5 ways to soothe agoraphobia

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Tackle the anxiety that comes with this fear of open spaces and being trapped in situations that are difficult to escape

It’s a panic disorder that centres on an intense fear about the possibility of experiencing anxiety or panic attacks in a situation where it’s difficult to escape, or of being in open spaces – and as we prepare to re-enter the world after more than a year of lockdown, agoraphobia is something many may be facing.

“This anticipatory anxiety is based on assumptions by the sufferer that they may have a panic attack where help is not available, or even humiliate themselves in front of others,” explains Paul Dodd, an integrative psychotherapeutic counsellor. “Fear and anxiety lead them to engage in safety behaviours, choosing to stay away from certain places or situations that they perceive could trigger panic attacks.”

Paul notes that the causes of agoraphobia are the subject of debate, but they may be linked to unconscious defence mechanisms that reinforce anxiety based on underlying assumptions about places or activities. If you are experiencing agoraphobia to the point where it is disrupting your life, it’s important to speak to a mental health professional or your GP. But here we outline some self-help strategies, to softly soothe these fears as we take the next steps back to normality.

1. Take action, now

It can be easy to brush things under the rug, or to avoid reaching out for help for fear of judgement or misunderstanding. But the sooner you address feelings of agoraphobia, the sooner you can start engaging in strategies to take back control.

“Don’t hide from your fears or engage in safety behaviours to keep you safe from anxiety, as this only serves as a temporary cure – the avoidance of an anxiety trigger may only prolong the panic disorder,” Paul explains. While these actions may feel soothing in the moment, long-term they could trap you in an unforgiving cycle.

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2. Refocus your thoughts

“Move from the ‘what if’, catastrophic, negative scenarios, to something based in fact – rather than making assumptions or holding automatic negative thoughts about a situation,” suggests Paul.

Letting go of those automatic negative thoughts isn’t easy, but if you notice you’re having one, call yourself out. Stop what you’re doing, acknowledge that anxious thought, label it, and try to move on with the rest of your day.

“Move from the ‘what if’, catastrophic, negative scenarios, to something based in facts”

3. Actively explore and engage in exposure therapy

Exposure therapy is a technique for treating anxiety and phobias where the individual is exposed to their fear in a safe, controlled way. It may feel daunting, but Paul explains that this method could be useful for dealing with agoraphobia.

“Find a friend or family member who is reliable and supportive, who can accompany you when engaging with this. Take one small step at a time, and gradually build up your tolerance to each triggering scenario,” he explains. “For example, you may be afraid of taking train journeys. I suggest having a friend accompany you on a train journey lasting just one-stop, then revisiting the same journey, but going for two stops with your friend. Finally, repeating the same route alone, going just one stop, and so on – slowly building your confidence in this way, one step at a time.”

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4. Practise mindfulness

“This means being able to be fully present in the moment rather than ‘time travelling’ – thinking of the past or future – for example when engaging in ‘what if’ scenarios which are often based solely on the future, instead of the here and now,” Paul says. “Concentrate on your surroundings, feel your feet on the floor – what can you hear, see or smell? This helps to reduce symptoms.”

5. Learn and practise breathing exercises

The power of our own breath should never be underestimated, and having a few breathing exercises in the back of your mind, to bring out when you begin to feel panic rising is an effective way to stay in control. Try the ‘4,7,8’ exercise: inhale through your nose to a count of four, hold your breath for a count of seven, and exhale through your mouth to a count of eight.

“Current advice is also to engage in ‘tapping’,” Paul adds. Emotional Freedom Technique (EFT), also known as tapping, teaches you to rhythmically tap specific parts of your body to help deal with stress. “The advantage of EFT is that it can be done alone, it can be very effective, and it can be done anywhere.”


 

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Police reforms bring renewed focus on mental illness

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Reforms in the wake of George Floyd’s death have brought a renewed focus on police response and mental illness.  

For decades, many have continued to raise their voices advocating for the mentally ill. The cry for changes to policing remain as the mentally ill in the tri-state area and across the nation have sometimes died during police interventions.

Hawa Bah, the mother of Mohamed Bah, continues to advocate for changes. Her son was killed in 2012 when she called an ambulance for help.

“I really don’t want other New Yorkers to get killed in front their family as they killed my son,” says Bah.  

However, mental health crises are common. According to 2017 numbers by the National Institute of Mental Health, one in five U.S adults live with a mental illness.

The mayor’s office tells News12 that an initiative, the Mental Health Emergency Pilot Program, covers Harlem and East Harlem and will respond to 911 mental health calls that do not involve a weapon or show signs of violence.

“This is a brand-new approach and it’s taken an extraordinary team to pull it together and let’s be clear, it’s a health-centered approach,” says Mayor Bill de Blasio.

While this program rolls out, lawmakers are hoping to reimagine public safety nationwide.

“Unfortunately, the criminal justice response is the default response. So, if you have currently somebody who’s having a mental health crisis they don’t need the police, they need help,” says state Sen. Kevin Parker.

Reporting and text by Phil Taitt. 

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Psychedelic analog reverses effects of stress in mouse study

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A novel compound similar in structure to the psychedelic drug ibogaine, but lacking its toxic and hallucinogenic effects, has been found to rapidly reverse the effects of stress in mice.

Researchers found that a single dose of tabernanthalog (TBG) can correct stress-induced behavioral deficits, including anxiety and cognitive inflexibility, and also promotes the regrowth of neuronal connections and restores neural circuits in the brain that are disrupted by stress. The study was published May 25 in Molecular Psychiatry.

“It was very surprising that a single treatment with a low dose had such dramatic effects within a day,” said corresponding author Yi Zuo, professor of molecular, cell, and developmental biology at UC Santa Cruz. “I had a hard time believing it even when I saw the initial data.”

TBG was developed in the lab of coauthor David Olson at UC Davis. Zuo’s lab worked with Olson on the initial studies of TBG, reported in Nature in 2020. The new study focused on the deleterious effects of stress using a protocol in which mice are subjected to mild, unpredictable stressors over a period of several days.

On the behavioral level, stress causes increased anxiety, deficits in sensory processing, and reduced flexibility in decision-making. In the brain, stress disrupts the connections between neurons and alters the neuronal circuitry, resulting in an imbalance between excitation and inhibition.

“Amazingly, TBG reversed all of the effects of stress,” Zuo said. “This study provides significant insights into neural mechanisms underlying the therapeutic effects of psychedelic analogs on mental illnesses and paves the way for future investigations to understand their cellular and circuit mechanisms.”

In recent years, there has been renewed interest in the use of psychedelic substances for treating illnesses such as addiction, depression, anxiety, and posttraumatic stress disorder. The hallucinogenic effects of these drugs remain a concern, however, and scientists have been unsure whether the hallucinations are therapeutically important or just a side effect.

Ibogaine has shown promise for treating addiction, but it causes dangerous heart arrhythmias in addition to being a powerful hallucinogen. TBG has not yet been tested in humans, but it lacks ibogaine’s toxicity in animal tests, and it doesn’t induce the head-twitch behavior in mice caused by known hallucinogens.

Initial studies of TBG found that it had antidepressant effects and reduced addictive behaviors in rodents. The new study was initiated by co-first author Michelle Tjia, then a graduate student in Zuo’s lab studying the effects of stress. After Tjia left for a postdoctoral position, co-first author Ju Lu, a project scientist in the lab, led additional studies. The researchers conducted a range of tests to evaluate behavioral responses to stress and the effects of treatment with TBG. They also performed imaging studies to assess changes in the brains of the mice at the neuronal level.

Studies using animal models — conducted in accordance with NIH regulations and reviewed and approved by Institutional Animal Care and Use Committees — remain vital to investigating complex psychiatric disorders.

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Materials provided by University of California – Santa Cruz. Original written by Tim Stephens. Note: Content may be edited for style and length.

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Depression impact on mother-infant relationships

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In a study funded by National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC) researchers examined whether depression, either before or during pregnancy, affects the mother-infant relationship. The research was published today (Tuesday 25 May) in BJPsych Open.

Researchers looked at the quality of mother-infant interactions eight weeks and 12 months after birth in three groups of women; healthy women, women with clinically significant depression in pregnancy, and women with a lifetime history of depression but healthy pregnancies.

The study used a sample of 131 women: 51 healthy mothers with no current or past depression, 52 mothers with depression referred to the South London and Maudsley NHS Foundation Trust Perinatal Psychiatry Services, and 28 ‘history only mothers with a history of depression but no current diagnosis.

Quality of interaction

At both eight weeks and 12 months, mothers and babies in the depression and history-only groups displayed a reduced quality of interaction. Specifically, at eight weeks, 62% in the group of mothers with depression during pregnancy and 56% in the group of mothers with a history-only of depression scored in the lowest category of relationship quality, where therapeutic interventions are recommended, compared with 37% in the healthy group. All mother and baby groups improved in their quality of interaction between 8 weeks and 12 months which researchers say indicates that with time all mothers and their babies can become more attuned to each other.

At six days, new-born babies of mothers in the depression and history-only groups had decreased social-interactive behaviour, which, together with maternal socio-economic difficulties, was also predictive of reduced quality of interaction, while postnatal depression was not.

Dr Rebecca Bind, lead author and Research Associate at Institute of Psychiatry, Psychology & Neuroscience, King’s College London, says: “Our findings suggest that perinatal mental health professionals should offer support not only to women with depression during pregnancy but also to pregnant women with a history of depression, as they may also be at risk of interaction difficulties. Future research should try to understand why a history of depression, despite a healthy perinatal period, may impact the developing relationship.”

Senior author Carmine Pariante, Professor of Biological Psychiatry at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London and Consultant Perinatal Psychiatrist at the South London and Maudsley NHS Foundation Trust, said:

“We recommend that healthcare professionals provide pregnant women at risk of interaction difficulties with examples of positive caregiving behaviours, and with ways to engage their babies and understand their needs, all of which could be incorporated into parenting and birth classes and health visits. We also suggest that interventions that can help the mother-infant interaction should be made more widely available, such as video feedback, where a clinician and mother discuss what behaviours work best to engage and comfort the baby, and structured mother-baby activities, such as art and singing groups. This is especially important because we know that the early years are vital for future mental health and wellbeing.”

The relationship between mothers and infants was assessed using the Crittenden Child-Adult Relationship Experimental-Index which assesses ‘dyadic synchrony’, a term that describes the quality of the relationship as a whole. Researchers analysed films of three-minute interactions filmed at eight weeks and 12 months postnatal. Mothers played with their babies while researchers scored the relationship based on seven aspects of behaviour: facial expression, vocal expression, position and body contact, affection and arousal, turn-taking contingencies, control, and choice of activity. The researchers are grateful to the women and their infants who participated in the PRAM-D study and to everyone on the study team who recruited, collected, and analysed data.

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Combating mental illness starts with candor – New York Daily News – New York Daily News

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Being raised in a traditional family, I was taught that jumping right to medicine was not an option, and therapy was the next big racket. The fact that I am a man made it worse, as men are not supposed to have feelings, or at least not show them. Now, I want to make it clear that this mindset doesn’t come from narrow-mindedness; it comes from fear.

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