Category Archives: Anxiety

CES Ultra is a non-drug approach to treatment of anxiety

Why Psychiatry needs CES (Cranial Electrotherapy Stimulation)

INSOMNIA

Many patients benefit from improving sleep hygiene and as a treatment for insomnia.

Others may improve using a sleep phase changes or treating the underlying problem such as sleep apnea, medical conditions, alcohol abuse, etc.

For many others, recent pharmacologic treatments prove effective and have minimal side effects. Targeting melatonin receptors is a novel and promising approach.

For many persons, however, existing treatments are ineffective, too expensive, result in side effects or conflict with their desire to avoid medications. Some side effects from medications are very disturbing, such as sleep associated behaviors that result in harm to self or others. For others, there is morning sedation, drug/drug interactions or rebound insomnia. When behavioral interventions are not effective, CES could be considered prior to initiating medications.

ANXIETY

There are many non-pharmacologic interventions for reducing anxiety. Some of these include dietary supplements, acupuncture, meditation, yoga, and exercise. These interventions, however, are not employed by a large segment of society that suffers from anxiety. These persons instead seek medications from their physician to alleviate their suffering. Typical classes of medications for anxiety include the SSRI’s, benzodiazepines as well as the off label use of antihistamines and atypical antipsychotic medications and antiepileptic medications. In addition to the inherent problems with SSRI’s, there are also problems with the other classes of medications. A serious potential side effect of benzodiazepines is their potential for inducing physical and psychological dependence. In addition, withdrawal symptoms can prove life threatening, especially with the shorter acting benzodiazepines like alprazolam. When taken as directed, which is often not the case; this class of medications can result in compromised coordination, slowed reaction time, falls, disinhibition, delirium, and anterograde amnesia.

It is not uncommon to see suicide attempts involving a combination of a benzodiazepines together with alcohol and/or another sedative hypnotic. While buspirone is relatively well tolerated, it has poor efficacy and a 3 to 4 week lag time to have an effect. Medications such as gabapentin are used off label but there is no research to support its efficacy for anxiety disorders. Unfortunately, physicians have begun using the atypical antipsychotic medications to treat anxiety. This class of medications has a large and increasing number of very serious side effects. Recent attention has been focused on their causing metabolic syndrome. They frequently cause extra pyramidal side effects, sedation, elevated prolactin levels and drug/drug interactions. All of these medications should be avoided during pregnancy and used with caution in the elderly. In short, the side effect profile of current pharmacologic treatments for anxiety limits their safe use.

DEPRESSION

There is considerable controversy regarding the efficacy for evidence based treatments for depression. The controversy also involves the risk/benefit analyses of currently approved interventions. While the primary focus has been on medications, similar concerns have been raised regarding certain psychotherapies, transcranial electromagnetic stimulation, vagal nerve stimulation, ECT and herbal and dietary supplements.

Through articles published in the lay press, the general public has been apprised of the controversy involving the efficacy of antidepressant medications. For example, Time magazine recently cited Kirsch’s meta-analysis in PLoS Medicine that found little benefit of antidepressants for most patients as well as Dr. John Krystal’s findings that about 25% of patients did worse on antidepressants than on placebo”. They have been informed about the black box warnings for SSRI’s causing suicidal behaviors. One of the results of this publicity is a growing movement away from all medications to “holistic” or “folk remedies”. In fact, many patients express fears of taking medications.

There is excellent data and clinical experience however to support the safety and lack of adverse side effects from CES and it should be included in the spectrum of available treatments as it poses very low risk of harm to patients.

Excerpts from “A View from the Trenches” written by Jason Worchel, M.D.

More CES Research – https://www.cesultra.com/research-resources.php

Fears of dentists cured by Cranial Electrotherapy

Experts believe electrotherapy is the key to solving anxiety related to the dentist. MILLIONS of people could be cured of their fear of dentist surgeries with the help of electrotherapy, new research has claimed

Tiny electrical currents into the brain could help solve people’s terrifying phobia of the dentist.

Experts said a handheld device which transmits cranial electrotherapy stimulation (CES) reduced anxiety among those with a long fear of dentists.

The study conducted in Nigeria for the Journal of Dental and Medical Sciences said the treatment is similar to the TENS machines used by pregnant women.

The device stimulates nerves for therapeutic purposes and is used by expectant mothers for pain relief.

The research scientists carried out tests on 40 adults scared of the dentist and divided them into four groups.

cranial-electrotherapy-for-dentist

One group were treated with CES, another had relaxation therapy, a third group had both treatments while a fourth had none.

Relaxation therapy involved patients spending 30 minutes with a specialist trainer who taught them exercises to help lower anxiety levels.

The CES worked just as well as the relaxation therapy after 45 minutes.

Whereas having both treatments had no extra benefits but all were far more effective then doing nothing to curb anxiety related to the dentist.

Read more – http://www.express.co.uk/life-style/health

A View from the Trenches: Why Psychiatry needs CES – Part 2

Anxiety

There are many non-pharmacologic interventions for reducing anxiety. Some of these include dietary supplements, acupuncture, meditation, yoga, and exercise. These interventions, however, are not employed by a large segment of society which suffers from anxiety. These persons instead seek medications from their physician to alleviate their suffering.

ces-treat-anxiety

Typical classes of medications for anxiety include the SSRI’s, benzodiazepines as well as the off label use of antihistamines and atypical antipsychotic medications and antiepileptic medications. In addition to the inherent problems with SSRI’s, there are also problems with the other classes of medications.

A serious potential side effect of benzodiazepines is their potential for inducing physical and psychological dependence. In addition, withdrawal symptoms can prove life threatening, especially with the shorter acting benzodiazepines like alprazolam. When taken as directed, which is often not the case; this class of medications can result in compromised coordination, slowed reaction time, falls, disinhibition, delirium, and anterograde amnesia.

It is not uncommon to see suicide attempts involving a combination of a benzodiazepines together with alcohol and/or another sedative hypnotic. While buspirone is relatively well tolerated, it has poor efficacy and a 3 to 4 week lag time to have an effect. Medications such as gabapentin are used off label but there is no research to support its efficacy for anxiety disorders.

Unfortunately, physicians have begun using the atypical antipsychotic medications to treat anxiety. This class of medications has a large and increasing number of very serious side effects. Recent attention has been focused on their causing metabolic syndrome. They frequently cause extra pyramidal side effects, sedation, elevated prolactin levels and drug/drug interactions. All of these medications should be avoided during pregnancy and used with caution in the elderly.

In short, the side effect profile of current pharmacologic treatments for anxiety limits their safe use. CES is a safe, initial alternative to such medications.

By Jason Worchel, M.D., a noted psychiatrist and Director of the Hilo Mental Health Center in Hilo, HI. This post is from a paper written by Dr. Worchel in his testimony before the F.D.A. concerning the effectiveness and safety of CES from the perspective of a practicing psychiatrist.

Why Psychiatry needs CES

The prime directive – Do No Harm

The primary duty to patients should be to “do no harm”. Avoiding harm typically results in an approach that follows a spectrum of interventions beginning with treatments that pose the least risk of adverse side effects.

The harm reduction approach increases the likelihood patients will benefit without being exposed to unnecessary risks of harm. CES should be included in the spectrum of available treatments as it poses very low risk of harm to patients.

ces-alternative-to-drugs

CES as a safe and effective alternative

People worried about the use of pharmaceutical drugs should consider CES as a safe and effective alternative

The FDA has expressed concern as to utilization of CES without first employing more “conventional” treatments. Unfortunately, the more conventional treatments at times are not only ineffective but also in many circumstances contribute to a worsening of the condition or result in deleterious side effects.

This can result in necessary therapeutic alliance adversely impacted. Frequently, patients will mention the advertisements they see on television by various attorneys soliciting patients who have been harmed by approved medications, ECT or other treatments. They are worried about being harmed by prescribed treatments and become suspicious of their health care professionals.

There is excellent data and clinical experience however to support the safety and lack of adverse side effects from CES and it should be included in the spectrum of available treatments as it poses very low risk of harm to patients.

Excerpts from “A View from the Trenches” written by Jason Worchel, M.D.

More CES Research – https://www.cesultra.com/research-resources.php

Symptoms and Signs indicating you may have an Anxiety Disorder

anxiety-faceAnxiety is a common mental state expressed as uneasiness or apprehension about an uncertain future event or occurrence. Any kind of anxious behaviour incites stress reaction within your body, expressing itself with symptoms of stress. Everyone experiences anxiety to some degree in response to various kinds of stimuli and this is “normal”. But your anxiety ceases to be normal and becomes a disorder when it adversely affects normal functioning, interfering with your normal lifestyle.

Anxiety disorders are relatively common and treatable mental disorders affecting about 18 percent of the U.S. population, making them the most common mental disorders in the United States. Of these, only about one-third of those suffering from anxiety disorders seek medical help as anxiety symptoms are perceived differently by different persons.

Has your “Normal” Anxiety become a “Disorder”?

When you inadvertently start expressing certain stress symptoms and signs, it might be an indication that your anxiety might have crossed the bounds of “normal” and entered the realms of a “disorder”.

Anxiety disorders arise from the intricate interplay of various risk factors, genes, brain chemistry, personality types, and life events. They result in a complex group of anxiety disorders, each disorder with their own peculiar symptoms and signs.

Some of the common anxiety disorders are Acute Stress Disorder, Agoraphobia without history of Panic Disorder, Anxiety Disorder due to a general medical condition, Anxiety Disorder not otherwise specified, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder (OCD), Panic Disorder with or without agoraphobia, Post-Traumatic Stress Disorder (PTSD), Social Phobia, Specific Phobia, or Substance Induced Anxiety Disorder.

So, what signs and symptoms indicate an anxiety disorder?

Actually, there is virtually no difference between symptoms and signs in ‘normal’ anxiety and anxiety ‘disorder’ except for persistence and increase in the number, type, intensity, frequency and duration of anxiety symptoms.

Although nowhere close to a complete list which includes hundreds of random symptoms, anxiety symptoms and signs commonly encountered include:

Physical Anxiety Symptoms

  1. Rapid heartbeat or palpitation
  2. Profuse sweating
  3. Choking sensation in the throat
  4. Abdominal cramps
  5. Dizziness and giddiness
  6. Increased frequency of urination and stools
  7. Burdened or difficulty in breathing
  8. Rapid shallow breathing
  9. Hot flushes or chills
  10. Sensation of lightness of head
  11. Tremors and jitteriness
  12. Muscular tension and twitches
  13. Headache or heaviness of head
  14. Unexplained tiredness and fatigue
  15. Difficulty in sleep initiation or continuation
  16. Nausea

Emotional Anxiety Symptoms

  1. Growing and persistent apprehension or fear of the unknown
  2. Feelings of dread without valid reason
  3. Problem concentrating on any task at hand
  4. Nervousness and restlessness
  5. Being irrationally irritable or edgy
  6. Difficulty in sleep
  7. Catastrophic thinking
  8. Heightened vigilance towards anything perceived as dangerous
  9. Absentmindedness
  10. Intense fear of death or doom
  11. Fear of losing one’s mind
  12. Feelings of detachment from reality

When should you seek Professional Help?

anxiety-treatment-cesultra

To have some anxiety means to be human, but when anxiety symptoms preoccupy your life, interfering with your normal functioning and lifestyle, it is time to visit your doctor.

You can use the Likert Anxiety Scale to help you decide if you need professional help. To check your Likert Anxiety Scale Score, click here.

You should be particularly cautious if your work or family life is disturbed or if your anxiety is making you depressed or causing you to resort to drinking or drugs or if you feel you have other mental conditions or you feel the urge to kill yourself.

You should immediately seek professional help so that early treatment may be initiated and to prevent any untoward outcome.