Anxiety and Depression

2014 ◽  
pp. 51-54
Author(s):  
David L Brody
Keyword(s):  
Depressive Symptoms ◽  
Mood Disorder ◽  
Sleep Disturbances ◽  
Anxiety And Depression ◽  
Pharmacological Interventions ◽  
Reactive Anxiety ◽  
Optimal Approach ◽  
Good Plan ◽  
Severe Anxiety

First, assess safety. Severe anxiety and depression can lead to suicide. Second, distinguish between reactive anxiety and depressive symptoms versus an impairing mood disorder. The “treatment” for reactive anxiety and depressive symptoms is education, reassurance, and a good plan to get the patient’s life back on track. If the patient has an impairing (but not immediately dangerous) mood disorder, it can be treated for the most part just like a mood disorder in the absence of concussion. The optimal approach usually involves both nonpharmacological and pharmacological interventions: exercise, treat sleep disturbances, psychological counseling, avoid substances that worsen mood overall such as alcohol and street drugs, consider appropriate long-term antidepressant/antianxiety medications. There are many options, but fluoxetine (Prozac) and venlafaxine (Effexor) may be good choices for patients where low energy is more concerning than anxiety, whereas paroxetine (Paxil) or sertraline (Zoloft) may be preferred when anxiety is a major component.

Anxiety and Depression

2019 ◽  
pp. 78-85
Author(s):  
David L. Brody
Keyword(s):  
Depressive Symptoms ◽  
Mood Disorder ◽  
Sleep Disturbances ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Anxiety And Depression ◽  
Limiting Factor ◽  
Reactive Anxiety ◽  
Optimal Approach ◽  
Good Plan

First, assess safety. Severe anxiety and depression can lead to suicide. Second, distinguish between reactive anxiety and depressive symptoms vs. an impairing mood disorder. The ‘treatment’ for reactive anxiety and depressive symptoms is education, reassurance, and a good plan to get the patient’s life back on track. If the patient has an impairing (but not immediately dangerous) mood disorder, it can be treated for the most part just like a mood disorder in the absence of concussion. The optimal approach usually involves both non-pharmacological and pharmacological interventions: exercise, treat sleep disturbances, psychological counseling, avoid substances that worsen mood overall such as alcohol and street drugs, consider appropriate long-term antidepressant /antianxiety medications. There are many options, and side effects can be the limiting factor. There has been recent interest in repetitive transcranial magnetic stimulation (rTMS) treatment for depression in concussion patients.

scholarly journals Ketamine: stimulating antidepressant treatment?

BJPsych Open ◽  
2016 ◽  
Vol 2 (3) ◽  
pp. e5-e9 ◽  
Author(s):  
Gin S. Malhi ◽  
Yulisha Byrow ◽  
Frederick Cassidy ◽  
Andrea Cipriani ◽  
Koen Demyttenaere ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mood Disorder ◽  
Clinical Experience ◽  
Antidepressant Treatment ◽  
Off Label Use ◽  
Off Label ◽  
Term Administration ◽  
Key Questions ◽  
Label Use

SummaryThe appeal of ketamine – in promptly ameliorating depressive symptoms even in those with non-response – has led to a dramatic increase in its off-label use. Initial promising results await robust corroboration and key questions remain, particularly concerning its long-term administration. It is, therefore, timely to review the opinions of mood disorder experts worldwide pertaining to ketamine's potential as an option for treating depression and provide a synthesis of perspectives – derived from evidence and clinical experience – and to consider strategies for future investigations.

The Role of Sexual and Gender Identity in Long-Term Psychodynamic Therapy for Comorbid Social Anxiety and Depression in an Adolescent Female

2018 ◽  
Vol 17 (5) ◽  
pp. 311-327
Author(s):  
Gretchen Kurdziel ◽  
Leticia Y. Flores ◽  
Jenny Macfie
Keyword(s):  
Depressive Symptoms ◽  
Social Anxiety ◽  
Gender Identity ◽  
Anxiety And Depression ◽  
Adolescent Female ◽  
Social Settings ◽  
Social Discomfort ◽  
And Gender

Adolescence is a time of significant change with social, cognitive, and emotional alternations, and growth of autonomy and identity. This is a single clinical case study that uses long-term psychodynamic psychotherapy with an adolescent female diagnosed with comorbid social anxiety and persistent depression. The treatment initially focused on addressing the patient’s self-esteem, perfectionism, and self-criticism. During the treatment it was revealed that the patient’s sexual and gender identity contributed to social anxiety and depressive symptoms, and the therapy conceptualized the role of these identities as contributing to social discomfort which perpetuated her depressive symptoms. Through accepting her budding sexual and gender identity, the patient successfully became more comfortable in social settings which ultimately alleviated her depressive symptoms. This treatment highlights the unique nature of working with an adolescent apart of the sexual and gender minority, and how these identities contributed to her experience of social anxiety and depression.

scholarly journals Does coronavirus pose a challenge to the diagnoses of anxiety and depression? A view from psychiatry

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Lynne M. Drummond
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Depressive Symptoms ◽  
Anxiety Disorder ◽  
Anxiety And Depression ◽  
The Novel ◽  
Novel Coronavirus ◽  
Pathological Anxiety

Some authors have suggested that the emergence of the novel coronavirus, SARS-CoV-2, and the subsequent pandemic has meant that the constructs of pathological anxiety and depression are meaningless owing to widespread anxiety and depressive symptoms. This paper examines what is required to make a diagnosis of a depressive or anxiety disorder and how this may differ from fleeting symptomatology in response to specific situations or stimuli. All people experience the emotions of both anxiety and depression, but far fewer have a persistent anxiety or depressive syndrome which interferes with their quality of life and functioning. The pandemic and its issues are then discussed, and existing studies examining the reactions of people living through the pandemic are presented. Finally, the paper examines possible ways to cope at times of increased stress and how we can try to protect ourselves from long-term mental health sequelae of chronic stress.

Association of anxiety and depressive symptoms with differing needs among recent breast cancer (BC) survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 244-244
Author(s):  
Steven C Palmer ◽  
Angela DeMichele ◽  
Marilyn M. Schapira ◽  
Karen Glanz ◽  
Abigail Blauch ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Unmet Needs ◽  
Unmet Need ◽  
Demographic Variables ◽  
Anxiety And Depression ◽  
Disease Characteristics ◽  
End Of Treatment ◽  
Insight Into ◽  
Missed Opportunity

244 Background: Although unmet needs are associated with general distress in long term BC survivors, it is unclear is different needs are associated with specific outcomes such as anxiety and depression among recent BC survivors. Such work may provide insight into the interventions needed to improve outcomes early in survivorship for patients. Methods: Eligibility included non-metastatic BC treated < 1 year prior. Prior to an initial survivorship visit, participants completed a PRO symptom measure and reported unmet need for assistance for symptoms experienced. Overall unmet need and unmet need domains (physical, psychosocial, sexual, hormonal) were examined. Anxiety and depressive symptoms were assessed using the HADS. Results: Participants (N = 137) were primarily white (72%), middle-aged (M = 55 yr), and treated for Stage I (47%) or II (38%) BC. Anxiety (M = 5.57, SD = 4.08) and depression (M = 3.21, SD = 3.33) were in the normal range, on average. 29% and 13% met “caseness” (i.e., above criteria for significant elevation) for anxiety and depression, respectively. Caseness for anxiety and depression were not significantly related to demographic variables, time from end of treatment, disease characteristics or treatment exposures (all p > 0.05). Meeting criteria for depression was associated with greater overall unmet need (M = 6.11 vs. M = 2.11, p < 0.001) and need in the physical (M = 2.66 vs. M = 0.83; p < 0.001) and psychosocial (M = 2.56 vs. M = 0.49; p < 0.001) domains, but unrelated to unmet sexual or hormonal needs (all p > 0.05). Meeting criteria for anxiety was associated with greater unmet need in the hormonal (M = .47 vs. M = 0.17; p < 0.05) and psychosocial (M = 1.33 vs. M = 0.55; p < 0.002) domains, but unrelated to unmet overall, physical or sexual needs (all p > 0.05). Conclusions: Unmet needs relate differentially to anxiety and depression in recent BC survivors. In particular, depression is associated with more than 3 times the number of unmet physical needs, while anxiety is associated with more than 2.5 times the number of unmet hormonal needs. Assessing psychosocial outcomes in the absence of unmet needs may represent a missed opportunity for intervention to improve outcomes for specific groups of survivors.

Psychological Distress and Sleep Disturbance Among Female Nurses: Anxiety or Depression?

2019 ◽  
Vol 32 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Ke-Hsin Chueh ◽  
Kai-Ren Chen ◽  
Ya-Hui Lin
Keyword(s):  
Psychological Distress ◽  
Sleep Quality ◽  
General Health ◽  
Sleep Disturbances ◽  
Anxiety And Depression ◽  
Stress Indicator ◽  
Female Nurses ◽  
Anxiety Depression ◽  
Occupational Stress Indicator

Introduction: Sleep quality is an important issue in nurses’ mental and general health. Long-term psychological distress leads to increased sleep disturbances among nurses. However, which forms of psychological distress are most associated with sleep disturbances is unclear among female nurses. Methodology: To determine which psychological distress factors are associated with sleep disturbances among female nurses. A total of 119 female Taiwanese nurses were recruited and surveyed using the Occupational Stress Indicator–2, Beck Anxiety Inventory, Beck Depression Inventory–II, and Pittsburgh Sleep Quality Index. Results: Overall, 68.9% of the nurses were poor sleepers, and 20.2% and 11.7% of them had more than moderate levels of anxiety and depression, respectively. A logistic regression analysis showed that sleep disturbances were associated with higher levels of depression and poorer general health. Discussion: Compared with anxiety, depression more heavily influences sleep disturbances among female nurses. Depression prevention should thus be a focus of mental health promotion for female nurses.

Changes in College Student Anxiety and Depression From Pre- to During-COVID-19: Perceived Stress, Academic Challenges, Loneliness, and Positive Perceptions

2021 ◽  
pp. 216769682110585
Author(s):  
Michelle Haikalis ◽  
Hannah Doucette ◽  
Matthew K. Meisel ◽  
Kelli Birch ◽  
Nancy P. Barnett
Keyword(s):  
Mental Health ◽  
College Students ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Global Mental Health ◽  
Anxiety And Depression ◽  
Academic Impact ◽  
Student Anxiety ◽  
Academic Challenges

The COVID-19 pandemic is a major stressor that has negatively impacted global mental health. Many U.S. college students faced an abrupt transition to remote learning in March 2020 that significantly disrupted their routines, likely causing changes in mental health. The current study examined changes in anxiety and depressive symptoms among 990 college students, from before COVID-19 had reached U.S. community spread to 5 months into the pandemic. Results indicate overall increases in anxiety and depressive symptoms; this effect was amplified as more COVID-related challenges with academic impact and loneliness were reported. Increases in anxiety and depression were buffered as a function of greater perceived positive changes attributed to COVID-19; the differences in anxiety and depressive symptoms over time were also lessened when greater perceived stress prior to COVID-19 was reported. Findings reveal an unexpected effect involving pre-pandemic stress, and highlight potential targets to promote resilience, which should be examined long-term.

Anxiety sensitivity and acculturative stress: Concurrent relations to mental health among Spanish-speaking Latinx in primary care

2020 ◽  
pp. 136346152094655 ◽  
Author(s):  
Michael J. Zvolensky ◽  
Jafar Bakhshaie ◽  
Justin M. Shepherd ◽  
Natalia Peraza ◽  
Andres G. Viana ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Acculturative Stress ◽  
Anxiety Sensitivity ◽  
Psychological Health ◽  
Care Setting ◽  
Anxiety And Depression ◽  
Severe Anxiety

The Latinx population suffers from mental health inequalities. Although past work has implicated acculturative stress and anxiety sensitivity as important individual difference factors for anxiety and depression in this group, it is presently unclear how they work together to influence more severe anxiety and depressive symptom expression among Latinx. To help address this gap in the existing literature, the current study evaluated the role of concurrent anxiety sensitivity and acculturative stress, in terms of anxiety and depressive symptoms and disorders, in a Latinx population in a primary care setting. Participants included 142 Latinx individuals (86.7% female; Mage = 39.66, SD = 11.34). After accounting for shared variance, the results indicated that both anxiety sensitivity and acculturative stress were significantly associated with anxious arousal symptoms, social anxiety, and depressive symptoms. However, anxiety sensitivity, but not acculturative stress, was significantly related to a number of mood and anxiety disorders. These findings suggest the importance of assessing both anxiety sensitivity and acculturative stress in routine mental health screening, as both factors may be related to poorer psychological health among this group.

scholarly journals Effects of anti-TNF therapy and immunomodulators on anxiety and depressive symptoms in patients with inflammatory bowel disease: a 5-year analysis

2021 ◽  
Vol 14 ◽  
pp. 175628482110337
Author(s):  
Alexander R. Siebenhüner ◽  
Jean-Benoît Rossel ◽  
Philipp Schreiner ◽  
Matthias Butter ◽  
Thomas Greuter ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Disease Activity ◽  
Therapy Group ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Significant Treatment ◽  
Group A ◽  
Inflammatory Bowel ◽  
Group B

Background and aims: Anxiety and depression are prevalent in patients with inflammatory bowel diseases (IBD), especially during IBD flares. IBD therapies can profoundly affect the mood of patients with IBD. We aimed to determine the long-term impact of anti-tumor necrosis factor (anti-TNF) and immunomodulators (IM) on anxiety and depressive symptoms in IBD patients. Methods: We compared three treatment groups with IM only (group A), anti-TNF ± IM (group B) and no such therapy (group C). Patients completed the hospital anxiety and depression scale (HADS) at 1 year, 3 years, and 5 years after start of treatment. Results: In total, 581 patients with IBD (42.9% Crohn’s disease, 57.1% ulcerative colitis/IBD unclassified) participated in this study. Effects of treatment were analyzed in a mixed effects model, with and without correction for confounders. Compared with group C, group B showed a significant treatment-related improvement in both anxiety and depressive symptoms within the first 2.5 years and also thereafter. Group A showed a significant long-term improvement of anxiety and both short-term and long-term improvement in depressive symptoms. The significance of these results was maintained after correction for confounders, including corticosteroid treatment. Additionally, both groups A and B showed a significant decrease in disease activity in the first 2.5 years after start of treatment and also thereafter. Anti-TNF and IM treatment were associated with a similarly significant decrease in anxiety and depressive symptoms over an observation period of up to 5 years. Conclusion: Besides a clear benefit for disease activity, anti-TNF and IM apparently improve the mood of patients with IBD.

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