I got an email this morning that I thought I would share. I have talked a lot about diet, but I also do believe that affirmations and remembering who you are can be helpful.
After all we do affirmations all the time. It is call the "what if" thinking and the constant loop of negative and scary thoughts or imagines we have passing through our mind. Which is why I believe that intentionally forcing good thoughts can be very helpful and help you find balance in this and any illness, mental or physical.
For me diet can work on your physical being. Diet can give your body all the tools it needs to cope with stress and heal your body and brain. Diet will give you the strength to help you change you thinking process and changing your thinking will help heal the self (the mind).
Here is the email:
"I used to suffer from that.
YOU NEED TO KICK ASS!
Your problems are your mind accepting the ridicule, rejection, and judgment of other people. It's about standing firmly in your own infinite empowerment and REFUSING to feel anything but perfectly natural, beautiful, peaceful, balanced, and competent.
Affirmations will work.
It's all a tragic waste of time. It's being a FOOL.
It's allowing a mindfuck to control your life.
There is nothing to learn.
There is no purpose for the experience.
There is no fruit.
There is only the reality that every second you spend in pain is a humiliating, degrading insult to your nature, your character, your strength, and your spirit.
REFUSE!
REFUSE to tolerate there being something wrong with you.
REFUSE to tolerate being insecure.
REFUSE to tolerate any person intimidating you.
REFUSE to tolerate the sickness that is society.
REFUSE to feel anything but your Natural Divinity and Infinite Empowerment.
Spirituality will set you free.
Transcending victim consciousness will teach you that you control the way you feel about yourself, your life, what you attract to yourself. It will teach you of your infinite internal source, which transcends ANY influence because it is an absolute force of nature.
You are an absolute force of nature.
You owe no apologies.
You owe no excuses.
You owe nothing.
You are a perfect, divine spirit, capable of absolutely anything.
Nothing more, nothing less."
Friday, October 31, 2008
Tuesday, October 28, 2008
The Things I Value
I saw my therapist today and she asked me to make a list of what I value and to bring it with me next week. This is actually very easy for me, after being through so much in my life I definitely know what I value, but I figured I would share it with you guys as well.
1. Compassion
2) My Health
3) Intelligence
4) Trust
5) People who just don't listen, but actually hear you.
6) The ability to think outside the box.
7) Those people that can walk in a room and their energy brightens it.
8) Making people laugh or people who can make me laugh.
9) Silence and stillness (Like being in a dark room alone, laying in bed and just touching the wall with your hand just to feel the coldness of the wall.)
1. Compassion
2) My Health
3) Intelligence
4) Trust
5) People who just don't listen, but actually hear you.
6) The ability to think outside the box.
7) Those people that can walk in a room and their energy brightens it.
8) Making people laugh or people who can make me laugh.
9) Silence and stillness (Like being in a dark room alone, laying in bed and just touching the wall with your hand just to feel the coldness of the wall.)
Monday, October 27, 2008
Free DVD About The Boiltarian Diet
I made a 43 min video about the diet I use to help myself cope with the stress anxiety puts on my body. A few posts down you can watch it for free online. The video was too large for youtube and for some reason google video is not letting me upload it. So I ended up uploading it to the internet archive. The down side to this is that site is so busy, that at times during the day you can't view it.
You can watch it for free on my blog or if you would like a DVD copy of it for free just e-mail me your full name and mailing address and I will get a copy out to you. I have already sent out about 24 copies.
The reason why it is free is because when you convert windows media video to DVD every so often the sound dips for a split second. Also on the DVD just like if you watch the video online there is 10 seconds or so where my voice goes out of sync with my lips and the sound messes up when I say "no bacon".
DVD's will be sent out as fast as possible and in the order requests are received so if you e-mailed me your address rest assured it will be mailed to you.
I am going to continue mailing this DVD out for free till I decide to end it. In the meantime I am eventually going to make a much more professional DVD (with my extremely amateur equipment and software hehe) and that one will be for sale. I already have a distribution company I am going to use when I am pleased with the end product.
The price of that DVD will be as cheap as I can make it. I am not looking to make a profit, but I think that company charges $5.54 per copy plus shipping so I will have to maybe have it around nine dollars. This way people who shop on amazon and have never seen my blog or have been lucky enough to find people on youtube who share the same illness can get a copy.
OK so for now you can get the free DVD by just e-mailing me your full name and mailing address to silentjealousy77@yahoo.com (I will ship to a po box, so if you are uncomfortable giving out your home address a po box is fine.)
***NOTE I will ship this DVD worldwide however make sure that if you are not in the United States that your DVD player can play NTSC format, because I do not have it available in PAL format, which I believe is used in Europe.
You can watch it for free on my blog or if you would like a DVD copy of it for free just e-mail me your full name and mailing address and I will get a copy out to you. I have already sent out about 24 copies.
The reason why it is free is because when you convert windows media video to DVD every so often the sound dips for a split second. Also on the DVD just like if you watch the video online there is 10 seconds or so where my voice goes out of sync with my lips and the sound messes up when I say "no bacon".
DVD's will be sent out as fast as possible and in the order requests are received so if you e-mailed me your address rest assured it will be mailed to you.
I am going to continue mailing this DVD out for free till I decide to end it. In the meantime I am eventually going to make a much more professional DVD (with my extremely amateur equipment and software hehe) and that one will be for sale. I already have a distribution company I am going to use when I am pleased with the end product.
The price of that DVD will be as cheap as I can make it. I am not looking to make a profit, but I think that company charges $5.54 per copy plus shipping so I will have to maybe have it around nine dollars. This way people who shop on amazon and have never seen my blog or have been lucky enough to find people on youtube who share the same illness can get a copy.
OK so for now you can get the free DVD by just e-mailing me your full name and mailing address to silentjealousy77@yahoo.com (I will ship to a po box, so if you are uncomfortable giving out your home address a po box is fine.)
***NOTE I will ship this DVD worldwide however make sure that if you are not in the United States that your DVD player can play NTSC format, because I do not have it available in PAL format, which I believe is used in Europe.
Keith Is Back Home
I picked Keith up from the airport yesterday afternoon. His trip went O.K.
I however did not end up quitting smoking and I am still disappointed by that. After 48 hours of not smoking my mother and I had an argument on the phone. Unable to handle stress without a cigarette and already in major withdrawal I drove to the gas station and bought a pack of cigarettes. I ended up smoking 12 in a row like a feen. Then I broke all the rest up and threw them out and stopped again.
Less than 24 hours later, Keith called me and had broken some promises to me and I caught him in a lie. I won't get into details because I try to keep our relationship private. But needless to say I drove at 4am to the supermarket and bought another pack of cigarettes.
As of now here is how the smoking is going. We are both smoking outside only. I refuse to smoke in the house. I don't care how cold it gets outside or if it is pouring rain, if I want a cigarette that bad I will just have to smoke it outside. Also I told Keith to no longer buy me cigarettes. If I want them bad enough I have to go out on my own and get them.
I will beat this addiction. I just hope I do before I end up with lung cancer or another smoking related disease.
My next serious attempt will be Tuesday afternoon. I will not bore you guys with the details, but promise as soon as I get one week without smoking I will let all of you know.
I however did not end up quitting smoking and I am still disappointed by that. After 48 hours of not smoking my mother and I had an argument on the phone. Unable to handle stress without a cigarette and already in major withdrawal I drove to the gas station and bought a pack of cigarettes. I ended up smoking 12 in a row like a feen. Then I broke all the rest up and threw them out and stopped again.
Less than 24 hours later, Keith called me and had broken some promises to me and I caught him in a lie. I won't get into details because I try to keep our relationship private. But needless to say I drove at 4am to the supermarket and bought another pack of cigarettes.
As of now here is how the smoking is going. We are both smoking outside only. I refuse to smoke in the house. I don't care how cold it gets outside or if it is pouring rain, if I want a cigarette that bad I will just have to smoke it outside. Also I told Keith to no longer buy me cigarettes. If I want them bad enough I have to go out on my own and get them.
I will beat this addiction. I just hope I do before I end up with lung cancer or another smoking related disease.
My next serious attempt will be Tuesday afternoon. I will not bore you guys with the details, but promise as soon as I get one week without smoking I will let all of you know.
Saturday, October 25, 2008
Agoraphobia and Panic Attack Diet (Boiltarian)
A lot of people wanted to know more information on the diet I have done that made me feel a lot better with my anxiety. So I figured I would do a video and try to sum it up for you. It is very amateur and at one point the audio goes out of sync for a few seconds. Sorry about that. I am still new to editing long videos.
I named the diet "The Boiltarian Diet". I was working out the details of it in the past, so if you see anything else online about the diet do not consider it correct at this point till I have time to change what I wrote and remove some videos I made about this diet in the past.
If you have questions feel free to email me.
Wednesday, October 22, 2008
My First Time Away From Keith
I dropped Keith off at the airport at 4:30am this morning. He is flying home to visit his family and friends in FL. He will only be gone 4 days, but to me it seems like an eternity. We have been together for almost 5 years and this will be the first time we have spent more than 24 hours apart from each other.
This is particularly hard on me because I have major trust and jealousy issues. Not only has most the boyfriends I have had in my life cheated on me, but they usually do it when they are on vacation away from me. Having these thoughts run through my mind are not easy for me to deal with and only upset me.
I just keep telling myself. I can not control another persons actions. I mean in reality I would have to watch him 24 hours a day to make sure he never cheated.
The worst part of dealing with myself on this topic is I am not free of this "sin" myself. I have myself cheated in past relationships. I also always got away with it. So in my mind I figure if I got away with it then he could as well.
The only reasons I knew my past boyfriends were cheating on me were because they were really bad at lying or covering their tracks.
My other fear is once he is away from me for a few days maybe he will enjoy it. Maybe he will see me as a burden and leave me. Again I am trying to keep those thoughts at bay.
All that being said I hope he has a good time. I will be so glad though when Sunday is here and I can pick him up from the airport. I really will miss him.
While he is gone I am going to make the bold attempt to quit smoking. Every time I stop I become a mega bitch. There will be no one here for me to yell at. I have no cigarettes left in the house except one which I plan on smoking after this blog post.
I have no intention of leaving my home for the 4 days he is gone so I don't give in and stop at a store to by cigarettes. I am also going to limit my conversations with my mother so that her nagging about a subject does not upset me and cause me to want to smoke.
I am sure that many people locked in their home for 4 days without leaving might start to drive them mad, so in this case being an agoraphobic might have it's upside.
I mentioned in a past blog that the new sneakers that didn't fit me I was going to be mailing to someone for free in New Orleans, LA. I just wanted to give you an update and I did mail them to someone name Scott last week. His house was destroyed during hurricane Katrina, but they have since rebuilt and have a new baby.
Anyway that is all for now. Pray that I can stop smoking finally. If I can't do it this time I will be very disappointed in myself. I hope you all have a great day.
This is particularly hard on me because I have major trust and jealousy issues. Not only has most the boyfriends I have had in my life cheated on me, but they usually do it when they are on vacation away from me. Having these thoughts run through my mind are not easy for me to deal with and only upset me.
I just keep telling myself. I can not control another persons actions. I mean in reality I would have to watch him 24 hours a day to make sure he never cheated.
The worst part of dealing with myself on this topic is I am not free of this "sin" myself. I have myself cheated in past relationships. I also always got away with it. So in my mind I figure if I got away with it then he could as well.
The only reasons I knew my past boyfriends were cheating on me were because they were really bad at lying or covering their tracks.
My other fear is once he is away from me for a few days maybe he will enjoy it. Maybe he will see me as a burden and leave me. Again I am trying to keep those thoughts at bay.
All that being said I hope he has a good time. I will be so glad though when Sunday is here and I can pick him up from the airport. I really will miss him.
While he is gone I am going to make the bold attempt to quit smoking. Every time I stop I become a mega bitch. There will be no one here for me to yell at. I have no cigarettes left in the house except one which I plan on smoking after this blog post.
I have no intention of leaving my home for the 4 days he is gone so I don't give in and stop at a store to by cigarettes. I am also going to limit my conversations with my mother so that her nagging about a subject does not upset me and cause me to want to smoke.
I am sure that many people locked in their home for 4 days without leaving might start to drive them mad, so in this case being an agoraphobic might have it's upside.
I mentioned in a past blog that the new sneakers that didn't fit me I was going to be mailing to someone for free in New Orleans, LA. I just wanted to give you an update and I did mail them to someone name Scott last week. His house was destroyed during hurricane Katrina, but they have since rebuilt and have a new baby.
Anyway that is all for now. Pray that I can stop smoking finally. If I can't do it this time I will be very disappointed in myself. I hope you all have a great day.
The First and Last Time I Address Hate Mail
This is going to be the first and last time I address hate mail or comments. On youtube I have my comments set to be approved for a reason. My videos are directed towards people that are suffering with panic attacks and agoraphobia. Many times comments will come in that "agoraphobia is fake" or "take meds".
I do not feel that those sort of comments should get through because after all the video are not for them and not very useful to the people watching my videos or reading my blog.
I recently got a comment that I would like to address. I tried to email the person back on youtube, but they have their account set to only receive email from people added to their friends list.
I have since removed the persons first comment because I have a strict policy of keeping any comments or emails I address here on the blog anonymous.
So here is the first comment:
"Hmm...I'm not sure how to respond. Most of "us" can barely make it to the mailbox, yet you're willing, and able to sacrifice yourself for the "cause" by going on Oprah?? How very noble of you."
Which I felt might be a little shady, but gave the person the benefit of the doubt and approved their message to which I replied.
"Well many times in my life I was unable to even go to the mailbox. I was never confined to a room in my home like some, but the longest I have been inside without leaving at all was a year. I still have major problems with many things when it comes to panic attacks and agoraphobia. Thankfully, right now I have 50% of it under control. I still suffer from it and with all the ups and downs I have had I am well aware that tomorrow may not be as easy as today."
The person replied to my comment which I did not approve by saying:
"After watching your vids & reading your blog, I truly believe there are other "issues" at play. Change your pdoc to one that will assist you in getting the benefits you're eligible for. And stop seeking your 15 min of fame as a "spokesperson" for something you have under control. Sorry, but we need a real one."
This is when I tried to email the person, but after clicking send youtube said the person did not accept emails from non friends.
My email to that person:
"Ok first off I am not seeking 15 mins of fame. The last thing I want is to have that. I am tired of how I have been treated since I developed panic attacks 17 years ago. If you don't feel that I am the right spokesperson why don't you be one as well. It would be a lot easier if many people with this issue spoke up in different ways they see fit at whatever level of agoraphobia or panic attacks they are in.
I do not completely have any of it under control. Most of the time I do not leave the house and half the time I have others do my shopping. It is just that the other half of the time I do go to the store, but many times I would have starved if no one went because I was not able to go outside my front door.
Besides panic attacks, anxiety in general, agoraphobia and my 3 phobias of blood, needles and dentists....what do you think my other "issues" are? If you tell me and it makes sense I will look into them.
I do not want to completely blow you off and I really think you have taken what I said the wrong way. I really would like to make other peoples lives easier. I would never want anyone to go through what I have been through with people, friends, family and doctors.
But like I said feel free as well to be your own spokesperson."
O.K. I wanted to address this because people with mental problems have had their own experience with different mental issues. I completely understand people are at different levels and different places in their life with their illness.
Here is the thing people. If you don't like how you are being treated and you see a major problem in society over any issue it is your responsibility to stand up for yourself and for others. You have to follow your own truth.
I do not expect everyone to like me that is a given. Everyone has their own opinion on subjects. If any of you do not agree with me or find that I am not helpful to you that is O.K. you are free to watch and read my blog and you are free to think I am a nutjob and ignore me.
What I would like to see however is if you don't like the idea of me becoming a spokesperson then become one yourself. If you don't like what I do, say or my past that is fine, but what are you doing to better your life and other peoples lives? If you sit in judgment of me and anyone else that is fine just as long as you are making your life and other peoples lives around you better. If you aren't and just sitting there blindly in judgment then all you are doing is spreading hate and not worth anyone's time.
As for changing Psych Doctors. I have had over 9. None of them (nor the general practitioner doctors) seem to think I need any form of assistance. Without health insurance you are limited on how much you can shop around. Also for those who don't know this, when you apply for disability they send you to their own doctor. A person who does not have any clue who you are. They ask you questions for about 10 minutes and then send their assessment off to the board. That doctors recommendation as well as your passed medical records are reviewed and the board about a year later makes it's decision.
For me the board found that I could get a "simple task job." They did not get that at that point I left my house once a week for a little over an hour to see my therapist. How they expected a home bound person to work outside the home is beyond me. Let alone how long would the employer keep a person who rarely could show up or stay?
I maybe able to leave my house more than some of you right now, but I have not been able to hold down a job at any point in my life due to anxiety.
I have had a unique perspective in my life. I have been blessed and cursed to see the darker side of life in general. Thankfully some of you never will know that world. Others I am sure have dealt with much worse and for that you have my sympathy and utmost respect.
For people trying to catch up on the blog and want to know more about me please refer to the blog link below.
http://brianunderwood.blogspot.com/2008/07/100-day-confessional.html
I do not feel that those sort of comments should get through because after all the video are not for them and not very useful to the people watching my videos or reading my blog.
I recently got a comment that I would like to address. I tried to email the person back on youtube, but they have their account set to only receive email from people added to their friends list.
I have since removed the persons first comment because I have a strict policy of keeping any comments or emails I address here on the blog anonymous.
So here is the first comment:
"Hmm...I'm not sure how to respond. Most of "us" can barely make it to the mailbox, yet you're willing, and able to sacrifice yourself for the "cause" by going on Oprah?? How very noble of you."
Which I felt might be a little shady, but gave the person the benefit of the doubt and approved their message to which I replied.
"Well many times in my life I was unable to even go to the mailbox. I was never confined to a room in my home like some, but the longest I have been inside without leaving at all was a year. I still have major problems with many things when it comes to panic attacks and agoraphobia. Thankfully, right now I have 50% of it under control. I still suffer from it and with all the ups and downs I have had I am well aware that tomorrow may not be as easy as today."
The person replied to my comment which I did not approve by saying:
"After watching your vids & reading your blog, I truly believe there are other "issues" at play. Change your pdoc to one that will assist you in getting the benefits you're eligible for. And stop seeking your 15 min of fame as a "spokesperson" for something you have under control. Sorry, but we need a real one."
This is when I tried to email the person, but after clicking send youtube said the person did not accept emails from non friends.
My email to that person:
"Ok first off I am not seeking 15 mins of fame. The last thing I want is to have that. I am tired of how I have been treated since I developed panic attacks 17 years ago. If you don't feel that I am the right spokesperson why don't you be one as well. It would be a lot easier if many people with this issue spoke up in different ways they see fit at whatever level of agoraphobia or panic attacks they are in.
I do not completely have any of it under control. Most of the time I do not leave the house and half the time I have others do my shopping. It is just that the other half of the time I do go to the store, but many times I would have starved if no one went because I was not able to go outside my front door.
Besides panic attacks, anxiety in general, agoraphobia and my 3 phobias of blood, needles and dentists....what do you think my other "issues" are? If you tell me and it makes sense I will look into them.
I do not want to completely blow you off and I really think you have taken what I said the wrong way. I really would like to make other peoples lives easier. I would never want anyone to go through what I have been through with people, friends, family and doctors.
But like I said feel free as well to be your own spokesperson."
O.K. I wanted to address this because people with mental problems have had their own experience with different mental issues. I completely understand people are at different levels and different places in their life with their illness.
Here is the thing people. If you don't like how you are being treated and you see a major problem in society over any issue it is your responsibility to stand up for yourself and for others. You have to follow your own truth.
I do not expect everyone to like me that is a given. Everyone has their own opinion on subjects. If any of you do not agree with me or find that I am not helpful to you that is O.K. you are free to watch and read my blog and you are free to think I am a nutjob and ignore me.
What I would like to see however is if you don't like the idea of me becoming a spokesperson then become one yourself. If you don't like what I do, say or my past that is fine, but what are you doing to better your life and other peoples lives? If you sit in judgment of me and anyone else that is fine just as long as you are making your life and other peoples lives around you better. If you aren't and just sitting there blindly in judgment then all you are doing is spreading hate and not worth anyone's time.
As for changing Psych Doctors. I have had over 9. None of them (nor the general practitioner doctors) seem to think I need any form of assistance. Without health insurance you are limited on how much you can shop around. Also for those who don't know this, when you apply for disability they send you to their own doctor. A person who does not have any clue who you are. They ask you questions for about 10 minutes and then send their assessment off to the board. That doctors recommendation as well as your passed medical records are reviewed and the board about a year later makes it's decision.
For me the board found that I could get a "simple task job." They did not get that at that point I left my house once a week for a little over an hour to see my therapist. How they expected a home bound person to work outside the home is beyond me. Let alone how long would the employer keep a person who rarely could show up or stay?
I maybe able to leave my house more than some of you right now, but I have not been able to hold down a job at any point in my life due to anxiety.
I have had a unique perspective in my life. I have been blessed and cursed to see the darker side of life in general. Thankfully some of you never will know that world. Others I am sure have dealt with much worse and for that you have my sympathy and utmost respect.
For people trying to catch up on the blog and want to know more about me please refer to the blog link below.
http://brianunderwood.blogspot.com/2008/07/100-day-confessional.html
Monday, October 20, 2008
Panic Attack Discussion
The following is a reply to the last letter I sent on youtube. What I did is break down the persons letter (the persons letter is in quotes) and my reply to that part of the letter is not. I hope it will be easy for the reader to follow along.
----------------------------
"Hi Brian-
I understand there are still a lot of things that you are dealing with and
I completely understand what you are saying. I agree that people in the medical field "should" be more sensitive but unfortunately they're not. There is no way for them to possibly understand what the sufferer goes through unless they have experienced it themselves."
My Reply: I would have to agree and disagree. Oncologists who treat cancer may not have had cancer themselves. Yet the person with cancer is treated as if they have a real illness.
----------------------------------------
"And of course, with all the people they see each day and all the different complaints, I am sure it's hard to stay sensitive when you hear it day-in and day-out from everyone. I think they become cold and I don't believe it's always intentional but I do believe that there could be more compassion. There are some that are doctors because it is their goal to "help" others but for many... it may have started out like that but it has become nothing but a profession. If only the world was a nicer place. :)"
My Reply: I agree, but I also would like to say that hearing it day in and day out is their job. Medical professionals should be held to a higher standard because they are not just a cashier checking us out at a retail store. When we are ill, sick and scared we have to entrust our lives to these people.
Teachers teach the same class to children in school day in and day out. They get the same questions asked to them over and over. Over and over they have to show children how to do math for example. The teacher can not just become complacent and on day six, third class, and ignore a child asking how to complete a math problem. The second a medical professional is just doing their job as a professional it is time for them to have follow up compassion classes or be removed.
----------------------------------------------------
"The word cure is different to everyone. For me, I don't use the word cure. I use the word recovery. And for me... it is not a destination but instead a point of being. I work hard everyday to stay in recovery. I keep my thoughts in place, watch what I eat, exercise ( to burn off excess adrenaline) and I don't allow my fears to swallow me to the point of avoidance anymore.
Years of personal research, I have learned that it takes a different combination of things to help different people. You really have to try different things to see what works best for you.
For me, it was a combination of CBT, exercise, and diet along with specific natural supplements."
My Reply: Recovery in the dictionary is stated as restoration or return to health from sickness and restoration or return to any former and better state or condition. I would agree that I am way better off now than 17 years ago when this problem first started. So if you take the time I had my first panic attack till now you could say that I am recovered or in a state of recovery. However I am not in a state of recovery if you focus on how I was before I ever had the panic attacks/anxiety start.
For many people who are recovered and/or cured they are not letting their fear swallow them to a point of avoidance anymore. However many are left living their lives not avoiding, but using their "tool box" of deep breathing or whatever their tool happens to be. You yourself said that you use exercise, diet and natural supplements, all are great and I know from experience they can help.
However many people have high stress lives, don't exercise and eating healthy is leaving the tomato on their burger. These people have not suffered from panic disorder and their is a good chance they will never have to deal with panic attacks or agoraphobia. So why are we different is my main point. I am looking for a cause or causes of the disorder. Especially now that the serotonin as well as the brain chemical theory is falling apart. CBT Map III program which claims a 70%-90% success rate states in their book, chapter 1, page 6 {Neurochemicals that may influence panic and anxiety include noradrenaline and serotonin. Although these types of substances may be present in greater amounts during the midst of anxiety and panic, there is no evidence to suggest that a neurochemical imbalance is the original, or main, cause of panic and anxiety.} Just so readers knows CBT Map III is used in the treatment of people with panic attacks by therapists.
Feeling the fear and doing it anyway is great and must be learned to help the person cope, but again I am interested in why this happens to us in the first place.
Mental illness is still a very taboo subject and it is my goal to not let it be one any longer. People with mental illness are still viewed by a large percentage of the public as weak or blamed for their illness. I recently said to my therapist that I do not completely trust the medical community because if this was 1965 I would be seeing a therapist and being treated for being a homosexual. I believe 1973 was when they finally removed homosexuality from the list of mental disorders. Yet in the mean time there were studies on lesbians that received shock treatments to cure them of their perversion. A little under 50 years ago they were trying experiments on people with schizophrenia by rubbing turpentine on their stomachs. Sigmund Freud use to give his depressed patients cocaine to treat their depression. Sigmund Freud later became addicted to cocaine and finally broke his addiction.
So when a doctor says to me take this SSRI it will make you feel better you have to remember I could shoot heroin and feel better it does not mean it is good for me. It does not address the cause. CBT also does not address the cause. Though I will say that CBT does help people learn to cope with the overwhelming emotions they have to deal with.
If you went into a dentist office and told the dentist that you have a heart condition the dentist may prescribe you an antibiotic a week before your visit. The dentist may also call your doctor to talk about if s/he feels it is safe for you to have a certain treatment. This is in complete contrast to what I have experience with dentists in the past and my current dentist. After explaining my state of anxiety and asking if I could be prescribed Valium before I had a root canal I was told "you don't need it." I was also denied nitrous oxide (laughing gas) because "I did not need it". Again the seriousness of the situation is not in many causes taken seriously and the patient is left dealing with a lot more emotional discomfort than is needed or not doing the procedure at all. It took me 3 years and 10 oral surgeon interviews before I found one that I trusted and listened to me. To that man I will be forever grateful. So I am not saying that all medical professionals are bad. I am saying the good ones are rare, but if you can find that gem it feels like a godsend.
--------------------------------------------------------------
"I did not reach my recovery by taking medications. There was a time when I thought I might need an SSRI - but quickly learned that it was not for me from all the research I did. When I learned that I would have to face my problems eventually without medication.... I thought...what's the sense of taking them? I also learned that people who do the CBT without meds have less of a chance of relapse.
This sounded real good to me but at the same time it was a very real, scary reality and these facts pushed me hard to practice everyday.
I am not suggesting that "doing" is what caused me to find recovery.
It was the "doing" along with telling myself the truth even though my symptoms told me otherwise. I felt like I was lying to myself.
My doctor gave me Ativan and told me to take them 3 x's a day for 10 days. I knew ahead of time they could be potentially addictive and so I did not follow his directions- Instead, I took them ONLY when when I felt I needed one. In the process of my therapy, I never finished that prescription and the ones I had left in the bottle became so old they literally disintegrated into powder."
My Reply: I do the same thing with my Xanax I take half of the dose they told me to take because though I am aware I am hooked to them right now coming off will be a lot easier than if I was taking the full dose. I completely understand why you handled the Ativan in that manner.
------------------------------------------------------------------
"There are many natural things that can help balance your brain chemicals. Even CBT has been proven to change the chemical imbalance in the brain during panic/agoraphobia and other mental illnesses. Margo Kidder ( an older actress) is an advocate of natural- alternative mental health. You might want to check their site for some helpful information- They talk alot about diet and supplements -
http://www.alternativementalhealth.com/ Like I said - for everyone, it's different.... you need to find a combination of things that work for you along with CBT. Do not give up."
My Reply: Again I would like to point out that the balancing out of brain chemicals is becoming a myth of the past when it comes to panic disorder. People seem to do just as well with placebo drugs as they do with the real drug. Now before people then say "well then see it is all in the persons mind" I would like to tell you a story about something called placebo surgery.
People took part in a study were they had a bad knee. The damage was visible on x-rays or CT scans. Everyone in the group had a pre-op exam. Everyone in the group was taken to the O.R. and was put under anesthesia. Everyone in the group then had an incision to their knee. Then 50% of the people actually had surgery on their knee injury. The other 50% after the cut was made were stitched back up right away with no surgery taking place. When the results came in about half of the people that had the surgery were doing better and/or cured. The group that did not have surgery about half of them were doing better and/or cured. The numbers were basically the same. Some how they body repaired physical damage because the person believed they had surgery.
I bring placbo up for a reason. Some people recover from CBT, some from medication, some from just being told it is not dangerous and normal, others pray and Jesus removes the illness or Allah removes it depending on your traditional religious background. The truth is a lot of recovery and cures could be being caused by a placebo effect. Now if a person finds a cure or recovery that way I think it is great because the person is no longer suffering. But what about the people left when these treatments don't work?
Being a homosexual I have been told I can "pray the gay away." and indeed there are many organizations mainly religious that agree, one being exodus international and the american psychiatric association up till 1973.
My main concern is that people with any mental illness be treated with dignity and respect. Someone with diabetes is not seen as weird, lazy, blamed or just not trying hard enough to make the diabetes disappear.
-----------------------------------------
"I also agree that many begin drinking due to self-medicating- I do believe that alcohol does exaggerate a preexisting anxiety problem."
My reply: In the long term it really does so if anyone reading this is abusing alcohol or any drug please try to seek help because it really is after awhile making your mental illness worse.
-----------------------------------------
"Anxiety is a learned behavior and can begin even as young as a small child."
My Reply: Anxiety is not always a learned behavior. Lets step out of the human realm for a minute. I had a cat when I was little. We got her as a kitten about 8 weeks old. She was never beat, she was just a very loved, cared for cat. She was a nervous wreck. Any sound would scare her and she would hide. She would even hide from myself and my family. She was always under weight and ate a lot of food because she always had so much nervous energy. She was tested for physical disorders to make sure nothing was wrong with her and she had a clean bill of health. If a stranger came over to the home to visit forget it, she was gone under a couch or into a closet. She would disappear at the speed of light. Now one good thing I will say about her is she lived to be almost 20 years old which is a very old age for a cat. I and my family have had cats since her passing and none were treated any differently and none were nervous like she was. For anyone who is interested reading this her name was Daisy. She really was a cute cat. :-)
O.K. back to humans. Many people have had panic attacks and did not develop panic disorder. They continue on and off to have a panic attack through out their life and just are not scared about having them. Yet they still get them. What would be the cause of their panic attacks, especially if they do not have a high stress lifestyle or worried?
-----------------------------------------------------
"I believe I had anxiety as a child and it followed me through adulthood and blossomed into a full panic/agoraphobia event. For me,
It was a severe amount of stress in my life that brought this on. I think it would have been easier for me to understand and recover.... if I knew more about stress and how it affected people. I am a type A personality and I work myself to the point of exhaustion. I was a people pleaser, do it all.... for everyone.... and I never put myself first.
My personalities along with being a negative thinker was a bad mix for me. I had to work hard to undo the habits that I learned from my own father."
My Reply: I agree this can be a major factor for some people with panic attacks, agoraphobia and anxiety. But again this brings me back to the example, everyone can have a seizure, but not everyone has epilepsy. I am not saying it is not as difficult for some people than others no matter what the reason. What I am saying is this could explain why treatment works for most, but not all. It could also explain why treatment works in different ways in different people and why there is so many different levels of recovery.
I would also like to state that information came out a few years back that it was discovered that the most common seizures, panic attacks and migraines seemed to be coming from the same area of the brain. Whatever became of that discovery I am unsure of. (Just so everyone knows anything that I am talking about can be looked up for free on google. No need to go out an buy a ton of books..unless you prefer books) :-)
------------------------------------------------------
"Recovery-Inc.Org is a FREE CBT program for people with all kinds of mental challenges. Yes, it's hard for someone with agoraphobia to go to these meetings but it's all about baby steps. I realize that finding therapies that are affordable is difficult , however, programs like this one are priceless. Recovery-Inc.Org is based on the works of Dr. Abraham Low."
My Reply: I will look into it as I am always trying to get more information on the subject. Just so my readers know I have not yet heard of Dr. Abraham Low so at this time I can not make a judgment call on his work.
-------------------------------------------------------
"There is also Lucinda Bassett's program "Attacking anxiety and Depression" through the Midwest Center. I did this program and although a lot of the information is the same as in Claire Weeke's books, I enjoyed listening to her tapes over and over again. Repetition was very important for me in retraining my brain to think the right things.
The only way to overcome agoraphobia is by taking small steps EVERY day."
My Reply: Lucinda Bassett's program costs about $300 and really is not new information for anyone that has been in treatment with an anxiety problem for a long time. Lucinda Bassett's approach is not much different than the CBT Map III program I brought up earlier. So to save money, and to get the same information buying some books by Claire Weeke's would be much cheaper for you and are just as inspirational. I would also like to say for people who are religious Christians you may enjoy or find comfort in a book called "Battlefield of the Mind" by Joyce Meyer.
------------------------------------------------------------------
"When it came to the fear of "passing out". I heard conflicting stories.
As well with vomiting. I used to fear all kinds of things. In fact, one of the REAL things I struggled with was ulcerative colitis. I had diarrhea very bad. These were extreme urges to run to the bathroom about 40 times a day or more. Many times, there would be nothing but blood."
My Reply: I too had this problem as well and was diagnosed with ulcerative colitis in late 1994 and took a drug called Azulfidine for 8 months. One night I had too much blood come out and was taken to Strong Memorial Hospital in Rochester, NY. where I was living at the time and going to college. I have been in remission for many years now thankfully.
-------------------------------------------------------------------
"I feared many times that I would not be able to find a bathroom. I had 3 small children at that time in my life as well. But I forced myself to challenge myself anyways. I would be in a store, facing my symptoms, and I worked the CBT while with little children that whined, I had to rush to the bathroom and take them along. Instead of leaving the store, I would stay. I went to the store daily - I thought people would think I lived there. But I was so focused on getting better that I did not care what others thought. In fact, I told myself "it's okay if I vomit in public - "it's okay if I faint"..... "I know that someone will help me should this happen". " I don't care what others think"..." I am not helpless". I realize some have vomited and some have fainted and it really is okay. It is inconvenient but at the same time, it is more important to face those fears and do it anyways."
My Reply: When it comes to facing my fears about vomiting in a store I have no problem. I am at a point in my life where I do not really care what the general public thinks of me. Do I want to throw up in the store? Not really and I know it would not be the end of the world. For health reasons I would like to not vomit when I get nervous. On average I throw up about twice a week for the past 17 years. That would mean I have vomited on average 1768 times. This has taken a toll on the back of my throat as well as the back of my teeth. Stomach acid has caused a large amount of damage to my teeth and is why I am having to go to the dentist for repairs. Sometimes I have thrown up so much, blood has come up and is the cause of why I was yet again taken to Bay Medical Center Emergency Room in Panama City, FL where I was living in 2006.
You made a statement that you know someone would help you. I hope that would be the case for you and all of us. I have my doubts in humanity in it's current state as shown in the video clips below:
-------------------------------------------------------------------------
"Dr. Archibald Hart talks a lot about the challenges men face in having these disorders- men suffer just as much as women - if not more due to the fact that society places upon them the stigma that they are supposed to be "stronger" than women in this sense. It's not right but the world is like that."
My Reply: I agree and it's not right but as you say "but the world is like that." Well it is up to all of us to change that. Many times people say "that is awful someone should do something about that." That person is you, me and all of us. If we do not stand for that any longer things can and will change.
------------------------------------------------------------------------
"Brian- hang in there. It is one thing to "do" and other to feel peace while "doing". Feeling the fear and doing it anyways is not the "cure".
What matters more is how you talk to yourself about being sick.
It is our own personal perception of things that can keep us stuck or make us free. The mind is a very powerful thing and many times there are things in our subconscious that we are not even aware we are thinking. Journaling helps get into this area of our brain and so I am glad you are blogging! It will allow you to go back and reread things and you may notice something later on in life that you didn't notice before. "
My Reply: Thank You. My goal is to have people put pressure on the medical community to find the cause and the cure. We have a war on cancer and a war on drugs...where is the war on mental illness? But more importantly it is to get people with mental illness the respect they deserve like any other human should have. My other goal is to have the proper training and up to date information passed on to medical professions. My blog is not just for me, but for anyone that has been through the ringer and still no better off and searching for answers.
--------------------------------------------------------------------
"I don't believe anxiety happens for no reason. I believe there is a reason for everything. Anxiety can be the result of a hormonal imbalance or something as simple as a prolapse valve in the heart.
There are different things- for me, it was too much stress...for too long of a period mixed with not understanding what I was feeling or going through.
Education is key and the earlier people are educated and understand, the sooner they can find healing so they can prevent further episodes.
I personally believe children should be taught about stress and anxiety in school in their health classes. If you train a child to see it for what it is, and how to deal with it, along with common fears and common feelings , they will be less likely to be afraid of their feelings and thoughts in the future."
My Reply: I agree that children should be taught about mental illness in school and how to handle their own feelings. I think this education is just as important for adults and especially medical professionals.
------------------------------------------------------------
"Well I must be going- Your long email has required a long response!
Sorry about that!
I wish you well in your journey Brian- there is still much to learn and I hope you find a combination of the right things that work for you. :)
Take Care! "
My Reply: Thank You and I wish you well as well. Thank you for taking the time to write to me and I hope others will take the time as well. If anyone would like to see my videos on youtube just search "silentjealousy77" and my videos will come up. Again thank you to the person who sent me this letter. I would also like to say to get caught up please return to the begining of my blog and read everything. This will give you a greater understanding of me, but also allow you to read questions that were already asked. :-)
----------------------------
"Hi Brian-
I understand there are still a lot of things that you are dealing with and
I completely understand what you are saying. I agree that people in the medical field "should" be more sensitive but unfortunately they're not. There is no way for them to possibly understand what the sufferer goes through unless they have experienced it themselves."
My Reply: I would have to agree and disagree. Oncologists who treat cancer may not have had cancer themselves. Yet the person with cancer is treated as if they have a real illness.
----------------------------------------
"And of course, with all the people they see each day and all the different complaints, I am sure it's hard to stay sensitive when you hear it day-in and day-out from everyone. I think they become cold and I don't believe it's always intentional but I do believe that there could be more compassion. There are some that are doctors because it is their goal to "help" others but for many... it may have started out like that but it has become nothing but a profession. If only the world was a nicer place. :)"
My Reply: I agree, but I also would like to say that hearing it day in and day out is their job. Medical professionals should be held to a higher standard because they are not just a cashier checking us out at a retail store. When we are ill, sick and scared we have to entrust our lives to these people.
Teachers teach the same class to children in school day in and day out. They get the same questions asked to them over and over. Over and over they have to show children how to do math for example. The teacher can not just become complacent and on day six, third class, and ignore a child asking how to complete a math problem. The second a medical professional is just doing their job as a professional it is time for them to have follow up compassion classes or be removed.
----------------------------------------------------
"The word cure is different to everyone. For me, I don't use the word cure. I use the word recovery. And for me... it is not a destination but instead a point of being. I work hard everyday to stay in recovery. I keep my thoughts in place, watch what I eat, exercise ( to burn off excess adrenaline) and I don't allow my fears to swallow me to the point of avoidance anymore.
Years of personal research, I have learned that it takes a different combination of things to help different people. You really have to try different things to see what works best for you.
For me, it was a combination of CBT, exercise, and diet along with specific natural supplements."
My Reply: Recovery in the dictionary is stated as restoration or return to health from sickness and restoration or return to any former and better state or condition. I would agree that I am way better off now than 17 years ago when this problem first started. So if you take the time I had my first panic attack till now you could say that I am recovered or in a state of recovery. However I am not in a state of recovery if you focus on how I was before I ever had the panic attacks/anxiety start.
For many people who are recovered and/or cured they are not letting their fear swallow them to a point of avoidance anymore. However many are left living their lives not avoiding, but using their "tool box" of deep breathing or whatever their tool happens to be. You yourself said that you use exercise, diet and natural supplements, all are great and I know from experience they can help.
However many people have high stress lives, don't exercise and eating healthy is leaving the tomato on their burger. These people have not suffered from panic disorder and their is a good chance they will never have to deal with panic attacks or agoraphobia. So why are we different is my main point. I am looking for a cause or causes of the disorder. Especially now that the serotonin as well as the brain chemical theory is falling apart. CBT Map III program which claims a 70%-90% success rate states in their book, chapter 1, page 6 {Neurochemicals that may influence panic and anxiety include noradrenaline and serotonin. Although these types of substances may be present in greater amounts during the midst of anxiety and panic, there is no evidence to suggest that a neurochemical imbalance is the original, or main, cause of panic and anxiety.} Just so readers knows CBT Map III is used in the treatment of people with panic attacks by therapists.
Feeling the fear and doing it anyway is great and must be learned to help the person cope, but again I am interested in why this happens to us in the first place.
Mental illness is still a very taboo subject and it is my goal to not let it be one any longer. People with mental illness are still viewed by a large percentage of the public as weak or blamed for their illness. I recently said to my therapist that I do not completely trust the medical community because if this was 1965 I would be seeing a therapist and being treated for being a homosexual. I believe 1973 was when they finally removed homosexuality from the list of mental disorders. Yet in the mean time there were studies on lesbians that received shock treatments to cure them of their perversion. A little under 50 years ago they were trying experiments on people with schizophrenia by rubbing turpentine on their stomachs. Sigmund Freud use to give his depressed patients cocaine to treat their depression. Sigmund Freud later became addicted to cocaine and finally broke his addiction.
So when a doctor says to me take this SSRI it will make you feel better you have to remember I could shoot heroin and feel better it does not mean it is good for me. It does not address the cause. CBT also does not address the cause. Though I will say that CBT does help people learn to cope with the overwhelming emotions they have to deal with.
If you went into a dentist office and told the dentist that you have a heart condition the dentist may prescribe you an antibiotic a week before your visit. The dentist may also call your doctor to talk about if s/he feels it is safe for you to have a certain treatment. This is in complete contrast to what I have experience with dentists in the past and my current dentist. After explaining my state of anxiety and asking if I could be prescribed Valium before I had a root canal I was told "you don't need it." I was also denied nitrous oxide (laughing gas) because "I did not need it". Again the seriousness of the situation is not in many causes taken seriously and the patient is left dealing with a lot more emotional discomfort than is needed or not doing the procedure at all. It took me 3 years and 10 oral surgeon interviews before I found one that I trusted and listened to me. To that man I will be forever grateful. So I am not saying that all medical professionals are bad. I am saying the good ones are rare, but if you can find that gem it feels like a godsend.
--------------------------------------------------------------
"I did not reach my recovery by taking medications. There was a time when I thought I might need an SSRI - but quickly learned that it was not for me from all the research I did. When I learned that I would have to face my problems eventually without medication.... I thought...what's the sense of taking them? I also learned that people who do the CBT without meds have less of a chance of relapse.
This sounded real good to me but at the same time it was a very real, scary reality and these facts pushed me hard to practice everyday.
I am not suggesting that "doing" is what caused me to find recovery.
It was the "doing" along with telling myself the truth even though my symptoms told me otherwise. I felt like I was lying to myself.
My doctor gave me Ativan and told me to take them 3 x's a day for 10 days. I knew ahead of time they could be potentially addictive and so I did not follow his directions- Instead, I took them ONLY when when I felt I needed one. In the process of my therapy, I never finished that prescription and the ones I had left in the bottle became so old they literally disintegrated into powder."
My Reply: I do the same thing with my Xanax I take half of the dose they told me to take because though I am aware I am hooked to them right now coming off will be a lot easier than if I was taking the full dose. I completely understand why you handled the Ativan in that manner.
------------------------------------------------------------------
"There are many natural things that can help balance your brain chemicals. Even CBT has been proven to change the chemical imbalance in the brain during panic/agoraphobia and other mental illnesses. Margo Kidder ( an older actress) is an advocate of natural- alternative mental health. You might want to check their site for some helpful information- They talk alot about diet and supplements -
http://www.alternativementalhealth.com/ Like I said - for everyone, it's different.... you need to find a combination of things that work for you along with CBT. Do not give up."
My Reply: Again I would like to point out that the balancing out of brain chemicals is becoming a myth of the past when it comes to panic disorder. People seem to do just as well with placebo drugs as they do with the real drug. Now before people then say "well then see it is all in the persons mind" I would like to tell you a story about something called placebo surgery.
People took part in a study were they had a bad knee. The damage was visible on x-rays or CT scans. Everyone in the group had a pre-op exam. Everyone in the group was taken to the O.R. and was put under anesthesia. Everyone in the group then had an incision to their knee. Then 50% of the people actually had surgery on their knee injury. The other 50% after the cut was made were stitched back up right away with no surgery taking place. When the results came in about half of the people that had the surgery were doing better and/or cured. The group that did not have surgery about half of them were doing better and/or cured. The numbers were basically the same. Some how they body repaired physical damage because the person believed they had surgery.
I bring placbo up for a reason. Some people recover from CBT, some from medication, some from just being told it is not dangerous and normal, others pray and Jesus removes the illness or Allah removes it depending on your traditional religious background. The truth is a lot of recovery and cures could be being caused by a placebo effect. Now if a person finds a cure or recovery that way I think it is great because the person is no longer suffering. But what about the people left when these treatments don't work?
Being a homosexual I have been told I can "pray the gay away." and indeed there are many organizations mainly religious that agree, one being exodus international and the american psychiatric association up till 1973.
My main concern is that people with any mental illness be treated with dignity and respect. Someone with diabetes is not seen as weird, lazy, blamed or just not trying hard enough to make the diabetes disappear.
-----------------------------------------
"I also agree that many begin drinking due to self-medicating- I do believe that alcohol does exaggerate a preexisting anxiety problem."
My reply: In the long term it really does so if anyone reading this is abusing alcohol or any drug please try to seek help because it really is after awhile making your mental illness worse.
-----------------------------------------
"Anxiety is a learned behavior and can begin even as young as a small child."
My Reply: Anxiety is not always a learned behavior. Lets step out of the human realm for a minute. I had a cat when I was little. We got her as a kitten about 8 weeks old. She was never beat, she was just a very loved, cared for cat. She was a nervous wreck. Any sound would scare her and she would hide. She would even hide from myself and my family. She was always under weight and ate a lot of food because she always had so much nervous energy. She was tested for physical disorders to make sure nothing was wrong with her and she had a clean bill of health. If a stranger came over to the home to visit forget it, she was gone under a couch or into a closet. She would disappear at the speed of light. Now one good thing I will say about her is she lived to be almost 20 years old which is a very old age for a cat. I and my family have had cats since her passing and none were treated any differently and none were nervous like she was. For anyone who is interested reading this her name was Daisy. She really was a cute cat. :-)
O.K. back to humans. Many people have had panic attacks and did not develop panic disorder. They continue on and off to have a panic attack through out their life and just are not scared about having them. Yet they still get them. What would be the cause of their panic attacks, especially if they do not have a high stress lifestyle or worried?
-----------------------------------------------------
"I believe I had anxiety as a child and it followed me through adulthood and blossomed into a full panic/agoraphobia event. For me,
It was a severe amount of stress in my life that brought this on. I think it would have been easier for me to understand and recover.... if I knew more about stress and how it affected people. I am a type A personality and I work myself to the point of exhaustion. I was a people pleaser, do it all.... for everyone.... and I never put myself first.
My personalities along with being a negative thinker was a bad mix for me. I had to work hard to undo the habits that I learned from my own father."
My Reply: I agree this can be a major factor for some people with panic attacks, agoraphobia and anxiety. But again this brings me back to the example, everyone can have a seizure, but not everyone has epilepsy. I am not saying it is not as difficult for some people than others no matter what the reason. What I am saying is this could explain why treatment works for most, but not all. It could also explain why treatment works in different ways in different people and why there is so many different levels of recovery.
I would also like to state that information came out a few years back that it was discovered that the most common seizures, panic attacks and migraines seemed to be coming from the same area of the brain. Whatever became of that discovery I am unsure of. (Just so everyone knows anything that I am talking about can be looked up for free on google. No need to go out an buy a ton of books..unless you prefer books) :-)
------------------------------------------------------
"Recovery-Inc.Org is a FREE CBT program for people with all kinds of mental challenges. Yes, it's hard for someone with agoraphobia to go to these meetings but it's all about baby steps. I realize that finding therapies that are affordable is difficult , however, programs like this one are priceless. Recovery-Inc.Org is based on the works of Dr. Abraham Low."
My Reply: I will look into it as I am always trying to get more information on the subject. Just so my readers know I have not yet heard of Dr. Abraham Low so at this time I can not make a judgment call on his work.
-------------------------------------------------------
"There is also Lucinda Bassett's program "Attacking anxiety and Depression" through the Midwest Center. I did this program and although a lot of the information is the same as in Claire Weeke's books, I enjoyed listening to her tapes over and over again. Repetition was very important for me in retraining my brain to think the right things.
The only way to overcome agoraphobia is by taking small steps EVERY day."
My Reply: Lucinda Bassett's program costs about $300 and really is not new information for anyone that has been in treatment with an anxiety problem for a long time. Lucinda Bassett's approach is not much different than the CBT Map III program I brought up earlier. So to save money, and to get the same information buying some books by Claire Weeke's would be much cheaper for you and are just as inspirational. I would also like to say for people who are religious Christians you may enjoy or find comfort in a book called "Battlefield of the Mind" by Joyce Meyer.
------------------------------------------------------------------
"When it came to the fear of "passing out". I heard conflicting stories.
As well with vomiting. I used to fear all kinds of things. In fact, one of the REAL things I struggled with was ulcerative colitis. I had diarrhea very bad. These were extreme urges to run to the bathroom about 40 times a day or more. Many times, there would be nothing but blood."
My Reply: I too had this problem as well and was diagnosed with ulcerative colitis in late 1994 and took a drug called Azulfidine for 8 months. One night I had too much blood come out and was taken to Strong Memorial Hospital in Rochester, NY. where I was living at the time and going to college. I have been in remission for many years now thankfully.
-------------------------------------------------------------------
"I feared many times that I would not be able to find a bathroom. I had 3 small children at that time in my life as well. But I forced myself to challenge myself anyways. I would be in a store, facing my symptoms, and I worked the CBT while with little children that whined, I had to rush to the bathroom and take them along. Instead of leaving the store, I would stay. I went to the store daily - I thought people would think I lived there. But I was so focused on getting better that I did not care what others thought. In fact, I told myself "it's okay if I vomit in public - "it's okay if I faint"..... "I know that someone will help me should this happen". " I don't care what others think"..." I am not helpless". I realize some have vomited and some have fainted and it really is okay. It is inconvenient but at the same time, it is more important to face those fears and do it anyways."
My Reply: When it comes to facing my fears about vomiting in a store I have no problem. I am at a point in my life where I do not really care what the general public thinks of me. Do I want to throw up in the store? Not really and I know it would not be the end of the world. For health reasons I would like to not vomit when I get nervous. On average I throw up about twice a week for the past 17 years. That would mean I have vomited on average 1768 times. This has taken a toll on the back of my throat as well as the back of my teeth. Stomach acid has caused a large amount of damage to my teeth and is why I am having to go to the dentist for repairs. Sometimes I have thrown up so much, blood has come up and is the cause of why I was yet again taken to Bay Medical Center Emergency Room in Panama City, FL where I was living in 2006.
You made a statement that you know someone would help you. I hope that would be the case for you and all of us. I have my doubts in humanity in it's current state as shown in the video clips below:
-------------------------------------------------------------------------
"Dr. Archibald Hart talks a lot about the challenges men face in having these disorders- men suffer just as much as women - if not more due to the fact that society places upon them the stigma that they are supposed to be "stronger" than women in this sense. It's not right but the world is like that."
My Reply: I agree and it's not right but as you say "but the world is like that." Well it is up to all of us to change that. Many times people say "that is awful someone should do something about that." That person is you, me and all of us. If we do not stand for that any longer things can and will change.
------------------------------------------------------------------------
"Brian- hang in there. It is one thing to "do" and other to feel peace while "doing". Feeling the fear and doing it anyways is not the "cure".
What matters more is how you talk to yourself about being sick.
It is our own personal perception of things that can keep us stuck or make us free. The mind is a very powerful thing and many times there are things in our subconscious that we are not even aware we are thinking. Journaling helps get into this area of our brain and so I am glad you are blogging! It will allow you to go back and reread things and you may notice something later on in life that you didn't notice before. "
My Reply: Thank You. My goal is to have people put pressure on the medical community to find the cause and the cure. We have a war on cancer and a war on drugs...where is the war on mental illness? But more importantly it is to get people with mental illness the respect they deserve like any other human should have. My other goal is to have the proper training and up to date information passed on to medical professions. My blog is not just for me, but for anyone that has been through the ringer and still no better off and searching for answers.
--------------------------------------------------------------------
"I don't believe anxiety happens for no reason. I believe there is a reason for everything. Anxiety can be the result of a hormonal imbalance or something as simple as a prolapse valve in the heart.
There are different things- for me, it was too much stress...for too long of a period mixed with not understanding what I was feeling or going through.
Education is key and the earlier people are educated and understand, the sooner they can find healing so they can prevent further episodes.
I personally believe children should be taught about stress and anxiety in school in their health classes. If you train a child to see it for what it is, and how to deal with it, along with common fears and common feelings , they will be less likely to be afraid of their feelings and thoughts in the future."
My Reply: I agree that children should be taught about mental illness in school and how to handle their own feelings. I think this education is just as important for adults and especially medical professionals.
------------------------------------------------------------
"Well I must be going- Your long email has required a long response!
Sorry about that!
I wish you well in your journey Brian- there is still much to learn and I hope you find a combination of the right things that work for you. :)
Take Care! "
My Reply: Thank You and I wish you well as well. Thank you for taking the time to write to me and I hope others will take the time as well. If anyone would like to see my videos on youtube just search "silentjealousy77" and my videos will come up. Again thank you to the person who sent me this letter. I would also like to say to get caught up please return to the begining of my blog and read everything. This will give you a greater understanding of me, but also allow you to read questions that were already asked. :-)
Sunday, October 19, 2008
My Nine Points Of Interest
A letter I received on youtube. My reply is under the letter.
"Agoraphobia is a real illness but it's also important to know that you can overcome it. For everyone, the recovery time is different. Persistence is the key. Avoidance only makes anxiety worse. Years ago Oprah had a show (before Dr. Phil was famous) where they worked with phobias, including agoraphobia.
You must not give up or see this illness as a "permanent" one. It's about retraining your brain to see things properly and it takes a lot of hard work and determination.
One of the programs I did, said that it takes at least 1000 times of telling yourself something before you finally believe it. This helped me to see that I had A LOT of work ahead of me with positive, truthful self-talk.
One of the books that helped me the most about agoraphobia was a book called "Hope and Help for My Nerves" by Claire Weekes. She also did another book based on panic/anxiety attacks called "Peace from nervous suffering". They are both very good however "Hope and Help" specifically speaks about agoraphobia ( avoidance behaviors).
Repetition is very important for people who are suffering from agoraphobia. For me, I had to visit the grocery store every day, stand in line, allow myself to panic and practice telling myself the truth - it was hard to do. Very uncomfortable. However, there was one truth that got me through that line everyday - it was the fact that I knew I could not live like that and I was willing to do whatever it took to get better. I learned that it takes your body a long time before it "feels" the affects of your new thoughts/behaviors.
So even when you think your practice sessions are not working....they are.
It's hard to believe what others have said about recovery. To trust what others have said to you about how to get better is very difficult. Because in the back of your mind you think that it worked for them...but what if it doesn't work for you. That's the famous lie that anxiety likes to tell. It's been telling it for decades and decades.
Feelings are not facts. Feelings indeed are the end result of what we tell ourselves.
You might also check out http://www.recovery-inc.org It's free and chances are good that you have one nearby. They also now offer meetings over the phone. This program is cognitive/behavioral "hands on" ( meaning that you learn the cognitive/behavioral approach in these meetings first-hand). For some, this is the best way since they have a hard time keeping their thoughts in line with truth, especially when severely anxious.
http://paniccure.com/Overcoming_Agoraphobia/Overcoming_Agoraphobia.htm
This website offers you a step-by-step plan. It helped me great many years ago and made a huge difference in my recovery.
If you ever have any questions about my experience or just want to vent, feel free to email anytime!
Don't give up! There is freedom- I know because I am finally free of that torment!"
-----------------------------------------------------------------------
My Reply:
I am glad you are doing better. I do have and read the book "Hope and Help for My Nerves" by Claire Weekes it is a very good book.
I just want to be more clear on what I am talking about in my videos. Fear of the way you feel is a trap that I understand. The more you are scared of lets say a dizzy spell, then you might have the thought "I hope I don't faint" this will set in motion your heart pounding because you took a simple dizzy spell and scared yourself more. And as you know it will spiral out of control.
I agree CBT and/or medications really can help this illness. However many times people throw around the word "cure". This all depends on what you think a "cure" is.
At one time I was completely in my house and now I am not. That part I can fix and have my ups and downs. I have had panic attacks for 17 years and agoraphobia mostly for the past 5 years due to the panic attacks. However here is the thing. I am not scared of having a panic attack or even the general anxiety that goes along with having the disorder.
Here is where my real interests fall:
1) The lack of understanding by the public and many medical professionals on the subject. I can not tell you how many times I have been treated badly by medical professionals or have had to explain to them what agoraphobia was. I feel they should be informed of the illness so they can help the person get through it and show compassion. Not treat people in away that will make them feel worse or more scared of a situation especially for people who have not yet learned to control their panic.
2) Responsible information given to the patient about the dangers of medications especially. SSRI drugs and the newer classes of SSNRI's. Only a well informed patient can make a well informed choice. There to date has been no long term studies on SSRI drugs used over the long term. Also many studies show that the SSRI drugs did a little better and sometimes worse in placebo trials.
3) After medication and CBT there are tools we all learn to deal with stressful situations such as deep breathing ect ect. At this point we are still left worrying more than the average person and just keeping it under control. I am more interested in why we are hyper-sensitive in the first place. An answer to that question could be very useful to people in the future who develop this problem.
4) People need to understand there is a range of panic attacks. Not all people with panic attacks fit in the same box. The easiest way to explain this is with seizures. Anyone can have a seizure be it from overdose, a hit to the head etc. Once the issue is removed, in this case being the medication we would not have a seizure again because the offending problem was removed. Now there are people with epilepsy. They have seizures for a completely different reason.
Keeping it in that context I would like people to understand that some people may develop panic disorder because of a very stressful time in their life once that problem is removed the panic attacks can be dealt with. Other people started having panic attacks for no reason. In many cases people can be helped. Especially to deal with the feelings of panic attacks and helped to stop the escalation once one starts. However there are some people where no matter how much CBT you do and no matter how many medications you take the high anxiety level remains. This is what is of great interest to me.
I have had people contact me who have done CBT and are currently on 7 different medications and they are still suffering. I have also had people who stopped medication and force themselves to go to work or live their life in general, but are still suffering.
For example I would get a job and go everyday, every month I would go and get my hair cut, I would go shopping when I needed food. At no point did I become "cured". Did I learn to deal with the feelings and not be scared of them? Sure. For that I am grateful. However what never went away and what indeed does not go away for a large part of people is they still experience having unrealistic body responses in normal everyday situations.
5) Truthful information given to people with panic attacks. Usually they are told no matter how bad the panic attack is it impossible to faint. This is not the case and many people with panic attacks have fainted during one. I feel it is best to inform them that though it usually doesn't happen it could. This way if that should happen to a person having a panic attack they do not completely flip out thinking they are worse off than someone else and becoming more frightened.
People are also told. You won't throw up during a panic attack you will just feel like you will. This is not true and I know that first hand. I throw up during most of my panic attack as well as when I am nervous in general. Throwing up does not scare me however I think you would agree it would be inconvenient to throw up while a dentist is working in my mouth or in isle 4 in the supermarket.
That phobias or feelings have never killed anyone. Well that also is not the truth. Though rare there has been 23 documented deaths due to blood/needle phobia. They died from cardiovascular collapse. This however is rare like I said. However when medical professionals are dealing with a blood/needle phobic (which is considered currently as genetic) they should have a crash cart and also a place for the person to lay down when blood is drawn.
Personally I have this phobia and I can not tell you how many places I have called that have no place for you to lay down. They all just have chairs to sit in.
6) Medicaid for people suffering with panic attacks and/or agoraphobia if they do not have health insurance. Without that getting the help they need to help control the panic attacks can become a challenge. For example I do not have health insurance and have been denied medicaid as well as other programs New York State offers. So every week I see a student in training. That is all I can afford. Calling around to doctors that treat this condition might have a sliding fee. If there normal fee is $120 for an hour they are willing to sometimes go to $70. That still comes out to $280 a month. Many people just do not have that kind of money.
7) The lack of knowledge in addiction recovery centers for people who became addicted to drugs or alcohol because that is the only way they knew how to control the anxiety at that point in time in their life. Many recovery centers place everyone is the same box, an "addict". Just like there are different people with levels of panic disorder there are different kinds of addicts.
From personal experience in an alcohol rehab program I was told all my anxiety was from drinking. However they never understood that the anxiety was there in high levels before I ever drank. I was self-medicating. This was not understood in the least and I was just told I could take paxil or zoloft. This of course right after they said "A drug is a drug is a drug." Rehab staff as well and many people involved in government think it can all be fixed with a pill. This is not the case in many peoples lives. Also because of side effects some people can not tolerate the drug itself and feel worse than they did having the panic attacks.
I was also told I would never be able to stop drinking without "them" or without A.A. Try getting an agoraphobic to an A.A. meeting where they have to talk and share. Especially as the anxiety is now climbing because for years you dulled it down with alcohol.
Again it was a lie. A.A. is a good program and has helped countless people. It was not for me and I was made to feel I could never stop drinking on my own. I did stop on my own and I am very thankful and proud of that. Especially since I was told it was impossible.
8) Diet can and does play a role in peoples lives. Not only for physical health, but in some people their mental health. I feel that should be looked into more.
9) That men who have this disorder are treated with respect and not considered weak or as other men put it to each other "stop acting like a girl." This behavior is unacceptable especially coming from a doctor, nurse or any medical professional. Our medical system needs a major overhaul and the professionals need more classes or refresher courses in compassion. In all disease the person is not a number and not their health insurance plan, but a person who has real feelings, a real life and real people who love them.
Brian :-)
"Agoraphobia is a real illness but it's also important to know that you can overcome it. For everyone, the recovery time is different. Persistence is the key. Avoidance only makes anxiety worse. Years ago Oprah had a show (before Dr. Phil was famous) where they worked with phobias, including agoraphobia.
You must not give up or see this illness as a "permanent" one. It's about retraining your brain to see things properly and it takes a lot of hard work and determination.
One of the programs I did, said that it takes at least 1000 times of telling yourself something before you finally believe it. This helped me to see that I had A LOT of work ahead of me with positive, truthful self-talk.
One of the books that helped me the most about agoraphobia was a book called "Hope and Help for My Nerves" by Claire Weekes. She also did another book based on panic/anxiety attacks called "Peace from nervous suffering". They are both very good however "Hope and Help" specifically speaks about agoraphobia ( avoidance behaviors).
Repetition is very important for people who are suffering from agoraphobia. For me, I had to visit the grocery store every day, stand in line, allow myself to panic and practice telling myself the truth - it was hard to do. Very uncomfortable. However, there was one truth that got me through that line everyday - it was the fact that I knew I could not live like that and I was willing to do whatever it took to get better. I learned that it takes your body a long time before it "feels" the affects of your new thoughts/behaviors.
So even when you think your practice sessions are not working....they are.
It's hard to believe what others have said about recovery. To trust what others have said to you about how to get better is very difficult. Because in the back of your mind you think that it worked for them...but what if it doesn't work for you. That's the famous lie that anxiety likes to tell. It's been telling it for decades and decades.
Feelings are not facts. Feelings indeed are the end result of what we tell ourselves.
You might also check out http://www.recovery-inc.org It's free and chances are good that you have one nearby. They also now offer meetings over the phone. This program is cognitive/behavioral "hands on" ( meaning that you learn the cognitive/behavioral approach in these meetings first-hand). For some, this is the best way since they have a hard time keeping their thoughts in line with truth, especially when severely anxious.
http://paniccure.com/Overcoming_Agoraphobia/Overcoming_Agoraphobia.htm
This website offers you a step-by-step plan. It helped me great many years ago and made a huge difference in my recovery.
If you ever have any questions about my experience or just want to vent, feel free to email anytime!
Don't give up! There is freedom- I know because I am finally free of that torment!"
-----------------------------------------------------------------------
My Reply:
I am glad you are doing better. I do have and read the book "Hope and Help for My Nerves" by Claire Weekes it is a very good book.
I just want to be more clear on what I am talking about in my videos. Fear of the way you feel is a trap that I understand. The more you are scared of lets say a dizzy spell, then you might have the thought "I hope I don't faint" this will set in motion your heart pounding because you took a simple dizzy spell and scared yourself more. And as you know it will spiral out of control.
I agree CBT and/or medications really can help this illness. However many times people throw around the word "cure". This all depends on what you think a "cure" is.
At one time I was completely in my house and now I am not. That part I can fix and have my ups and downs. I have had panic attacks for 17 years and agoraphobia mostly for the past 5 years due to the panic attacks. However here is the thing. I am not scared of having a panic attack or even the general anxiety that goes along with having the disorder.
Here is where my real interests fall:
1) The lack of understanding by the public and many medical professionals on the subject. I can not tell you how many times I have been treated badly by medical professionals or have had to explain to them what agoraphobia was. I feel they should be informed of the illness so they can help the person get through it and show compassion. Not treat people in away that will make them feel worse or more scared of a situation especially for people who have not yet learned to control their panic.
2) Responsible information given to the patient about the dangers of medications especially. SSRI drugs and the newer classes of SSNRI's. Only a well informed patient can make a well informed choice. There to date has been no long term studies on SSRI drugs used over the long term. Also many studies show that the SSRI drugs did a little better and sometimes worse in placebo trials.
3) After medication and CBT there are tools we all learn to deal with stressful situations such as deep breathing ect ect. At this point we are still left worrying more than the average person and just keeping it under control. I am more interested in why we are hyper-sensitive in the first place. An answer to that question could be very useful to people in the future who develop this problem.
4) People need to understand there is a range of panic attacks. Not all people with panic attacks fit in the same box. The easiest way to explain this is with seizures. Anyone can have a seizure be it from overdose, a hit to the head etc. Once the issue is removed, in this case being the medication we would not have a seizure again because the offending problem was removed. Now there are people with epilepsy. They have seizures for a completely different reason.
Keeping it in that context I would like people to understand that some people may develop panic disorder because of a very stressful time in their life once that problem is removed the panic attacks can be dealt with. Other people started having panic attacks for no reason. In many cases people can be helped. Especially to deal with the feelings of panic attacks and helped to stop the escalation once one starts. However there are some people where no matter how much CBT you do and no matter how many medications you take the high anxiety level remains. This is what is of great interest to me.
I have had people contact me who have done CBT and are currently on 7 different medications and they are still suffering. I have also had people who stopped medication and force themselves to go to work or live their life in general, but are still suffering.
For example I would get a job and go everyday, every month I would go and get my hair cut, I would go shopping when I needed food. At no point did I become "cured". Did I learn to deal with the feelings and not be scared of them? Sure. For that I am grateful. However what never went away and what indeed does not go away for a large part of people is they still experience having unrealistic body responses in normal everyday situations.
5) Truthful information given to people with panic attacks. Usually they are told no matter how bad the panic attack is it impossible to faint. This is not the case and many people with panic attacks have fainted during one. I feel it is best to inform them that though it usually doesn't happen it could. This way if that should happen to a person having a panic attack they do not completely flip out thinking they are worse off than someone else and becoming more frightened.
People are also told. You won't throw up during a panic attack you will just feel like you will. This is not true and I know that first hand. I throw up during most of my panic attack as well as when I am nervous in general. Throwing up does not scare me however I think you would agree it would be inconvenient to throw up while a dentist is working in my mouth or in isle 4 in the supermarket.
That phobias or feelings have never killed anyone. Well that also is not the truth. Though rare there has been 23 documented deaths due to blood/needle phobia. They died from cardiovascular collapse. This however is rare like I said. However when medical professionals are dealing with a blood/needle phobic (which is considered currently as genetic) they should have a crash cart and also a place for the person to lay down when blood is drawn.
Personally I have this phobia and I can not tell you how many places I have called that have no place for you to lay down. They all just have chairs to sit in.
6) Medicaid for people suffering with panic attacks and/or agoraphobia if they do not have health insurance. Without that getting the help they need to help control the panic attacks can become a challenge. For example I do not have health insurance and have been denied medicaid as well as other programs New York State offers. So every week I see a student in training. That is all I can afford. Calling around to doctors that treat this condition might have a sliding fee. If there normal fee is $120 for an hour they are willing to sometimes go to $70. That still comes out to $280 a month. Many people just do not have that kind of money.
7) The lack of knowledge in addiction recovery centers for people who became addicted to drugs or alcohol because that is the only way they knew how to control the anxiety at that point in time in their life. Many recovery centers place everyone is the same box, an "addict". Just like there are different people with levels of panic disorder there are different kinds of addicts.
From personal experience in an alcohol rehab program I was told all my anxiety was from drinking. However they never understood that the anxiety was there in high levels before I ever drank. I was self-medicating. This was not understood in the least and I was just told I could take paxil or zoloft. This of course right after they said "A drug is a drug is a drug." Rehab staff as well and many people involved in government think it can all be fixed with a pill. This is not the case in many peoples lives. Also because of side effects some people can not tolerate the drug itself and feel worse than they did having the panic attacks.
I was also told I would never be able to stop drinking without "them" or without A.A. Try getting an agoraphobic to an A.A. meeting where they have to talk and share. Especially as the anxiety is now climbing because for years you dulled it down with alcohol.
Again it was a lie. A.A. is a good program and has helped countless people. It was not for me and I was made to feel I could never stop drinking on my own. I did stop on my own and I am very thankful and proud of that. Especially since I was told it was impossible.
8) Diet can and does play a role in peoples lives. Not only for physical health, but in some people their mental health. I feel that should be looked into more.
9) That men who have this disorder are treated with respect and not considered weak or as other men put it to each other "stop acting like a girl." This behavior is unacceptable especially coming from a doctor, nurse or any medical professional. Our medical system needs a major overhaul and the professionals need more classes or refresher courses in compassion. In all disease the person is not a number and not their health insurance plan, but a person who has real feelings, a real life and real people who love them.
Brian :-)
Domestic Partnership
Next Wednesday morning Keith is going to FL. to visit his family. I am going to drop him off at the airport and he returns on Sunday afternoon. We have been together almost 5 years and this will be the first time we have spent more than 24 hours apart. Since I tend not to leave my house much I am sure I will be a bit lonely. Being a nervous person I am worried about other things as well like him cheating on me, his plane crashing or him seeing how good life is away from me and no longer wanting to be with me. I will just be glad when he is back home.
While he is gone I am going to try to stop smoking. I figure I might as well go through the withdrawal alone. I get so angry and pick fights with people every time I stop so this way there will be no one here to yell at. I think I will actually have a fair shot at stopping if I am left alone and nothing major comes up in my life. Since Keith smokes he said that if I quit smoking while he is gone he will start smoking outside.
I think I am actually hooked to my Xanax. It is a very low dose and I have no plans on stopping anytime soon so I am not stressing over it too much. The reason why I feel like I am hooked is because if it is time to take my pill my body will actually wake me up. Sometimes I even feel a bit ill around the time I have to take it. However as bad as this is to say I have much larger demons to worry about than a Xanax addiction right now.
I went to my student therapist last Tuesday and I think I finally got through to her. Each person I have ever seen talks about me being cured from medication, cognitive behavioral therapy (CBT) or whatever happens to be in fashion that year. I have done many programs all claiming a 70%-90% success rate. None have worked on me. She wanted to do CBT again and at first I was going to, but the more I thought about it it just seemed like a waste of time. I have already done CBT three times with no success.
A large part of treatment seems to be getting to a point where you are not scared of the feelings you are having. The problem is most of the time I am not scared of how I feel. I have lived with it for so long that I am pretty use to it. Now to be fair if I have a very strong panic attack, which happens rarely now, it might take me by surprise by being so intense and that would scare me. Not because of how I feel, but because I don't want to really be having a heart attack someday and instead of going to the Emergency Room sitting here at home doing deep breathing and drop dead. That is one thing no one can give me a straight answer on. How do I know when there really is something wrong?
Anyway, my therapist and I are actually going to be trying something new...acceptance. Acceptance of me always having anxiety and most the time feeling like crap. I actually like that idea and will see how it goes. There is a lot of anger inside of me because I keep being told I can be well and then never am. I look at it this way. If a person was in chronic pain they would have to learn to live in chronic pain. Well I am in chronic pain...just not that kind of pain, but pain nonetheless.
You guys, sometimes I get so tired of dealing with it and I am sure many of you can relate. Like I said before most of the time I am not even scared of the "feelings". However I am so tired of throwing up before I see a doctor, dentist or anything my brain deems too stressful. I am not scared of being lightheaded, but I am tired of being lightheaded. I am tired of being tired.
New York State does not allow gay marriage, but it does allow domestic partnerships. Keith and I have talked about it and it looks like I am getting "married" soon. We are going to see if prenuptial agreements are needed for domestic partnerships and how they work compared to marriage. We just want to make sure should we split what is mine is mine and what is his is his. Especially since our parents are getting on in years and if they should pass away we want to make sure the other can't get it in a messy "divorce" situation. I can't see him taking everything I have and I don't think I would act that way either, but better to have a prenuptial because as many people know love can turn to hurt and sometimes that leads to revenge on the person we once loved.
This is a sucky reason to get "married", but if we do I can have health insurance finally. I can go under his health plan and it will only be $176 a month. Maybe I can finally see a real therapist and get some tests run at the doctor that are long over due. As any reader of my blog knows every year or so I need to get a chest x-ray since I had lung surgery. Last year it cost me $600 for the x-ray. I just do not have that kind of money. Not to mention God forbid if I was to get cancer or was in a car crash. How would I ever pay that back?
While he is gone I am going to try to stop smoking. I figure I might as well go through the withdrawal alone. I get so angry and pick fights with people every time I stop so this way there will be no one here to yell at. I think I will actually have a fair shot at stopping if I am left alone and nothing major comes up in my life. Since Keith smokes he said that if I quit smoking while he is gone he will start smoking outside.
I think I am actually hooked to my Xanax. It is a very low dose and I have no plans on stopping anytime soon so I am not stressing over it too much. The reason why I feel like I am hooked is because if it is time to take my pill my body will actually wake me up. Sometimes I even feel a bit ill around the time I have to take it. However as bad as this is to say I have much larger demons to worry about than a Xanax addiction right now.
I went to my student therapist last Tuesday and I think I finally got through to her. Each person I have ever seen talks about me being cured from medication, cognitive behavioral therapy (CBT) or whatever happens to be in fashion that year. I have done many programs all claiming a 70%-90% success rate. None have worked on me. She wanted to do CBT again and at first I was going to, but the more I thought about it it just seemed like a waste of time. I have already done CBT three times with no success.
A large part of treatment seems to be getting to a point where you are not scared of the feelings you are having. The problem is most of the time I am not scared of how I feel. I have lived with it for so long that I am pretty use to it. Now to be fair if I have a very strong panic attack, which happens rarely now, it might take me by surprise by being so intense and that would scare me. Not because of how I feel, but because I don't want to really be having a heart attack someday and instead of going to the Emergency Room sitting here at home doing deep breathing and drop dead. That is one thing no one can give me a straight answer on. How do I know when there really is something wrong?
Anyway, my therapist and I are actually going to be trying something new...acceptance. Acceptance of me always having anxiety and most the time feeling like crap. I actually like that idea and will see how it goes. There is a lot of anger inside of me because I keep being told I can be well and then never am. I look at it this way. If a person was in chronic pain they would have to learn to live in chronic pain. Well I am in chronic pain...just not that kind of pain, but pain nonetheless.
You guys, sometimes I get so tired of dealing with it and I am sure many of you can relate. Like I said before most of the time I am not even scared of the "feelings". However I am so tired of throwing up before I see a doctor, dentist or anything my brain deems too stressful. I am not scared of being lightheaded, but I am tired of being lightheaded. I am tired of being tired.
New York State does not allow gay marriage, but it does allow domestic partnerships. Keith and I have talked about it and it looks like I am getting "married" soon. We are going to see if prenuptial agreements are needed for domestic partnerships and how they work compared to marriage. We just want to make sure should we split what is mine is mine and what is his is his. Especially since our parents are getting on in years and if they should pass away we want to make sure the other can't get it in a messy "divorce" situation. I can't see him taking everything I have and I don't think I would act that way either, but better to have a prenuptial because as many people know love can turn to hurt and sometimes that leads to revenge on the person we once loved.
This is a sucky reason to get "married", but if we do I can have health insurance finally. I can go under his health plan and it will only be $176 a month. Maybe I can finally see a real therapist and get some tests run at the doctor that are long over due. As any reader of my blog knows every year or so I need to get a chest x-ray since I had lung surgery. Last year it cost me $600 for the x-ray. I just do not have that kind of money. Not to mention God forbid if I was to get cancer or was in a car crash. How would I ever pay that back?
Saturday, October 11, 2008
Dental Mercury Fillings
Finally the FDA has caught on (well starting to, they always issue the warning to pregnant women and children first) to what I have been saying about Mercury in the dental fillings. I never wanted the metal fillings in my mouth and told the dentist, yet I have two. I have been treated like I am crazy for not wanting them by therapists in the past because the "FDA says it's safe" and at the dentist office over not wanting a "fluoride treatment" which hopefully the FDA will come to terms with eventually.
I do not care what the current FDA recommendations are about "not removing the mercury containing fillings" when the rest of my teeth are done they are coming out. I am just so annoyed that I will have to end up in the dentist chair longer than I needed to be (esp. when I have a large issue with being at the dentist), had the dentist and medical professionals backed me up. Not to mention wasted money on two fillings.
It is very hard to go it alone, medical professionals keep repeating there is no danger and you start to doubt your own sanity after awhile. Besides, I told the dentist I did not want them, yet he pays little attention to what I have to say and did them anyway, since he never writes anything down (I should not have to remind the dentist every visit).
If he takes issue with me not getting them I am going to get another dentist period. If a metal has to be used it can be gold though in most causes that is not necessary and the price is not astronomical because such a little amount is used. Not to mention worth it for not having mercury vapors when I chew being inhaled into my lungs and entering my blood stream.
Mercury can only be dumped in two places. A toxic waste facility and the human mouth. (Even your energy saving light bulbs have to have special treatment when disposed of.) Mercury is considered one of the most toxic elements.
Even when the silver content is sold from the filling as scrap metal there is a warning from scrap metal dealers.
"Dental Amalgam Scrap: Dental Amalgam Scrap shall consist of dental filling materials that are a silver alloy.
CAUTION : common dental amalgam is a Silver/Mercury alloy and should be treated with the proper handling and packaging methods to ensure the containment of Mercury vapors and Mercury exposure.
This materials should be tested (assayed) and sold by the silver content. as agreed upon by the buy and seller."
--------------------------------------------------
From the FDA site in June 2008
Questions and Answers on Dental Amalgam
1. What is dental amalgam?
Dental amalgam is the silver-colored material used to fill (restore) teeth that have cavities. Dental amalgam is made of two nearly equal parts: liquid mercury and a powder containing silver, tin, copper, zinc and other metals. Mercury concentration in dental amalgams is generally about 50% by weight, while the silver concentration ranges from 20-35%.
2. What is FDA’s role in dental amalgam?
Dental amalgams are medical devices and are regulated by FDA’s Center for Devices and Radiological Health (CDRH). CDRH is responsible for ensuring that medical devices are reasonably safe and effective and that the labeling has adequate directions for use and any appropriate warnings.
3. What are the safety concerns about dental amalgam?
Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses. When amalgam fillings are placed in teeth or removed from teeth, they release mercury vapor. Mercury vapor is also released during chewing. FDA’s rulemaking (described in question 7) will examine evidence concerning whether release of mercury vapor can cause health problems, including neurological disorders, in children and fetuses.
Since the 1990s, FDA and other government agencies (CDC, NIH) have reviewed the scientific literature looking for links between dental amalgams and health problems. In September 2006, an advisory panel to the FDA reviewed FDA’s research and heard presentations from the public about the benefits and risks of mercury and amalgam.
You can read the summary of the panel meeting at: http://www.fda.gov/cdrh/meetings/090606-summary.html
In addition, a complete transcript is available at: http://www.fda.gov/ohrms/dockets/ac/cdrh06.html#dentalproductspanel
4. Are there other dental filling materials that can be used instead of amalgam?
Yes, there are several other types of dental fillings.
Resin composites are tooth-colored materials made from powdered glass and resin compounds. When composites were initially introduced, they were not very strong and were used primarily in the front teeth. Newer composites are stronger, although they still tend to wear more than metal-based materials and generally need earlier replacement.
Glass ionomer cement is also a tooth-colored material. It is not usually used for long-term fillings because it breaks easily.
Porcelain, gold, and other metals are also used as filling materials. Gold and porcelain are used for inlays, veneers, crowns, and bridges. These fillings are made outside the mouth and cemented into place after they are formed.
5. Should I have my amalgam fillings removed and replaced with these other materials? If I have a cavity, should I choose to get amalgam fillings?
FDA does not recommend that you have your amalgam fillings removed. FDA is engaged in a rulemaking that may lead to revised labeling. It is also reviewing evidence about safe use, particularly in sensitive subpopulations.
If you are concerned about the possible health effects of amalgam fillings, you should talk with your qualified health care practitioner.
Dental amalgam fillings are very strong and durable, they last longer than most other types of fillings, and they are relatively inexpensive. You may want to weigh these advantages against the possibility that dental amalgam could pose a health risk, until further information is conveyed through the rulemaking (see question 7) or otherwise.
6. Should pregnant women and young children use or avoid amalgam fillings?
The recent advisory panel believed that there was not enough information to answer this question.
Some other countries follow a “precautionary principle” and avoid the use of dental amalgam in pregnant women. Advice about dental amalgams from regulatory agencies in other countries is available below.
Canada: http://www.hc-sc.gc.ca/ahc-asc/media/nr-cp/1996/1996_63_e.html
France: http://afssaps.sante.fr/ang/pdf/amalgam.pdf
Sweden: http://www.kemi.se/templates/Page.aspx?id=5233
Pregnant women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking dental care, but should discuss options with their health practitioner.
7. What is the next step for FDA?
In 2002, FDA published a proposed rule to classify dental amalgam as a class II device with special controls. On April 28, 2008, FDA reopened the comment period for that proposed rule. The comment period will be open until July 28, 2008. After reviewing all comments, FDA intends to issue a final rule classifying dental amalgam.
By July 28, 2008, FDA is requesting comments supported by empirical data and scientific evidence concerning this classification and special controls for dental amalgam. In addition, if class II (special controls) is the appropriate classification for these devices, FDA requests comment on whether the two types of special controls proposed by FDA in 2002 (materials and labeling) provide reasonable assurance of the safety and effectiveness of these devices and on whether the special controls FDA described in 2002 should be revised in light of the recommendations and with respect to the discussions by the 2006 joint committee.
Controls on the Materials. For example, should the material controls proposed by FDA address conformance to recognized consensus standards that make recommendations for testing, compressive strength, and identifying the mercury vapor released by the device?
Labeling Controls. For example, how should labeling controls, if any, address the disclosure of composition, including mercury content, and precautions regarding use of the device in sensitive subpopulations composed of individuals who respond biologically at lower levels of exposure to mercury than the general population? If so, which subpopulations should be included (e.g., children under age 6, pregnant and lactating women, hypersensitive or immunocompromised individuals)? Should the labeling controls require more specific patient labeling (e.g., informing patients of identified sensitive subpopulations of the mercury content, the alternatives to the device and their relative costs, and health risks associated with the failure to obtain dental care)?
For the agency’s future analysis of benefits and costs of the regulatory options for dental amalgams, FDA also requests comments, including available data, on the following questions:
(1) How many annual procedures use mercury amalgams? What are the trends?
(2) What are the differences in cost between amalgams and alternative materials (e.g., composite, other metals, ceramics, etc.)? Are there differences in replacement lives?
(3) What are reimbursement rates for dental amalgam and the alternative materials?
(4) How would labeling describing the risks of amalgam for certain subpopulations (e.g., children under age 6, pregnant and lactating women, hypersensitive or immunocompromised individuals) affect the demand for, and use of, mercury amalgam? How would the risks included in the labeling be communicated to those subpopulations?
(5) What is the current exposure to mercury for patients? For professionals? What would be the reduction in exposure associated with the use of alternative materials?
Updated June 3, 2008
I do not care what the current FDA recommendations are about "not removing the mercury containing fillings" when the rest of my teeth are done they are coming out. I am just so annoyed that I will have to end up in the dentist chair longer than I needed to be (esp. when I have a large issue with being at the dentist), had the dentist and medical professionals backed me up. Not to mention wasted money on two fillings.
It is very hard to go it alone, medical professionals keep repeating there is no danger and you start to doubt your own sanity after awhile. Besides, I told the dentist I did not want them, yet he pays little attention to what I have to say and did them anyway, since he never writes anything down (I should not have to remind the dentist every visit).
If he takes issue with me not getting them I am going to get another dentist period. If a metal has to be used it can be gold though in most causes that is not necessary and the price is not astronomical because such a little amount is used. Not to mention worth it for not having mercury vapors when I chew being inhaled into my lungs and entering my blood stream.
Mercury can only be dumped in two places. A toxic waste facility and the human mouth. (Even your energy saving light bulbs have to have special treatment when disposed of.) Mercury is considered one of the most toxic elements.
Even when the silver content is sold from the filling as scrap metal there is a warning from scrap metal dealers.
"Dental Amalgam Scrap: Dental Amalgam Scrap shall consist of dental filling materials that are a silver alloy.
CAUTION : common dental amalgam is a Silver/Mercury alloy and should be treated with the proper handling and packaging methods to ensure the containment of Mercury vapors and Mercury exposure.
This materials should be tested (assayed) and sold by the silver content. as agreed upon by the buy and seller."
--------------------------------------------------
From the FDA site in June 2008
Questions and Answers on Dental Amalgam
1. What is dental amalgam?
Dental amalgam is the silver-colored material used to fill (restore) teeth that have cavities. Dental amalgam is made of two nearly equal parts: liquid mercury and a powder containing silver, tin, copper, zinc and other metals. Mercury concentration in dental amalgams is generally about 50% by weight, while the silver concentration ranges from 20-35%.
2. What is FDA’s role in dental amalgam?
Dental amalgams are medical devices and are regulated by FDA’s Center for Devices and Radiological Health (CDRH). CDRH is responsible for ensuring that medical devices are reasonably safe and effective and that the labeling has adequate directions for use and any appropriate warnings.
3. What are the safety concerns about dental amalgam?
Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses. When amalgam fillings are placed in teeth or removed from teeth, they release mercury vapor. Mercury vapor is also released during chewing. FDA’s rulemaking (described in question 7) will examine evidence concerning whether release of mercury vapor can cause health problems, including neurological disorders, in children and fetuses.
Since the 1990s, FDA and other government agencies (CDC, NIH) have reviewed the scientific literature looking for links between dental amalgams and health problems. In September 2006, an advisory panel to the FDA reviewed FDA’s research and heard presentations from the public about the benefits and risks of mercury and amalgam.
You can read the summary of the panel meeting at: http://www.fda.gov/cdrh/meetings/090606-summary.html
In addition, a complete transcript is available at: http://www.fda.gov/ohrms/dockets/ac/cdrh06.html#dentalproductspanel
4. Are there other dental filling materials that can be used instead of amalgam?
Yes, there are several other types of dental fillings.
Resin composites are tooth-colored materials made from powdered glass and resin compounds. When composites were initially introduced, they were not very strong and were used primarily in the front teeth. Newer composites are stronger, although they still tend to wear more than metal-based materials and generally need earlier replacement.
Glass ionomer cement is also a tooth-colored material. It is not usually used for long-term fillings because it breaks easily.
Porcelain, gold, and other metals are also used as filling materials. Gold and porcelain are used for inlays, veneers, crowns, and bridges. These fillings are made outside the mouth and cemented into place after they are formed.
5. Should I have my amalgam fillings removed and replaced with these other materials? If I have a cavity, should I choose to get amalgam fillings?
FDA does not recommend that you have your amalgam fillings removed. FDA is engaged in a rulemaking that may lead to revised labeling. It is also reviewing evidence about safe use, particularly in sensitive subpopulations.
If you are concerned about the possible health effects of amalgam fillings, you should talk with your qualified health care practitioner.
Dental amalgam fillings are very strong and durable, they last longer than most other types of fillings, and they are relatively inexpensive. You may want to weigh these advantages against the possibility that dental amalgam could pose a health risk, until further information is conveyed through the rulemaking (see question 7) or otherwise.
6. Should pregnant women and young children use or avoid amalgam fillings?
The recent advisory panel believed that there was not enough information to answer this question.
Some other countries follow a “precautionary principle” and avoid the use of dental amalgam in pregnant women. Advice about dental amalgams from regulatory agencies in other countries is available below.
Canada: http://www.hc-sc.gc.ca/ahc-asc/media/nr-cp/1996/1996_63_e.html
France: http://afssaps.sante.fr/ang/pdf/amalgam.pdf
Sweden: http://www.kemi.se/templates/Page.aspx?id=5233
Pregnant women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking dental care, but should discuss options with their health practitioner.
7. What is the next step for FDA?
In 2002, FDA published a proposed rule to classify dental amalgam as a class II device with special controls. On April 28, 2008, FDA reopened the comment period for that proposed rule. The comment period will be open until July 28, 2008. After reviewing all comments, FDA intends to issue a final rule classifying dental amalgam.
By July 28, 2008, FDA is requesting comments supported by empirical data and scientific evidence concerning this classification and special controls for dental amalgam. In addition, if class II (special controls) is the appropriate classification for these devices, FDA requests comment on whether the two types of special controls proposed by FDA in 2002 (materials and labeling) provide reasonable assurance of the safety and effectiveness of these devices and on whether the special controls FDA described in 2002 should be revised in light of the recommendations and with respect to the discussions by the 2006 joint committee.
Controls on the Materials. For example, should the material controls proposed by FDA address conformance to recognized consensus standards that make recommendations for testing, compressive strength, and identifying the mercury vapor released by the device?
Labeling Controls. For example, how should labeling controls, if any, address the disclosure of composition, including mercury content, and precautions regarding use of the device in sensitive subpopulations composed of individuals who respond biologically at lower levels of exposure to mercury than the general population? If so, which subpopulations should be included (e.g., children under age 6, pregnant and lactating women, hypersensitive or immunocompromised individuals)? Should the labeling controls require more specific patient labeling (e.g., informing patients of identified sensitive subpopulations of the mercury content, the alternatives to the device and their relative costs, and health risks associated with the failure to obtain dental care)?
For the agency’s future analysis of benefits and costs of the regulatory options for dental amalgams, FDA also requests comments, including available data, on the following questions:
(1) How many annual procedures use mercury amalgams? What are the trends?
(2) What are the differences in cost between amalgams and alternative materials (e.g., composite, other metals, ceramics, etc.)? Are there differences in replacement lives?
(3) What are reimbursement rates for dental amalgam and the alternative materials?
(4) How would labeling describing the risks of amalgam for certain subpopulations (e.g., children under age 6, pregnant and lactating women, hypersensitive or immunocompromised individuals) affect the demand for, and use of, mercury amalgam? How would the risks included in the labeling be communicated to those subpopulations?
(5) What is the current exposure to mercury for patients? For professionals? What would be the reduction in exposure associated with the use of alternative materials?
Updated June 3, 2008
Monday, October 6, 2008
Convenient Health Food
In many of my videos and writings I have brought up eating healthy to help combat anxiety and depression. However in a modern day world this is not always easy or convenient. By no means am I able to stick to a healthy diet 100% of the time. Not to long ago I ate an entire medium pizza just because I did not feel like having to make any food and because I was not in the mood for any of my "convenient healthy food". So when you try to eat better don't feel bad if a few days here and there you go crazy and eat a box of Twinkies.
Eating healthier gets easier with time. One of the first things you have to do is get most of the things you have read about out of your head. There are so many conflicting diets. Vegan, Vegetarian, Raw Diet, Raw Vegan, Paleolithic Diet, the list goes on and on. There is nothing wrong with most of the diets. But as I have found one size does not fit all. There is no perfect diet. There is only "your" perfect diet. One diet may do wonders for other people and make you a complete mess.
After much research it is my opinion that the "natural" human diet is fruit, vegetables and insects with a very small amount of wild animal such as rabbit, snake, frog, and squirrel. That being said, short of a nuclear war or total economic meltdown I am not about to go harvesting the ants and mealworms just yet.
OK so how can you make super easy choices in a complicated world. These are not "perfect" choices. These are just "better" choices. They like anything else come with their downside.
Canned Food: Low sodium is best but if the store does not have low sodium its ok. White Potato, Carrots, Beans (not pork and beans just plain beans), spinach and beets. Canned chicken and canned sardines. All you have to do is open the can, drain and eat it right out of the can with a fork. Canned food does not have to be heated it is precooked. Sometimes what you can do when you are very hungry and about to eat, lets say half a cake, is open a can of carrots and eat that first. Then eat the cake.
Boil in bag white rice: Just boil water, throw the bag in and about 10 minutes later you have rice. Add your favorite herbs and spices and a little salt if you like or just eat it plain. Tomato sauces mix well with rice. (Brown Rice is better but not always in the convenient boil in bag).
Olive Oil: Extra Virgin Olive Oil is the best choice. Buy a good brand it will taste better and be smoother. Pour the olive oil on to a tablespoon put it in your mouth and swallow. Take two tablespoons then drink a glass of water.
Baby Food: Go and buy stage 3 baby food. Beach-Nut and Gerber are the least expensive, but you could also buy the more expensive organic baby food if you wish. Be sure to buy it in jars only and not the plastic containers. Some of the best choices are carrot, sweet potato, banana, and pear. Open the jar and pour the contents into a cup. Add some cold water to the jar and replace the lid. Shake the jar up and then pour that into your cup. Then add a tiny amount of water to the jar again and shake. Then pour that into the cup. Take a spoon, stir and then drink. You will be surprised how good it actually will taste. When it comes to baby food do not be scared to try the ones with meat. I was for awhile assuming it would taste awful and be gross. It isn't. The ones I have tried are both by Beach-Nut and are Country Vegetable & Chicken and Turkey with Rice. They do contain whole peas and whole bits of rice so be sure when you drink you know that some chewing will be involved.
Applesauce: Get the kind that is 100% natural with no sugar or corn syrup added. Eat it plain or do a 50/50 mix. Add applesauce into a cup and then add some warm water, stir and drink.
Rice Milk: Try this in place of milk but make sure you get the fortified kind that contains Calcium and Vitamin D. Make sure it says Dairy Free.
Multi-Vitamin: Make sure it contains 100% of your Iodine. If you are a man or if you are a woman who no longer gets her menstrual cycle the vitamin should be Iron Free.
There are no hard set rules but things I like to avoid when possible are: Microwaves, Corn, Corn Syrup (basically anything corn), Soy, artificial colors and flavors, artificial sweeteners.
Things to experiment with: Gluten Free and Dairy Free Diets. Maybe try a Grain Free Diet. See how that works for you.
If you are not like me and do not mind having blood work then three great test to have run are an allergy test to foods, celiac disease and hemochromotisis. Also have your Vitamin D levels checked.
Other than that make your own healthy choices. Eat a well balanced diet. Try to get enough sleep. If you are able too try to be sure you are asleep between 10pm and 2am. That is easier said than done if you are like me and can't sleep sometimes. I end up going to bed at 7am and waking up at 3pm.
Don't underestimate the sun. Get some when you can. Do not sit and burn in it, but be sure you get unprotected sun light on your skin.
Try meditation or chanting if you are open to it. One great mediation that walks you through it step by step (which I find helpful otherwise my brain is talking to me too much) is called "Living Soul Meditation" by Mitchell Gibson. If you get the CD the first few time you listen... you will just go through it till you understand it. After that you will have memorized it and you can flow through the CD much easier. (Just so you know I am not going to get any money if you order the CD. I Just really have found it helpful at times.) Here is the link to the CD. http://www.tybro.com/html/audio_cd_s.html
Eating healthier gets easier with time. One of the first things you have to do is get most of the things you have read about out of your head. There are so many conflicting diets. Vegan, Vegetarian, Raw Diet, Raw Vegan, Paleolithic Diet, the list goes on and on. There is nothing wrong with most of the diets. But as I have found one size does not fit all. There is no perfect diet. There is only "your" perfect diet. One diet may do wonders for other people and make you a complete mess.
After much research it is my opinion that the "natural" human diet is fruit, vegetables and insects with a very small amount of wild animal such as rabbit, snake, frog, and squirrel. That being said, short of a nuclear war or total economic meltdown I am not about to go harvesting the ants and mealworms just yet.
OK so how can you make super easy choices in a complicated world. These are not "perfect" choices. These are just "better" choices. They like anything else come with their downside.
Canned Food: Low sodium is best but if the store does not have low sodium its ok. White Potato, Carrots, Beans (not pork and beans just plain beans), spinach and beets. Canned chicken and canned sardines. All you have to do is open the can, drain and eat it right out of the can with a fork. Canned food does not have to be heated it is precooked. Sometimes what you can do when you are very hungry and about to eat, lets say half a cake, is open a can of carrots and eat that first. Then eat the cake.
Boil in bag white rice: Just boil water, throw the bag in and about 10 minutes later you have rice. Add your favorite herbs and spices and a little salt if you like or just eat it plain. Tomato sauces mix well with rice. (Brown Rice is better but not always in the convenient boil in bag).
Olive Oil: Extra Virgin Olive Oil is the best choice. Buy a good brand it will taste better and be smoother. Pour the olive oil on to a tablespoon put it in your mouth and swallow. Take two tablespoons then drink a glass of water.
Baby Food: Go and buy stage 3 baby food. Beach-Nut and Gerber are the least expensive, but you could also buy the more expensive organic baby food if you wish. Be sure to buy it in jars only and not the plastic containers. Some of the best choices are carrot, sweet potato, banana, and pear. Open the jar and pour the contents into a cup. Add some cold water to the jar and replace the lid. Shake the jar up and then pour that into your cup. Then add a tiny amount of water to the jar again and shake. Then pour that into the cup. Take a spoon, stir and then drink. You will be surprised how good it actually will taste. When it comes to baby food do not be scared to try the ones with meat. I was for awhile assuming it would taste awful and be gross. It isn't. The ones I have tried are both by Beach-Nut and are Country Vegetable & Chicken and Turkey with Rice. They do contain whole peas and whole bits of rice so be sure when you drink you know that some chewing will be involved.
Applesauce: Get the kind that is 100% natural with no sugar or corn syrup added. Eat it plain or do a 50/50 mix. Add applesauce into a cup and then add some warm water, stir and drink.
Rice Milk: Try this in place of milk but make sure you get the fortified kind that contains Calcium and Vitamin D. Make sure it says Dairy Free.
Multi-Vitamin: Make sure it contains 100% of your Iodine. If you are a man or if you are a woman who no longer gets her menstrual cycle the vitamin should be Iron Free.
There are no hard set rules but things I like to avoid when possible are: Microwaves, Corn, Corn Syrup (basically anything corn), Soy, artificial colors and flavors, artificial sweeteners.
Things to experiment with: Gluten Free and Dairy Free Diets. Maybe try a Grain Free Diet. See how that works for you.
If you are not like me and do not mind having blood work then three great test to have run are an allergy test to foods, celiac disease and hemochromotisis. Also have your Vitamin D levels checked.
Other than that make your own healthy choices. Eat a well balanced diet. Try to get enough sleep. If you are able too try to be sure you are asleep between 10pm and 2am. That is easier said than done if you are like me and can't sleep sometimes. I end up going to bed at 7am and waking up at 3pm.
Don't underestimate the sun. Get some when you can. Do not sit and burn in it, but be sure you get unprotected sun light on your skin.
Try meditation or chanting if you are open to it. One great mediation that walks you through it step by step (which I find helpful otherwise my brain is talking to me too much) is called "Living Soul Meditation" by Mitchell Gibson. If you get the CD the first few time you listen... you will just go through it till you understand it. After that you will have memorized it and you can flow through the CD much easier. (Just so you know I am not going to get any money if you order the CD. I Just really have found it helpful at times.) Here is the link to the CD. http://www.tybro.com/html/audio_cd_s.html
Sunday, October 5, 2008
October Sneakers
It always amazes me how some days are better than others. Last week I was feeling pretty good. I was confident that I could get my tetanus shot, quit smoking and finish up getting my teeth fixed. I viewed it as not so bad and that I would get through it. Now confident is the last thing I feel.
The past few days have not been so easy on me. My mind is back in some form of chaos. I have no idea what causes my down fall. Maybe it is the little things that add up or at least little things that I let get to me. Things I rather not discuss with people or sometimes when I do open up about them the lack of concern I get about an issue.
I have not drank alcohol in almost a year. But something else started a year ago after I stopped. Something that has worried me a lot. It is not the most pleasant topic. But my bowel color is way off a lot of the time. It was always normal before, I never had a problem with it. Now I get all shades. The worst being gray and sometimes almost white.
This of course last year concerned me a great deal. I looked up that it could mean liver problems and with the way I use to drink it would not have surprised me. I also read it meant that it could mean gallbladder problems. So last year despite my immense fear (to put it mildly) I had my blood taken to check my liver enzymes and I also had an ultrasound of my gallbladder, gallbladder duct, liver and pancreas. That was all ordered of course after I told my nurse of the color change and how light it was.
All the tests came back perfect. I started to think it was the xanax I was taking. So I tapered off the xanax and everything went back to normal. So I was happy. I thought problem solved. Then a few weeks later the light pale color returned. I looked at what I was eating, anything that could be causing this problem. Back when I first had the tests run I was so sick feel. Sicker than I have ever felt in my life. I can't even put into words how I felt. There was no pain just this feeling of death growing inside me, sucking every last bit of energy out of my body.
Most of the time when it happens now I don't feel sick, but sometimes I still do. I have told the nurse I see that it still occurs on and off but I get that "silly look"..the kind of look you get when you are an "anxious person". I have told my mom about it, but she not knowing hardly anything medical is no help. She usually says things like "well you can't be the only one with it." and I am sure I am not the "only one" but I would like to know what the hell is going on with my body.
It is not like I have not have had things go wrong before. Major things, like having part of my right lung removed a few months before it would have killed me. Part of this is my problem. I could push more. Demand more tests, but the truth is, I am too scared. I think the next test would be a colon scope and I know to many people it would not be that big of a deal, to me it is. Between the tetanus shot and up coming dental work as silly as it may sound I just can't add anything else to my plate.
Since this problem happens with or without taking xanax I finally went back on xanax a little over a month ago, maybe longer. I am allowed to take 3 pills a day but because of my history with substance abuse I take one pill a day. I break it in half and take half in the morning and the other half twelve hours later. On really bad days I might take three halves.
This morning in the shower I just started crying. I only allowed myself to do it for a minute or so. What I was really crying over I don't even know. I think I just feel overwhelmed. I don't feel like I am able to take care of myself. Many times I feel like my words are empty. It's funny the only people that actually listen to me are strangers. Strangers that have gone through some of my hardships or even have had more. At least they understand where I am coming from.
I am not one to live in guilt, but sometimes I can't help but feel guilty about how I complain about things when I know others are way worse off. All I have to do is get a tetanus shot (that I assume will kill me or disable me) and get a few teeth fixed. Assuming the pale bowel color really is nothing..then there is nothing wrong with me. Some people are actually dying or suffering thousands of times more than me right now. Yet here I sit, complaining and deeply upset. I don't even know sometimes why I am so upset.
Oh just so people know if you have been following my blog, I did end up taking an HIV test and it came back negative. So I don't have HIV which is a large weight off my shoulders. I also took a genetic test for Hemochromatosis (Iron Overload) and I had none of the genes for that disorder. I checked because I am of Irish descent which accounts for a large portion of people with Hemochromatosis. Not having the genes does not make it impossible not to develop it but it makes it a lot less likely.
Awhile back I wrote about a person in Cambodia that I mailed money too. We had become online friends and I just wanted to help him out. He never asked me for money, but I just felt the need to do something for someone else. He did end up getting the money and was thankful. Every so often I mail more to him. We keep in touch through e-mail.
Keith and I went to Walmart over a month ago and he bought me a pair of new sneakers. For some reason even though they were my size they really did not end up fitting. So I ended up getting a new pair. We never got around to bringing them back so I asked Keith if he would mind if I just gave them away for free. He said he didn't mind. I asked him to pick a state for me to send them too. I figured since he bought them he should pick the state. He choose New Orleans, Louisiana. So at some point this week I am going to place ad on craigslist on the New Orleans board. The first person to send me their mailing address will get them.
Maybe I am crazy. I don't know why I choose to mail things all over the country or world for that matter. Sometimes I feel I should do things for others. Other times maybe it is a selfish move on my part. Giving to burn off some Karmic debt I owe. But then if I am helping to improve my own Karma or improve my standing with God in general it is a lost cause. You have to actually give without expecting anything in return. And sometimes I am expecting less suffering and less fear.
Though I know I am not going to drink alcohol, esp. while taking xanax, sometimes I just want to be drunk or drugged out of my mind. I just want to escape myself even if it is for a little while. Other times I just want to wrap myself up in a cocoon and never come out, but that is not how life works. Tomorrow I will wake up, get out of bed and push through another day.
The past few days have not been so easy on me. My mind is back in some form of chaos. I have no idea what causes my down fall. Maybe it is the little things that add up or at least little things that I let get to me. Things I rather not discuss with people or sometimes when I do open up about them the lack of concern I get about an issue.
I have not drank alcohol in almost a year. But something else started a year ago after I stopped. Something that has worried me a lot. It is not the most pleasant topic. But my bowel color is way off a lot of the time. It was always normal before, I never had a problem with it. Now I get all shades. The worst being gray and sometimes almost white.
This of course last year concerned me a great deal. I looked up that it could mean liver problems and with the way I use to drink it would not have surprised me. I also read it meant that it could mean gallbladder problems. So last year despite my immense fear (to put it mildly) I had my blood taken to check my liver enzymes and I also had an ultrasound of my gallbladder, gallbladder duct, liver and pancreas. That was all ordered of course after I told my nurse of the color change and how light it was.
All the tests came back perfect. I started to think it was the xanax I was taking. So I tapered off the xanax and everything went back to normal. So I was happy. I thought problem solved. Then a few weeks later the light pale color returned. I looked at what I was eating, anything that could be causing this problem. Back when I first had the tests run I was so sick feel. Sicker than I have ever felt in my life. I can't even put into words how I felt. There was no pain just this feeling of death growing inside me, sucking every last bit of energy out of my body.
Most of the time when it happens now I don't feel sick, but sometimes I still do. I have told the nurse I see that it still occurs on and off but I get that "silly look"..the kind of look you get when you are an "anxious person". I have told my mom about it, but she not knowing hardly anything medical is no help. She usually says things like "well you can't be the only one with it." and I am sure I am not the "only one" but I would like to know what the hell is going on with my body.
It is not like I have not have had things go wrong before. Major things, like having part of my right lung removed a few months before it would have killed me. Part of this is my problem. I could push more. Demand more tests, but the truth is, I am too scared. I think the next test would be a colon scope and I know to many people it would not be that big of a deal, to me it is. Between the tetanus shot and up coming dental work as silly as it may sound I just can't add anything else to my plate.
Since this problem happens with or without taking xanax I finally went back on xanax a little over a month ago, maybe longer. I am allowed to take 3 pills a day but because of my history with substance abuse I take one pill a day. I break it in half and take half in the morning and the other half twelve hours later. On really bad days I might take three halves.
This morning in the shower I just started crying. I only allowed myself to do it for a minute or so. What I was really crying over I don't even know. I think I just feel overwhelmed. I don't feel like I am able to take care of myself. Many times I feel like my words are empty. It's funny the only people that actually listen to me are strangers. Strangers that have gone through some of my hardships or even have had more. At least they understand where I am coming from.
I am not one to live in guilt, but sometimes I can't help but feel guilty about how I complain about things when I know others are way worse off. All I have to do is get a tetanus shot (that I assume will kill me or disable me) and get a few teeth fixed. Assuming the pale bowel color really is nothing..then there is nothing wrong with me. Some people are actually dying or suffering thousands of times more than me right now. Yet here I sit, complaining and deeply upset. I don't even know sometimes why I am so upset.
Oh just so people know if you have been following my blog, I did end up taking an HIV test and it came back negative. So I don't have HIV which is a large weight off my shoulders. I also took a genetic test for Hemochromatosis (Iron Overload) and I had none of the genes for that disorder. I checked because I am of Irish descent which accounts for a large portion of people with Hemochromatosis. Not having the genes does not make it impossible not to develop it but it makes it a lot less likely.
Awhile back I wrote about a person in Cambodia that I mailed money too. We had become online friends and I just wanted to help him out. He never asked me for money, but I just felt the need to do something for someone else. He did end up getting the money and was thankful. Every so often I mail more to him. We keep in touch through e-mail.
Keith and I went to Walmart over a month ago and he bought me a pair of new sneakers. For some reason even though they were my size they really did not end up fitting. So I ended up getting a new pair. We never got around to bringing them back so I asked Keith if he would mind if I just gave them away for free. He said he didn't mind. I asked him to pick a state for me to send them too. I figured since he bought them he should pick the state. He choose New Orleans, Louisiana. So at some point this week I am going to place ad on craigslist on the New Orleans board. The first person to send me their mailing address will get them.
Maybe I am crazy. I don't know why I choose to mail things all over the country or world for that matter. Sometimes I feel I should do things for others. Other times maybe it is a selfish move on my part. Giving to burn off some Karmic debt I owe. But then if I am helping to improve my own Karma or improve my standing with God in general it is a lost cause. You have to actually give without expecting anything in return. And sometimes I am expecting less suffering and less fear.
Though I know I am not going to drink alcohol, esp. while taking xanax, sometimes I just want to be drunk or drugged out of my mind. I just want to escape myself even if it is for a little while. Other times I just want to wrap myself up in a cocoon and never come out, but that is not how life works. Tomorrow I will wake up, get out of bed and push through another day.
Thursday, October 2, 2008
The Medicine Buddha
The Medicine Buddha. I listen to this to try to quiet my mind. Maybe it will work for someone else out there.
(If this youtube video ever goes down for more than a few days please email me so I can replace it)
(If this youtube video ever goes down for more than a few days please email me so I can replace it)
Back Seeing A Therapist.
I am back to seeing a therapist.
I go to this program every year now. This being my third year. Since I don't have health insurance all I can afford is to see students in training. Each year I get someone new and each year I have to reexplain my situation. Usually I have new concerns I need addressed as I quickly fill the new person in within a few 50 min sessions with 32 years of my life story.
This year I am taking a more direct route. I have printed off about 30 pages from this blog and just handed it over. It is easier than explaining everything again. Truth is I am tired of explaining myself.
The person I am seeing would like to try CBT (Cognitive Behavioral Therapy MAP-3). Which for me is nothing new. CBT is the first thing I did when I first saw someone in 1996. It seems to have come full circle. The Chapter 1 she photo copied out of the CBT Book states that people with panic disorder or anxiety in general do not have a chemical imbalance in their brain. Isn't that what I have been defending over the past decade to doctors and therapists? And more recently on this blog and youtube.
I never bought into the "imbalance" but I have lived through the SSRI era of paxil and zoloft. The quick fix for all problems. I am not saying that these drugs don't work in some people. I am saying their is always a price to be paid and risks. You just have to measure the risks you are willing to take. Like right now I take Xanax. Not that it helps much.
Now for me CBT does not work at least in the past. CBT is sort of how I cope in general anyway on my own. But sure why not do it again? What else is there?
Truth be told I almost want to just stop going to therapy altogether. Sometimes I have just stopped caring. I can only do so much on my own but without support and understanding from most medical professionals, family, or the public in general how can I do it all alone?
So anyway to speed up the process with the new person I am seeing I have yet another letter I will hand her next Tuesday. In some parts it might sound harsh but I rather not have to deal with the crap I normally do.
Here is the letter it is mostly worked out but still in draft form. Oh and when it says "(packet included)" it is the print out of what I have listed in my last post about blood/needle phobia and the things in quotes is just in reference to what the CBT MAP-3 program states:
""Clients learn specific intervention skills, including how to slow down physiological reactivity through breathing retraining and muscle relaxation training"
This I already do and 90% of the time this is how I cope (this eases it but does not stop it). The other 10% of the time breaks down to the following.
1) I am not in the mood to cope that day so I just deal with the situation or to tired to deal with it so I just don't bother.
2) Other people around me cause distractions or help make the situation worse. Example when I told the dentist "I know my gums bleed but lets not talk about that" stated before hand it is brought up anyway. Or "you don't look so good" when I am already trying to focus and not pass out during a blood draw.
3) The anxiety is so intense that I have not mastered easing it at that level (happens rarely)
"how to decatastrophise through actual prediction testing:"
1) I do this as well. Example when I get my hair cut nothing overwhelming has ever happened and even if something did I would have to deal with the situation at hand and just get through it. Yet knowing this does not seem to make a difference. In fact most situations that I know are not dangerous and nothing ever has happened before, or even something I enjoy doing still sets the process in motion automatically. This can and has happened even when I am fed up with the anxiety and could careless about myself or anyone else for that matter (meaning I care zero what people think about me at that time). Basicly I question my disastrous thoughts and paint them in a different more positive way, know that I can not predict the future and it is never as bad as I imagine anyway (so far).
"how to lessen fearfulness through exposure to feared sensations in safe settings."
1) Exposure no matter how often or far apart seems to have no effect. Going to the same job everyday does not ease it. Getting my hair cut in the past once a month for 17 years.. sometimes even at places that were quiet and the people who worked there were enjoyable did not change the out come much. Also somedays at work were better than others anxiety wise. There is nothing different between the days other than the fact my body is not acting up on some. Somedays at work everything was fine other days I was throwing up.
"sensations in safe settings"
1) I can not get these sensations in a safe setting. Most I can't even bring on if I wanted to at will. Hyperventilation is not something I do during a panic attack or anxiety in general. I was able to eliminate that years ago and am not willing to do that just to get dizzy and bring that feeling back into the forefront of my mind. I also don't get dizzy during panic attacks anymore. Unless it was a long lasting dizzy spell I am not bothered by feeling temporarily dizzy as I experience that at random times be it from being tired or having a cold.
---------
I am not willing to work on blood phobia in this setting because I do not feel this is the proper clinical setting to address that phobia (infomation packet included).
----------
What I am willing to work on:
1) How to cope when my mind becomes so filled with chaos that I cannot stop the racing thoughts, worries and dreams even with deep breathing and decatastrophizing / or positive thoughts. Uncontrolled this can lead me into a depression.
2) I am not scared of when I throw up, not scared of the panic attack or anxiety in itself. I am just tired of feeling so uncomfortable all the time. Years ago I was scared and worried it would kill me on the spot. It hasn't and I have had no choice but to endure it. A lot of therapy depending on the treatment plan can include exposure, breathing techniques, distraction, self-hypnosis, religion (in a church setting treatment plan), medication etc etc.
What it does not address and what I would like and I don't even know if it is possible is deep down I do not want to be focusing on my breathing while shopping, getting my hair cut, seeing a doctor etc etc. I just want to be normal and have my body just behave itself. After all these are not dangerous situations and I know it. I would like to enjoy them without my body fighting me.
A lot of times therapy goes back and forth with "are you worried you are going to throw up?" "so what if you do throw up?" "why do you mind what people think if you throw up?" "sometimes people have a virus and throw up so it's normal" (which I am aware of but this is not a virus or a one time flu). "have you tried not to throw up? and what happens when you do try not to?" "do you worry about throwing up therefore causing a self fulfilling prophecy?" .....For me the real answer is when I am nervous I throw up it is just what happens. It is a pain to deal with and most likely damaging to my health. I do not want to throw up when nervous so how do I stop that? How do I stop my body from shaking even when I am not scared of the situation or even if I am?
How do I deal with people who are demeaning, rude, unsympathetic, uneducated or just plain jerks about my situation? How do I claim my place of power when I am not in a place of power in some situations? How do I do this without a proper support structure in place?
How do I deal with a situation that makes me nervous that I do deem as a possible dangerous situation? How do I sleep when my body refuses to?
How do I know when something real is happening such as a heart attack and not just blow it off as anxiety?
------------------------------------
Word games:
If I say I "can't" I do not mean there is some invisable wall or force stopping me. In general I just mean I "can't" do something at that moment in time for whatever the reason or situation at hand. I do not think I always "can't" I am using the word "can't" as anyone would in everyday common language. "can't" does not mean I am unwilling.
"is just what happens" does not mean there is a law in my head that states that there is a rule, a conclusion of absolutes. I just mean in this time and space, it is what it is, and has been occuring in the now and/or past. There is no future prediction of forever happening. Most the time I am not thinking in terms of "forever" or "always" (in future tense).
"always" I am using in common terms meaning most of the time (and sometimes "always" does mean something "always" happens in the present and past)
"normal" means in general what most the population does not "do, have or think"
Word games do nothing for me other than frustrate me since I then have to define every meaning of common words I may use in a sentence to convey a thought or explain to someone who is not me how something "is" or "feels".
------------------------------------
Praise:
I am not receptive to praise in most cases. It depends on the delivery. In a normal adult voice and only when it's for something big. Some how being praised for going to the supermarket, mailbox, or any other simple everyday tasks makes me feel ill. To me it's corny and the "woooooow thaaaats Greeattt" is not needed. For some reason praise in general does not motivate me.
--------------------------------------
I am an extremely open person (maybe to open with people). You can ask me any question you want. If it is something I rather not answer at that time I will just say "I do not want to answer that". I am hard to offend so don't be concerned with that. (and no I am not worried that you are concerned).
I do not think I am always right. New information can and does change my mind about issues or changes it over time. When it comes to people in general we all in some way have a belief system. So at times I just agree to disagree.
Basicly I am flexable."
So that is it. That is my letter. Any of you who have been in therapy for any amount of time might be able to relate to what I am talking about.
You know reading over my posts sometimes I hope some of you are getting something out of this because I find it very difficult to express what I am feeling into words. That mixed with my grammar being awful....well I just hope someone gets it. :-)
I go to this program every year now. This being my third year. Since I don't have health insurance all I can afford is to see students in training. Each year I get someone new and each year I have to reexplain my situation. Usually I have new concerns I need addressed as I quickly fill the new person in within a few 50 min sessions with 32 years of my life story.
This year I am taking a more direct route. I have printed off about 30 pages from this blog and just handed it over. It is easier than explaining everything again. Truth is I am tired of explaining myself.
The person I am seeing would like to try CBT (Cognitive Behavioral Therapy MAP-3). Which for me is nothing new. CBT is the first thing I did when I first saw someone in 1996. It seems to have come full circle. The Chapter 1 she photo copied out of the CBT Book states that people with panic disorder or anxiety in general do not have a chemical imbalance in their brain. Isn't that what I have been defending over the past decade to doctors and therapists? And more recently on this blog and youtube.
I never bought into the "imbalance" but I have lived through the SSRI era of paxil and zoloft. The quick fix for all problems. I am not saying that these drugs don't work in some people. I am saying their is always a price to be paid and risks. You just have to measure the risks you are willing to take. Like right now I take Xanax. Not that it helps much.
Now for me CBT does not work at least in the past. CBT is sort of how I cope in general anyway on my own. But sure why not do it again? What else is there?
Truth be told I almost want to just stop going to therapy altogether. Sometimes I have just stopped caring. I can only do so much on my own but without support and understanding from most medical professionals, family, or the public in general how can I do it all alone?
So anyway to speed up the process with the new person I am seeing I have yet another letter I will hand her next Tuesday. In some parts it might sound harsh but I rather not have to deal with the crap I normally do.
Here is the letter it is mostly worked out but still in draft form. Oh and when it says "(packet included)" it is the print out of what I have listed in my last post about blood/needle phobia and the things in quotes is just in reference to what the CBT MAP-3 program states:
""Clients learn specific intervention skills, including how to slow down physiological reactivity through breathing retraining and muscle relaxation training"
This I already do and 90% of the time this is how I cope (this eases it but does not stop it). The other 10% of the time breaks down to the following.
1) I am not in the mood to cope that day so I just deal with the situation or to tired to deal with it so I just don't bother.
2) Other people around me cause distractions or help make the situation worse. Example when I told the dentist "I know my gums bleed but lets not talk about that" stated before hand it is brought up anyway. Or "you don't look so good" when I am already trying to focus and not pass out during a blood draw.
3) The anxiety is so intense that I have not mastered easing it at that level (happens rarely)
"how to decatastrophise through actual prediction testing:"
1) I do this as well. Example when I get my hair cut nothing overwhelming has ever happened and even if something did I would have to deal with the situation at hand and just get through it. Yet knowing this does not seem to make a difference. In fact most situations that I know are not dangerous and nothing ever has happened before, or even something I enjoy doing still sets the process in motion automatically. This can and has happened even when I am fed up with the anxiety and could careless about myself or anyone else for that matter (meaning I care zero what people think about me at that time). Basicly I question my disastrous thoughts and paint them in a different more positive way, know that I can not predict the future and it is never as bad as I imagine anyway (so far).
"how to lessen fearfulness through exposure to feared sensations in safe settings."
1) Exposure no matter how often or far apart seems to have no effect. Going to the same job everyday does not ease it. Getting my hair cut in the past once a month for 17 years.. sometimes even at places that were quiet and the people who worked there were enjoyable did not change the out come much. Also somedays at work were better than others anxiety wise. There is nothing different between the days other than the fact my body is not acting up on some. Somedays at work everything was fine other days I was throwing up.
"sensations in safe settings"
1) I can not get these sensations in a safe setting. Most I can't even bring on if I wanted to at will. Hyperventilation is not something I do during a panic attack or anxiety in general. I was able to eliminate that years ago and am not willing to do that just to get dizzy and bring that feeling back into the forefront of my mind. I also don't get dizzy during panic attacks anymore. Unless it was a long lasting dizzy spell I am not bothered by feeling temporarily dizzy as I experience that at random times be it from being tired or having a cold.
---------
I am not willing to work on blood phobia in this setting because I do not feel this is the proper clinical setting to address that phobia (infomation packet included).
----------
What I am willing to work on:
1) How to cope when my mind becomes so filled with chaos that I cannot stop the racing thoughts, worries and dreams even with deep breathing and decatastrophizing / or positive thoughts. Uncontrolled this can lead me into a depression.
2) I am not scared of when I throw up, not scared of the panic attack or anxiety in itself. I am just tired of feeling so uncomfortable all the time. Years ago I was scared and worried it would kill me on the spot. It hasn't and I have had no choice but to endure it. A lot of therapy depending on the treatment plan can include exposure, breathing techniques, distraction, self-hypnosis, religion (in a church setting treatment plan), medication etc etc.
What it does not address and what I would like and I don't even know if it is possible is deep down I do not want to be focusing on my breathing while shopping, getting my hair cut, seeing a doctor etc etc. I just want to be normal and have my body just behave itself. After all these are not dangerous situations and I know it. I would like to enjoy them without my body fighting me.
A lot of times therapy goes back and forth with "are you worried you are going to throw up?" "so what if you do throw up?" "why do you mind what people think if you throw up?" "sometimes people have a virus and throw up so it's normal" (which I am aware of but this is not a virus or a one time flu). "have you tried not to throw up? and what happens when you do try not to?" "do you worry about throwing up therefore causing a self fulfilling prophecy?" .....For me the real answer is when I am nervous I throw up it is just what happens. It is a pain to deal with and most likely damaging to my health. I do not want to throw up when nervous so how do I stop that? How do I stop my body from shaking even when I am not scared of the situation or even if I am?
How do I deal with people who are demeaning, rude, unsympathetic, uneducated or just plain jerks about my situation? How do I claim my place of power when I am not in a place of power in some situations? How do I do this without a proper support structure in place?
How do I deal with a situation that makes me nervous that I do deem as a possible dangerous situation? How do I sleep when my body refuses to?
How do I know when something real is happening such as a heart attack and not just blow it off as anxiety?
------------------------------------
Word games:
If I say I "can't" I do not mean there is some invisable wall or force stopping me. In general I just mean I "can't" do something at that moment in time for whatever the reason or situation at hand. I do not think I always "can't" I am using the word "can't" as anyone would in everyday common language. "can't" does not mean I am unwilling.
"is just what happens" does not mean there is a law in my head that states that there is a rule, a conclusion of absolutes. I just mean in this time and space, it is what it is, and has been occuring in the now and/or past. There is no future prediction of forever happening. Most the time I am not thinking in terms of "forever" or "always" (in future tense).
"always" I am using in common terms meaning most of the time (and sometimes "always" does mean something "always" happens in the present and past)
"normal" means in general what most the population does not "do, have or think"
Word games do nothing for me other than frustrate me since I then have to define every meaning of common words I may use in a sentence to convey a thought or explain to someone who is not me how something "is" or "feels".
------------------------------------
Praise:
I am not receptive to praise in most cases. It depends on the delivery. In a normal adult voice and only when it's for something big. Some how being praised for going to the supermarket, mailbox, or any other simple everyday tasks makes me feel ill. To me it's corny and the "woooooow thaaaats Greeattt" is not needed. For some reason praise in general does not motivate me.
--------------------------------------
I am an extremely open person (maybe to open with people). You can ask me any question you want. If it is something I rather not answer at that time I will just say "I do not want to answer that". I am hard to offend so don't be concerned with that. (and no I am not worried that you are concerned).
I do not think I am always right. New information can and does change my mind about issues or changes it over time. When it comes to people in general we all in some way have a belief system. So at times I just agree to disagree.
Basicly I am flexable."
So that is it. That is my letter. Any of you who have been in therapy for any amount of time might be able to relate to what I am talking about.
You know reading over my posts sometimes I hope some of you are getting something out of this because I find it very difficult to express what I am feeling into words. That mixed with my grammar being awful....well I just hope someone gets it. :-)
Blood/Needle Phobia UPDATE
To copy and paste the information on the seriousness of blood and needle phobia go to a page I setup http://www.silentjealousy.org
From there you can copy and paste the information to your friends and/or print it out to bring to your doctors.
Thank You.
From there you can copy and paste the information to your friends and/or print it out to bring to your doctors.
Thank You.
Blood/Needle Phobia and Death
Many people do not know that blood/needle phobia is the only phobia that can lead to death in rare cases. I have this phobia and working with the medical community on this issue has been a nightmare. I have found them to me ill informed on the subject and how to handle the situation.
So below I have a report wrote by a Doctor (Hamilton, James G. MD.,Source: Journal of Family Practice)
I am going to have to start taking responsibility for educating my surrounding area on this topic by making copies with what little money I have and sending this report or dropping this report off in person to nursing organizations, hospitals, dentists and blood labs. I assume in some cases I will have to bring 100 copies to places like Emergency Rooms since they are heavily staffed.
You can help in the following way. Copy the report below and mail it or drop it off to your doctor and local dentist offices etc. Look up random addresses to doctors in the phone book if you have to and mail copies when you can.
The people who have anxiety and depression (including myself) have to start fighting back against the biases we face from having this illness or illnesses. I am not concerned with the cause or treatment when it comes to doctors and the lay public. We have all heard "Well just take a pill", "Just relax". You each have heard your own condescending remakes I am sure. And as we all know their treatments do not work for everyone.
If you do not have blood/needle phobia please still take time to print out the report below and mail it to some places in your area. The more we take a stand the more things will change for us and others in the future with an issue.
Also by all means if you have a great doctor or dentist email me their name and address and contact info so I can post it. Also if you have had a negative experience with a medical professional of any kind email me with their info and your experience with them so they can be exposed and people with these conditions can avoid the hardships you have endured. My email is silentjealousy77@yahoo.com. You can also write to me:
Brian
PO BOX 8533
Albany, NY. 12208
The report below is the part you would print and send to the medical professionals in your area.
--------------------------------------------------------------------------
The following is by James G. Hamilton, M.D. in the August, 1995 issue of The Journal of Family Practice. [Vol. 41, No.2, pp. 169-175]
"Needle Phobia: A Neglected Diagnosis
Source: Journal of Family Practice
Date: 08/1995
Citation (v41 n2) Start Page: p169(7) ISSN: 0094-3509
Author(s): Hamilton, James G.
Needle phobia is a recently defined medical condition that affects at least 10% of the population. Because persons with needle phobia typically avoid medical care, this condition is a significant impediment in the health care system. The etiology of needle phobia lies in an inherited vasovagal reflex of shock, triggered by needle puncture. Those who inherit this reflex often learn to fear needles through successive needle exposure. Needle phobia is therefore both inherited and learned.
In a family practice, needle phobia can be managed by reassurance and education, avoidance of needles, postural and muscle tension techniques, benzodiazepines, nitrous oxide gas, and topical anesthesia applied by iontophoresis.
Key words. Needle phobia; phobic disorders; needles; vasovagal reflex; syncope; vasovagal syncope; iontophoresis. (J Fam Pract 1995; 41:169-175)
Needle phobia is a condition that has become an increasingly important issue in medicine because of the modern reliance on injections and blood testing. Contrary to popular belief, needle phobia is not confined to children, is not an emotion-driven or transient phenomenon, and is not a rare condition. Clinicians need to be aware of needle phobia because it is a common condition and because needle-phobic persons tend to avoid medical treatment, which can lead to serious health problems as well as social and legal problems.
Needle phobia has been defined as a formal medical condition(1)(2) and has recently been included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) within the diagnostic category of Blood-Injection-Injury Phobia.(3) A review of the background medical literature and suggestions for management of needle phobia are presented here.
The etiology of needle phobia is rooted in an inherited vasovagal reflex that causes shock with needle puncture. With repeated needle exposure, those with an inherited vasovagal shock reflex tend to develop a fear of needles. Unlike most other phobias, in which exposure to the feared object excites tachycardia, victims of needle phobia typically experience a temporary anticipatory tachycardia and hypertension, which on needle insertion turns into bradycardia and hypotension (Figure), accompanied by pallor, diaphoresis, tinnitus, syncope or near-syncope, and sometimes asystole or death.(1)
[ILLUSTRATION OMITTED]
According to the DSM-IV, a phobia is defined by the presence of fear and by avoidance behavior.(3) The symptom of avoidance of needles, doctors, dentists, etc, is central to the definition of needle phobia, since avoidance of health care is surely a health care problem. However, because needle phobia is also accompanied by numerous physiological changes in blood pressure, pulse, electrocardiogram (ECG) waveforms, and stress hormone levels,(1)(2) these measurements can also be used to define this condition (Table 1). While a dislike or mild fear of needles is very common, needle phobia can be more rigorously defined by objective clinical findings in addition to subjective symptoms.
Table 1. The Primary Factors Underlying the Recognition and Diagnosis of
Needle Phobia
Past medical history(*)
(1) Self-report by the patient of a long-term needle fear, usually from childhood, that the patient recognizes as unreasonable.
(2) Exposure to or anticipation of a needle procedure invariably triggers immediate anxiety, sometimes in the form of a panic attack. In children, the anxiety may be expressed by crying, psychomotor agitation, freezing, or clinging.
(3) Needle procedures, often along with associated medical objects or situations, are avoided either some or all of the time.
(4) The needle avoidance and fear interfere significantly with health care or with normal occupational, academic, or social activities, or the patient is markedly distressed about having the fear.
Family medical history
Approximately 80% of patients with needle phobia report strong needle fear in a first-degree relative, ie, parent, child, or sibling.
Clinical findings
(1) Physical symptoms of syncope, near-syncope, light-headedness, or vertigo upon needle exposure, along with other autonomic symptoms, eg, pallor, diaphoresis, nausea.
(2) Cardiovascular depression with a drop in blood pressure or pulse or both; with or without an initial rise in blood pressure or pulse or both.
(3) Electrocardiogram anomalies of virtually any type.
(4) Rises in any combination of several stress hormones: antidiuretic hormone, human growth hormone, dopamine, catecholamines, corticosteroids, renin, endothelin, and [beta]-endorphin.
(*)Modified from Diagnostic criteria for specific phobia. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association, 1994:410.
NOTE: A diagnosis of needle phobia can be made by past medical history alone. In addition, however, victims of needle phobia typically have symptoms of decreased cerebral perfusion, cardiovascular changes, electrocardiogram changes, and hormonal rises.
Needle Phobia in Family Practice
Those with needle phobia are often terrified of routine needle procedures, and a few are so frightened that they would rather die than have a needle procedure.(4) Even such relatively minor needle procedures as venipuncture(1)(5) or subcutaneous injection(6) can cause a vasovagal shock reflex and evoke patient resistance. When those with needle phobia do agree to needle procedures, they often experience syncope, fall and sustain trauma, have convulsions, lose bowel and bladder control, evoke the calling of cardiac codes, or otherwise cause great concern among staff and family members. Others with needle phobia are simply noncompliant with medical treatment regimens, eg, insulin self-injections.
Victims of needle phobia possess a heightened risk of morbidity and mortality simply because they avoid health care, sometimes for many years,(1)(7) and even when the need for treatment is compelling.(1)(4)(6)(7)(8) Approximately 5% to 15% of the population, for example, decline necessary dental treatment, primarily because they fear oral injections.(8) With an incidence of needle phobia of at least 10%, it is reasonable to hypothesize that a large hidden population goes without regular health care because of this condition. The recognition, acceptance, and communication of this danger by both the medical community and the public, and the development of methods to compensate for needle fear in clinical practice, represent probably the greatest challenges that this condition poses for family medicine.
Needle phobia also can cause major social and legal difficulties in one's life. A fear of blood testing or immunization can interfere with or even destroy plans for marriage, travel, education, immigration, or employment. Students may be discouraged from biological, nursing, or medical careers because of their fear of needles,(4) and women wishing to have children may be thwarted by needle fear.(4)(7) Legal problems can arise when blood tests are ordered by a court in paternity cases, and some victims of needle phobia have even been charged by the police for failure to agree to blood testing.(4) The best-selling book The Blooding detailed the resistance that authorities in England experienced against mass blood testing to eliminate suspects in a murder case.(9) In the United States, involuntary blood testing of accused drunk drivers has led to four cases being appealed to the US Supreme Court.(10)(11)(12)(13)
Occasionally, needle phobia can be fatal. At least 23 reported deaths can reasonably be ascribed solely to needle phobia and its vasovagal reflex during needle procedures such as venipuncture, blood donation, arterial puncture, pleural tap, and intramuscular and subcutaneous injections.(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Other reports and indirect evidence further suggest that needle procedures can result in sudden death.(26)(27)(28)(29) A death by needle phobia can be due to either or both of two mechanisms: an abrupt vasovagal drop in blood pressure and perfusion, especially in an arterial tree already compromised by atherosclerosis, could cause myocardial infarction(25)(29) or cerebral infarction; or a vasovagal reflex could impair the sinoatrial or atrioventricular node enough to cause ventricular fibrillation or asystole.(27)(30)
Prevalence of Needle Phobia
Because needle phobia has only recently been defined, only indirect estimates of its prevalence can be inferred from the literature. One study of 449 Canadian women found that 21.2% experienced mild to intense fear, and 4.9% had a phobic level of fear of injections, blood, injury, doctors, dentists, and hospitals.(31) Another study estimated that 9% of the US population in the age bracket of 10 to 50 years old have an injection phobia, and 5.7% have seen a physician about this phobia.(32) Dread of a painful injection was present in 11% of 100 English office patients.(33) Through in-hospital interviews, 22% of 184 teenaged maternity patients in Nashville, Tennessee, were found to have a fear of blood drawing strong enough to make it hard for them to come to a public clinic for prenatal care.(34) In random surveys, 23% of 200 Swedes(35) and 27% of 177 US college students(36) reported needle fear as the main reason for not donating blood.
The prevalence of needle phobia is probably lower in population samples from clinics or hospitals since those with needle phobia tend to select themselves out of such populations. Even in a general population sample, many people express denial of their needle fear. Therefore, most of the studies done so far probably underestimate the true prevalence of needle phobia. Although the percentage is currently unknown, an estimate of at least 10% is credible.
Etiology of Needle Phobia
In the author's experience with over 50 patients with needle phobia, and in all similar cases reported in the medical literature, those afflicted inevitably display symptoms of an autonomic vasovagal reflex whenever they undergo a needle procedure. The neurophysiology of the vasovagal reflex is grounded in both a vagal bradycardia and a vasodilatation from withdrawal of [alpha]-sympathetic arteriolar tone, which together cause hypotension.(2)(30) In addition, associated neurological circuits cause ECG anomalies and stress hormone release.(30) Because most victims of the vasovagal reflex do not actually lose consciousness, the term "vasovagal reflex" is more accurate than "vasovagal syncope," the term most often used in the older literature. Although the vasovagal reflex has classically been described as being biphasic, with an anticipatory rise in blood pressure and pulse before needle puncture and a sudden plunge in both after puncture(1)(4)(27)(37) (Figure), the author has observed that some patients with needle phobia do not have this initial cardiovascular rise.
Physical Symptoms of the Vasovagal Reflex
The vasovagal reflex in needle phobia may include virtually any type and combination of autonomic symptoms, eg, a clammy diaphoresis, pallor, nausea, respiratory disturbances, and various levels of unresponsiveness.(1)(4)(30)(37)(38)(39)(40) Although the onset of the vasovagal reflex from the start of a needlestick is often immediate, ie, within 2 to 3 seconds, a prospective study of 84 blood donors who fainted found that 16.7% experienced syncope from 5 to 30 minutes after phlebotomy.(38) Another series of 64 blood donors who fainted found that 14% fainted after leaving the phlebotomy site and returning to work, sometimes several hours later.(39)
Although most victims of needle phobia who faint are unconscious for only a few seconds, a survey of 298 vasovagal fainters found that several had a loss of consciousness for 10 to 30 minutes, and a few lost consciousness for 1 to 2 hours.(40) Although blood pressure usually returns to normal within 2 hours, and most vasovagal victims feel well enough to resume normal activity within several hours, others have anxiety, malaise, and weakness for 1 to 2 days after a vasovagal attack.(38)(40)
Convulsions during vasovagal fainting, which are much more frequent than commonly realized, are a general response of the central nervous system (CNS) to the cerebral hypoxia of vasovagal shock. Of 84 blood donors who fainted, 14.3% had prominent tonic--clonic episodes, and another 27% had tonic muscular rigidity.(38) Furthermore, even having a finger pricked for blood typing can cause syncope with convulsive seizures.(38)
Electrocardiogram Changes
In several case reports, ECG changes during the vasovagal reflex among patients with needle phobia have included sinus arrhythmia, premature atrial contractions, premature junctional contractions, unifocal and multifocal premature ventricular contractions, bigeminy, first- and second-degree block, changes in P waves, ST waves, and T waves, sinus bradycardia, sinus tachycardia, ventricular tachycardia, ventricular fibrillation, and asystole.(1)(2)(5)(26)(27)(28)(37) Presumably, these ECG changes are secondary to vagal influence on the sinoatrial and atrioventricular nodes, and perhaps also to the antagonism between the activated sympathetic and parasympathetic systems on the heart.(27)
Stress Hormone Changes
At least 11 stress hormones have been reported to elevate during needle stimulation. Increased cortisol and corticotropin (ACTH) levels secondary to venipuncture and needle phobia have been documented.(1)(2)(41)(42) In one study, cortisol levels rose above average in 7 of 15 subjects, with a positive correlation between cortisol level and the number of vasovagal symptoms.(42) In my experience, corticotropin-releasing factor also can elevate during needle procedures, as can dopamine. In 25% of 28 subjects in 112 trials, human growth hormone levels rose in response to venous catheterization.(42) In three needle-induced vasovagal subjects, [beta]-endorphin levels were observed to rise,(42) but sometimes they do not rise.(1)
Similarly, epinephrine and norepinephrine levels do not always become elevated during episodes of needle phobia.(1) They have been observed to decrease in eight subjects who fainted after venipuncture, presumably related to the withdrawal of sympathetic vascular tone.(43) In another study, however, 21 young women dental patients had increased levels of epinephrine, but not norepinephrine, with a decrease in epinephrine after the procedure.(44) The findings of both of these studies are compatible with a biphasic cardiovascular response.
Probably because the pituitary perceives a reduced intravascular volume during vasovagal shock, vasopressin or antidiuretic hormone (ADH) rises in the vasovagal reflex with venipuncture,(1)(2)(45) as does endothelin.(45) Renin also increased by 200% in one patient with needle phobia,(46) but aldosterone and angiotensin levels have not yet been tested in needle phobic patients. The ADH rise causes pallor during the vasovagal reflext by sharply decreasing cutaneous blood flow, and may also contribute to nausea.(1) This ADH rise is often dramatic, reaching as high as 46 times normal values,(45) and may be responsible, along with the catecholamine elevation, for the intense fear that victims of needle phobia learn in response to their vasovagal reflexes.(1)
Needle Phobia: Inherited or Learned?
Clear evidence exists to support the hypothesis of a hereditary component to needle phobia. Both the vasovagal reflex and needle phobia strongly tend to run in families.(1)(2)(7)(47)(48)(49) The heritability of blood-injury phobia in twin studies, including fear of injections, wounds, blood, and pain, has been estimated to be 48%.(50) Variations in PR, QRS, and QT intervals and heart rate have heritabilities of 30% to 60%,(51) and the autonomic control of the cardiovascular system in general, based on twin comparisons, is probably genetically influenced.(52) Therefore, the plunges in blood pressure and pulse and the ECG anomalies during a needle-phobic response are surely also genetically influenced. The release of stress hormones likewise can reasonably be assumed to be genetically influenced.
In addition to genetic factors, however, a learned component to needle fear also can be identified among those with needle phobia. Needle fear often first comes into awareness after a negative experience at the doctor's or dentist's office.(6)(7)(8) One patient, for example, developed needle phobia in childhood when he was verbally abused and restrained by health care personnel during several painful medical procedures.(6) In one study of 56 persons with injection phobia, 52% traced their fear to such negative conditioning, with a mean age at onset of 8.06 years, and another 24% dated their fear to an episode of vicarious conditioning at seeing another child, often a sibling, have a negative reaction to needles.(47) Over time, with more needle exposures, this fear tends to organize and solidify into a conscious phobia, with an anticipatory anxiety before needle encounters. The learning of fear often becomes generalized in that those who are initially fearful only of needles may develop fear of objects or situations associated with needles, such as blood, injuries, syringes, doctors, dentists, nurses, white laboratory coats, examination rooms, hospitals, and even the antiseptic smell of offices or hospitals.(4)(31)(50)
Based on these studies, one can hypothesize that the trait of needle phobia is both inherited and learned. A vasovagal reflex has been found in all patients with needle phobia tested so far, and the medical histories of most of them include an adverse learning experience that triggered the needle fear.(47) Therefore, a reasonable theoretical model might propose that needle phobia depends both on an inherited reflex that is hard-wired in neurocardiovascular and neuroendocrine pathways and on the learning of a conscious fear.
Blood-injury phobia, which is often linked with needle phobia,(3) probably often arises when a patient with a strong vasovagal reflex undergoes a needle procedure or has an accident that results in a vasovagal response. The victim may focus on the sight of blood or injury to the extent that the blood-injury cue serves as a conditioned stimulus to trigger a vasovagal response thereafter. Although many needle-phobic persons also have blood-injury fears, further consideration should be given to whether these two phobias should be combined into a single diagnostic category, as is now the case in DSM-IV.
Evolution of the Needle Phobia Trait
The presence of a genetic trait among a species automatically indicates that the trait must have been selected for during the evolution of that species. The needle phobia trait probably evolved among the human species in response to piercing, stabbing, and cutting injuries.(1) The vast majority of violent deaths in our species' evolutionary history have been caused by skin penetration from teeth, claws, fangs and tusks, and from sticks, stone axes, knives, spears, swords, and arrows. Besides death resulting from direct trauma or hemorrhage, many of these deaths were due to infections secondary to skin penetration. A reflex that promoted the learning of a strong fear of skin puncture had clear selective value in teaching humans to avoid such injuries. Over the 4+ million years of human evolution, surely many genes controlling blood pressure, pulse, cardiac rhythm, and stress hormone release were selected for to create the vasovagal reflex.
The wide variation in the subjective symptoms and physiological responses of persons with needle phobia means that this trait, like most other human traits, is not an all-or-none phenomenon. The genes that promote needle phobia, as with other polygenic traits such as height, weight, or intelligence, are probably distributed among the human population in a continuous bell-shaped curve. Thus, both strong- and weak-trait individuals interact with the medical environment in a lifelong process of learning through varying needle exposure to create a wide expression of the needle phobia trait.
Management of Patients with Needle Phobia
It is essential that family physicians be knowledgeable about how to manage needle fear if they are to adequately treat these patients (Table 2). Communicating empathy and respect for patients with needle phobia by assuring them that they are not "wimps" or "oddballs" helps them accept their condition without embarrassment. Most victims of needle phobia sincerely believe that their problem is all in their mind and that they would not be fearful if they were stronger or more mature. Many simply do not realize that there are many others with similar fears. Giving patients a name for this condition legitimatizes it to them and gives them a tool they can use to buffer their interaction with the health care system. Reassurance and education, mainstays within the family doctor's armamentarium, almost always help.
Table 2. Techniques of Managing Patients with Needle Phobia
* Reassurance: discussion about the normality and prevalence of needle fear.
* Education: explanation of the inherited, involuntary nature of needle phobia and the various methods available to counter this condition.
* Avoidance of unnecessary or excessive needle procedures limits the conditioning of a vasovagal-based fear response and facilitates patient compliance with medical treatment.
* Desensitization therapy requires a motivated patient, yet may decondition the autonomic symptoms and fear experienced by patients with mild needle phobia and can extinguish associated blood-injury fears.
* Nerve-gate blocking distracts the patient by stimulating the area of needle use.
* Elevation of lower extremities in recumbent position with applied muscle tension augments the central venous reservoir, increases stroke volume, and helps maintain cerebral perfusion.
* Rapid-acting benzodiazepines, eg, diazepam or lorazepam, have an onset of action within 5 to 15 minutes from ingestion. A relatively large dose (eg, 10 to 20 mg po of diazepam) may be necessary and can be combined with nitrous oxide.
* Topical anesthesia at the needle site, eg, ice, ethyl chloride spray, or topical anesthetics. Topical anesthetics penetrate the skin much faster and deeper when driven by iontophoresis.
Alternative methods of drug delivery can sidestep the issue of needle fear by avoiding needles altogether. Nasal sprays that deliver vasopressin, calcitonin and insulin, sprays that immunize against influenza and dust-mite allergens, and an oral form of insulin are all now in investigative trials in the United States. Topical analgesic patches and opiate suppositories can be used in cases of severe pain, eg, metastatic cancer, which might otherwise be managed with intravenous drips. Many other medicines could obviously be administered without needles.
When needle use is necessary, any one of several methods or a combination of methods may be useful. Desensitization therapy by a psychiatrist or clinical psychologist is usually lengthy, expensive, and of variable efficacy.(1)(6)(7)(8) Nerve gate-blocking methods, eg, pinching or rubbing the area to distract the patient during a needle-stick, can be helpful. Shock and syncope are reduced among phobic patients by having them lie supine with legs elevated and tense their muscles during needle procedures to increase cerebral blood flow.(53) Needle-phobic patients should also be routinely premedicated with oral, sublingual, or intranasal benzodiazepines,(2) with N[O.sub.2],(8) or both. Sublingual atropine to block bradycardia also may be beneficial.(2) Since a vasovagal reaction can injure or even kill a patient, having on hand an oxygen source and a "crash cart" for cardiac resuscitation is mandatory with any needle-phobic patient undergoing a needle procedure.
Topical anesthesia of the autonomic sensory neural net at the needle site can be used to interrupt the vasovagal reflex at its origin so that the reflex is not triggered. Ethyl chloride spray can temporarily anesthetize the skin, but this affects only the superficial skin layers and lasts for only a few seconds. The skin can also be anesthetized by an ice pack, although freezing is unpleasant and can damage tissue. In placebo-controlled studies, topical anesthetics containing a mixture of lidocaine and prilocaine have been shown to work well in pediatric patients,(54) and topical mixtures of tetracaine, adrenalin, and cocaine (TAC ointment) or tetracaine, adrenalin, and lidocaine have been long used in emergency departments for surface anesthesia.(55) To work on intact skin, however, all these mixtures must be applied for 1 to 2 hours and have a depth of anesthesia of only 2 to 3 mm.
The depth and effectiveness of topical anesthesia is greatly enhanced by the technique of iontophoresis (or ionphoresis). Iontophoresis involves soaking an absorbent pad with lidocaine and driving it through the skin with a tiny electrical current from a battery-powered unit.(35)(56) Because lidocaine is a positively charged molecule, the electrode pad's positive charge repels the lidocaine, propelling it through the skin by way of the sweat ducts. Using iontophoresis, an injection or venipuncture site can be completely anesthetized to a depth of 1 to 2 cm in less than 10 minutes.(56)
The procedure of iontophoresis has been assigned insurance reimbursement codes, and an iontophoresis unit(*) for use with needle phobic persons has been cleared by the Food and Drug Administration. This instrument has been demonstrated to be effective for venipuncture and joint injections(56) and has applications, for example, in blood donor drives(35) and pediatric immunization programs. The ease of use of iontophoresis raises the intriguing possibility of creating in the near future medical environments that are completely free of needle phobia.
Acknowledgments
The author wishes to thank Nancy R. Hamilton, RN, for her most gracious patience and support during the preparation of this paper, and also Gary Hadden, Department of Psychiatry, Duke University, for his expert assistance.
References
(1.)Ellinwood EH, Hamilton JG. Case report of a needle phobia. J Fam Pract 1991; 32:420-3.
(2.)Hamilton J, Ellinwood E. Needle phobia [abstract]. South Med J 1991; 84(Suppl):2S-27.
(3.)Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994:405-11.
(4.)Marks I. Blood-injury phobia: a review. Am J Psychiatry 1988; 145:1207-13.
(5.)Galena HJ. Complications occurring from diagnostic venipuncture. J Fam Pract 1992; 34:582-4.
(6.)Jacobsen PB. Treating a man with needle phobia who requires daily injections of medication. Hosp Community Psychiatry 1991; 42:877-8.
(7.)Hsu LKG. Novel symptom emergence after behavior therapy in a case of hypodermic injection phobia. Am J Psychiatry 1978; 135:238-9.
(8.)Lemasney NJ, Holland T, O'Mullane D, O'Sullivan VR. The aetiology and treatment of needle phobia in the young patient--a review. J Ir Dent Assoc 1989; 35:20-3.
(9.)Wambaugh J. The blooding. New York, NY: William Morrow, 1989:210-4, 217.
(10.)Schmerber v California, 384 US 757, 86 SCt 1826 (1966).
(11.)Breithaupt v Abram, 352 US 432, 77 SCt 408 (1957).
(12.)South Dakota v Neville, 459 US 553, 103 SCt 916 (1983).
(13.)Hammer v Gross, 932 F2d 842 (USCA, 9th Cir, 1991). cert denied, 112 SCt 582 (1991).
(14.)Boas EP. Some immediate causes of cardiac infarction. Am Heart J 1942; 23:1-15.
(15.)Cass N [letter]. Anaesth Intensive Care 1978; 6:169-70.
(16.)Dale WA. Cardiac arrest: review and report of 12 cases. Ann Surg 1952; 135:376-93.
(17.)Kulvin MM. Scared to death [letter]. JAMA 1966; 198:90.
(18.)Lockey RF, Benedict LM, Turkeltaub PC, Bukantz SC. Fatalities from immunotherapy (IT) and skin testing (ST). J Allergy Clin Immunol 1987; 79:660-7.
(19.)Lockhart RJ. Toxic erythema; T.A.B. (intravenously); coronary thrombosis; sudden death. Br J Dermatol Syphilis 1939; 51:318-21.
(20.)Morland A. Pleural shock. Lancet 1949; 2:1021-3.
(21.)Rutsky EA. Bradycardic rhythms during peritoneal dialysis. Arch Intern Med 1971; 128:445-7.
(22.)Sauls LJ. Sudden death at impasse. Psychoanal Forum 1966; 1:88-93.
(23.)Turk LN, Glenn WWL. Cardiac arrest. N Engl J Med 1954; 251: 795-803.
(24.)Turkeltaub PC, Gergen PJ. The risk of adverse reactions from percutaneous prick-puncture allergen skin testing, venipuncture, and body measurements. J Allergy Clin Immunol 1989; 84:886-90.
(25.)Zukerman CM. Fatality in a blood donor; a case report, with a review of the literature. Ann Intern Med 1947; 26:603-8.
(26.)Caplan RA, Ward RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia. Anesthesiology 1988; 68:5-11.
(27.)Engel GL. Psychologic stress, vasodepressor (vasovagal) syncope, and sudden death. Ann Intern Med 1978; 89:403-12.
(28.)Schlesinger Z, Barzilay J, Stryjer D, Almog CH. Life-threatening "vagal reaction" to emotional stimuli. Isr J Med Sci 1977; 13:59-61.
(29.)Spiess BD, Sassetti R, McCarthy RJ, Narbone RF, Tuman KJ, Ivankovich AD. Autologous blood donation: hemodynamics in a high-risk patient population. Transfusion 1992; 32:17-22.
(30.)van Lieshout JJ, Wieling W, Karemaker JM, Eckberg DL. The vasovagal response. Clin Sci 1991; 81:575-86.
(31.)Costello CG. Fears and phobias in women. J Abnorm Psychol 1982; 91:280-6.
(32.)Agras S, Sylvester D, Oliveau D. The epidemiology of common fears and phobias. Compr Psychiatry 1969; 10:1511-56.
(33.)Keep PJ, Jenkins JR. From the other end of the needle. The patient's experience of routine anesthesia. Anaesthesia 1978; 33:830-2.
(34.)Cartwright PS, McLaughlin FJ, Martinez AM, Caul DE, Hogan IG, Reed GW, Swafford MS. Teenagers' perceptions of barriers to prenatal care. South Med J 1993; 86:737-41.
(35.)Arvidsson SB, Ekroth RH, Hansby AMC, Lindholm AH, William-Olsson G. Painless venipuncture. A clinical trial of iontophoresis of lidocaine for venipuncture in blood donors. Acta Anaesthesiol Scand 1984; 28:209-10.
(36.)Oswalt RM, Napoliello M. Motivations of blood donors and nondonors. J Appl Psychol 1974; 59:122-4.
(37.)Greenfield ADM. An emotional faint. Lancet 1951; 1:1302-3.
(38.)Lin JT-Y, Ziegler DK, Lai C-W, Bayer W. Convulsive syncope in blood donors. Ann Neurol 1982; 11:525-8.
(39.)Poles FC, Boycott M. Syncope in blood donors. Lancet 1942; 2:531-5.
(40.)Wayne HH. Syncope. Am J Med 1961; 30:418-38.
(41.)Kraemer RR, Blair S, Kraemer GR, Castracane VD. Effects of treadmill running on plasma beta-endorphin, corticotropin, and cortisol levels in male and female 10K runners. Eur J Appl Physiol Occup Physiol 1989; 58:845-51.
(42.)Rose RM, Hurst MW. Plasma cortisol and growth hormone responses to intravenous catheterization. J Hum Stress 1975; 1:22-36.
(43.)Ziegler MG, Echon C, Wilner KD, Specho P, Lake CR, McCutchen JA. Sympathetic nervous withdrawal in the vasodepressor (vasovagal) reaction. J Auton Nerv Syst 1986; 17:273-8.
(44.)Taggart P, Hedworth-Whitty R, Carruthers M, Gordon PD. Observations on electrocardiogram and plasma catecholamines during dental procedures: the forgotten vagus. BMJ 1976; 2:787-9.
(45.)Kaufmann H, Oribe E, Oliver JA. Plasma endothelin during up-right tilt: relevance for orthostatic hypotension? Lancet 1991; 338:1542-5.
(46.)Goldstein DS, Spanarkel M, Pitterman A, Toltzis R, Gratz E, Epstein S, Keiser HR. Circulatory control mechanisms in vasodepressor syncope. Am Heart J 1982; 104:1071-5.
(47.)Ost L-G. Acquisition of blood and injection phobia and anxiety response patterns in clinical patients. Behav Res Ther 1991; 29:323-32.
(48.)Kleinknecht RA, Lenz J. Blood/injury fear, fainting and avoidance of medically-related situations: a family correspondence study. Behav Res Ther 1989; 27:537-47.
(49.)Camfield PR, Camfield CS. Syncope in childhood: a case control clinical study of the familial tendency to faint. Can J Neurol Sci 1990; 17:306-8.
(50.)Torgersen S. The nature and origin of common phobic fears. Br J Psychiatry 1979; 134:343-51.
(51.)Hanson B, Tuna N, Bouchard T, Heston L, Eckert E, Lykken D, et al. Genetic factors in the electrocardiogram and heart rate of twins reared apart and together. Am J Cardiol 1989; 63:606-9.
(52.)Losse H, Kretschmer M, Kuban G, Bottger K. Die vegetative struktur des individuums I and II. Acta Neuroveg 1956; 13:337-99.
(53.)Ost L-G, Fellenius J, Sterner U. Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behav Res Ther 1991; 29:561-74.
(54.)Joyce TH III. Topical anesthesia and pain management before venipuncture. J Pediatr 1993; S24-9.
(55.)Ernst AA, Marvez E, Nick TG, Chin E, Wood E, Gonzaba WT. Lidocaine adrenalin tetracaine gel versus tetracaine adrenaline cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5 to 17 years. Pediatrics 1995; 95:255-8.
(56.)Hamilton JG, Wrenn R, Garcia-Caro M, Hamilton N. Office management of needle fear and needle phobia by lidocaine iontophoresis. Presented at 87th Scientific Assembly, Southern Medical Association, New Orleans, La, Oct 31, 1993.
(*)This unit, the NeedleBuster, is now available commercially from Life-Tech, Inc, Houston, Texas; (800) 231-9841.
COPYRIGHT 1995 Dowden Health Media, Inc.
COPYRIGHT 2004 Gale Group"
So below I have a report wrote by a Doctor (Hamilton, James G. MD.,Source: Journal of Family Practice)
I am going to have to start taking responsibility for educating my surrounding area on this topic by making copies with what little money I have and sending this report or dropping this report off in person to nursing organizations, hospitals, dentists and blood labs. I assume in some cases I will have to bring 100 copies to places like Emergency Rooms since they are heavily staffed.
You can help in the following way. Copy the report below and mail it or drop it off to your doctor and local dentist offices etc. Look up random addresses to doctors in the phone book if you have to and mail copies when you can.
The people who have anxiety and depression (including myself) have to start fighting back against the biases we face from having this illness or illnesses. I am not concerned with the cause or treatment when it comes to doctors and the lay public. We have all heard "Well just take a pill", "Just relax". You each have heard your own condescending remakes I am sure. And as we all know their treatments do not work for everyone.
If you do not have blood/needle phobia please still take time to print out the report below and mail it to some places in your area. The more we take a stand the more things will change for us and others in the future with an issue.
Also by all means if you have a great doctor or dentist email me their name and address and contact info so I can post it. Also if you have had a negative experience with a medical professional of any kind email me with their info and your experience with them so they can be exposed and people with these conditions can avoid the hardships you have endured. My email is silentjealousy77@yahoo.com. You can also write to me:
Brian
PO BOX 8533
Albany, NY. 12208
The report below is the part you would print and send to the medical professionals in your area.
--------------------------------------------------------------------------
The following is by James G. Hamilton, M.D. in the August, 1995 issue of The Journal of Family Practice. [Vol. 41, No.2, pp. 169-175]
"Needle Phobia: A Neglected Diagnosis
Source: Journal of Family Practice
Date: 08/1995
Citation (v41 n2) Start Page: p169(7) ISSN: 0094-3509
Author(s): Hamilton, James G.
Needle phobia is a recently defined medical condition that affects at least 10% of the population. Because persons with needle phobia typically avoid medical care, this condition is a significant impediment in the health care system. The etiology of needle phobia lies in an inherited vasovagal reflex of shock, triggered by needle puncture. Those who inherit this reflex often learn to fear needles through successive needle exposure. Needle phobia is therefore both inherited and learned.
In a family practice, needle phobia can be managed by reassurance and education, avoidance of needles, postural and muscle tension techniques, benzodiazepines, nitrous oxide gas, and topical anesthesia applied by iontophoresis.
Key words. Needle phobia; phobic disorders; needles; vasovagal reflex; syncope; vasovagal syncope; iontophoresis. (J Fam Pract 1995; 41:169-175)
Needle phobia is a condition that has become an increasingly important issue in medicine because of the modern reliance on injections and blood testing. Contrary to popular belief, needle phobia is not confined to children, is not an emotion-driven or transient phenomenon, and is not a rare condition. Clinicians need to be aware of needle phobia because it is a common condition and because needle-phobic persons tend to avoid medical treatment, which can lead to serious health problems as well as social and legal problems.
Needle phobia has been defined as a formal medical condition(1)(2) and has recently been included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) within the diagnostic category of Blood-Injection-Injury Phobia.(3) A review of the background medical literature and suggestions for management of needle phobia are presented here.
The etiology of needle phobia is rooted in an inherited vasovagal reflex that causes shock with needle puncture. With repeated needle exposure, those with an inherited vasovagal shock reflex tend to develop a fear of needles. Unlike most other phobias, in which exposure to the feared object excites tachycardia, victims of needle phobia typically experience a temporary anticipatory tachycardia and hypertension, which on needle insertion turns into bradycardia and hypotension (Figure), accompanied by pallor, diaphoresis, tinnitus, syncope or near-syncope, and sometimes asystole or death.(1)
[ILLUSTRATION OMITTED]
According to the DSM-IV, a phobia is defined by the presence of fear and by avoidance behavior.(3) The symptom of avoidance of needles, doctors, dentists, etc, is central to the definition of needle phobia, since avoidance of health care is surely a health care problem. However, because needle phobia is also accompanied by numerous physiological changes in blood pressure, pulse, electrocardiogram (ECG) waveforms, and stress hormone levels,(1)(2) these measurements can also be used to define this condition (Table 1). While a dislike or mild fear of needles is very common, needle phobia can be more rigorously defined by objective clinical findings in addition to subjective symptoms.
Table 1. The Primary Factors Underlying the Recognition and Diagnosis of
Needle Phobia
Past medical history(*)
(1) Self-report by the patient of a long-term needle fear, usually from childhood, that the patient recognizes as unreasonable.
(2) Exposure to or anticipation of a needle procedure invariably triggers immediate anxiety, sometimes in the form of a panic attack. In children, the anxiety may be expressed by crying, psychomotor agitation, freezing, or clinging.
(3) Needle procedures, often along with associated medical objects or situations, are avoided either some or all of the time.
(4) The needle avoidance and fear interfere significantly with health care or with normal occupational, academic, or social activities, or the patient is markedly distressed about having the fear.
Family medical history
Approximately 80% of patients with needle phobia report strong needle fear in a first-degree relative, ie, parent, child, or sibling.
Clinical findings
(1) Physical symptoms of syncope, near-syncope, light-headedness, or vertigo upon needle exposure, along with other autonomic symptoms, eg, pallor, diaphoresis, nausea.
(2) Cardiovascular depression with a drop in blood pressure or pulse or both; with or without an initial rise in blood pressure or pulse or both.
(3) Electrocardiogram anomalies of virtually any type.
(4) Rises in any combination of several stress hormones: antidiuretic hormone, human growth hormone, dopamine, catecholamines, corticosteroids, renin, endothelin, and [beta]-endorphin.
(*)Modified from Diagnostic criteria for specific phobia. In: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association, 1994:410.
NOTE: A diagnosis of needle phobia can be made by past medical history alone. In addition, however, victims of needle phobia typically have symptoms of decreased cerebral perfusion, cardiovascular changes, electrocardiogram changes, and hormonal rises.
Needle Phobia in Family Practice
Those with needle phobia are often terrified of routine needle procedures, and a few are so frightened that they would rather die than have a needle procedure.(4) Even such relatively minor needle procedures as venipuncture(1)(5) or subcutaneous injection(6) can cause a vasovagal shock reflex and evoke patient resistance. When those with needle phobia do agree to needle procedures, they often experience syncope, fall and sustain trauma, have convulsions, lose bowel and bladder control, evoke the calling of cardiac codes, or otherwise cause great concern among staff and family members. Others with needle phobia are simply noncompliant with medical treatment regimens, eg, insulin self-injections.
Victims of needle phobia possess a heightened risk of morbidity and mortality simply because they avoid health care, sometimes for many years,(1)(7) and even when the need for treatment is compelling.(1)(4)(6)(7)(8) Approximately 5% to 15% of the population, for example, decline necessary dental treatment, primarily because they fear oral injections.(8) With an incidence of needle phobia of at least 10%, it is reasonable to hypothesize that a large hidden population goes without regular health care because of this condition. The recognition, acceptance, and communication of this danger by both the medical community and the public, and the development of methods to compensate for needle fear in clinical practice, represent probably the greatest challenges that this condition poses for family medicine.
Needle phobia also can cause major social and legal difficulties in one's life. A fear of blood testing or immunization can interfere with or even destroy plans for marriage, travel, education, immigration, or employment. Students may be discouraged from biological, nursing, or medical careers because of their fear of needles,(4) and women wishing to have children may be thwarted by needle fear.(4)(7) Legal problems can arise when blood tests are ordered by a court in paternity cases, and some victims of needle phobia have even been charged by the police for failure to agree to blood testing.(4) The best-selling book The Blooding detailed the resistance that authorities in England experienced against mass blood testing to eliminate suspects in a murder case.(9) In the United States, involuntary blood testing of accused drunk drivers has led to four cases being appealed to the US Supreme Court.(10)(11)(12)(13)
Occasionally, needle phobia can be fatal. At least 23 reported deaths can reasonably be ascribed solely to needle phobia and its vasovagal reflex during needle procedures such as venipuncture, blood donation, arterial puncture, pleural tap, and intramuscular and subcutaneous injections.(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Other reports and indirect evidence further suggest that needle procedures can result in sudden death.(26)(27)(28)(29) A death by needle phobia can be due to either or both of two mechanisms: an abrupt vasovagal drop in blood pressure and perfusion, especially in an arterial tree already compromised by atherosclerosis, could cause myocardial infarction(25)(29) or cerebral infarction; or a vasovagal reflex could impair the sinoatrial or atrioventricular node enough to cause ventricular fibrillation or asystole.(27)(30)
Prevalence of Needle Phobia
Because needle phobia has only recently been defined, only indirect estimates of its prevalence can be inferred from the literature. One study of 449 Canadian women found that 21.2% experienced mild to intense fear, and 4.9% had a phobic level of fear of injections, blood, injury, doctors, dentists, and hospitals.(31) Another study estimated that 9% of the US population in the age bracket of 10 to 50 years old have an injection phobia, and 5.7% have seen a physician about this phobia.(32) Dread of a painful injection was present in 11% of 100 English office patients.(33) Through in-hospital interviews, 22% of 184 teenaged maternity patients in Nashville, Tennessee, were found to have a fear of blood drawing strong enough to make it hard for them to come to a public clinic for prenatal care.(34) In random surveys, 23% of 200 Swedes(35) and 27% of 177 US college students(36) reported needle fear as the main reason for not donating blood.
The prevalence of needle phobia is probably lower in population samples from clinics or hospitals since those with needle phobia tend to select themselves out of such populations. Even in a general population sample, many people express denial of their needle fear. Therefore, most of the studies done so far probably underestimate the true prevalence of needle phobia. Although the percentage is currently unknown, an estimate of at least 10% is credible.
Etiology of Needle Phobia
In the author's experience with over 50 patients with needle phobia, and in all similar cases reported in the medical literature, those afflicted inevitably display symptoms of an autonomic vasovagal reflex whenever they undergo a needle procedure. The neurophysiology of the vasovagal reflex is grounded in both a vagal bradycardia and a vasodilatation from withdrawal of [alpha]-sympathetic arteriolar tone, which together cause hypotension.(2)(30) In addition, associated neurological circuits cause ECG anomalies and stress hormone release.(30) Because most victims of the vasovagal reflex do not actually lose consciousness, the term "vasovagal reflex" is more accurate than "vasovagal syncope," the term most often used in the older literature. Although the vasovagal reflex has classically been described as being biphasic, with an anticipatory rise in blood pressure and pulse before needle puncture and a sudden plunge in both after puncture(1)(4)(27)(37) (Figure), the author has observed that some patients with needle phobia do not have this initial cardiovascular rise.
Physical Symptoms of the Vasovagal Reflex
The vasovagal reflex in needle phobia may include virtually any type and combination of autonomic symptoms, eg, a clammy diaphoresis, pallor, nausea, respiratory disturbances, and various levels of unresponsiveness.(1)(4)(30)(37)(38)(39)(40) Although the onset of the vasovagal reflex from the start of a needlestick is often immediate, ie, within 2 to 3 seconds, a prospective study of 84 blood donors who fainted found that 16.7% experienced syncope from 5 to 30 minutes after phlebotomy.(38) Another series of 64 blood donors who fainted found that 14% fainted after leaving the phlebotomy site and returning to work, sometimes several hours later.(39)
Although most victims of needle phobia who faint are unconscious for only a few seconds, a survey of 298 vasovagal fainters found that several had a loss of consciousness for 10 to 30 minutes, and a few lost consciousness for 1 to 2 hours.(40) Although blood pressure usually returns to normal within 2 hours, and most vasovagal victims feel well enough to resume normal activity within several hours, others have anxiety, malaise, and weakness for 1 to 2 days after a vasovagal attack.(38)(40)
Convulsions during vasovagal fainting, which are much more frequent than commonly realized, are a general response of the central nervous system (CNS) to the cerebral hypoxia of vasovagal shock. Of 84 blood donors who fainted, 14.3% had prominent tonic--clonic episodes, and another 27% had tonic muscular rigidity.(38) Furthermore, even having a finger pricked for blood typing can cause syncope with convulsive seizures.(38)
Electrocardiogram Changes
In several case reports, ECG changes during the vasovagal reflex among patients with needle phobia have included sinus arrhythmia, premature atrial contractions, premature junctional contractions, unifocal and multifocal premature ventricular contractions, bigeminy, first- and second-degree block, changes in P waves, ST waves, and T waves, sinus bradycardia, sinus tachycardia, ventricular tachycardia, ventricular fibrillation, and asystole.(1)(2)(5)(26)(27)(28)(37) Presumably, these ECG changes are secondary to vagal influence on the sinoatrial and atrioventricular nodes, and perhaps also to the antagonism between the activated sympathetic and parasympathetic systems on the heart.(27)
Stress Hormone Changes
At least 11 stress hormones have been reported to elevate during needle stimulation. Increased cortisol and corticotropin (ACTH) levels secondary to venipuncture and needle phobia have been documented.(1)(2)(41)(42) In one study, cortisol levels rose above average in 7 of 15 subjects, with a positive correlation between cortisol level and the number of vasovagal symptoms.(42) In my experience, corticotropin-releasing factor also can elevate during needle procedures, as can dopamine. In 25% of 28 subjects in 112 trials, human growth hormone levels rose in response to venous catheterization.(42) In three needle-induced vasovagal subjects, [beta]-endorphin levels were observed to rise,(42) but sometimes they do not rise.(1)
Similarly, epinephrine and norepinephrine levels do not always become elevated during episodes of needle phobia.(1) They have been observed to decrease in eight subjects who fainted after venipuncture, presumably related to the withdrawal of sympathetic vascular tone.(43) In another study, however, 21 young women dental patients had increased levels of epinephrine, but not norepinephrine, with a decrease in epinephrine after the procedure.(44) The findings of both of these studies are compatible with a biphasic cardiovascular response.
Probably because the pituitary perceives a reduced intravascular volume during vasovagal shock, vasopressin or antidiuretic hormone (ADH) rises in the vasovagal reflex with venipuncture,(1)(2)(45) as does endothelin.(45) Renin also increased by 200% in one patient with needle phobia,(46) but aldosterone and angiotensin levels have not yet been tested in needle phobic patients. The ADH rise causes pallor during the vasovagal reflext by sharply decreasing cutaneous blood flow, and may also contribute to nausea.(1) This ADH rise is often dramatic, reaching as high as 46 times normal values,(45) and may be responsible, along with the catecholamine elevation, for the intense fear that victims of needle phobia learn in response to their vasovagal reflexes.(1)
Needle Phobia: Inherited or Learned?
Clear evidence exists to support the hypothesis of a hereditary component to needle phobia. Both the vasovagal reflex and needle phobia strongly tend to run in families.(1)(2)(7)(47)(48)(49) The heritability of blood-injury phobia in twin studies, including fear of injections, wounds, blood, and pain, has been estimated to be 48%.(50) Variations in PR, QRS, and QT intervals and heart rate have heritabilities of 30% to 60%,(51) and the autonomic control of the cardiovascular system in general, based on twin comparisons, is probably genetically influenced.(52) Therefore, the plunges in blood pressure and pulse and the ECG anomalies during a needle-phobic response are surely also genetically influenced. The release of stress hormones likewise can reasonably be assumed to be genetically influenced.
In addition to genetic factors, however, a learned component to needle fear also can be identified among those with needle phobia. Needle fear often first comes into awareness after a negative experience at the doctor's or dentist's office.(6)(7)(8) One patient, for example, developed needle phobia in childhood when he was verbally abused and restrained by health care personnel during several painful medical procedures.(6) In one study of 56 persons with injection phobia, 52% traced their fear to such negative conditioning, with a mean age at onset of 8.06 years, and another 24% dated their fear to an episode of vicarious conditioning at seeing another child, often a sibling, have a negative reaction to needles.(47) Over time, with more needle exposures, this fear tends to organize and solidify into a conscious phobia, with an anticipatory anxiety before needle encounters. The learning of fear often becomes generalized in that those who are initially fearful only of needles may develop fear of objects or situations associated with needles, such as blood, injuries, syringes, doctors, dentists, nurses, white laboratory coats, examination rooms, hospitals, and even the antiseptic smell of offices or hospitals.(4)(31)(50)
Based on these studies, one can hypothesize that the trait of needle phobia is both inherited and learned. A vasovagal reflex has been found in all patients with needle phobia tested so far, and the medical histories of most of them include an adverse learning experience that triggered the needle fear.(47) Therefore, a reasonable theoretical model might propose that needle phobia depends both on an inherited reflex that is hard-wired in neurocardiovascular and neuroendocrine pathways and on the learning of a conscious fear.
Blood-injury phobia, which is often linked with needle phobia,(3) probably often arises when a patient with a strong vasovagal reflex undergoes a needle procedure or has an accident that results in a vasovagal response. The victim may focus on the sight of blood or injury to the extent that the blood-injury cue serves as a conditioned stimulus to trigger a vasovagal response thereafter. Although many needle-phobic persons also have blood-injury fears, further consideration should be given to whether these two phobias should be combined into a single diagnostic category, as is now the case in DSM-IV.
Evolution of the Needle Phobia Trait
The presence of a genetic trait among a species automatically indicates that the trait must have been selected for during the evolution of that species. The needle phobia trait probably evolved among the human species in response to piercing, stabbing, and cutting injuries.(1) The vast majority of violent deaths in our species' evolutionary history have been caused by skin penetration from teeth, claws, fangs and tusks, and from sticks, stone axes, knives, spears, swords, and arrows. Besides death resulting from direct trauma or hemorrhage, many of these deaths were due to infections secondary to skin penetration. A reflex that promoted the learning of a strong fear of skin puncture had clear selective value in teaching humans to avoid such injuries. Over the 4+ million years of human evolution, surely many genes controlling blood pressure, pulse, cardiac rhythm, and stress hormone release were selected for to create the vasovagal reflex.
The wide variation in the subjective symptoms and physiological responses of persons with needle phobia means that this trait, like most other human traits, is not an all-or-none phenomenon. The genes that promote needle phobia, as with other polygenic traits such as height, weight, or intelligence, are probably distributed among the human population in a continuous bell-shaped curve. Thus, both strong- and weak-trait individuals interact with the medical environment in a lifelong process of learning through varying needle exposure to create a wide expression of the needle phobia trait.
Management of Patients with Needle Phobia
It is essential that family physicians be knowledgeable about how to manage needle fear if they are to adequately treat these patients (Table 2). Communicating empathy and respect for patients with needle phobia by assuring them that they are not "wimps" or "oddballs" helps them accept their condition without embarrassment. Most victims of needle phobia sincerely believe that their problem is all in their mind and that they would not be fearful if they were stronger or more mature. Many simply do not realize that there are many others with similar fears. Giving patients a name for this condition legitimatizes it to them and gives them a tool they can use to buffer their interaction with the health care system. Reassurance and education, mainstays within the family doctor's armamentarium, almost always help.
Table 2. Techniques of Managing Patients with Needle Phobia
* Reassurance: discussion about the normality and prevalence of needle fear.
* Education: explanation of the inherited, involuntary nature of needle phobia and the various methods available to counter this condition.
* Avoidance of unnecessary or excessive needle procedures limits the conditioning of a vasovagal-based fear response and facilitates patient compliance with medical treatment.
* Desensitization therapy requires a motivated patient, yet may decondition the autonomic symptoms and fear experienced by patients with mild needle phobia and can extinguish associated blood-injury fears.
* Nerve-gate blocking distracts the patient by stimulating the area of needle use.
* Elevation of lower extremities in recumbent position with applied muscle tension augments the central venous reservoir, increases stroke volume, and helps maintain cerebral perfusion.
* Rapid-acting benzodiazepines, eg, diazepam or lorazepam, have an onset of action within 5 to 15 minutes from ingestion. A relatively large dose (eg, 10 to 20 mg po of diazepam) may be necessary and can be combined with nitrous oxide.
* Topical anesthesia at the needle site, eg, ice, ethyl chloride spray, or topical anesthetics. Topical anesthetics penetrate the skin much faster and deeper when driven by iontophoresis.
Alternative methods of drug delivery can sidestep the issue of needle fear by avoiding needles altogether. Nasal sprays that deliver vasopressin, calcitonin and insulin, sprays that immunize against influenza and dust-mite allergens, and an oral form of insulin are all now in investigative trials in the United States. Topical analgesic patches and opiate suppositories can be used in cases of severe pain, eg, metastatic cancer, which might otherwise be managed with intravenous drips. Many other medicines could obviously be administered without needles.
When needle use is necessary, any one of several methods or a combination of methods may be useful. Desensitization therapy by a psychiatrist or clinical psychologist is usually lengthy, expensive, and of variable efficacy.(1)(6)(7)(8) Nerve gate-blocking methods, eg, pinching or rubbing the area to distract the patient during a needle-stick, can be helpful. Shock and syncope are reduced among phobic patients by having them lie supine with legs elevated and tense their muscles during needle procedures to increase cerebral blood flow.(53) Needle-phobic patients should also be routinely premedicated with oral, sublingual, or intranasal benzodiazepines,(2) with N[O.sub.2],(8) or both. Sublingual atropine to block bradycardia also may be beneficial.(2) Since a vasovagal reaction can injure or even kill a patient, having on hand an oxygen source and a "crash cart" for cardiac resuscitation is mandatory with any needle-phobic patient undergoing a needle procedure.
Topical anesthesia of the autonomic sensory neural net at the needle site can be used to interrupt the vasovagal reflex at its origin so that the reflex is not triggered. Ethyl chloride spray can temporarily anesthetize the skin, but this affects only the superficial skin layers and lasts for only a few seconds. The skin can also be anesthetized by an ice pack, although freezing is unpleasant and can damage tissue. In placebo-controlled studies, topical anesthetics containing a mixture of lidocaine and prilocaine have been shown to work well in pediatric patients,(54) and topical mixtures of tetracaine, adrenalin, and cocaine (TAC ointment) or tetracaine, adrenalin, and lidocaine have been long used in emergency departments for surface anesthesia.(55) To work on intact skin, however, all these mixtures must be applied for 1 to 2 hours and have a depth of anesthesia of only 2 to 3 mm.
The depth and effectiveness of topical anesthesia is greatly enhanced by the technique of iontophoresis (or ionphoresis). Iontophoresis involves soaking an absorbent pad with lidocaine and driving it through the skin with a tiny electrical current from a battery-powered unit.(35)(56) Because lidocaine is a positively charged molecule, the electrode pad's positive charge repels the lidocaine, propelling it through the skin by way of the sweat ducts. Using iontophoresis, an injection or venipuncture site can be completely anesthetized to a depth of 1 to 2 cm in less than 10 minutes.(56)
The procedure of iontophoresis has been assigned insurance reimbursement codes, and an iontophoresis unit(*) for use with needle phobic persons has been cleared by the Food and Drug Administration. This instrument has been demonstrated to be effective for venipuncture and joint injections(56) and has applications, for example, in blood donor drives(35) and pediatric immunization programs. The ease of use of iontophoresis raises the intriguing possibility of creating in the near future medical environments that are completely free of needle phobia.
Acknowledgments
The author wishes to thank Nancy R. Hamilton, RN, for her most gracious patience and support during the preparation of this paper, and also Gary Hadden, Department of Psychiatry, Duke University, for his expert assistance.
References
(1.)Ellinwood EH, Hamilton JG. Case report of a needle phobia. J Fam Pract 1991; 32:420-3.
(2.)Hamilton J, Ellinwood E. Needle phobia [abstract]. South Med J 1991; 84(Suppl):2S-27.
(3.)Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994:405-11.
(4.)Marks I. Blood-injury phobia: a review. Am J Psychiatry 1988; 145:1207-13.
(5.)Galena HJ. Complications occurring from diagnostic venipuncture. J Fam Pract 1992; 34:582-4.
(6.)Jacobsen PB. Treating a man with needle phobia who requires daily injections of medication. Hosp Community Psychiatry 1991; 42:877-8.
(7.)Hsu LKG. Novel symptom emergence after behavior therapy in a case of hypodermic injection phobia. Am J Psychiatry 1978; 135:238-9.
(8.)Lemasney NJ, Holland T, O'Mullane D, O'Sullivan VR. The aetiology and treatment of needle phobia in the young patient--a review. J Ir Dent Assoc 1989; 35:20-3.
(9.)Wambaugh J. The blooding. New York, NY: William Morrow, 1989:210-4, 217.
(10.)Schmerber v California, 384 US 757, 86 SCt 1826 (1966).
(11.)Breithaupt v Abram, 352 US 432, 77 SCt 408 (1957).
(12.)South Dakota v Neville, 459 US 553, 103 SCt 916 (1983).
(13.)Hammer v Gross, 932 F2d 842 (USCA, 9th Cir, 1991). cert denied, 112 SCt 582 (1991).
(14.)Boas EP. Some immediate causes of cardiac infarction. Am Heart J 1942; 23:1-15.
(15.)Cass N [letter]. Anaesth Intensive Care 1978; 6:169-70.
(16.)Dale WA. Cardiac arrest: review and report of 12 cases. Ann Surg 1952; 135:376-93.
(17.)Kulvin MM. Scared to death [letter]. JAMA 1966; 198:90.
(18.)Lockey RF, Benedict LM, Turkeltaub PC, Bukantz SC. Fatalities from immunotherapy (IT) and skin testing (ST). J Allergy Clin Immunol 1987; 79:660-7.
(19.)Lockhart RJ. Toxic erythema; T.A.B. (intravenously); coronary thrombosis; sudden death. Br J Dermatol Syphilis 1939; 51:318-21.
(20.)Morland A. Pleural shock. Lancet 1949; 2:1021-3.
(21.)Rutsky EA. Bradycardic rhythms during peritoneal dialysis. Arch Intern Med 1971; 128:445-7.
(22.)Sauls LJ. Sudden death at impasse. Psychoanal Forum 1966; 1:88-93.
(23.)Turk LN, Glenn WWL. Cardiac arrest. N Engl J Med 1954; 251: 795-803.
(24.)Turkeltaub PC, Gergen PJ. The risk of adverse reactions from percutaneous prick-puncture allergen skin testing, venipuncture, and body measurements. J Allergy Clin Immunol 1989; 84:886-90.
(25.)Zukerman CM. Fatality in a blood donor; a case report, with a review of the literature. Ann Intern Med 1947; 26:603-8.
(26.)Caplan RA, Ward RJ, Posner K, Cheney FW. Unexpected cardiac arrest during spinal anesthesia. Anesthesiology 1988; 68:5-11.
(27.)Engel GL. Psychologic stress, vasodepressor (vasovagal) syncope, and sudden death. Ann Intern Med 1978; 89:403-12.
(28.)Schlesinger Z, Barzilay J, Stryjer D, Almog CH. Life-threatening "vagal reaction" to emotional stimuli. Isr J Med Sci 1977; 13:59-61.
(29.)Spiess BD, Sassetti R, McCarthy RJ, Narbone RF, Tuman KJ, Ivankovich AD. Autologous blood donation: hemodynamics in a high-risk patient population. Transfusion 1992; 32:17-22.
(30.)van Lieshout JJ, Wieling W, Karemaker JM, Eckberg DL. The vasovagal response. Clin Sci 1991; 81:575-86.
(31.)Costello CG. Fears and phobias in women. J Abnorm Psychol 1982; 91:280-6.
(32.)Agras S, Sylvester D, Oliveau D. The epidemiology of common fears and phobias. Compr Psychiatry 1969; 10:1511-56.
(33.)Keep PJ, Jenkins JR. From the other end of the needle. The patient's experience of routine anesthesia. Anaesthesia 1978; 33:830-2.
(34.)Cartwright PS, McLaughlin FJ, Martinez AM, Caul DE, Hogan IG, Reed GW, Swafford MS. Teenagers' perceptions of barriers to prenatal care. South Med J 1993; 86:737-41.
(35.)Arvidsson SB, Ekroth RH, Hansby AMC, Lindholm AH, William-Olsson G. Painless venipuncture. A clinical trial of iontophoresis of lidocaine for venipuncture in blood donors. Acta Anaesthesiol Scand 1984; 28:209-10.
(36.)Oswalt RM, Napoliello M. Motivations of blood donors and nondonors. J Appl Psychol 1974; 59:122-4.
(37.)Greenfield ADM. An emotional faint. Lancet 1951; 1:1302-3.
(38.)Lin JT-Y, Ziegler DK, Lai C-W, Bayer W. Convulsive syncope in blood donors. Ann Neurol 1982; 11:525-8.
(39.)Poles FC, Boycott M. Syncope in blood donors. Lancet 1942; 2:531-5.
(40.)Wayne HH. Syncope. Am J Med 1961; 30:418-38.
(41.)Kraemer RR, Blair S, Kraemer GR, Castracane VD. Effects of treadmill running on plasma beta-endorphin, corticotropin, and cortisol levels in male and female 10K runners. Eur J Appl Physiol Occup Physiol 1989; 58:845-51.
(42.)Rose RM, Hurst MW. Plasma cortisol and growth hormone responses to intravenous catheterization. J Hum Stress 1975; 1:22-36.
(43.)Ziegler MG, Echon C, Wilner KD, Specho P, Lake CR, McCutchen JA. Sympathetic nervous withdrawal in the vasodepressor (vasovagal) reaction. J Auton Nerv Syst 1986; 17:273-8.
(44.)Taggart P, Hedworth-Whitty R, Carruthers M, Gordon PD. Observations on electrocardiogram and plasma catecholamines during dental procedures: the forgotten vagus. BMJ 1976; 2:787-9.
(45.)Kaufmann H, Oribe E, Oliver JA. Plasma endothelin during up-right tilt: relevance for orthostatic hypotension? Lancet 1991; 338:1542-5.
(46.)Goldstein DS, Spanarkel M, Pitterman A, Toltzis R, Gratz E, Epstein S, Keiser HR. Circulatory control mechanisms in vasodepressor syncope. Am Heart J 1982; 104:1071-5.
(47.)Ost L-G. Acquisition of blood and injection phobia and anxiety response patterns in clinical patients. Behav Res Ther 1991; 29:323-32.
(48.)Kleinknecht RA, Lenz J. Blood/injury fear, fainting and avoidance of medically-related situations: a family correspondence study. Behav Res Ther 1989; 27:537-47.
(49.)Camfield PR, Camfield CS. Syncope in childhood: a case control clinical study of the familial tendency to faint. Can J Neurol Sci 1990; 17:306-8.
(50.)Torgersen S. The nature and origin of common phobic fears. Br J Psychiatry 1979; 134:343-51.
(51.)Hanson B, Tuna N, Bouchard T, Heston L, Eckert E, Lykken D, et al. Genetic factors in the electrocardiogram and heart rate of twins reared apart and together. Am J Cardiol 1989; 63:606-9.
(52.)Losse H, Kretschmer M, Kuban G, Bottger K. Die vegetative struktur des individuums I and II. Acta Neuroveg 1956; 13:337-99.
(53.)Ost L-G, Fellenius J, Sterner U. Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behav Res Ther 1991; 29:561-74.
(54.)Joyce TH III. Topical anesthesia and pain management before venipuncture. J Pediatr 1993; S24-9.
(55.)Ernst AA, Marvez E, Nick TG, Chin E, Wood E, Gonzaba WT. Lidocaine adrenalin tetracaine gel versus tetracaine adrenaline cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5 to 17 years. Pediatrics 1995; 95:255-8.
(56.)Hamilton JG, Wrenn R, Garcia-Caro M, Hamilton N. Office management of needle fear and needle phobia by lidocaine iontophoresis. Presented at 87th Scientific Assembly, Southern Medical Association, New Orleans, La, Oct 31, 1993.
(*)This unit, the NeedleBuster, is now available commercially from Life-Tech, Inc, Houston, Texas; (800) 231-9841.
COPYRIGHT 1995 Dowden Health Media, Inc.
COPYRIGHT 2004 Gale Group"
Subscribe to:
Posts (Atom)