The Science of Slow Breathing

In an April 5, 2017 article in the New York Times, Gretchen Reynolds reviews new research on the science of slow breathing and how this ancient technique may work to promote relaxation, reduce anxiety, and prevent panic attacks. The technique of controlled breathing or pranayama (प्राणायाम) is referred to in the Bhagavad Gita, and thus dates back at least to …

Anxiety and Bipolar

For many people with bipolar anxiety is a bigger problem than mood swings. It is not that unusual for someone with bipolar to report that their first “symptom” of a psychiatric nature was the onset of anxiety early in childhood. Let’s take a look at this information again… 90% of people with bipolar have an anxiety disorder diagnosis. 2/3rds have had …

Acceptance and Commitment Therapy Part 2: Defusion

Defusion is one of the six core processes that make up Acceptance and Commitment Therapy (ACT). These core processes, which also include acceptance (click here to review this process as described in Part 1), present-moment awareness, self-as-context, values, and committed action, are aimed at cultivating psychological flexibility, or the ability to have all of our thoughts and feelings while continuing …

Accepting the Loss

One of my patients wrote to me this morning asking if she could get a medication to help with her anxiety. She has been trying to find a good therapist for quite a while and I think she might have found someone who could really help her. But this is making her feel anxious and irritable. Now she has to wrestle …

Acceptance and Commitment Therapy Part 1: Acceptance and Willingness

I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour workshop on Acceptance and Commitment Therapy (ACT) and deepening experiential practices in ACT sessions (largely based on the book The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy*). This post is Part …

Herd Instinct in Humans: The Source of Anxiety and Depression?

Jeffrey Kahn has written a fascinating book (Angst: Origins of Anxiety and Depression in Oxford Press) suggesting an evolutionary source for much of human psychopathology. He gave a Grand Rounds presentation at UCLA in February of 2015 that outlined some of his theories and that presentation has been the subject of a vigorous discussion online. In essence, Jeffrey argues that …

Treating Anxiety – An Update by Kelsey

Treating anxiety is an important part of working with people with depression or bipolar. This update focuses on changes that have taken place in the field in the last five years that might be relevant to many people dealing with depression and anxiety. Imagine that you are taking a nice, peaceful walk in the woods. It is a lovely, warm, clear …

Accepting Uncertainty

We are often trapped more by what we think about how things should be, or “have to be,” than by the reality of the challenges we face.  This week I have been noticing how often the phrase “I can’t stand.XX” precedes a statement that is quite obviously not true.  Someone who has been living with the uncertainty of multiple sclerosis for …

Bipolar Disorders and Exercise: Working Out Can Tone Up Your Neurotransmitters – Arnrow

Neurotransmitters are the chemicals that your brain cells (neurons) use to transmit information, without them we cannot think or act. It is no wonder that too much or too little of any one particular neurotransmitter can have substantial effects on how our body and brain functions. For example, people with mood disorders tend to have low levels of the four major …

Medications for Anxiety

A writer we have been seeing for about a year for depression and bipolar sent me an email yesterday – “I need something for my anxiety…” Often anxiety is the symptom that is of greatest concern to people who have bipolar or depression. Working through my thought process as I tried to come up with an answer for the woman …

Passing on PTSD to Children

At a recent scientific meeting, Rachael Yehada showed that traits that are related to posttraumatic stress disorder PTSD can be passed on to children during pregnancy. Mothers in New York City who were pregnant on September 11, 2001 and developed post-traumatic stress disorder (PTSD) had children with low cortisol in their blood (a sign of PTSD). But if the fathers …