All the Little Warning Signs

Posted Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

A friend of mine died last week from cancer. She was 52 years old.  Few people knew how seriously ill she was.  She didn’t want pity.  She didn’t even want sympathy.  The only thing she wanted was exuberance in life and dignity in death.  She successfully achieved both.

Sitting in the back of the church and listening to her eulogy, I wondered how many people struggle silently with serious illness and stress.  I suspect every one of us knows people who, despite their poise and polish, suffer tremendous personal anguish that remains hidden from the world.  They function day to day scarcely skipping a beat.  They’re the first ones to lend a hand when someone else is in a jam and they hardly ever grumble or gripe.  Other folks tend to dump extra work in their laps because they’re so good-natured and conscientious.

Then one day, overwhelmed by stress, illness, depression, or exhaustion, these selfless stoics collapse.  Nearly everyone in their sphere of influence is shocked because they failed to notice all the little warning signs.  Somehow it was so easy to overlook the growing fatigue, the waning enthusiasm, or the uncharacteristic irritability.  I’d like to say that doctors are usually expert at recognizing the subtle signs of serious illness and stress.  But the truth is, most of us are not.  Doctors, by and large, are so accustomed to chronic exhaustion in their own lives, they often overlook it completely in others.  There is no laboratory test for stress and no scan will screen for exhaustion.  It takes time and concern and insight to detect the subtle signs of serious stress.  And while many of us may be interested in the well-being of others, few of us take the time to develop true insight into other people’s problems.

Maybe if we all slowed down long enough to notice a friend’s fatigue or a colleague’s quiet mood, we could do something helpful before it is too late.  Maybe if we stopped placing so many unreasonable demands on one another, we wouldn’t be plagued by chronic fatigue and burnout.  Maybe if we made an effort to be more friendly and flexible in our daily encounters, folks would feel free to ask for help when they need it.

It would be wonderful if teachers and preachers and bosses and bureaucrats would promote empathy and compassion as much as they promote rules and regulations.  But until patience and kindness work their way into the culture’s curricula, we’ll have to rely on the insight of individuals.

Do you know someone who’s overwhelmed, worn out, dejected, or depressed?  Be gentle with him or her.  Cut such people some slack.  They may be up against serious stress or illness.  Be kind to them and to everyone you encounter today.  You may not have the chance to be kind to them tomorrow.

Steady As She Goes

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are you afraid to open your financial statements for March? Have the recent market gyrations triggered a sudden interest in Xanax? Nonstop news cycles and social media postings have spawned massive overreactions to every comment made by political or business leaders. Down drafts of 1,000 points can cause even the most seasoned investors to panic. Over the past two months I’ve had to curtail my exposure to the business networks. Watching the Dow Jones Industrial Average plunge 700 points at 2 P.M. can make me feel as if I’m about to go into ventricle fibrillation. I’d rather stay in normal sinus rhythm.

Sadly, that is not a joke. I have a vivid memory of sitting at a stoplight in Little Rock, Arkansas, on October 19, 1987. It was about 5:30 P.M., and I was headed home from my office. Over the car radio I heard, “The Dow Jones Industrials are down 517 points.” I distinctly remember thinking, “Oh, he’s reading that wrong! The DOW couldn’t possibly be down that much.” It was.

Shortly after I arrived home, my beeper went off. One of my favorite patients was in the emergency room (ER) with a massive myocardial infarction. George A. was a 76-year-old gentleman from Hope, Arkansas. He had grown up in poverty but had educated himself and built up several successful businesses. He was bright, witty, charming, dapper, and gracious. But on that day, George A. had lost over a million dollars, at least on paper. He was devastated.

I grabbed my bag and raced back to the hospital. We got George admitted to the cardiac care unit (CCU). His electrocardiogram (EKG) looked awful, and he looked worse. He was utterly convinced that one dreadful day on Wall Street had destroyed his future. Around 8 P.M., George become very ill (coded). We worked on him frantically for over an hour, but we couldn’t bring him back. There was no doubt in my mind that the thought of financial ruin had literally scared George to death. I felt numb.

Later that week, two of my colleagues committed suicide. They had also lost a fortune, at least on paper. Everyone was stunned and afraid that week. One year later, however, the market had recovered nearly all of its losses. Thirty years later I still mourn the loss of three good people. For all intents and purposes, they died from acute financial panic.

I am no financial genius. But forty years of investing have taught me a few lessons that may help someone else:

  • Don’t watch market moves minute to minute. Before long, you’ll need heavy sedation.
  • Don’t dump stocks when everyone is panicking. You’ll almost always miss out on the best part of the recovery phase.
  • Remember the wisdom of the ancient Greeks: Moderation in all things. Balance stocks, mutual funds, bonds, certificates of deposit (CD’s), cash, real estate, and precious metals based on your age, health, family needs, and risk tolerance.
  • Don’t give in to ignorance, laziness, fear, or greed. Sixty-six percent of millennials have nothing stashed away for retirement. Failure to invest is one of the greatest mistakes of all.
  • No matter what happens, avoid the temptation to overreact. You are infinitely more important than your financial statements.

Now take a deep breath and open the statements from March. Steady as she goes. You’ll be fine.

Anxiety

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Barbara Sternberg, Ph.D.

A basic human emotion, anxiety is the sensation of worry, fear, apprehension, panic, tension, or unease that occurs in response to situations that seem overwhelming, dangerous, threatening, or distressing.  Manifesting in such forms as worry prior to a major test, nervous anticipation of a social occasion or business event, or heightened alertness in the face of apparent peril, anxiety is an intuitive recognition that action of some kind should be taken.

Anxiety that prompts appropriate action is a normal, adaptive response to temporary stress or uncertainty.  Detrimental anxiety overwhelms the individual experiencing it, preventing appropriate action or producing counterproductive responses.  Prolonged, intense, or inappropriate worry that interferes with normal function or that is a source of significant emotional or physical distress may signal the presence of an anxiety disorder.  Free-floating anxiety that occurs in the absence of an external threat and is pronounced enough to impair daily function may also be symptomatic of an anxiety disorder.

An estimated 40 million Americans over 18 years of age — about 18 percent of the adult population of the United States — experience anxiety disorders.  In contrast to relatively mild transient anxiety induced by a stressful event like public speaking or a first date, anxiety disorders persist for six months or longer and can worsen without treatment (NIMH). According to the National Comorbidity Survey Replication, overall lifetime prevalence of anxiety disorders in the U.S. is 28.8 percent, meaning that more than one out of every four adults experiences at least one anxiety disorder during his or her lifetime. Anxiety disorders are approximately twice as common in women as in men. Most people who are affected by anxiety disorder have more than one, and nearly 75 percent of those who have an anxiety disorder experience their first episode by the time they reach 21.5 years of age.

Although anxiety disorders are highly treatable, only about one third of those with these disorders receive treatment.

Coping with Anxiety

Although evidence indicates that early treatment of anxiety disorders can prevent such complications as depression and severe phobic avoidance, only about one victim in four ever seeks medical help. Recommended self-help strategies for anxiety management include:

  • maintaining perspective.
  • being informed.
  • having a positive outlook.
  • building resilience.
  • creating a social network.
  • seeking help when necessary.

When personal anxiety management proves ineffective, a family physician can help determine if symptoms are caused by an anxiety disorder, another medical condition, or combined factors.  Coexisting medical conditions may have to be treated or brought under control before the anxiety disorder can be addressed, by a psychologist, psychiatrist, social worker, or counselor. Some people with anxiety disorders must try several treatments or combinations of treatments before finding one that relieves their distress.  Medications do not cure anxiety disorders, but antidepressants, anti-anxiety drugs, and beta-blockers may control some physical symptoms while the patient receives psychotherapy.