Panic Attack? Don't Panic.
Dr. Katherine Shear is the Marion E. Kenworthy Professor of Psychiatry in Social Work at Columbia University. A graduate of the University of Chicago and Tufts University Medical School, her primary areas of investigation include anxiety disorders, depression, and (most recently) bereavement and grief. Her research has produced a number of widely used clinical assessment tools, including the Panic Disorder Severity Scale and the Generalized Anxiety Disorder Severity Scale. Dr. Shear's groundbreaking grief research was recently featured in the New York Times.
Question: What triggers a panic attack?\r\n
Dr. Katherine Shear: So what triggers a panic attack is – I'm hesitating because there's sort of two main models of this. I mean, one is that – I guess both of them center on the idea that everyone, you know, is capable of having a panic attack. If a tiger suddenly ran into the room, you would probably have a panic attack. And so that means that we have the brain circuitry to have a panic attack. And the idea is that the circuitry is meant to be triggered by actual immediate danger. And people who have clinical panic attacks have those attacks when there is no real danger. And so what we think is the trigger is more easily set off, so to speak.\r\n
Now, what sets it off? It can almost be like a loose wire. You can think of it as a loose wire in your fire alarm system or something. So sometimes it can just set off. But a lot of times, there's a lot of evidence that what triggers a panic attack is an actual bodily sensation of the sort that you have when you have anxiety. So if you think about adrenalin rush, you have heart palpitations; you get a little short of breath, you feel a little shaky, sweaty. Any of those kinds of feelings can trigger kind of what we call catastrophic misinterpretations on the part of the person who's prone to having panic attacks so that they're – what we know about such people is that they're more sensitive than the rest of us to the bodily sensations to start with.\r\n
So if you had, for example, panic attacks, you would be better able to tell me right now what your heart rate is, then I would be able to tell you. And so there's that sensitivity to start with and then something starts your heart racing. And that could be running up a flight of stairs. It could be drinking a cup of coffee. It could be getting mad at someone, you know, any of those kinds of things. Your heart starts to race and all the sudden, you sense that pretty early on when it starts to beat faster. And all the sudden, you are feeling – and your mind automatically thinks something terrible is happening – something very dangerous is happening within your body. You might think you're having a heart attack or a stroke or some such thing. And so that is frightening in itself, right? So then that triggers more fear, more bodily sensations in your continuing in that.\r\n
Question: How can you bring a panic attack under control?\r\n
Dr. Katherine Shear: Sure. I mean, I think that the treatments that we do that have been proven to be helpful for people center on kind of – it's almost like you have a phobia of your own bodily sensations. So you know how we work with phobias. If you were afraid of cats, someone who's afraid of cats, we'd put them in front of cats, right, so that they essentially learn that cats really aren’t that dangerous. And so we follow that same principal with panic attacks and we evoke bodily sensations. So we might have someone run in place in the office and their heart starts to race and they see that that's a normal reaction to running in place. And we're sort of there with them and helping them with that. And we basically desensitize them and teach them also what is behind a panic attack.\r\n
Question: Where does normal anxiety end and clinical anxiety begin?\r\n
Dr. Katherine Shear: Well, you know, that's a very good question because that's what we're grappling with right this minute in the new diagnostic system that's being – you know, every so often we rewrite the psychiatric diagnostic system. And so one of the big questions is should we be looking at anxiety and mood and other kinds of psychological problems on a dimensional scale like that. And if so, where's the cutoff? And so it's probably not just in one place. Now the scales that I've developed are ones that are focused very much so on diagnoses that we already make. And so there, the cutoff is basically determined by when we can diagnose panic disorder, for example. The Panic Disorder Severity Scale, we can say that – I can tell you a number. But, you know, there's a number that corresponds to the best kind of indicator that someone will have a diagnosis of panic disorders. So that's how we do that.\r\n
But it's absolutely true that there's a dimension – that these symptoms occur in a dimensional way such that certainly there's normal anxiety and there's normal panic, even. So panic's different from anxiety because panic is an immediate fear reaction, right? Whereas anxiety is more something we think is going to happen in the future. So panic occurs when you think, like I said before, if there's a tiger in the room or someone's pointing a gun at you. It's the future, but it's the immediate future, as opposed to I'm anxious about a test I'm going to have to take next week or something.
Recorded on November 3, 2009
Interviewed by Austin Allen
If a tiger ran in the room, says Dr. Katherine Shear, we'd all have one. Fortunately, like the tiger, panic attacks can be tamed.
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The results of this study showed depressive symptoms being highest in adolescence, declining in early adulthood and then climbing back up again into one's early 30s.
- A 2020 Michigan State University study examined the link between teen social networks and the levels of depression later in life.
- This study used data from the National Longitudinal Study of Adolescent to Adult Health, specifically targeting social network data. The results showed depressive symptoms being highest in adolescence and declining in early adulthood, then climbing back up again into one's early 30s.
- There are several ways you can attempt to stay active and socially connected while battling depression, according to experts.
The study suggested that teenagers who have a smaller social circle showed higher rated of depression later on in life.
Credit: asiandelight/Shutterstock<p><a href="https://www.eurekalert.org/pub_releases/2020-09/msu-tsn093020.php" target="_blank" rel="noopener noreferrer">A 2020 Michigan State University study</a> examined the link between teen social networks and the levels of depression later in life. The results of this study suggested teens who have a larger number of friends in adolescent years may be less likely to suffer from depression later in life. These findings were especially prominent in women.</p><p>This study used data from the National Longitudinal Study of Adolescent to Adult Health, specifically targeting social network data. This data asks students to select up to 5 male and 5 female friends and indicate how often they felt depressive symptoms. </p><p>MSU Sociology Assistant Professor Molly Copeland and lead author Christina Kamis (Sociology doctoral candidate at Duke University) published the study in the Journal of Health and Social Behavior in September. </p><p><strong>Female teenagers may struggle more with depression during their teen years but show fewer depressive symptoms later in life.</strong> </p><p>For female adolescents, popularity can lead to increased depression during their teen years. However, this ultimately may lead to lasting benefits of fewer depressive symptoms later in life. "Adolescence (is) a sensitive period of early life when structural facets of social relationships can have lasting mental health consequences," Copeland wrote, adding that "compared to boys, girls face additional risks from how others view their social position in adolescence."</p><p>Throughout this study, men showed no association between popularity and depressive symptoms, however, they did show benefits from naming more friends. As for why this is, Copeland has a theory: perhaps the expectations on young girls (compared to young boys) as well as the roles that lead to popularity can create a kind of stress and strain felt more prominently by girls than boys. </p><p>While this does create more difficult teen years for young girls, the stress and strain may lead to giving these girls a psychological skillset that benefits them later in life, allowing them to deal with stressful situations more easily.</p><p>The study also suggested that teenagers who have a smaller social circle showed higher rates of depression later on in life. </p><p><strong>Results from both men and women followed a U-shaped trajectory of depressive symptoms.</strong></p><p>The results showed depressive symptoms being highest in adolescence and declining in early adulthood, then climbing back up again into one's early 30s. This was particularly more noticeable in women, who showed a steeper decline in symptoms between the ages of 18-26, followed by a more rapid increase in symptoms in their early 30s. </p>
How to stay social while battling depression<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ1MjA3MC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNDMyNDY1N30.e1ULIJ5QYXh4H1SGUPUTJqYBCnX2XWp6InjPRr-2Bdw/img.jpg?width=1245&coordinates=0%2C22%2C0%2C22&height=700" id="832fd" class="rm-shortcode" data-rm-shortcode-id="b360bb24fb8d6025680bfffb52fd5982" data-rm-shortcode-name="rebelmouse-image" alt="depression support group illustration" />
Attending support groups, planning activities with family or even just a weekly phone call to a friend can help alleviate depression.
Credit: Mascha Tace/Shutterstock<p>Although maintaining relationships can help you cope, it can also be one of the most difficult things to do when you're experiencing depression.</p><p>As Dr. Jennifer L. Payne (an assistant professor/co-director of the Women's Mood Disorders Center at Johns Hopkins Hospital in Baltimore) <a href="https://www.everydayhealth.com/hs/major-depression/staying-socially-active-with-depression/" target="_blank" rel="noopener noreferrer">tells Everyday Health</a>: "One of the common symptoms of depression is social isolation." </p><p>Payne goes on to explain that you can "soak up some energy" by simply being around other people, moving around, and staying active.</p><p><strong>Creating a daily schedule and planning activities ensures action. </strong></p><p>While it may be easy to turn down last-minute plans, it's more difficult to cancel plans you've already committed to with friends and family. While it's important not to overwhelm yourself with a packed schedule, creating a minimal daily schedule that involves seeing friends and family or doing activities that you've previously enjoyed can ensure you stay active and often makes you feel more accomplished at the end of each day. </p><p><strong>Support groups and social networking with people who understand. </strong></p><p>While depression can very easily make you feel isolated and alone, surrounding yourself with others who may be struggling with depression as well can help in multiple ways. You will have peer support from people who relate to how you're feeling plus the added benefit of being around people, which can raise your spirits. </p><p><strong>Keeping a journal (and setting goals) can help you feel accomplished. </strong></p><p>Keep a thought journal and detail certain daily or weekly goals (such as a plan to call a friend on Monday or to visit your local coffee shop for a change of scenery on Thursday). These small, achievable goals not only get you out of the house and/or interacting with others, but they also provide a sense of accomplishment and satisfaction once they are complete. </p><p><strong>Random acts of kindness, such as volunteering, will make you feel good. </strong></p><p><a href="https://bigthink.com/mind-brain/kindness-benefits-james-doty?utm_term=Autofeed&utm_medium=Social&utm_source=Twitter#Echobox=1596517476" target="_self">Being kind is good for your health</a> in many different ways. Doing something nice for others can boost your serotonin levels. Serotonin is a neurotransmitter that is responsible for feelings of satisfaction and well-being. Similar to exercise, kindness, and altruism can also release endorphins, creating a <a href="https://www.quietrev.com/6-science-backed-ways-being-kind-is-good-for-your-health/#:~:text=Kindness%20releases%20feel%2Dgood%20hormones&text=Doing%20nice%20things%20for%20others,as%20a%20%E2%80%9Chelper's%20high.%E2%80%9D" target="_blank" rel="noopener noreferrer">temporary sense of euphoria</a> that can help combat depressive symptoms. </p>
Researchers have just discovered the remains of a hybrid human.
90,000 years ago, a young girl lived in a cave in the Altai mountains in southern Siberia. Her life was short; she died in her early teens, but she stands at a unique point in human evolution. She is the first known hybrid of two different kinds of ancient humans: the Neanderthals and the Denisovans.
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