Identifying Transgender Youth Early Provides Opportunity and Hope

December 14th, 2011

This Boston Globe article about identical twins, one with male gender expression and one with female gender expression, outlines treatment options that I hope are available to everyone in the future.  The article outlines how medications can be used to suppress puberty and allow family and professionals time to carefully consider the options and to explore the complex issues involved.  Since puberty can be restarted at any time by simply withdrawing the medications, there are few drawbacks to this technique.  If the person decides to continue, suppression of puberty reduces the amount of time, expense and pain that go into gender transition for people who have already gone through puberty.

 

Anxiety Attacks 101

January 5th, 2011

There are quite a few fancy techniques for coping with anxiety attacks.  Over the years I’ve boiled it down to a few simple concepts. I hope you’ll find them helpful.

What is an anxiety attack?

First of all, let’s make clear what we’re talking about. Anxiety attacks, also called panic attacks, are a period of intense anxiety and fear. (Well, that was obvious!)  Physical changes in the body also occur such as increased heart rate, pounding or ringing in the ears, feeling faint, sweating, shaking, feelings of dread, and fear of dying or going crazy. If you’re not sure you’ve ever had one, you probably haven’t. They aren’t subtle.

The disclaimer you’ve been waiting for…

Let’s get the disclaimer out of the way: If you experience these symptoms, you should go immediately to a medical facility for an assessment. Many of these symptoms are also the symptoms of a heart attack. You should have it checked out and only once you know your symptoms are anxiety related should you take my advice below.  This article is not intended to replace treatment by a professional.  If you are having anxiety attacks, talk to your doctor or a mental health professional.  They can help you rule out possible medical causes of your symptoms.

Get your head in the game

Now, there are a few things you have to convince yourself of if you hope to reduce the distress associated with anxiety attacks.

  • Anxiety attacks will not harm you. You will not die.  You will not go crazy.  They are VERY uncomfortable but not life-threatening.
  • The fear of having an anxiety attack encourages more attacks in the future.  You’ll have to get Zen about it.  Resolve to cope with whatever comes to you that day, anxiety attack or not.
  • Do not avoid places because you fear you will have an anxiety attack.  This will only cause further problems.  Refuse to allow your anxiety to make your world smaller.
  • Hold your head high.  Don’t hide.  Most people around you will never notice you are having an anxiety attack.  If they do, they will have to deal with it too!  Why should you have to deal with it alone?

Right about now most people with anxiety attacks are looking at me like I’m crazy.  ”I’m not supposed to care if I’m having an anxiety attack?  Go to places that cause them? Are you nuts?”  Well, maybe, but you will improve if you take my advice.  The real problem with anxiety attacks is our reaction to them.  For most people, anxiety attacks will reduce to a manageable level normally unless they are reinforced by behavior.

Now, notice I never said this would be easy or fun!  It will be uncomfortable, you might even look silly, but you will get through it.  Most of the techniques therapists use for anxiety accomplish one thing: distracting you long enough for your body’s natural equilibrium to return.  You can stand on your head and recite poetry in pig Latin if you like.  That’s just kind of difficult to pull off in the grocery store.

What can you do without paying me money?

After you’ve convinced yourself of the concepts above, fire up Google and find some relaxation techniques.  I won’t bore you with them here and you can find dozens of great ones on the internet.  Practice them daily at first.  Get good at them.  If one doesn’t work for you, try another until you find one.  Do NOT use them during your anxiety attacks until you are expert at the technique you’ve chosen.  Keep in mind that these techniques are only meant to keep your more comfortable until the anxiety passes.  They will not magically kill your anxiety immediately.

What I can do for you

  • Speed up your recovery
  • Help you analyze what triggers your anxiety
  • Teach you more about how your thinking affects your anxiety
  • Suggest relaxation techniques based on your lifestyle and personality
  • Cheer you on through your successes
  • Provide a place where you can practice without feeling foolish
  • Provide a referral to a prescriber if you would like to explore medications

Parting thoughts…

Anxiety is a part of life but it shouldn’t control you.  There is hope for feeling more comfortable and getting back to doing the things you enjoy without fear of anxiety attacks.  Good luck to you!  I know you can do it.  Have questions?  Feel free to give me a call.  I’m always willing to chat for a few minutes and help you find out if I can be of service to you.

Seasonal affective disorder FAQ

September 27th, 2010

How common is seasonal affective disorder?

About 10 percent of people in the northern latitudes of the US have some seasonal mood changes and 1-2 percent of those will have severe symptoms.

How is seasonal affective disorder different from regular depression?

Seasonal depression is marked by increased appetite, craving starchy or sugary foods, weight gain, loss of energy, increased desire to sleep, difficulty concentrating, and social withdrawal.

What causes it?

No one really knows what causes seasonal depression but there are some good leads.  Sunlight helps balance the daily hormonal changes in the body and less sunlight makes it harder for your body to know when it should be awake or asleep.  The further you live from the equator, the less sunlight you will get during winter months and thus have more potential for seasonal mood changes.

What can I do to help myself?

Try these strategies if your seasonal blues are mild:

  • Get outside into the sunlight daily
  • Open blinds and turn on lights in your home
  • Exercise at least three times per week
  • Avoid long naps
  • Get out of bed at the same time each day
  • Limit starchy or sugary foods
  • Keep socially active

If your seasonal swings are causing problems with relationships or work, seek professional assistance.  Don’t wait for things to get worse, seasonal symptoms resolve more quickly and are less severe if treated early.

What treatments can a medical professional offer?

Light therapy (sitting in front of a special light source each day)

  • Pros: does not involve taking medications, few side effects
  • Cons: it takes discipline and planning to spend 30 to 60 minutes sitting in one location every day.
  • Medications prescribed by your doctor

  • Pros: easy to use, inexpensive.
  • Cons: side effects can be bothersome but they usually quickly decrease to tolerable levels
  • Counseling

  • Pros: techniques learned will last a lifetime
  • Cons:  requires a time commitment
  • Taking a vacation to a warm southern location

  • Pros: vacations are fun!
  • Cons: expensive, difficult to schedule the vacation at the correct time because onset of seasonal mood problems can change from year to year.
  • Want more information? The Mayo Clinic has a very complete overview of Seasonal Affective Disorder.