Ep. 012 - How to reverse weight gain from antipsychotic medication?
Ask A Psychiatrist
This episode deals with the question of weight gain from antipsychotic medication: I'm on 20 milligrams of olanzapine. It's helping me and I don't want to change it. The only thing is that I've gained a lot of weight that makes me feel very unattractive. I’ve spoken to my psychiatrist about it, but I haven't gotten any guidance on the matter. Are there any solutions to weight gain from this kind of medicine? Modern antipsychotic medications can be very helpful for some people. And they are less likely to cause neurological side effects, compared to their first-generation predecessors....
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Ep. 011 - What is akathisia, and how to stop it?
Ask A Psychiatrist
What is akathisia? Akathisia is a relatively common medication side effect. Akathisia is a feeling of restlessness that many people find difficult to describe. Many people with akathisia say that it makes them feel like they would like to crawl out of their skin. What does akathisia feel like? Akathisia can be just an uncomfortable feeling. But for many people that feeling of restlessness translates into not being able to sit still. (Akathisia comes from Greek words that mean “not able to sit down”). It can involve fidgeting, or not being able to sit down or lie down for very long...
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Ep. 010 - Lack of insight into mental illness: Are there any new leads?
Ask A Psychiatrist
This week’s listener question was “is there any new research about curing anosognosia?” Anosognosia is a medical term derived from Greek root words that mean “lack of disease knowledge.” Although anosognosia started off as a neurological concept, it's also very common for people with psychiatric conditions to have no awareness that their symptoms are unusual, or that they could indicate the presence of a mental illness. Emerging data suggest that impaired insight in mental illness might -- like neurological anosognosia -- involve those outer layers of the right side of the brain. It...
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Ep. 009 - Can Antidepressants Reduce Self-Harm?
Ask A Psychiatrist
Can Antidepressants Reduce Self-Harm? Self-harm is a common behavior. About 1 in 8 children and up to 1 in 5 adolescents will deliberately injure themselves without suicidal intent. But even without suicidal intention, self-harm is an alarming and potentially dangerous behavior. Self-harm is a sign that something is wrong… but what’s the best way to help? It’s not uncommon for someone with self-harming behavior to be prescribed an antidepressant. Most of us would think that someone who is repeatedly harming themselves is very sad or depressed. So, it’s not surprising that doctors might...
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Ep. 008 - What is Cannabinoid Hyperemesis Syndrome?
Ask A Psychiatrist
Cannabinoid Hyperemesis Syndrome (also called CHS) is the topic of this week’s episode. Melissa and Dr. Erik answer the question “How can something that’s an anti-vomiting medicine be the cause of a vomiting illness”? Cannabinoid hyperemesis syndrome involves symptoms like loss of appetite, stomach pain, nausea, and vomiting. Vomiting attacks come in waves or cycles. A vomiting attack can last many hours or several days and can be severe enough to cause dehydration or a host of other serious complications. Cannabinoid hyperemesis syndrome affects some people who use...
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Ep. 007 - Is it possible to prevent Alzheimer’s disease?
Ask A Psychiatrist
In this episode, Melissa and Dr. Erik discuss Alzheimer’s disease and address the question of whether it’s possible to prevent Alzheimer’s disease. What is Alzheimer’s disease? Alzheimer’s disease is one of several causes of dementia. The American Psychiatric Association has renamed “dementia” and now refers to this type of condition as “Neurocognitive Disorder.” Either name refers to a decline in cognitive performance. “Cognition” is a broad term which can include things like: attention, decision-making, recognition of language, faces, or situations, learning, or...
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Ep. 006 - Are There Any Medications to Treat Alcoholism?
Ask A Psychiatrist
At least 1 of every 20 adults has an alcohol use disorder. The average life expectancy of a person with alcohol use disorder is shortened by about 29 years.
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Ep. 005 - What is borderline personality disorder?
Ask A Psychiatrist
This week’s podcast episode focuses on borderline personality disorder. Borderline personality disorder is a common condition Borderline personality disorder is relatively common. It’s a condition that currently affects about 1 out of every 60 people (). Up to 1 of every 20 people may be diagnosed with borderline personality disorder at some point in their lives (). “Borderline personality disorder” is a terrible name Dr. Messamore starts off by pointing out that the name of this condition – “borderline personality disorder” – is long overdue for change. It is based on...
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Ep. 004 - What is psychosis?
Ask A Psychiatrist
Psychosis is a word that gets spoken a lot, but that gets discussed very little. About 1 of every 11 people will experience psychosis at some point in their lives. But even though it’s a common experience, we hardly ever talk about it. In this episode of Ask A Psychiatrist, Dr. Erik Messamore and Melissa Xenophontos discuss psychosis. Dr. Messamore explains what psychosis is, how it happens, and what to do about it. We learn that it’s easier to understand – and probably more accurate – to think of psychosis as a misperception syndrome. Psychosis by itself is not a standalone diagnosis....
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Ep. 003 - Does therapy help?
Ask A Psychiatrist
There are so many forms of therapy today that it can be hard to decide which is best for you. One of these types is “psychotherapy,” which sounds a lot scarier than it is. In this episode of “Ask a Psychiatrist” we learn about what psychotherapy is, how it can benefit your thought life, and why fears about undergoing psychotherapy still persist. Dr. Erik Messamore explains the history of psychotherapy and how Freud’s findings dominated professional psychiatric thinking for decades. After about the 1960s or so, Dr. Messamore explains, psychology underwent enormous strides to get us to...
info_outlineAnyone who has ever felt anxiety (which pretty much includes all human beings) knows how uncomfortable it can be. In this episode of “Ask a Psychiatrist” we learn about our internal early-warning systems and what it means when our bodies and minds cascade into something more than experiencing the ordinary stressors of everyday life.
Dr. Erik Messamore explains that anxiety usually consists of two separate but intertwined processes – the physiological “fight or flight” reaction AND a host of thoughts that usually involve forecasting something bad in the near or distant future.
The good news for those of us locked in worry, tension, or panic is that scientists have been studying anxiety for over 100 years. We have a lot of knowledge about anxiety – not only how it works but also how to treat it.
Covering both the physiological and psychological elements, Dr. Messamore breaks down the impacts of anxiety on the body as well as the thought patterns that can heighten those symptoms. He provides a framework for examining some of the successful behavioral interventions available as well as thoughts about the role of drug treatment options.
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KEY TAKEAWAYS:
- (01:35) – Anxiety is a normal emotion – even helpful, despite often being uncomfortable.
- (02:56) – Some of the physical symptoms that signal anxiety:
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- An uncomfortable, almost painful feeling of apprehension.
- Heart racing and difficulty catching one’s breath.
- Muscle tension and hyper-vigilance (which often extends to interrupting sleep).
- Feelings of nausea, urgency to urinate or empty one’s bowels.
- (04:26) – About thoughts that can either result from or precipitate anxiety:
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- Ruminating on or catastrophizing about the future.
- High alert signals reach the brain and start a loop to justify the feeling.
- (07:24) – Anxiety involves two components:
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- Physiological: Preparing the body to fight or flee.
- Thought: Drives or explains to the brain why this feeling exists.
- (08:00) – Anxiety is relatively easy to study because reliable, inexpensive instruments are available to study symptoms, which are mostly objectively measurable and observable.
- Three strategies for treating anxiety:
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- (10:13) – Cognitive Behavior Therapy (CBT): Offers tools to short-circuit anxious thoughts and physical reactions by redirecting responses that do not serve and tend to get locked into a negative loop.
- (17:10) – Systematic Desensitization: Some common phobias/anxieties may be hard-wired biologically and can be overcome by systematically titrating exposure to that which is threatening or fear-inducing. (Dr. Messamore shares detailed, vivid examples of this technique.)
- (22:46) – Exposure and Response Prevention Therapy: A treatment that identifies stressors in the brain and then subtly interrupts any source of reward/relief, initially causing discomfort but incrementally helping to build tolerance and new ways to manage anxiety.
- (27:12) – There are drug treatment options available as an alternative to behavioral therapies. In some cases they can modulate or block reflexive physiological symptoms so that patients can develop adaptive strategies for coping with stressors.
- (31:13) – A bit about SSRIs (selective serotonin reuptake inhibitors) that are sometimes prescribed to get physiological responses in the body under control and opening the possibility of treating underlying psychological/emotional issues.
- (32:05) – Dr. Messamore explains that there are various approaches to treating anxiety, including the effective use of cognitive behavioral and drug treatment programs in combination.
QUOTABLE:
“(An anxiety disorder) can begin to take on a life of its own. It goes from something that is really annoying to something that can have the emotional power of a monster that wants to devour you.”
“When your heartbeat starts to accelerate in response to a thought, then we have a scenario that I call ‘The Feel Makes It Real.’ ”
“Anxiety is a universal human experience. It’s extremely uncomfortable.”
“People who are anxiety-prone and suffer from anxiety disorders overwhelmingly … look into the future and provide a negative outcome. And thoughts drive emotions.”
“Some people find that the physiological response of the body is just so overpowering that using psychological skills has limited value or almost no value at all.”
“Medicine can be very helpful and the choice to use medicine or the decision about what is the right time is deeply personal.”
“For most people it’s ideal to use medicines that can control physiological response in combination with proven, evidence-based psychological therapies because the two of them feed from each other ... It accelerates the program.”
“The good news is that anxiety has been studied longer and probably better than any other mood state in humans. We have a lot of techniques that can be very effective and have been proven.”
About the Host:
Dr. Erik Messamore is a board-certified psychiatric physician and PhD-level pharmacologist. He’s a consultant psychiatrist, researcher, lecturer, teacher, and solution-focused scholar currently affiliated with the Northeast Ohio Medical University in Rootstown, Ohio. He is joined on this podcast by Melissa Xenophontos, a journalist, radio producer and longtime mental health advocate.
Contacts:
Website: www.ErikMessamore.com
Dr. Messamore @LinkedIn
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