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Co-Occurring Disorders with PTSD

Many people may think they have anxiety because they suffer from social anxiety, or they have difficulty making quick decisions or any decision at all. Or some may feel as though they seem to be functioning in “survival mode” in order to just get through the day. While it may be determined that they do have anxiety, in some instances, they may actually be suffering from PTSD, or Post Traumatic Stress Disorder as well as one or more co-occurring disorders.

PTSD Statistics

It has been estimated that almost 8% of Americans will suffer from PTSD symptoms at some point during their life. Women are twice as likely as men to develop PTSD, with the numbers 10.4% and 5% respectively. Approximately 3.6%, or 5.2 million adults in the U.S. have PTSD during the course of a given year.

PTSD Symptoms

Three different kinds of symptoms are experienced with PTSD:

  • First set of symptoms involve reliving the trauma in some way
  • Second set of symptoms occur when you purposefully stay away from places or people that remind you of the trauma; you become isolated from other people or feel numb
  • The third set of symptoms include feeling irritable, startling easily, or feeling on guard

Examples of PTSD Symptoms

While there are numerous symptoms reported with PTSD, following are some of the more commonly reported issues:

  • Loss of confidence in trusting your own instincts
  • Social anxiety
  • Difficulty at times separating reality from imagination
  • Waking up frequently at night; having a “fitful” sleep
  • Finding yourself flip-flopping on making a decision
  • Difficulty with short term memory retention
  • Finding it difficult to focus on a task, conversation, idea; difficulty with following through to the end of a thought process
  • Physical or mental lethargy
  • Feeling hopelessness, despair, or depression
  • Becoming exhausted after even small tasks; simple things become “just too hard to do”
  • Making poor life choices where you feel shame instead of making choices to change the situation to the positive
  • Confusion as to why you feel in a “fog” or feel “shell-shocked” by life in general
  • Exhibiting addictive behaviors as a means of escape

Co-Occurring Conditions with PTSD

Those that suffer from PTSD are also commonly diagnosed with other disorders such as depression, substance abuse, anxiety, difficulties with memory or cognition, as well as other problems with mental health or physiological changes.  The disorder itself is associated with impairment of the ability to function in social or family life – it is common to see problems with relationships, family discord, difficulties in parenting, and job instability.

For men, more than half with PTSD also have problems with alcohol; the most common co-occurring issues for men in order are depression, conduct disorder, and substance abuse.

For women, just under half of those with PTSD experience depression; the next most common co-occurring mental health issues are specific fears, anxiety, problems related to alcohol.

PTSD Psychiatric Care

PTSD is not just a “veteran’s ailment.” PTSD can occur across every socio-economic status and life stage. Call Dr. Hege for a confidential appointment at one of his convenient weekend and weeknight office hours for a comprehensive evaluation that addresses your primary and co-occurring issues.

Sexual Side Effects and Psychiatric Medications

Reporting a sexual side effect while using psychiatric medications is a common complaint for both men and women. The severity of sexual side effects vary widely depending on the person, how they react to their medication, the specific medication prescribed, the dosage taken, and any co-existing medical disorders such as heart disease, cancer, and diabetes.

Sexual Side Effects

Psychiatric medication may effect sexual function in a number of ways. The severity of sexual side effects may be minor, may ease up as your body adjusts or become a continuing issue that impacts life enjoyment. Sexual side effects include:

  • Erectile problems
  • Orgasm difficulties
  • Problems with arousal and satisfaction
  • A change in the desire for sex

Statistics of Sexual Dysfunction

Most of the research available on impaired sexual function and psychiatric medication focus primarily on depression and antidepressants. Sexual dysfunction however is also a concern for those diagnosed with anxiety disorders, mood disorders, bipolar disorder, and schizophrenia to name a few. While 35% to 50% of those with untreated major depression report some type of sexual issue, those taking SSRIs (anti-depressant medication) report 30% to 40% delayed orgasm, 20% report decreased libido, and 10% of men complain of erectile function.

Impact of Psychiatric Medications on Sexual Function

The following classes of medication listed indicate some common drugs within each class that have more reported sexual side effects versus those with fewer reported sexual side effects:

Antidepressants:

  • More reported side effects: Celexa (citalopram), Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline)
  • Fewer reported sexual side effects: Wellbutrin, Aplenzin, Forfivo XL (bupropion), Cymbalta (duloxetine), Remeron (mirtazapine), Viibryd (vilazodone)

Antipsychotics:

  • Increased side effects: Cozaril (clozapine), Risperdal (risperidone)
  • Fewer reported effects: Abilify (aripiprazole), Zyprexa (olanzapine), Seroquel (quetiapine)

Sedatives:

  • Increased sexual side effects: Valium (diazepam), Mellaril (thioridazine)
  • Less reported effects: BuSpar (buspirone)

Reduce Psychiatric Sexual Side Effects

The solution is not to stop the medication you need for your mental health issues but rather to work with your psychiatrist to find an effective medication or combination of medications that work for you and reduce any sexual dysfunction that you have been experiencing.

Call Dr. Hege for a confidential appointment – there are many avenues of treatment available to help you live a full and satisfying life. Let Dr. Hege help.

Panic Attack Help: Stop The Fear

Symptoms experienced during an anxiety or panic attack are the results of one’s mind: a “flight or fight” response which produces numerous physiological changes within the body. These “flight or fight” symptoms are not a sign of illness but of the body trying to prepare for a perceived or anticipated threat.

Help for Panic Episodes

Having a panic attack may be one of the worst situations to find yourself in. Even though most panic attacks peak at 10 minutes and end within 20-30 minutes, that time may feel like the “hours” will never end. Mental health professionals experienced in the treatment of anxiety and panic attacks can help end the moments of excruciating fear.

Panic Attack Common Symptoms

While the symptoms experienced during an anxiety or panic attack make for a very long list, varying between each person in severity and occurrence, the following list details some of the most common ones reported.

  • Shortness of breath, feeling smothered –may be most distressing symptom experienced
  • Heart palpitations, racing or slowed heart beat – due to release of stress hormones
  • Chest pain
  • Globus Hystericus: Difficulty swallowing; “lump” or pressure in throat
  • Shaking (internal or external) or shivering
  • Dry mouth
  • GI upset (indigestion, heartburn, diarrhea)
  • Insomnia, sleep disturbances
  • Feeling “electric shock or jolt” is common and often radiates from the chest
  • Numbness to face or head, pain to neck and shoulders – muscle tightness restricts blood vessels and nerves which cause numbness, pain and unusual sensations to head/face
  • Increased sensitivity to sound, smell, light and touch
  • Headaches and “tight band” feeling around head
  • Agoraphobia (safety seeking behavior)
  • Fear of losing control is high on the list during a panic attack
  • Tingling in hands or feet a normal expected symptom
  • Derealization and depersonalization can occur with even low level anxiety
  • Aggression and fear closely related – a panic attack may lead to aggressive outbursts

While this is a fairly extensive list of panic attack and anxiety attack symptoms, the list grows with individual reported experiences and symptoms. With a history of chronic panic attacks the severity of symptoms may also progress to depression or thoughts of suicide. You do not have to face this alone – work with a psychiatrist to help end the fear and panic.

Panic Attack Psychiatrist

Experienced consultation and treatment is available locally. Stop your anxiety and panic attacks – Call the office for a confidential appointment at a time convenient for you.

10 Behaviors that Indicate a Mental Health Problem

People with quirky or eccentric personalities may be more interesting or fun to be around, but when their behaviors become too extreme or negatively impact their lives, there may be something else at play, including the possibility of a mental health disorder. In the U.S., about one in five adults, or almost 44 million people exhibit the occurrence of a mental illness every year.

Signs and Behaviors of Mental Health Issues

You may feel that you are unique and different, or even having a personality that is often misunderstood – when do those thoughts change over to questioning if you need to see a psychiatrist? There are certain behaviors and signs that do signal a need to see a mental health practitioner – if you recognize any of the following in yourself it does not mean you are disturbed or crazy, but rather that your life may be able to benefit from an aspect of mental health guidance and treatment.

  • Difficulty coping with life on a day to day basis, having irrational fears
  • Intense anxiety where every worry is “super-sized” and worst case scenario is expected
  • Feeling overcome with sadness, or feeling down or hopeless on a regular basis that affects your ability to function
  • Unexplained and recurrent headaches, stomach-aches or a rundown immune system
  • Using a substance to cope with daily life; use of alcohol, illegal or prescription drugs, over-the-counter medications or other illicit activities to numb emotional pain
  • Have impulsive or obvious mood swings
  • Cannot shake the impact of recent or past traumatic events
  • Thinking about suicide or hurting one self
  • Serious anger issues, significant irritability, hostility, rage and frequent outbursts of anger
  • Distorted body image along with a highly troubled relationship with food and eating

Help is a Phone Call Away

While the list above does not cover all the mental health issues or concerns a person may have, it does highlight some of the most common behaviors and signs that a comprehensive evaluation by a skilled psychiatrist may provide a diagnosis for. Mental health disorders are treatable. Call for an appointment.

Mental Health Issues in Diabetes Overlooked

Diabetes has numerous co-morbidities associated with it such as the most common ones of obesity, hypertension, fatty liver disease, cancer, and obstructive sleep apnea. An article published in the Journal of the American Medical Association notes that among the wide range of comorbidities associated with diabetes, mental health issues are most often overlooked even when these same issues have the potential to compromise self-management of diabetic control, increasing the risk for serious complications which include amputations, stroke, blindness and premature death.

Statistics of Adverse Effects of Mental Health on Diabetes Outcomes

Even though there are potential adverse effects of mental health issues on diabetic outcomes and national healthcare costs, only one-third of patients with these co-existing conditions will receive an accurate diagnosis and treatment. An example that depicts the prevalence of mental health illness that is associated with diabetes are the rates of major depressive disorder; this common disorder affects 6.7% of adults in the U.S., yet for those with Type 1 or Type 2 diabetes the percentage rate of diagnosed major depressive disorder is 2 times greater.

Anxiety Disorders Also Commonly Found in Diabetic Management

Panic disorder, generalized anxiety disorder and post-traumatic stress disorder are also common mental health issues associated with diabetes whether or not comorbid depression is also present. When anxiety symptoms overlap symptoms of hypoglycemia, patients may become confused, not knowing whether the symptoms are anxiety based or if the problem is low blood glucose levels that need immediate treatment.

Mental Health Treatment and Diabetic Comorbidities

The mental health comorbidities of diabetes are treatable. Successful treatment is dependent upon a timely referral to a mental health provider for diagnosis and treatment. A skilled psychiatrist understands the relationship between your medical status and your mental health needs. Call the office for a comprehensive evaluation and establishment of an accurate treatment plan.

When Anxiety Becomes an Anxiety Disorder

While most adults have experienced periods of anxiety, fear, or uncertainty related to a stressful event, a developing problem at work or within a social relationship, these episodes typically last for a short period of time. The National Institute of Mental Health reports that anxiety disorders affect around 40 million adults in the U.S. each year with these episodes lasting for a longer time period of at least 6 months. Living with an anxiety disorder left untreated often becomes worse over time and can incapacitate a person.

Anxiety Disorder Comes in a Variety of Forms

Anxiety disorders bring distress and havoc to one’s life along with constant feelings of worry and fear; the intensity and duration of an episode often leave one crippled, unable to live a normal life. Anxiety disorders can appear as any of the following types:

  • Panic disorder – feelings of terror that can strike suddenly “out of nowhere” without any warning
  • Social anxiety disorder or Social phobia – brings overwhelming worry, nervousness and self-consciousness about everyday social situations; includes fear of being judged or ridiculed by others, or fear of embarrassing oneself
  • Specific phobias – leaves one with an inappropriate intense fear of a specific object or situation, often resulting in avoidance of regular daily situations
  • Generalized anxiety disorder – this type of anxiety disorder leaves one with excessive unrealistic worry, stress and tension without any cause or reason

Common Symptoms of an Anxiety Disorder

The symptoms of an anxiety disorder vary depending on the type of the disorder. The most common general symptoms of adult anxiety disorder include:

  • Feelings of panic, fear, uneasiness, nervousness
  • Sleeping difficulties, trouble getting to sleep and staying asleep for any length of time
  • Complaints of having cold or sweaty hands or feet
  • Complaints of having shortness of breath (SOB)
  • Heart palpitations
  • Feelings of restlessness and poor ability to sit still
  • Complaints of dry mouth
  • Complaints of numbness or tingling in the hands or feet
  • Feelings of chronic nausea
  • Muscle tension
  • Feeling dizzy

Causes of Anxiety Disorders

Following years of research, the exact cause of anxiety disorders is unknown. In the professional world it is thought that adult anxiety disorders are from a combination of factors which include environmental stress and physiological changes in the brain itself.  Studies of adult anxiety disorders also show that these disorders may be partly inherited from one or both parents, and that experiencing a significant trauma or event may trigger an anxiety disorder in those who have inherited the susceptibility to having one of these disorders.

If anxiety, stress and fear are starting to overtake your life, make the call to Dr. Hege, the area’s premier psychiatrist for adult anxiety disorders. Call for a confidential appointment. Dr. Hege offers convenient evening and weekend appointments to help work around your life schedule.

Social Anxiety is #3 Psych Disorder

The Social Anxiety Institute estimates that 7% of the U.S. population is currently faced with social anxiety disorders, with the lifetime prevalence rate reaching up to 14%. Millions around suffer from social anxiety every day – research studies show that social anxiety disorder is the third largest psychological disorder in the U.S., following depression and alcoholism as the number one and two disorder.

What is Social Anxiety?

Most people experience anxiety, shyness or self-consciousness during their lifetime. It is normal to feel anxious or to get the “jitters” before a speech, social encounters, an interview, or an important event, yet still be able to function in your regular day to day schedule. Social anxiety disorder however does interfere with your normal daily routine and brings tremendous distress into your life for weeks or months before the event occurs.

Triggers for Social Anxiety

Having periods of social anxiety or social phobia during certain situations is very common throughout the population. HelpGuide.org reports social anxiety disorder brings long-lasting significant emotional distress and requires professional intervention for successful recovery. Common triggers for social anxiety disorder  include:

  • Being observed while working on something
  • Making small talk
  • Being called on in class
  • Making a phone call
  • Attending parties or social gatherings
  • Meeting new people
  • Having interpersonal relationships
  • Taking an exam
  • Using public bathrooms
  • Public speaking
  • Being teased or criticized (even as a joke)
  • Being part of a group interaction or sharing activity

Three Main Symptoms of Social Anxiety Disorder

The three main symptoms that are seen with social anxiety disorder are emotional, physical and behavioral based.

        Emotional Symptoms include:

  • Excessive self-consciousness and anxiety in everyday normal social situations
  • Intense worry for days, weeks, or even months before a social situation
  • Extreme fear of being watched or judged by others, especially strangers
  • Fear that you will embarrass or humiliate yourself

        Physical Symptoms of social anxiety disorder include:

  • Exhibiting a red face, blushing, sweating or hot flashes
  • Shortness of breath
  • Upset stomach, nausea
  • Trembling or shaking of body part or of voice
  • Feelings of racing heart or chest tightness or pressure
  • Feeling dizzy or faint

Behavioral symptoms commonly occurring:

  • Avoiding social situations that limits your activities or disrupts your life
  • Staying quiet in the background to escape notice and embarrassment
  • Needing a buddy to go along with you no matter where you might be headed
  • Drinking before social situations to soothe your nerves

Help is Available to Recover from Social Anxiety Disorder

Stop letting social anxiety run your life. Help is a phone call away.

Dr. Hege understands your fears and needs — evening private appointments and even video conferencing may be part of your treatment plan which may include medication, cognitive behavioral therapy and additional adjunct therapies.

Panic Disorder Can Develop or Worsen During Menopause

On any given day there are approximately 45 million American women that are going through menopause, with 5% of that number between the ages of 45 to 50 years old.

Research data from the CDC indicate that while the majority of women transition to menopause without developing any troubling psychiatric problems, panic disorder is the most common mental health issue reported.

Menopausal Panic Attacks Can Last For Years

Menopause often brings difficult emotional and physiological changes during this change of life phase. Studies show new-onset panic disorder has become a common new diagnosis for women going through menopause. In addition, women with pre-existing panic disorder may find their symptoms and mood changes worsen. Menopause brings changing hormone levels where women often report alternating periods of extreme rage, mood swings and depression that can last for a few months to a period that covers many years.

Reason For Menopausal Panic Attacks

While it may be unclear as to the exact cause of a woman’s panic attack or disorder, it has been found that women are twice as likely to suffer from panic disorder as men, most notably during PMS, pregnancy and menopause. Hormones have been identified as the one common underlying cause in all of these cases. In addition, women entering menopause who are already living a stressful lifestyle or who are going through a particularly emotional life event are left even more susceptible to developing a panic disorder.

Panic Attack Symptoms During Menopause

Panic disorder is an anxiety disorder described as unexpected and repeated episodes of intense fear which includes chest pain, shortness of breath, heart palpitations, dizziness, heavy sweating, or gastrointestinal distress. During menopause the development of a panic disorder is often extremely debilitating when fluctuating hormone levels play havoc with a woman’s psychological and physiological state of health. Initial panic episodes often lead a woman to seek emergency medical care thinking that she is having a heart attack.

Treatment for Menopausal Panic Attacks

There is hope and relief from the many symptoms of menopausal panic attacks. An experienced psychiatrist with a history of successful treatment for women who develop mental health issues during menopause, has a wide variety of treatment options to fit one’s individual needs.  Following a comprehensive evaluation, medication may be part of the answer during the time of menopause with its hormone fluctuations.

Medications prescribed may include Xanax, Klonopin, Ativan, Librium, Zoloft, Elavil, Tofranil, Lexapro, Sinequan and many others. Atlanta menopausal panic disorder psychiatrist Dr. Darvin Hege may prescribe medications and may also suggest cognitive behavioral therapy or other adjunct therapies if your anxiety and fears feel insurmountable to you.

Atlanta Menopausal Panic Attack Psychiatrist

If you are in the beginning, middle or end phases of menopause and are experiencing anxiety, panic attacks or mood swings, make the call to Dr. Darvin Hege, an Atlanta menopausal panic attack psychiatrist and get your life back in balance again.

Anxiety Disorders: the Most Common Mental Illness in America Today

Anxiety and worry is a normal part of our human makeup. In the distant past, anxiety had a purpose that helped our ancient ancestors survive by keeping them alert to the dangers they faced daily so they could be ready to act and stay alive. Today we are far removed from the need for being constantly on guard against a hostile world to ensure our survival.

When worry and anxiety become extreme, out of control, prolonged, begin to affect our ability to do our jobs, affect our relationships with others, or we begin to lose the enjoyment of life, we may need help getting balance back into our lives. Included in the category of anxiety disorders are panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and several phobias such as agoraphobia, and excessive social shyness. Anxiety disorders are the most common form of mental illness, affecting 40 million adults in the United States, according to the Anxiety and Depression Association of America.

According to the National Institute of Mental Health, mental disorders are the leading cause of disability in the United States. A psychiatrist can quickly determine if you are suffering from an anxiety disorder or other disorders that can affect the ability to function normally and enjoy life. By knowing which medications to prescribe for those affected with anxiety disorders or other mental disorders, a psychiatrist can help to restore your mental health. Medication is an important option to consider and has helped thousands to regain balance in their lives and enabled them to function as contributing members of society.

Atlanta Anxiety Disorder Psychiatrist

If you’re looking for an experienced Atlanta anxiety disorder psychiatrist who has been helping people in the Atlanta area for many years, contact Dr. Hege. He can help with your anxiety disorder. He can help prescribe you medications that may help you regain your enjoyment of life. Give us a call or submit a message through our online form.

Panic Attacks And Menopause

First of all, let's agree that menopause is no walk in the park for many women. Their hormones are constantly fluctuating back and forth, they have hot flashes and mood swings, and they either can't sleep or they wake up with night sweats. Add in anxiety and panic attacks and many women will feel like they are going right over the edge. Panic attacks and menopause just don't mix well.

Simple anxiety is something everyone experiences on occasion. We all stress over projects at work or issues at home. But, panic attacks are anxiety attacks on steroids. A panic attack can make the sufferer feel like they are having a heart attack! The most common symptoms people have with panic attacks are racing heart beats or heart palpitations, chest pain or discomfort, a feeling of shortness of breath or choking, sweating, dizziness or feeling lightheaded or faint, and unnatural fear and anxiety. To get an idea of what a panic attack is like, think about how you feel when you are cut off by another car and narrowly miss hitting someone or something. Now, multiply that feeling tenfold!

Women who are experiencing a panic attack are likely to breathe shallowly and rapidly. Their racing heartbeat makes them more upset, and the terror and fear that something horrible is happening to them only increases their panic. Panic attacks are not triggered by something in the environment around the sufferer or by something they did; rather the attacks begin for no apparent reason and are as likely to affect someone who is sitting calmly while reading a book as they are to affect a woman in a stressful situation.

While people can be prone to panic attacks at any stage of life, women are more likely than men to suffer from them, and panic attacks and menopause seem to go hand in hand. Many women today are stressed out and overworked, and put themselves at the back of the line behind family and work needs. When women enter perimenopause and menopause, their bodies begin to have hormone imbalances. It is believed that these hormone imbalances, coupled with stress, are at least partially to blame for an increased susceptibility to panic attacks.

Many women will go through perimenopause and menopause, and panic attacks will only happen once or twice during the entire process. For other women, menopause and panic attacks will become a way of life until menopause is completed. For these women, medication may hold the answer to getting them through this troubling time of life.

Dr. Darvin Hege, an Atlanta, GA psychiatrist says "there are two classes of anti-panic medicines that are highly effective. They are Benzodiazepines (Group 1) which consist of Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), Tranxene, Serax Valium, Librium, and others, and Antidepressant/Anti-panic medicines (Group 2) consisting of SSRI's (Zoloft, Prozac, Paxil, Celexa, Lexapro, and Luvox) and tricyclics (Tofranil, nortriptyline, protriptyline, Elavil, Sinequan, Surmontil, and others)." Dr. Hege further notes that "the most important difference between Group 1 and Group 2 is that medicines in Group 1 work much quicker, i.e. stop panic attacks in twenty minutes to a couple of weeks in worse cases. Group 2 requires 1-8 weeks to be effective. However, Group 1 can be physically addictive. Group 2 medicines are just as likely to stop all panic attacks as Group 1 after a lag period. The lag period is 1-3 weeks to the onset of reducing the severity and frequency of attacks. It takes Group 2, 3-10 weeks to totally stop all panic attacks in 70% of patients. Most people need to be on medicine for at least 1 year to significantly reduce the risk of relapse back into panic attacks soon after stopping the medicines."

Menopause and panic attacks are not something that women just have to "put up with". For those women who suffer relatively few attacks, natural therapies or stress reduction can help. Yoga, meditation, and exercise can help calm otherwise frantic lifestyles. Just the simple fact of knowing what a panic attack feels like can help women respond less negatively if they have one. For those women who can not deal with the anxiety and fear that a combination of menopause and panic attacks can bring on, there is relief in the form of counseling and medication.

Dr. Darvin Hege has 25 years of experience dealing with patients who have panic attacks and menopause simultaneously. He offers evening and weekend office hours at his Atlanta, GA practice. Call today at 770 458-0007 for an evaluation for relief of your panic attacks and for help deciding the most effective and safest treatment. >