling the smallest thing," the way you think now, I invite you to change the tune and think: "If that happens, I am calling my doctor immediately. He will fix the problem again, just like he has done before, and I will be all right again." This way, you will have a completely different answer to your old question. Your neurons will gradually line up in the "I am OK" direction and you will, in time and with practice, 'forget' to be afraid."

"Can it be that easy?" she asked.

"It's called brain plasticity. The phenomenon is real. But it's not necessarily easy to do, because in order for the neurons to connect in a different way, they will need to develop new connections among each other. This is done by growing dendrites that reach between neurons. That is why you need to practice this new way of thinking, to stimulate the growth of the these new dendrites in a positive direction."

"How long will it take?"

"Perhaps weeks or even months."

"What can I do in the mean time?" she asked, scared that she will suffer from anxiety a long time.

"You could use this short acting anti-anxiety medication," I said, "but use it only when you need it, only when you feel you can not control your anxiety by talking yourself out of it." And I instructed her exactly how to use it.

"Do you think I can do it?" she asked, barely daring to believe there is hope in sight.

"Absolutely. You are a strong person, remember? You know you can do it. One dendrite at the time."

She gave me a long look, as if she was not sure whether to believe me or not. Then, as if she made an agreement with herself, she said firmly:

"I will do this. One dendrite at the time. I will beat this fear." And left my office with the defiant look on her face.

Few weeks later, she was back at work.

2009 MENTAL HEALTH STAMP – Sending a message of hope

2009 MENTAL HEALTH STAMP – Sending a message of hope

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The Canadians decided to have a stamp that would increase the awareness about mental illness, as it is predicted that one in four Canadians suffer or will suffer from some type of mental illness at some point in their lives. Interestingly enough, we have the same numbers in the US. But do we come up with a public statement about it, like a stamp or anything else, to talk about this? Not yet. Perhaps we are not yet ready to talk about the elephant in the room. I do believe though that the tide is changing and we will soon treat mental illnesses with less shame and more openness--a far more constructive attitude than DENIAL.

"LEVEL 12" ANXIETY

Last week I was sitting in my office, talking with a new patient. It was September 22, the first day of autumn, according to my calendar, and the second day of a heat wave in Los Angeles.

My new patient was saying he suffers from "anxiety". I asked what kind. "The kind with panic attacks," he said, frustrated. How bad? "When I have a mild one, I feel I will pass out any minute. But when I have a bad one, I feel I am going to die."

OK, I got the idea. I asked him to tell me, on a scale 1 to 10, how badly he feels when he has one of these panic attacks. "12" he said without any hesitation.

My new patient, turned out, has never talked about his anxiety with anyone until one month ago, when he decided to see a therapist. His panic attacks got worse because he went back to school. He decided to study to get his master degree "which I should have done when I was younger," he said. But back in school, he had deadlines, finals and presentations, which triggered more panic attacks. When was the last one? "When I had to give a 20 minute presentation in front of my colleagues. It was a disaster!" I immediately worried that the school might not be such a good idea for him, after all. "What was a disaster? Your presentation?" I asked. "No, no" he laughed,"that was a complete success. I've got an A plus all right. I was a disaster. Me, inside, because nobody knew how terribly anxious I was. Nobody knew I was having a panic attack at the same time."

We started talking about the treatment options, how he could learn how to talk himself out of these panic attacks and how anti-anxiety medication will lower his anxiety just enough so that he can begin controlling the symptoms using the power of his rational mind. He has never seen a psychiatrist before and did my best not to overwhelm him. I suggested he start reading as much as he can about anxiety, especially books on Cognitive Behavior Therapy (CBT) which teaches people how to put mind over mood. My favorite in this category is "Feeling Good" by Dr. Burns, a collaborator of Dr. Aaron Beck, which originally put this method together. We talked about medication options too. "Is this medication going to...change me?" he asked. No, medication can not change people, I explained, they can only change themselves. There have been occasions in my line of work when I wished I would have a medication that could change some peoples' personalities but unfortunately such medication doeasn't exist. Not yet, anyway.

In the end, he agreed to try a small dose of Lexapro, just to test it out. I invited him, as I usually do with all my patients, to take notes and tell me exactly how it makes him feel, because it will help me a great deal to figure out how to adjust it.

I hope he felt good about our meeting. The best part of his story is that I believe he will do very well. I have seen many patients like him: dealing with anxiety for years, forgetting even how it feels not to be anxious, but when they decide to get help, they stick to the intervention plan and improve beyond their most optimistic dreams.

This patient in particular I think will do well. He has decided he will no longer allow his anxiety to stay in his way. The fact that he chose to continue with school despite worsening of anxiety, and rather than quiting his classes, he decided to address the anxiety by talking to a doctor about it (a scary idea for many), speaks volumes about his determination to get well.

In my experience, these are exactly the patients who do very well because they are deeply committed to the success of their own treatment.

I know it will be a pleasure working with him and I look forward to witnessing his progress.

ORGANIZED ESCAPES

Often my patients come in with a feeling of dread about their lives. When I ask them when was the last day off they allowed themselves to enjoy, many can't even remember it. Their lives look like a dry, endless stream of work days. It's all about work. How do they relax? Well, they may eat comfort foods, or they may drink a little too much or they may smoke or other habits with immediate rewards but long term bad consequences--escapes that are, in fact, toxic and unfulfilling.

I strongly believe that we all need "escapes." The trick is what kind. We can choose from many, the ones that work for us the best, the ones that relax us, that nourish our souls, or makes us happy. Example: making time for a 15 minute walk in the morning or in the evening, learning some Yoga stretches and stretch on the floor before going to bed. You can, if you want, get even more ambitious and get a gym membership or take Pilates. Some volunteer for different organizations. Some pick up a hobby--one of my patients got into photography this way. One patient who was very anxious and could not "unwind" in the evening, said jokingly that what relaxes her is watching the old Lucille Ball series. I suggested she should put them on every evening, just to feel in the company of her favourite characters and relax while getting ready for bed.

You could organize other kinds of escapes as well: a week-end get away, a show or a concert, a dinner with a friend, etc.

If we have something to look forward at the end of the day or week or year, it's easier to get through the day, or week or year. This way, the days or weeks gain meaning and identity. When we look ahead, rather than seeing an endless desert of work days, we see in the middle of the desert patches of green and cool--oasis of our planed escapes, waiting for us to get done with work and finally play and relax.

It may seem a simple thing to do, but try to fit a relaxing moment in your schedule and you will see how challenging this is. There are also huge rewards: every one of my patients who took this simple advice to heart became more efficient and less stressed out each Monday morning.

THE HEALING POWER OF PETS PART 1

They share our lives. They live with us. They are there when we are happy, celebrating with us, or sad, being supportive, loving and kind, when perhaps no one else is. Just because they don't speak English doesn't mean they don't understand what is going on. They may actually understand much more than we do, or than we give them credit for. They have feelings and thoughts. What they don't have, is layers upon layers of denial, shame or wishful thinking. They are much more likely to accept reality for what it is than we are. At a deeper, more intuitive level, animals may be more sophisticated than us, simply because they do not inhibit their feelings by an overpowering "rational" mind. They accept them and go with the flow. House pets are even more advanced in thinking and feeling because we expose them to such a variety of stormy feelings and emotions that they have to learn how live and adjust to us constantly. Well documented psychological studies have shown that they understand many of our words. For example, dogs can understand over a hundred words and can do simple math.


There are many medical research studies about the beneficial influence of having pets. The most famous one, although not the most recent, done with people who have had one heart attack, showed that having a pet, especially a dog, lowered the probability of having a second heart attack in a year (the length of the study), compare to people who did not have any pets. Modern research have shown that pet owners have lower levels of cholesterol, handle stress better and overall have a longer life span. I have included the following link for more info on this:

The Animal/Human Bond: A Prescription for Good Health. Carson, Lynn. American Journal of Health Education, 2006 Nov-Dec; 37(6): 361-365



The common belief is that people are healthy because they walk their dog and therefore, they exercise, which they might not otherwise do. Personally, I believe it is a gross oversimplification. The comfort and unconditional love and support pets provide, it's unique, and can't be found in anybody else quite like that. Can you think of anyone that cares for you and is absolutely devoted to you more than your pet, while asking so little in exchange?



I believe our pets are our connection to the wild, to the world of natural instincts, to a universe of collective consciousness of all beings. Their kindness, patience and enormous capacity for love tell me that this universe we often don't feel it exists, is a positive force. Whether or not we are conscious of it. We are not consciously thinking about gravity either, yet we are all subjected to it and no one denies it anymore. There are many things that exist, even when science, with its current abilities, may not be able to detect it. For example, how could spirituality be detected and measured? Or compassion, or greed? What is the right scale for happiness or unhappiness? Just because these other realities can not be subjected to measures and classifications the way our physical universe can, it doesn't mean they don't exist all around us and that we don't react to them constantly. Dalai Lama makes this case very clear in his book, The Universe in a Single Atom: The convergence of Science and Spirituality in which science and spirituality do not contradict, but enhance each other.

You can find a brief analysis of this book at http://www.nytimes.com/2005/09/18/books/review/18johnson.html?_r=1

One way to get in touch with these realities are the relationships we develop with other beings: humans, animals, trees, nature, environment.


Many of my patients have told me that at their lowest point, in the depths of their despair of anxiety and depression, the thought of abandoning their pets and the worry of what would become of them was the only thought that stopped them from committing suicide. And I believed them.

LESSONS ABOUT LIFE I HAVE LEARNED FROM SWIMMING

Since I started learning how to swim taking lessons with my coach, Susan, I realized how many parallels with real life swimming has. I came to swimming late, only few years back. I had to relay practice and understand its dynamics before I could do it. It is difficult because I want to learn to "right" way, the "total immersion, fish like" swimming, which requires skill rather than sheer force.

I often give examples from my "swimming journey" to my patients. They often find them amusing but helpful. For example, when I didn't know how to swim and I was afraid of going down to the bottom, I had the bad habit of flailing my arms desperately in all directions, creating lots of waves and sinking lower and lower toward the bottom. But when I relaxed and floated as still as I could on the water, despite the fact that I was still terrified I will go down, the water was, miracle, supporting me like a pillow.

I tell this anecdote often to my anxious patients. Anxiety makes people fighting with life, struggling to push ahead only to see that they are falling further and further behind. Why is that happening? Because anxious feelings are never good counselors. Acting out of fear makes you uncoordinated in your actions just as it makes your movements uncoordinated and inefficient in the water. But if you try to calm yourself down and clear your head, you will begin to see the things you need to do in order to solve your problem.

"IS THIS HELPING YOU?"

This is a question Marta used to ask me at the end of every session. She was 76 years old when we've met, with a very bright, sharp mind but a failing body. Her breathing was heavy, she had difficult to control high blood pressure. She walked with difficulty and had hearing aids. But she also had steely blue eyes and a warm, broad smile. She didn't want to come and see me initially. She has never seen a psychiatrist before and she didn't know how "these things work." She was convinced by her primary care physician to come though because she "seemed" depressed.

From our first session, I understood she was, in fact, very lonely. She had a daughter but their relationship was "tense, to put mildly," as she described it. Other than that, she had nobody to talk to. She felt "lonely and useless and just a piece of meat no one wants to take into account."

I decided to begin by asking her questions about herself and encouraged her to answer them at length. "I came from Poland when I was very young, with nothing in my pockets but my clenched fists," she began. After a while, she ended up owning a small business. She made a lot of money and lost a lot of money. She had a husband and she divorced him after a while. "He was nothing but a womanizer." She met the love of her life and lost it because he was Catholic and permanently married and she couldn't stand anymore hiding their relationship from the world, in shame.

As she was talking, I realized what a strong person she has been through out her life and how she never allowed adversities to bring her down. Never before, until now, confronted with the aging crisis. Old and unable to be as mobile as she once was, and especially since she became unable to work, her whole universe shrank to a very small space she did not fit in.

I offered her a short acting anti-anxiety medication, Ativan 0.5 milligrams, to take as needed if she becomes very upset or anxious. She declined. I offered her a low dose of an anti-depressant in the hope it will help her better cope with her circumstances. She declined as well. At the end of our first session, she asked me for the first time: "How did this chat is going to help me? Did it help you figure out how to help me?" I said yes, very much, and she left.

Appointment after appointment we would sit down and chat about treasured moments of her life. Happy and sad moments. "You are a good listener," she said to me once. I was. I was deeply moved by the dramatic ups and downs of her life. She was also a captivating story teller. I gradually got to know and admire her.

At the end of each session she would ask me "Is this helping you?" At some point I considered letting her know that our sessions are supose to help her, not me. I didn't, though. I knew that they did. Our chats about who she was in the past reminded her of her strength, making her feel more empowered and more driven to have a better life and, oddly, more relaxed embracing all these feelings. She had one weakness: her doughter, who was "a spoiled brat," demanding and manipulative. But gradually, as Marta got back in touch with herself, she began setting better limits with her daughter as well. Their realtionship became less stressful. She was again in control.

We kept talking about how she felt when she had her business and how much she enjoyed having people around her in the past. In the present, she gradually started getting out of the house and making new friends. She felt happier and no longer lonely. She even asked me to give her the contact information of a Chinese brush painting teacher close to her home, and started taking classes, which she enjoyed tremendously. Her blood pressure became easier to control. She gained a more youthful spring in her gait.

All the while she would ask, with a smile and a wink, at the end of our each session "Is this helping you?" Yes, it did, by helping me understand her better. But it also helped me personally. I enjoyed her stories, her power and her resilience. She created instinctively a relationship with me that was giving her what she was missing: respect and support. With that, she went into the world to conquer it once more. And conquer it she did. She is not longer depressed. She hardly needs to see me now. Once in a while she gives me a call to check in. Her happy, strong, somewhat raspy voice makes my day every single time she calls.

"Is this helping you?"

WHAT TO ASK ABOUT ANXIETY/A NEW YORK TIMES ARTICLE

I came across this article in the New York Times. I hope you will find it helpful. Please let me know if you did or you found it too dry.

If you have questions about it or about anxiety in general, I will be happy to address them, within a reason, considering we can only chat on line.

I strongly encourage my patients to get informed but to try not to misinterpret what they read on the Internet. If they don't understand something, I ask them to send me the link or make a note about the question they have and we discuss it when we meet.

I believe people suffering from anxiety need to be informed as much as possible about anxiety definition, treatment, prognosis, etc., in order to understand and follow an intervention plan. I always like to work with patients motivated to learn and to get involved in their treatment. I feel we become a team, working together toward a common goal: their healing and happiness.


What to Ask About Anxiety
By IRENE WIELAWSKI
The New York Times
July 2008

Confronting a new diagnosis can be frightening — and because research changes so often, confusing. Here are some questions you may not think to ask your doctor, along with notes on why they’re important.
Why are you considering a diagnosis of anxiety disorder?
Psychiatric illness is not as easily diagnosed as, say, an infection, where a simple blood test can yield definitive answers. For anxiety disorders, it is important to assess the degree of anxiety in specific situations to determine whether it is interfering with work, school, personal relationships or other aspects of daily life. Correct diagnosis is necessary for appropriate treatment.
Is this your area of expertise? If not, can you refer me to a specialist in anxiety disorders?
Anxiety disorders can be serious, with potentially life-long implications and complex treatment options. The diagnosis should be made only after a thorough and systematic workup by professionals who are experts in psychiatric disorders.
What type of anxiety disorder do I have?
There are several types of anxiety disorders. The most common is generalized anxiety disorder. Others are panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Each has a specific set of symptoms, and treatments depend on the diagnosis.
How do you treat anxiety disorders?
Treatment is tailored to individual patients and usually includes psychotherapy, medication or a combination. Unlike some psychiatric illness, anxiety disorders can resolve after a period of treatment.
What side effects might I have from medication to control my illness?
The drugs prescribed for anxiety disorders are powerful and potentially habit forming. They also have side effects like drowsiness, reduced muscle coordination, problems with balance, sleep disturbance, headaches and nausea. Not everyone has these reactions, but the possibility should be discussed with the prescribing physician so you know how to report and handle them.
How do I know if the medication is working?
Because psychiatric drugs alter mood and behavior and affect patients differently, patients and family members have an important role to play in precisely recording any changes in response to medication, positive as well as negative. This helps the physician fine-tune dosages or substitute alternative medicines.
Can drugs for anxiety disorders affect other medical conditions like asthma, diabetes or heart problems?
Anxiety specialists have several medications to choose from, depending on what works best in combination with drugs required for other medical conditions. It is important to keep all of your doctors up to date on prescribed medication and alert everyone if a new drug is added to the mix.
How should we communicate with you after hours or in an emergency?
Anxiety disorders, especially panic and post-traumatic stress disorders, can be unpredictable and potentially volatile. Families should coordinate an emergency plan with the treating physician.
Why do you think my child has an anxiety disorder? Isn’t it normal for children to be nervous before tests or shy about speaking in front of the class?
It’s normal to have some degree of nervousness or “stage fright” before a performance or test or special event. But when these feelings are so intense that they prevent children from achieving to their ability or cause physical symptoms like stomachaches on test days, for example, this may indicate an anxiety disorder.

The President's Speech & Mental Health Care | Reuters

The President's Speech & Mental Health Care | Reuters

This press release is yet another recent proof that the understanding about mental illness and mental health is expanding from the mental health providers, to the public at large, to the media and to the political discourse.

For those who suffer in the loneliness of their emotional pain and despair, this speech by the president, and the media renewed focus on mental health, is a ray of hope that their pain will finally be heard and more help will soon become available for the treatment that will restore them back to health.

THE SYMBOL OF BETTER THAN CURED

In Chinese brush painting, the lotus flower is a symbol of renewal and rebirth. It is a living testimony that just as a beautiful flower rises from the dark and muddy soil of the bottom of the pond, so can we rise up from the depths of our suffering, transforming it into beauty, kindness and compassion, taking from it the strength to go on.

I have learned these symbols and meanings from my teachers of Chinese brush painting. The symbol I have chosen for Better than Cured is a lotus flower I have painted during a workshop at UCLA with a renowned Chinese brush painting teacher, Mr. Ning yeh.

I feel that each and everyone of my patients rising from the depths of dispair, suffering from mental illness for years, fighting their way to the surface and blooming into building a beautiful life, is a lotus flower conquering the world all over again.

I have witnessed this transformation many times in my patients. I now share with you the ways and results of Better than Cured because with this method I was able to assist them on their way toward healing and happiness.

THE STORY OF BETTER THAN CURED

I immigrated to the United Stated in 1995, the same year I graduated from Medical School at University of Medicine Timisoara, Romania. After passing the medical board exams, I started the post-graduate four-year residency training program at the University of Southern California.

This particular residency program offered training in the private hospital of USC, but also in the Los Angeles County Hospital, where I was extensively involved in the treatment of severely mentally ill patients who faced enormous medical, social and financial difficulties.

Treating these patients had a profound effect upon me. I developed a deep sense of compassion for all people who suffer, especially for those who are so unfortunate as not to have families or support while having to struggle with devastating mental illnesses.

To help my patients, I also learned to look beyond medical treatment and medication. They were never enough considering their many unfulfilled basic needs. At first, I learned to offer a sandwich from the cafeteria and a kind word. I went on to learn how to help them get a job, succeed in a job interview, find the life-saving comfort of a pet or of appropriate support group organizations like the Gays and Lesbian Center, etc. They needed far more than relief of symptoms. They needed material and emotionally support beyond standard hospital assistance. The seeds of Better than Cured were germinating.

At the same time as my medical residency, I was learning to make a new country, the US, my country, my people, my culture. I was an outsider transitioning to insider, to citizenship and an American heritage. At the same time, I was a maturing cosmopolitan, comfortable in various subcultures and different economic and social circles. All this would broaden my ability to reach a far wider range of friends—and, yes, patients and readers.

In 2002, immediately after graduating from my residency, I open my own private practice, where I have continued many of the principles I learned in my training. My practice is now at the edge of Beverly Hills, an affluent area, adjacent to Cedars Sinai Medical Center with which I am affiliated and where I teach and supervise psychiatry residents. My patient population has changed, but the essence of their needs has not. They are looking for fulfillment, wellness and happiness just like my County patients were. The difference is they have more resources and their mental illnesses have a far better prognosis because they mostly belong to the 94% of people suffering from a mild or moderate mental illness which is easier to treat to remission. My new patient population has raised new questions: “Yes, I no longer suffer from my anxiety or depression, or panic attacks. Now what? I realize I am doing a brainless job, far below my new abilities. I am in an abusive relationship…What can I do about that?” This is when I started learning about life coaching. This is when I started to fully reach beyond to some state better than just cured for my patients.

BETTER THAN CURED IN ACTION, PART 1

Here is one example of how therapy, medication and life coaching can blend together in helping someone feel better, find peace of mind and become inspired to take the actions leading to success and happiness--a state of better than cured.

I had recently a new patient coming to see me complaining of severe anxiety and depression for six months. He had another psychiatrist who tried to help him by just cranking up his medication and achieved only side effects, which worsened his sense of despair and hopelessness.

Talking about his depression, I learned that he had a history of mood swings and his depression is more of an “agitated depression” type, manifested with a great deal of anxiety, restlessness, panic attacks mixed in with depression and a sensation of racing thoughts.

He also told me that about six months ago he was turned down by a group of investors when he presented an ambitious business plan. He could not handle the rejection, which he took very personally. But he had difficulties rethinking his next step because his anxiety and depression were paralyzing his mind and his actions. He has been going around and around this circle of hopelessness for months with the end result of becoming more and more discouraged.

From the first session of working together, we decided that:

1. He will put on hold for two months the work on the new business strategy and will devote all his energy to getting well.

2. We reduced the hiked up doses of medications improving the side effects and making the medication tolerable. After discussing several other medication options, he agree to try a mood stabilizer (Abilify) to help him control his symptoms better.

3. From the therapy point of view, we started working on learning how to cope with rejection, especially because he was a successful business man who was not used to be turned down. Two months later, his anxiety, depression and racing thoughts were under control.


After five or six weeks of working on these issues, he was not as afraid of failure as he once was and was finally ready to begin working on a new business plan. Only this time, he took more time to think it through, took into account some of the broader economic factors which he ignored the first time and prepared better for the board meeting by setting up prior private meetings with some of the investors to explain his ideas in detail.

Three months later, he had it all: he was felling healthy and emotionally strong, was no longer afraid that things may not always go his way and finally got his bold business plan approved. He was excited and ready to go.

He told me he was happy.