Listen to this podcast to find out about CBT, or cognitive-behavioral therapy, and how therapists use it to treat anxiety and related disorders.
People often jokingly point to odd habits or tidiness as signs of obsessive-compulsive disorder, or OCD. But the truth is OCD is a very real disorder that affects more than 2 million Americans, and there is a big difference between maintaining a morning routine or keeping a clean home and living with the disorder.
This study examines whether an antibiotic, d-cycloserine (DCS), boosts the effectiveness of cognitive behavior therapy (CBT) for social anxiety. CBT has been shown to be effective for the treatment of social anxiety in children and adults, but even after treatment, approximately 40% may remain diagnosable. All participants will receive 12 weekly CBT sessions. In addition to receiving the CBT, participants will be randomly assigned (similar to a coin toss) to receive either DCS or a placebo (sugar pill). The pill will be taken 1-2 hours prior to each of the 12 CBT sessions.
- Subjects between 8 yrs of age (preadolescents) and under 55 yrs of age.
- Subjects medically healthy.
- Able to give informed consent.
- Not on psychotropic meds for a minimum of 6 weeks for fluoxetine; a minimum of 1 week for PRN benzodiazepines and beta blockers, and a minimum of 3 weeks for all other psychotropic meds.
- Subjects diagnosed with DSM IV symptoms of social phobia, generalized or specific type.
- Current major depressive disorder.
- Lifetime diagnosis of psychotic disorder, bipolar disorder, eating disorder, mental retardation, substance or alcohol dependence (other than nicotine); active suicidal ideation.
- Current or lifetime history of a neurological disorder (other than tic disorders, febrile seizures of infancy), seizure disorder.
- Any unstable medical condition.
- Use of any psychoactive substance in the past 30 days.
Experts recognize that aging and anxiety are not mutually exclusive: Anxiety is as common among the old as among the young. In fact, many older adults with an anxiety disorder had one when they were younger.
Generalized anxiety disorder (GAD) is the most common anxiety disorder among older adults, though anxiety disorders in this population are frequently associated with traumatic events such as a fall or acute illness.
Researchers studying stroke patients have found a strong association between impairments in a network of the brain involved in emotional regulation and the severity of post-stroke depression. (Radiology, published online June 5, 2012) Read more.
Melinda Stanley, PhD
Professor and Head, Division of Psychology
The McIngvale Family Chair in Obsessive Compulsive Disorder Research
Menninger Department of Psychiatry and Behavorial Sciences
Mental Health Services Researcher, Houston Center for Quality of Care and Utilization Studies
Michael E. DeBakey Veterans Affairs Medical Center
Affiliate Investigator, South Central Mental Illness Research,
Education, and Clinical Center
Diagnosis and treatment should start with the primary care physician. Many older people feel more comfortable talking to a doctor with whom they already have a relationship. If they trust their primary care physician, chances are greater that they will accept treatment or a referral to a mental health professional.
Success in treating anxiety in an older adult depends on a partnership between the patient, the family, and the doctor. Everyone must agree on the nature of the problem and make a commitment to stick with treatment.
Worried about an aging parent or relative? Talking to older parents or loved ones about changes in their lives is one of the best ways to find out about problems.
Ask about any changes you notice in the following areas:
Recognizing an anxiety disorder in an older adult can be challenging. Aging brings a higher prevalence of medical conditions, concern about physical problems, and a greater use of prescription medications. Some symptoms of anxiety may include headaches, back pain, or a rapid heartbeat. As a result, separating a medical condition from symptoms of an anxiety disorder is more complicated.
Diagnosing anxiety in people with dementia can be difficult, too. Impaired memory may be interpreted as a sign of anxiety or dementia, and fears may be excessive or realistic.
Research on the course and treatment of anxiety in older adults lags behind that of other mental conditions such as depression and Alzheimer's.
Until a few years ago, anxiety disorders were believed to decline with age. That’s because older patients are less likely to report psychiatric symptoms and more likely to emphasize their physical complaints.
But experts now recognize that aging and anxiety are not mutually exclusive: Anxiety is as common among the old as among the young. In fact, many older adults with an anxiety disorder had one when they were younger.