How to Help in a Panic Attack | Mental Health First Aid


Panic attacks are incredibly common, and it can cause people to hyperventilate and to breathe out a lot, which breathes off the carbon dioxide, can make you feel very light-headed and means that you can just not be able to control your breathing at all. It is very, very frightening. It can give you palpitations, it can give you tremor. There's a lot of people get so frightened, that they think they're having a heart attack. If you suspect somebody is having a panic attack, please don't be tempted to use paper bags or anything that you may have heard about in the past.


The best way is to stay as calm as you can and breathe nice and calmly, too, and the calmer you are, the calmer they will be. Try and encourage them to breathe in and out very slowly. So, try and remove them from anything obvious that is causing them the distress, if you can, and try and get them to focus on breathing slowly in and out. Sometimes it can help to use your hands to do that. But breathing techniques have been shown to be the most effective to calm somebody when they're having a panic attack..



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How to stop panic attacks naturally and fast: avoid caffeine?


Paul asks “is it true that I can stop my panic attacks naturally and fast… by simply avoiding caffeine?” Hi, I’m Michael Norman and welcome to “PanicFree TV’s Fact or Fiction”. This is where as a scientist and anxiety specialist, I help you cut through the noise, myths, and popular claims… and show you the simple science of what really works to stop your panic attacks fast, for good.


Now, caffeine can definitely trigger panic attacks in some people, but there is a counterintuitive twist. I’ll share this twist with you in just a moment — but first, let me answer your question. Caffeine can create all kinds of body sensations that can resemble a panic attack. It can cause heart palpitations, tremors, anxiety, and nausea — and if someone is scared of those sensations, then caffeine can trigger a panic attack for them.


This is actually quite common in moderate to high doses of caffeine. For example, in a 2015 study… nearly half of everyone who’d been diagnosed as having 'panic disorder' had a panic attack after being given 400mg of caffeine in one serving. When they were given the placebo, none of them had a panic attack. Now 400mg is quite a lot caffeine to have in one serving, so we’re talking about higher doses than most of us would have at any one moment in time. It’s about 4-6 cups of instant coffee Or 2-3 cups of drip coffee. It’s 5 red bulls.


Or 13 cans of coke. Now, again, that’s a lot of caffeine… and I don’t know how much you consume, but if you have a lot, or if you think you’re more sensitive to caffeine than normal… then it’s probably worthwhile cutting back or eliminating caffeine for a while to see if that makes any difference for you. So… what’s the counterintuitive twist I mentioned earlier? Well, believe it or not… while caffeine can trigger panic attacks in some people, it has also been used to “cure” panic attacks in others.


How is this possible? It’s possible because caffeine can’t DIRECTLY trigger a panic attack. All it can do is create some panic-like body sensations — and it’s only if your brain mistakenly misinterprets those sensations as being dangerous… that a panic attack can result. This is why, in the past, what some researchers have done, is they’ve used high-dose caffeine to deliberately induce panic-like symptoms… so that people with panic attacks can practice not being scared of them. Because if you’re not scared the sensations that caffeine can induce, then it won’t be able to trigger a panic attack. Now, I definitely DON’T recommend this approach, especially at home without medical supervision… and I’d never ever use it myself with any clients because it’s not particularly effective… it only works with a limited number of people… and I can show you far faster, far more effective, and far more gentle ways of quickly becoming panic-free for good.


The only reason I mention it here, is just to give you the full picture. Again Caffeine doesn’t directly cause panic attacks. Instead, it’s your response to the sensations that caffeine can create, that can trigger a panic attack or not. However, if you consume a lot of caffeine, or if you think you’re more sensitive to it than normal… then it’s probably worthwhile to try cutting back or eliminating caffeine for a while, to see if that makes any difference for you. Now, if you’re wondering… what’s the best way to naturally stop your panic attacks fast so you never have to endure another one again… even if you drink a lot of coffee? If you’re wondering that… then you’ll find the answers in my free “Panic Free TV” foundation series.


It’s simple science-based help for panic attacks that will show you the fastest, natural way to go from wherever you are right now… back to a life that’s as normal, care-free, and panic-free, as anyone else you know. The solutions for panic are very simple, but they’re deeply counterintuitive and that’s why I created this foundation series. Again, it’s completely free, it will make an immediate, important difference in your life and to watch it right now, simply click on the link on your screen or in the description below, enter your details, and get started today on your journey back to a normal, panic-free life.


I’m Michael Norman. Thank you so much for watching. I’ll see you soon..



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Panic Attack Treatment: 2 Proven Techniques + 5 Must-Know Facts (New Research)


In today’s video I’m going to share with you 5 essential, little-known scientific-facts and insights that you absolutely must know about, if you want to quickly and effectively treat your panic attacks. I’m also going to give you 2 unique, counterintuitive techniques, that have BOTH been scientifically proven to help treat anxiety and to treat panic disorder — so you can use these techniques to make a significant, positive difference in your life, today. Hi, I’m Michael Norman, and as scientist and paid-on-results anxiety specialist with clients from over 103 countries around the world, I’ve witnessed first hand how panic attacks and panic disorder, have impacted the lives of even the strongest, bravest people.


Whether someone’s a celebrity, a highly-respected doctor, a CEO, whether they’re a student, a stay at home mum, or anyone else, panic doesn’t discriminate. Almost 1 in 3 people will experience a panic attack in their life-time, and I’ve been through it too. Thankfully though, there’s some good news to this story, because thanks to the last 3 decades of scientific research, panic is now one of most treatable issues there is, if you get the right scientifically grounded help, and that’s what this video is all about. Now, years ago Albert Einstein wisely pointed out: “If I were given one hour to save the world, I would spend 59 minutes defining the problem and one minute solving it.” This is especially true when it comes to successfully treating the panic attacks you’ve had, because, as you’ll soon discover for yourself, once you have an accurate understanding of what’s been happening to you, how panic really works, and what’s been keeping it in your life, surprisingly, the solution suddenly becomes much clearer, as does the path back to a normal, panic-free life.


So with all of this in mind, let’s move onto the first counterintuitive fact, FACT 1: The Term “Panic Attack” Is Not Only Completely Misleading, It Can Actually Make It More Difficult To Recover. Words carry a lot of power. They can mislead us, they can deceive us, they can send us in the wrong direction, down the wrong path, or they can illuminate deeper truths, show us where to go, and help us to find our way home. And knowing this is true, I hope it’s obvious why I consider it so very important, that you know, that a panic attack is absolutely NOT an “attack”. That phrase is totally misleading, and as you’ll understand before you finish this video, it can create a mindset that make things much worse, making it much harder to successfully treat panic.


If we really care about solving your problem once and for all, then, obviously, we really care about the truth, and the overwhelming scientific evidence is that every panic attack you’ve ever had, was not an attack at all, but surprisingly, it was just an innocent, very well-intended, over-protective MISTAKE. To explain this more, I’m going to share with you a short clip from my “Panic Free TV Foundation” video series, which presents a simple but important thought-experiment, Which of these two smoke alarms would you prefer to have protecting you in your home? Would you prefer to have smoke alarm that sometimes FAILS to go off, and stays silent, even though there’s a deadly fire in your house? Or, would you prefer to have a smoke alarm that never misses a real fire, but occasionally goes off when you burn the toast, even though there is no danger, and everything is actually fine? Now of course, we’d all prefer to have a perfect smoke alarm system, that never make any mistakes — but the reality is, we live in complex and often ambiguous world.


And so if you had to choose between one of these two options, what would you chose? An under-sensitive smoke alarm that could miss a real fire and kill you? Or an over-sensitive smoke alarm that occasionally has unpleasant, noisy false alarms, but never misses a real fire, and always keeps you safe? It’s a simple answer, isn’t it. When it comes to our survival, to our LIFE, it’s better to have an alarm system that errs on the side of safety, even if that means, we sometimes get false alarms. So what does this have to do with panic? Well, "panic attacks" are nothing more than false alarms of our over-protective, life-saving fear systems. And while it probably hasn’t felt that way for you in the past, the truth is that a panic "attack" is just a terrifying, overwhelming, over-protective MISTAKE. It’s a mistake, that ironically, is motivated by your brain’s #1 priority in life — to keep you safe. Panic attacks are our brain and body, following the same “better safe than sorry” philosophy, that every good smoke detector system uses.


And it’s far healthier, in fact it’s optimal, to have a fear system that is biased to be over-sensitive and to occasionally give us false alarms, than it is to have an under-sensitive system, that could miss real danger, that could kill us. So a panic attack is JUST an over-protective mistake. The only real problem, and it’s a big one, is that it’s a terrifying mistake. It’s a mistake that can leave us feeling exposed, vulnerable, and unsafe. Even though no one dies from a panic attack, and even though panic could never ever make anyone truly go crazy, the false alarm of a panic attack often creates a very powerful ILLUSION, that these things could happen. And that’s why I really believe, that you are incredibly, So again, a panic attack is NOT an “attack”. Instead, it’s a false alarm. It’s a mistaken effort to protect you, from a danger that’s not there.


Unfortunately, the reason why it’s so scary, the reason why it’s one of the most horrible experiences anyone could ever go through, is because a false alarm sounds the same as a real alarm. And with a panic false alarm, because we so often don’t know what’s going on, the confusion and uncertainty can make everything even more alarming. And that’s why it’s so very important you know about fact #2. Believe it or not, all the strange and scary symptoms you’ve had because of panic, especially the ones that seem the most dangerous, all they really are, are just harmless byproducts, of a false alarm. Fortunately, thanks to a lot of research, we know how a false alarm alone, can create them, We know they can’t kill you, We know they can’t make you truly go crazy, And we know that, reassuringly, as you learn about this, it can help you immediately feel safer and more secure.


Now, since we have a lot to cover in this video, I’m not going to go into the details here, even though this is a very important topic. Since I cover this in depth in my free “Panic Free TV Foundation Series”, if you want to learn more, as I recommend you do, then you’ll find what you’re looking for when you get to episode 2 of my Foundation Series. Again, my it’s completely free, at least at the moment, so you can watch it by visiting www.PanicFree.TV, or by clicking YouTube information icon in the top right hand corner of this video. Okay let’s move on to, FACT 3: There is the core, hidden pattern behind every panic false alarm you’ve ever had , and as you’ll soon see, this pattern reveals to us, the fastest, most effective, most direct path, back to a normal, panic-free life. If you’ve ever been told that you have panic disorder, even though I’m not at all a fan of that label at all, this is the core pattern we want to shift together, so that you can finally be 100% panic-free.


To explain more, here’s another short clip from my foundation series, A panic attack happens when anxiety creates body sensations and anxious thoughts, And, because our brain has mistakenly learnt to fear those body sensations or thoughts, it creates even more anxiety. That increased anxiety then creates even MORE body sensations and thoughts, and around the cycle people go. I call this The Panic Pattern, because it’s THE pattern behind every scary false alarm. It’s a HARMLESS vicious cycle, that can escalate, into a full fight/flight response. So, let me share with you one of the most common examples of this pattern, because it helps illustrate this, more clearly. Since anxiety makes everyone’s heart beat a little faster, if something happens in our lives that makes us fearful or anxious enough, naturally our heart will speed up.


Again, this is a completely natural and healthy response that we all have. But if someone is scared of that, if they’re scared of having a faster heart beat, then anytime they get anxious enough, for whatever reason, it can trigger The Panic Pattern. Anxiety would make their heart beat faster, and a faster heart beat would make them more anxious, which would further increases their heart beat, and a harmless, but scary vicious cycle, would ensue. This is the core pattern behind every panic false alarm. And it can work if people fear a faster heart beat, or any other anxiety-related body sensation, that they happen to be scared of. Again, a panic false alarm happens when anxiety creates body sensations and anxious thoughts, and, because our brain has mistakenly learnt to fear those body sensations and thoughts, that creates even more anxiety.


And that increased anxiety then creates even MORE body sensations and thoughts, and around the cycle we go. Now you might be asking: what’s the deal with panic that’s triggered by external situations — like driving, or flying, shopping, leaving the house, or other things? Why does that happen? Well, if it happens, it’s because those external situations have become associated with anxiety, and so they feed right into The Panic Pattern. Anything that triggers enough anxiety to create a feared body sensation, can trigger the whole vicious cycle, and therefore a panic attack. Now, there are several reasons why understanding “The Panic Pattern” is so important — the most important by far, is that it reveals to us the fastest, most effective, most direct path, back to a normal, panic-free life.


I’ll talk about this more in just a moment, but first, it’s essential we cover fact #4 Following commonsense tends to backfire, keeps people stuck, and reinforces The Panic Pattern If you’ve struggled to find the answers you need, then please know, it’s definitely NOT your fault. Even though panic is one of the most treatable issues there is, unfortunately it’s also one of the most counterintuitive. What seems as if it SHOULD work with panic DOESN’T.


And what DOES work tends to fly in the face of commonsense. There are several important examples of this, but for now, in this video, I’m just going to mention one very, very briefly, And that example of how commonsense tends to backfire with panic, is trying to fight it Trying to stop, suppress, or fight back against panic is one of the most natural responses in the world. Any sensible, intelligent person would try to do it, But unfortunately, as a huge amount of research shows, when it comes to panic what we resist doesn’t just persist, unfortunately, it often becomes stronger, more resilient, and more enduring.


When we try and fight panic, it typically leads to more intense, more enduring panic-related body-sensations and thoughts, not less. In the short-term this fuels to “The Panic Pattern”, and in the long-term it increases the chance of further, frequent, ongoing false alarms. While I explain this in depth in my foundation series, I hope you can now appreciate yet another reason why I am definitely not a fan of the term “panic attack”. When people are mislead into believing that panic is an “attack”, or a “trick”, or a “monster”, or any other unhelpful, conflict based metaphor, then it’s only natural that they’d try and fight it, which unfortunately doesn’t only NOT help, it actively makes the situation worse. Believe it or not, even doing absolutely NOTHING, is a far more effective strategy than trying to fight panic, and if that statement seem a little crazy to you, then consider that doing essentially nothing, was a key part of a pioneering approach to panic, developed my compatriot Claire Weekes, more than 60 years old. STRATEGY #1 Weekes was an Australian doctor, and she was the pioneer of acceptance-based approaches for panic and anxiety, which are so common today.


She urged people not to try and fight panic, but instead, to utterly accept it, to “float” through it, to use her words, and to let time pass, until it goes away. How could this be helpful? Well, if we go back to the scene I you showed earlier in this video, with burning toast, when we try to fight a false alarm, it’s like pushing that toast back into the toaster, and turning that toaster up.


Even though it’s still just burning toast, it leads to much more smoke, and as a result, a much longer false alarm. However, when we utterly accept a false alarm, it’s like turning that toaster off. Even though the smoke may linger for a while, if you let time pass as Weekes used to say, the smoke WILL clear, and things will more quickly return to normal. Now, obviously, I’ll well aware that trying to accept a false alarm is far, far easier said than done — and this is why acceptance-based approaches take time and practice to work.


Weekes was very honest about this, and she urged people to be realistic, so they would stick with the process, even through setbacks. In her own words, if you use an acceptance-based approach, “don’t count the days, don’t count the months, let time pass” Because, “even with compete acceptance, it takes about 2 months to desensitise the body” While this has been shown to be true for all acceptance-based approaches scientifically studied, even though acceptance is a slow process, it does help, if people stick with it. And for the 1960’s accepting panic and anxiety was a revolutionary idea, which helped hundreds of thousands of people, who way back, at that point in history, had little else that worked. Now, since were covering such an important topic here, that of NOT fighting panic, I want to share a second, even more useful strategy, one that you can use to actually stop a false alarm, if you have one. This is strategy #2 Now, before I share this strategy with you, I need to warn you upfront, that when I explain it you, you’ll probably think it’s totally crazy.


That’s totally ok, but also keep in mind that we know from research, that this counterintuitive strategy is more effective than many of the most commonly used approaches to treating panic. It’s is more effective than breathing exercises. It’s more effective than relaxation techniques. And it’s more effective than cognitive approaches — where someone tries to use logic to dismiss, talk back to, or “correct” anxious thoughts. What’s this “crazy” strategy that can actually help? It’s using a paradoxical approach where, if you get a false alarm, instead of trying to fight it, you VOLUNTARILY try to make it stronger and last longer. Now, how could such a “crazy” approach ever work? Well there are several reasons beyond the scope of this video, but to give you just one reason here, I’d like you to consider this: Have you ever tried to force yourself to fall asleep, but as a result, you found yourself being more awake? Have you ever tried so hard to forget something, that you ending up thinking about it even more? Or have you’ve ever tried to force yourself to be attracted to someone you didn’t have ANY feelings for, and, as a consequence, you became even more aware that person wasn’t right for you.


If you’ve ever had one of these experiences, then you might appreciate that, when we try to force an involuntary, automatic, mental or emotional process, sometimes all that effort backfires, and it inhibits that very process. This is something we can use to our advantage with panic, and it’s why, when I first meet a new client, if they’re having a false alarm because they’ve left their comfort zone even to talk to me, I never ask them to relax. Instead, very often, I ask them to voluntarily make the false alarm a LOT bigger. I ask them to voluntarily give me the biggest false alarm they’ve ever had. And what happens universally, is they can’t. Paradoxically, it relaxes them.


Now, obviously, when I work with clients 1-on-1 there is a unique art and skill to making sure this works optimally for each individual, but the use of paradoxical approaches like this, isn’t something I invented. Famous therapists like Alfred Adler, Victor Frankl and Milton Erickson, as far back as 90 to 100 years ago, EACH independently discovered that instead of trying to fight with a problem, sometimes you get far better results by, paradoxically, trying to encouraging it. When done correctly, even with self-application, even in a basic form as I’m sharing with you here, this approach has been shown to be a useful first step for helping people with panic — one that, again, is more effective than breathing exercises, more effective than relaxation techniques, and more effective than trying to use logic to debate, talk-back to, or change anxious thoughts. Again, the approach is, if you get a false alarm, instead of trying to fight it, you voluntarily try as hard as you can to FORCE IT, trying with all your willpower, to compel it to become the biggest, longest lasting false alarm you’ve ever had, as fast as it can.


Now, as useful as this approach can be as a first step, obviously it’s just that, a first step. It’s a tool to help people realise that panic doesn’t work the way you think it does, and that, paradoxically, you can get much more control when you don’t follow commonsense. Now, I want to shift mindsets and very briefly introduce you to a totally different orientation to treating panic. Because, obviously, as nice as it is to have ways to accept, cope with, or even stop a false alarm after it happens, obviously, approaches like that are highly reactive. You have to remember what to do, You have to be able to consciously apply that strategy in the heat of the moment, which often isn’t easy, And worst of all, even if you have a really good technique that works, you’ve still had to go through the unpleasant experience of having your day interrupted by a false alarm Obviously, none of that is optimal at all. So what’s the solution? Well, I’m sure you’ve heard the old saying that prevention is better than cure, and obviously, what’s far more useful and far more effective, is if we can help you automatically prevent future false alarms, so they never even happen in the first place.


Because, for me, “Panic Free" is NOT about coping better with false alarms, because if you have to cope with or accept false alarms, that means you still get them. “Panic Free” doesn’t even mean that you’re able to immediately stop a false alarm, as soon as it begins — because, at best, that's just a good start. What "Panic Free" really means is that panic has truly become a total non-issue for you, in your life. It means you're naturally and effortlessly, as panic-free, care-free and “normal”, as anyone else you know, without you having to even think about it. And what’s the fastest, most effective way to help you reach the point where you’re truly panic free? Well that leads us into fact #5 FACT 5: We Can Automatically Prevent Future False Alarms, By Quickly Ending “The Panic Pattern” Whether you’ve had just a few false alarms so far, whether you’ve had them for years or even decades, or whether you’ve been diagnosed as having panic disorder, if we can change your automatic responses so that instead of feeling anxious you’re AUTOMATICALLY calm, relaxed, and secure in response to the very triggers that triggered “The Panic Pattern” for you in the past, then there can’t be a vicious cycle, and you won’t be able to panic.


This is the focus of all my work, and obviously, if you like this video and you want more of my help, then obviously I have so much more to share with you. While you’ll notice I have a range of resources on my website, including ways you can work with me personally, I recommend you start first with my free foundation series, which goes into everything we’ve talked about here, plus a lot more, in much more detail. Again, my foundation series is totally free at the moment, and you can watch the first episode in full right now by clicking the link in the description, by visiting my website at www.panicfree.tv, or by clicking the information icon in the top right hand corner of this video. Thousands of people, from all walks of life, have gone through my foundation series, and since so many of them have openly said that it’s made a real, positive difference in their lives, I think you’ll discover too, when you watch it for yourself, that it also makes a real, positive difference for you.


I hope this video has obviously been helpful for you, and if it has then please leave me a comment below, so that I know, you’d like me to make more videos, like this video here on YouTube. Also, if you’d like be immediately notified as soon as I publish new, helpful videos, like this video here, then obviously subscribe to my YouTube channel and automatically, this will happen. Remember, panic is one of the most treatable issues there is, if you get the right scientifically grounded help. You are not alone, and not matter what you’ve been through, there’s so much we can do to help make an immediate positive difference in your life. Thank you so much for watching. I hope again that this video was incredibly useful for you. I’m Michael Norman, and this has been another episode of Panic Free TV.



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Panic Attack Help – Part 1: You Are Not Alone (Surprising Scientific Research)


If you’ve ever felt alone, weak, or ashamed because of having panic attacks… then this short video has been made precisely for you. Hi, I’m Michael Norman, and as scientist and anxiety specialist with clients from over 103 countries around the world… I’ve seen how deeply panic attacks can impact people. People often feel alone, weak, or even ashamed because they have panic attacks… and there’s absolutely no need for any of that. To make sure that you know this is true… and that you know you’re not weak… you’re not alone… and there’s no need to EVER feel ashamed… I want to ask you an important question: What percentage of people do you think have had at least one panic attack in their lifetime? Take a moment and get curious about it.


What’s your guess? Would you guess as high as 28%? That’s a lot of people, and yet this is what the best research shows. What this means is that if you have 200 friends on Facebook…it’s a good estimate that between 40 to 60 of them will experience a panic attack in their lifetime. You can look through your newsfeed and consider this, if you ever feel alone. And if you live in a city with 1 million people… then, based on averages, there are probably two to three hundred thousand people all around you, who’ve either experienced a panic attack already, or likely will in the future.


Along with all of this, almost 1 in 20 people will experience what’s often labelled “Panic Disorder”. Now, for several reasons, I’m definitely not a fan of labels, like “Panic Disorder”—but that’s a discussion for another time. What the “Panic Disorder” label refers to though, is when somebody has frequent enough, unexpected panic attacks, that it significantly changes their behaviour, or robs them of their sense of safety. And 1 in 20 people will meet the criteria for “Panic Disorder” some time in their lifetime. We’re talking about a huge amount of people! In fact… if everyone just in the US, who meet the criteria for “Panic Disorder” sometime in their lifetime, were put into one city… it would be bigger than New York, Los Angeles, and Chicago combined — the three biggest US cities! And if we look at the global picture… hundreds of millions of people, have all been through similar kinds of experiences as you have — including me! So… if you’ve ever felt alone, weak or ashamed in anyway because of the panic attacks you’ve had… I hope you now know…you are definitely not alone… Even the strongest, bravest people can get panic attacks… And there’s absolutely no reason to feel ashamed, because surprisingly, panic is a FAR more common part of the human experience… than most people would ever realise.


Now if you’d like to know why so many of us have had problems with panic attacks… and more importantly… if you’d like to know how to end your panic attacks for good… then this is what I cover inside my “Panic Free TV” foundation series. It’s a completely free series, and I think you’ll agree after you’ve started watching it, that it makes a very real, very important difference in your life. To watch my foundation series right now, simply click on the link on your screen or in the description below, and get started today on your journey back to a normal, panic-free life. I hope this video has been valuable to you. I’m Michael Norman, thank you so much for watching..



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Social Anxiety or Agoraphobia?


Hey everybody. Happy Thursday! And when it's Thursday … what is it? I'm doing an FAQ video or things in the media. There are a lot of things in the media. Many of you have commented. Don't think that I have missed it. But I had a couple of good questions today that I wanted to address. And I've been doing some thinking about videos, and I think I'm going to do my journal topics as separate videos.


I find many of you have let me know that you really like those short, clip videos, where it's just something inspirational to kind of help get you through your day. So instead of doing two videos a week, now I'll do three. And I'll do a, you know, journal topic inspiration. So share your ideas! If there's anything that you've read about, heard about, saw on Pinterest or something tweet it to me, leave it in the comments below. And I shall make a video about that. So today I have two questions, and both of these are really good. So let's get going. First question says, "Hey Kati. First of all very nice video." This person's referring to the agoraphobia video I put out on Monday. If you haven't checked it out, you should check it out.


"I have a question. Describing the disorder you really focused on embarrassment connected to the possibility of getting out of a stressful situation. Does this feeling have anything in common with social anxiety? And if so, what are the main differences?" Because if you remember correctly in my video I talk about agoraphobia being an anxiety disorder. Now the really awesome thing about the DSM … cause I have to put a different book under my thing, because I had to use this to reference … is that it shares with you differential diagnoses, which is really the way of saying how is this different from the other disorders. Because a lot of them seem very similar. How do we differentiate between the two? And it says, I'm gonna read this to you, 'cause I tend to blab so sometimes it's good if I just read you what it says.


So with reference to social anxiety disorder, or social phobia, it says "agoraphobia should be differentiated from social anxiety disorder based primarily on the situational clusters that trigger the fear, anxiety or avoidance, and the cognitive ideation." So in social anxiety disorder the focus is on the fear of being negatively evaluated. If you remember when I've talked about this in other videos, social anxiety is when we fear what other people are thinking of us, what they might say to others about us, that we could be negatively evaluated by them. Agoraphobia is more about trying to get out, having a panic attack, being embarrassed about trying to leave. Now I see how these kind of go together, but you can also see how they're separated. The social anxiety is more about how we're perceived by others, where as agoraphobia is just the fear, like it says the fear or anxiety or avoidance because we worry about how we'll get out if we have a panic attack.


Or that it could be really embarrassing, because we might stumble, like try to get out really quickly. I hope that that makes it clear. If you need more clarification feel free to re-ask the question and I can blab some more. Okay. Question number two, "Hey Kati my therapist told me she'd like me to see a dietician." Uhh, she didn't! "Only I'm not sure I really need it." You never think you do. Sorry I'll stop with my commentary. "I do some eating disorder behaviors, but I still eat enough most days. And the behaviors are only there for a few days, and then I have other behaviors. Different behaviors that switch off and on. And I've only seen my therapist for two times now. And I've only really told her what went wrong. I don't want to waste peoples' time going to a dietician when I don't really need it." This got so much chatter on the website.


Holy schmollies, you guys really had opinions about this. So I thought, let's talk about it. Now seeing a dietician is good. It's something that we can all, all of us who have any kind of eating disorder behaviors. I know you're thinking but I don't really think I have an eating disorder. I only purge sometimes or I only restrict, but it comes off and on. I have a video from like I don't know … any of my OG's out there? It's like two years ago, my original FAQ video. I'm wearing like a teal sweater. It says FAQ on the thumbnail so just search. Well no you can't, because all of my videos would come up. But anyway it says FAQs. One of them is If You Think You Have an Eating Disorder You Probably Do.


Just let that wash over you for a second. Because I know it's hard, and we always think "But it's not that bad. I don't do it all the time. It comes and goes." Eating disorders are sneaky. They like come in, I feel like they're like ink in water, where all of a sudden the water is turned a whole different color. But we're like but it only just started this little. It's crazy. It can get in there, morph, change. As soon as you think you understand where it comes from and what it's doing, it's already changing to something else. And so even when we feel like "it's not bad enough to get more help" we still need to get more help. Because the sooner we get the help, the better. And seeing a dietician, whether we binge, whether we purge, whether we binge and purge, whether we restrict, whether we over exercise.


It doesn't matter. We're using any kind of eating disorder behavior, a dietician can really help. They're not going to make you get fat. They're not gonna make you eat too much food. That's part of their job. They're going to work with you to put together a plan, set goals with you, and they're going to check in with you. And they're going to challenge you, but it's all part of the process. Just like with the therapist, I'm not going to make you go all the way at once. Like we're gonna go through this, just, you know, get through all this shit and move on. That's not how it works. It's a process, and they're going to work with you. And I encourage all of you, when you're therapist says you know you should probably see a dietician, do it. They are really helpful. They are amazing. They will definitely help you manage those symptoms. They'll ask you the hard questions about food and what you think about food.


Because we know it's not about the food, but we're using food to cope. And so they will work on that spot with you so your therapist can help you better manage the emotional stuff. Together you get the best results, so don't think you have to be on death's doorstep to get help. Don't think that you have to be really thick in your eating disorder to get a dietitian to help you.


You can all benefit. If you're struggling with any eating disorder behavior please see a dietitian as well as a therapist. It gives you the best outcome. Promise. Okay. I love you all. I will see you, I'm not sure when I'll put out the journal topic video. You'll just have to subscribe, so you don't miss it. And then I will see you all on Monday. And some of you I'll see in New York. Yea! Okay, bye! Subtitles by the Amara.org community.



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What is Separation Anxiety? Fear of Abandonment?


hey everybody today we're going to talk about separation anxiety what is it and how can we overcome it but first are you new to my channel welcome make sure you are subscribed and have your notifications turn on because I release videos on Mondays and on Thursdays and I don't want you to miss out but let's get into this topic separation anxiety is actually a disorder that's found in the dsm-5 in previous DSM s this could only be diagnosed in children but recently they've realised that this can occur in adults as well and they have expanded the diagnostic criteria which is as follows number one developmentally inappropriate and excessive fear or anxiety concerning separation from those whom the individual is attached and as evidenced by at least three of the following okay so we have to have that and then we have to have at least three of the following criteria number one recurrent excessive distress when anticipating or experiencing separation from home or from a major attachment figure so we have to just get really upset if we have to be away from someone who really care about number two persistent and excessive worry about losing a major attachment figure or about possible harm to them such as illness injury disasters or death number three having persistent and excessive worry about experiencing a distressing event like getting kidnapped being in an accident etc and that distressing event will cause separation from a major attachment figure so again we just don't want to be separated from them it makes us really upset number four persistent reluctance or refusal to go out away from home go to school go to work or elsewhere for fear of separation you can see how this is all like I just don't want to be separated from them number five persistent and excessive fear of or reluctance about being alone or without a major attachment figure at home or in other settings number six persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure and number seven repeated nightmares involving the theme of separation number eight repeated complaints of physical symptoms include headaches or stomach aches when separation from a major attachment figure occurs or is anticipated now just to recap we need to have at least three of those eight that I just listed off and so just keep that in mind as I move through the next portions of the diagnosis and the next is the fear anxiety or avoidance is persistent lasting at least four weeks and children and adolescents and typically six months or more in adults and that's important when we're diagnosing we need to know how long this has to been going on because following a trauma maybe we might experience some of these symptoms but it typically wouldn't last for you know more than a month or more than six months and finally the disturbance has to cause clinically significant distress or impairment and make it hard for us to dysfunction in our life and it cannot be better explained by another mental disorder like autism spectrum disorder agoraphobia generalized anxiety disorder etc in truth separation anxiety is really a survival technique that kept us safe when we were a baby and if our caregiver leaves us will cry and become extremely distressed so that they come back and care for us because we need it because we can't survive on our own right but after the age of two most children know that even if their caregiver leaves they'll come back they may cry a bit at the beginning like if your first dropping your child off at daycare they can fuss a bit but they'll be easily soothed and go back to plane or whatever they were doing they can integrate easily without becoming completely overwhelmed and for that reason the key feature in diagnosing separation anxiety disorder is that the level of distress or anxiety that we experience is much greater than what is expected at that developmental stage I just want to pause for a minute so you can fully absorb that it doesn't always have to do with age necessarily it's all about developmental stage and what's expected for us and our response to our attachment figures at that stage children who struggle with this can cling to their attachment figures unable to be soothed by anyone else and even report feeling physically ill if they're separated from them adults with this disorder may be uncomfortable when traveling independently they can experience nightmares about separating from attachment figures or even the really concerned with their children or spouse and continuously check up on them about their whereabouts and how they're doing also I think it's important to note that separation anxiety disorder is often referred to as fear of abandonment in adults and as far as I can read and research about it these two terms were used to describe the same symptoms now my guess is that we have these two terms because they used to think separation anxiety only happened in children and so they had to come up with another term for the same symptoms in adults but that's just my hypothesis what do you think while we don't know the exact cause of separation anxiety we do know that children who have dealt with loss like death of a loved one or a pet change of schools divorce etc are at a higher risk for developing it we also know that overprotective or anxious parenting can lead children to developing separation anxiety disorder as well but other than that there needs to be a lot more research done because they're still looking into genetics and they're not completely sure which ones cause what but the good news is that there are treatment options to look into in number one for children slight changes and parenting techniques can really really help you can communicate that you have to leave telling them ahead of time so they have a little time to prepare and letting them know how long roughly you'll be gone and remind them a few times that you will be back and make sure you don't tease them or become upset about their anxiety just assure them that you will return and remain calm while you're speaking with them about it so that they don't think you're anxious to that can just make it worse really also don't leave during naps or try to sneak out I know a lot of parents try to do this because it just makes it easier you don't have to be there when they're really upset but not giving them the time to be part of the transition and given the opportunity to be soothed can make it even worse and it can make it last even longer you can also practice short separations like walking to the corner to drop some mail off and coming back or even just leaving the room for a bit only to reappear a few seconds later and this can really help young children understand that separation just because they don't see someone is temporary and there's nothing to be scared of because they will come back for adolescents or adults psychotherapy helps so so much talk therapy can help us uncover where this fear or anxiety comes from and what triggers it once we know what triggers it then we can try out our new techniques to self-soothe or distract when we need to since this can be caused by loss grief counseling or even trauma therapy like EMDR somatic experiencing attachment based therapies etc they can help a lot too and third medication like SSRIs SNRIs have been shown to help as well because if you remember this is an anxiety disorder an inter depressants are known to relieve anxious symptoms so please speak to your doctor if this is something that you're interested in I know doing hard work like this can be overwhelming and often upsetting but trust me if we find the right therapist to work with it can and will get better this video has been brought to you by the Kenyans on patreon if you would like to support the creation of these mental health videos click the link the description and check it out and please share this video too you never know who it could help and last did I leave anything out treatment options or symptoms that you wish I'd mentioned what's been your experience with this let us know in those comments down below and I will see you next time bye




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VA Disability Benefits for Anxiety


Good afternoon and welcome to CCK live. My name is Jenna Zellmer and joining me today are Alyse Galoski and Nick Briggs We all work on Veterans Benefits appeals here at CCK And today we're gonna be talking about anxiety. Now before we get into it I just wanted to remind you all that if you have any questions or comments during our conversation You can go ahead and leave them in the comment box below You will also be posting links to blogs and more information on our website at CCK-LAW.com So let's get into it. So Nick, why don't you start us off? We're gonna be talking about both service connection and increased rating for anxiety today Let's start with talking about service connection So Nick what are some common anxiety disorders that veterans can claim service connection for? Sure So one of the more common types that we see are generalized anxiety disorders But there are also other specific types of anxiety disorders like social anxiety, Panic disorders, and then specific phobias like agoraphobia.


Okay. And Alyse, what are some common symptoms that characterize these anxiety disorders? Sure So there's some of those like invisible symptoms like excessive worry or difficulty concentrating but then there's also symptoms that physically manifest so you can Feel jumpy or you might be dizzy, have difficulty sleeping have mental have muscle tension feel nauseous or even lightheaded. So these are all manifestations of an underlying anxiety condition and I think that it's really important. I think a lot of times veterans Think that they can only give service-connected for PTSD because I think that you know often PTSD is goes in hand-in-hand with a lot of experiences the veterans experience in service but Even though anxiety disorders are a little bit different if you go to your doctor, and they don't diagnose you with PTSD But they do diagnose you with any of these symptoms or any of the anxiety disorders that Nick mentioned And you can still claim service-connection for that specific condition. So What do veterans need in order to show service connection for this condition? So the first and most important thing that you want to be able to demonstrate is in service incurrence And that can take a number of different forms either the veterans specifically treats for and is diagnosed with an anxiety disorder in service They might just check that they were experiencing depression or excessive worry on their discharge Examination or there might have been some specific incident that they remember that caused their anxiety, and it's continued to persist since then You don't need to be diagnosed with anxiety.


Sure. Okay, you just have to have some sort of notation. Alyse, what else? What after an in-service occurrence, what else do you need? First thing that you need is a Nexus so, that's what's gonna Connect both your in service condition to what's going on with you now Typically that's gonna require some type of medical opinion because lay persons are not competent typically to make that connection so It's a medical opinion Usually that's gonna draw that nexus. And we have a Facebook live All about what you need to show all three elements of service connection, so we'll link that In our notes, and if you want more information just on general service connection. You can check us out there So Alyse you had mentioned that you need a nexus and that generally requires an examination or medical determination so, how do C&P exams which is what we also call them which stands for compensation and pension exam How do those work in relation to anxiety conditions? What would happen in a service connection for anxiety claim? Sure So typically with a C&P exam you're going to be meeting with a VA physician Who it's gonna be somebody that you've never met before most likely they will ask you about your experiences during service They'll also ask you about experiences that you have now.


They may also ask you about Any medical history any family medical history It's gonna be a lot of questions that are all gonna be what they're gonna use to Support an opinion on as to whether what's what you have now is related to service or not So it's gonna be a lot of those background questions family medical questions And they'll also ask you about what your current symptoms are. Mm-hmm And I think we also have a Facebook live all about C&P examinations Which has a lot of great information kind of explaining what's gonna happen in these exams and what you should and shouldn't you do. I think the biggest thing is you have to always show up for your examinations and then if you get an unfavorable opinion Nick, what are some remedies that the veteran can pursue? Sure Well oftentimes a veteran won't necessarily know that the opinion was negative until they get the next decision from VA denying their claim so first and foremost They need to make sure that they're requesting a copy of their VA examination which they're entitled to do And then once they have the exam they should go through it at length making sure to identify any specific problems that they noticed or things that they think Conflict with other evidence they've submitted before one of the things that VA examiner's are supposed to do is review the claims file and make sure that they're looking at Everything the veterans submitted including lay evidence and then considering all of those things in light of the examination itself Great.


Um, I think you know the one important thing that I heard you saying that is lay evidence So, you know, we've talked about medical evidence and why we need that usually for a nexus But can you talk a little bit about what other kind of evidence including lay evidence You might need to support a claim for anxiety? Sure lay evidence is often one of the things we go to most often if only because a lot of the time veterans don't feel comfortable seeking treatment for their condition during service or even afterward because it's something that you know, It's kind of stigmatized and people don't necessarily like to talk about it so it could be many years before they actually go get to the point where they feel they need to seek treatment and Lay evidence from the veteran him or herself and all their family members can help fill in some of those gaps But whenever possible it's also a good idea to submit treatment information from either your VA doctors or any private psychologists that you see.


So Let's kind of take a step back and talk about The Appeals Modernization Act. So we have a whole Facebook live on the AMA as we call it essentially back in February VA totally revamped their appeal system and so now There are several different Avenues that a veteran can pursue after they receive a unfavorable rating decision. So if A veteran, you know wants to file an appeal. What should they kind of know about the AMA? After they receive a rating decision from VA? Sure So the most important thing is that if their claim was previously denied and they're filing a supplemental claim Which is one of the new options under the appeals modernization system. They need to make sure that they're submitting new and relevant evidence That's meant to be a relatively relaxed evidentiary standard So it could be something as simple as providing a lay statement talking about how their symptoms are related to service Um, it could be submitting medical evidence establishing that they have a current diagnosis.


But whatever it is, it needs to be something that is relevant to their claim And then they can also pursue taking their case to the board with or without submitting additional evidence if they really do think That it's a situation where the regional office is just getting it wrong. But all of those options are still available to them They just need to be conscious of the 1-year time frames. Great. Yeah, I think You know, the AMA is a pretty new system and it's pretty complicated Although it is supposed to provide veterans with more choices, and it's supposed to clarify a lot of things I think it's still unclear kind of how it's going to work for veterans so we would really encourage you if you're seeking to initiate an appeal under the AMA to Consult your veteran service organization or an attorney. Someone who has some expertise in this area of law And as I mentioned, we'll link some more information to the AMA in the case notes or in the in the comments below so we're talking about service connection and we mentioned in-service incurrence a Nexus and a current, you know disability What if a veteran doesn't have an in-service occurrence can the veteran get service connection another way Alyse? Yes.


So an alternative way to get service connection is called secondary service connection This happens when you have an already service-connected disability, that is either causing or aggravating Your anxiety or a second condition So say that you have just for example you have a knee condition and your knee condition causes you a lot of pain and It makes you anxious to to get out of bed. It makes you anxious to walk down the street or to walk to work You could potentially show that you have secondary service connection for your anxiety because your knee conditions already service-connected whether it's either causing or Aggravating an already, you know existing anxiety condition Yeah, I think that anxiety is something that a lot of veterans probably have secondary to their service connected disabilities, especially physical disabilities I think In your example for example If the veteran had a lot of instability in their knee and they were never sure whether or not they were gonna fall You know I can imagine that causing a lot of anxiety And so just the same way that you would need a nexus opinion for direct service connection You would still want to get a doctor to make an opinion about whether or not that knee causes or aggravates anxiety.


Really good So let's assume that a veteran has received service connection, you know, they've met that first threshold Either secondary or direct. Let's talk about how VA rates anxiety. So Let's take a step back a little bit and talk about kind of how VA rates things in general and I think that we do Have some information on that in our past Facebook lives Alyse you want to talk a little bit about what Diagnostic codes are? And what the diagnostic code for anxiety is? Sure So if you think about the diagnostic code the best way think of it is it's this rubric Where they where the VA has established certain Disabilities and under those disabilities are certain rubrics.


If you meet certain criteria under the rubric then you're granted You should be granted or certain rating specifically anxiety is rated under the general formula for medical or mental rather disorders So that's gonna also include other Mental disorders which could be schizophrenia. It could also be PTSD the very many different types of anxiety there are and probably any other type of Mental condition that you can think of are all rated under the same Diagnostic code that's going to be diagnostic 4.130 That diagnostic code goes up to 100% It starts at a non-compensable rating of 0% And it lists specific symptoms and overall functional impairment that you would have to meet to Get a specific rating So Nick, Alyse mentioned that kind of several different Psychiatric conditions are all rated under this one general formula. So what Happens if the veteran has for example, both anxiety and PTSD or anxiety and depression? Does that affect your rating at all? Sure, so like Alyse mentioned, you know, even though individual psychiatric conditions do have their own diagnostic codes they're all rated under this general formula and Because of that and because they're all rated based off of the same criteria of factoring it in the same symptoms You're not going to receive separate ratings for each individual mental health condition.


They're going to figure out which symptoms are imposed by each of those conditions and then give you one overall rating using the general formula. Good and I think it's important to kind of keep that in mind when you're looking at your rating code sheet, you know, every rating decision comes with the code sheet that lists out all of your disabilities and over the course of your life and your different appeals your rating for your psych condition can change and the Characterization of your psych condition can change based on what VA determines– kind of what the diagnosis you have so for example you know veterans who were service-connected a long time ago for psychiatric conditions might be originally rated under something called like a nervous condition and then as you know medical information has kind of evolved that could get re-characterized as PTSD or anxiety and then sometimes You know a veteran could be service connected for one thing and then later on claim service connection for another psychiatric condition As Nick said you're not gonna get a separate rating for that second condition But they might recharacterize what it's called on your code sheet and so that's important to keep in mind and just to make sure that you know, if There are symptoms that weren't originally Compensated under your original characterization, but you feel are now Encompassed in that in that characterization you might want to make a claim for an increase rating.


So, you know Alyse you mentioned the different possible rating levels and you mentioned that The diagnostic code and the rating formula provides different symptoms and different criteria that you need to meet in order to get to a higher rating so Do veterans have to meet every single criteria in that rating in order to get to the higher rating? No. So technically you don't even have to meet a single one of the criteria What you have to do is show that your functional loss is similar and what's called severity frequency and duration To the type of symptoms and functional loss listed in this diagnostic code.


So if you receive a board decision that says, "The veteran is not entitled to a higher rating because he does because although he has certain symptoms in the seventy Criteria, he does not have them all that would be error" You don't have to meet all of their criteria What you have to do is show that your functional loss is overall similar in severity duration and frequency To these types of symptoms that they're listing it's a list.



It's a non exhaustive list and it's really just supposed to be examples And there are two cases that kind of go to that point about this, Claudio and Mauer. Yes, so For those of you who kind of want to take a little deeper into the case law The court has made clear that these symptoms are not required. So Nick what happens if a veteran's condition is so severe that they actually have to get hospitalized? Sure so periods of Hospitalization are considered to be totally disabling So in a situation where a veteran's hospitalized due to their mental health disability for more than 21 days They're entitled to a 100% rating for the period of the hospitalization But if the veteran is hospitalized for an extended stay of more than six months They're not only assigned the 100% rating for the entire length of the hospitalization But as well as six additional months after the date of their discharge I think that makes sense.


If you think about how VA rates disabilities and that the ratings are supposed to be based on Impairment in earning capacity. So obviously if a veteran is hospitalized they can't be working and so, you know It's really important if you do get hospitalized you want to make sure that you Tell VA and make sure the VA is appropriately compensating you so that's really important to keep that in mind and then you know I think that a lot of times when the veterans are going to seek treatment or they're seeking a VA examination They get something called GAF scores GAF So Alyse, do you want to talk about a little bit about GAF scores and whether or not they're even still relevant or what? What's going on with GAFscores? Sure so a GAF score is a somewhat or outdated way that Practitioners used to measure how severe a person's psychiatric disorder was it is from a previous version of the DSM a VA has since come out with a court decision called golden which says that those GAF scores are No longer in the dsm-5 and therefore they're they're outdated and they shouldn't be used by the board So in some circumstances, you might still see them mentioned your board decisions But the board really shouldn't be relying on them to deny you a higher rating Yeah, and if you see the board talk about gaps scores in relation to what rating you should be receiving That should be a red flag and and you can talk to you know An attorney or a VSO about potentially appealing that decision to the board Or to the court, excuse me, And Alyse mentioned the DSM.


So the DSM stands for Diagnostic Statistical Manual it's the manual that all Mental health professionals use in diagnosing mental health conditions. So we have a question from Stephen can you explain the difference between occupational and social impairment with reduced reliability and productivity and occupational and social impairment with deficiencies in most areas So these are the criteria for the 50 and the 70% ratings and this is actually an excellent question so. I'm smiling stephen Because it is a very good question and it's one that the board has not yet answered for us Yeah the court or the court, rather.


So They haven't provided exact definitions of what those things mean But if you look to the diagnostic code, you can try and get a sense of what types of symptoms fall under each of those But unfortunately they don't have like, a You know a straight answer for you because the court and the board– VA have not defined it further than what we already see In the code, you can look at some of the symptoms for example in the 50% What is contemplated by occupational and social impairment with reduced reliability and productivity include flattened effect Panic attacks more than once a week impaired judgment impaired abstract thinking difficulty in establishing and maintaining social Relationships in the step higher you're seeing it involve more areas of your life Other than just the occupation and some of your relationships.


You're also seeing suicidal ideation obsessive rituals Near-continuous panic rather than panic attacks once a week. You're seeing an inability to establish and maintain Effective relationships now what we were saying before you do not need to show all of these symptoms It's just meant to be a list of examples to give you an idea of what that level of functional loss is. Precisely Become the different ratings are so vague. Right. What is the difference between reduce reduced reliability and Deficiencies in most areas? And so you use the symptoms in order to kind of parse that out but as Alyse said, you know, the court hasn't really given us a lot of guidance on this and that results in a lot of wildly, inconsistent board decisions And that's –sorry Nope, go ahead. That's what makes the board's Requirement to provide adequate reasons and bases so important because they don't have a strict definition of what these things mean They're really supposed to be properly explaining to you As the veteran why you're not entitled to a higher rating With what we call adequate reasons and basis.


Yeah and it's especially important in the Context of anxiety disorders because often times it's the type of mental health illness that might only really manifest itself in two or three specific Symptoms where it's the overwhelming anxiety and frequent panic attacks that are causing you to be unable to function in these areas But because VA tends to rely on the number of symptoms that you have rather than how severe they are It can get complicated especially when they're not really Defining the concepts that they're using. Right, sure that goes back to what Alyse was saying about It's really focusing on the frequency severity and duration of these symptoms And so if you see VA kind of using this rating criteria as a checklist that should you know You know raise a red flag that it's probably not a very good decision and that you could potentially appeal it yeah, I think that's a really good point Nick, especially because we are talking about anxiety, which is not a condition that Typically actually manifests itself into a lot of the symptoms that you see in the highest 100% rating like hallucination But if you for example have such severe agoraphobia that you can't leave your house or can't leave your room Then you might have total occupational social impairment.


So even though a Agoraphobia isn't a symptom listed under the 100% the overall functional loss might be enough to get you there. Mm-hmm so it's a really great question and I think it's just it really highlights why this area of law is so Unclear and why it's important to You know consult with your VSO or consult with an attorney because they can kind of navigate this and figure out what the best solution or argument to make in your case is. Great so We talked about GAF scores And the DSM, so I think the next thing that we want to talk about is what happens if a mental health condition Overlaps a non psychiatric condition Nick. Do you want to talk about that? I mean It's a concept we talk about a lot called pyramiding and I think we have our own Facebook live sessions on that topic So, please refer to that if you have any more detailed questions but the basic idea is that VA is only going to compensate each symptom that a veteran experiences once so if the veteran Experiences or suffers from an orthopedic disability that causes sleep impairment and then a psychiatric disability that causes sleep impairment They're gonna generally rate that symptom under one of those diagnostic codes one of those conditions and then not rate it under the other one just to make sure that they're not overcompensating the veteran for the symptom.


Then I think that the kind of reverse of that is what Alyse was mentioning earlier as if your psychiatric condition results in non psychiatric symptoms then you can potentially get It's like the opposite of pyramiding it's when pyramiding isn't a problem is when there are distinct manifestations of Your condition and you can get separate ratings for that. So, um, we talked a little bit about this in terms of total occupational and social impairment But what happens if a veteran's anxiety prevents them from working? Sure, so there is an avenue to receive a 100% rating called tdiu this is what you may be entitled for if your Disabilities could be your anxiety alone or your anxiety combined with all of your other service-connected disabilities prevent you from obtaining securing what's called substantial gainful employment So this is actually a lower standard than total occupational impairment substantially gainful employment is another one of those terms that we're working on having, you know, getting a really good definition for But basically it is something that is more than just a marginal employment something that is more than what we call protected work environment and If somebody if somebody's anxiety or somebody's anxiety combined with their other disabilities prevent them from really obtaining Secure employment then they might be entitled to to TDIU we have Absolutely have a lot of information on their website about tdiu.


That is a very large area of veterans law But it so if you have any questions about that Absolutely advise you to look at our website as well as well our other– I'm sure there's a Facebook you're live on that as well. Definitely So what other kinds of evidence? Should veterans be kind of collecting and submitting in order to support their increased rating claims, Nick? we've mentioned it a few times in the context of service connection, but it applies equally well to Increased ratings and that's lay evidence Obviously the veteran will only see their treating provider or a VA doctor every so often There are going to be months or even years where they don't seek treatment But the people who know them who live with them who experience their symptoms on the day to day basis are often in the best Position to provide a description of you know, what those symptoms are and how they affect them I'm so getting statements from yourself getting statements from family members can go a long way And I think you know one of the most common mistakes I see in that situation is at the board or VA Provides or assigned more value to those treatment records as opposed to the lay statements and as Nick said I think it's really important to kind of highlight that they are both equally valuable and that they are probably complementary in most situations so even though a veteran You know might go to treatment and might not be super-severe on that one day he goes to treatment if he has all these lay statements filling in the gaps between treatment you can kind of get a bigger picture so That's kind of one of the more common mistakes that I see VA making Just to kind of wrap things up Do you guys have any other? thoughts on common mistakes VA makes in adjudicating anxiety claims or things that you think letter and should remember when they're making these claims? One thing actually it's along the lines of lay statements if you are submitting lay statements and this is kind of a new one Make sure that what you're submitting is legible because you'll want to make it easy for VA to agree with you So if they can't really read your handwriting then it's very difficult for them to understand what symptoms or what your story is.


So I just suggest whether you're typing it or in very neat handwriting lay statements should be Legible easy to understand make it easy for them to want to give you an increased rating. That's really good advice It's better for us too Another common example we see in the case of service connection is VA improperly requiring a verified stressor Which is something that's only really in place for post-traumatic stress disorder So most veterans are probably most familiar with PTSD.


So that tends to be the condition that they claim But VA is supposed to construe that Claim broadly and liberally so the veteran might end up being diagnosed with a different mental health disability But because they claimed PTSD initially VA will often get stuck on trying to adjudicate the claim at way But at the end of the day like we talked about before it's really just all about establishing Anxiety in service or reports of anxiety and then symptoms afterward. That's really good Great. Um Thank you for joining us today.


We will be back next week and we hope that you check out all the information we provided.



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Depressive and Bipolar Disorders: Crash Course Psychology #30


American psychologist and professor of psychiatry, Kay Redfield Jameson, It is one of the most important references for bipolar disorder in the world. She has spent her career researching and teaching this disease and writing groundbreaking books about it. It is a disease that she personally suffered throughout her adulthood. In her diary, "Restless Mind," Jameson described bipolar disorder in detail. She wrote about not sleeping for days on end, and about feeling high for long periods of time And filling it in notebooks full of successive and great ideas. And while she was going through these obsessive states, she felt a very inflated significance for herself. He committed reckless acts that made her happy at the time, but which led to dire consequences, Like uncontrollable shopping or indulging in promiscuous behavior Or accumulating credit card debt and consuming all of the money in her accounts. But these episodes were followed by a severe depression, including severe depressive episodes Makes her think of suicide. At 28 years old, Jameson committed suicide By taking an overdose of lithium, she fell into a coma, but thankfully she regained consciousness Then she decided to search for a solution in medication and psychotherapy.


With her research and writing, Dr. Jameson has paved the way for our understanding For bipolar disorder, depression, and interconnected mental disorders What we today call mood disorders. And you may be one of the best ambassadors and representatives of the people Who lead a successful and fruitful life despite their mental illnesses. Like the anxiety disorders we talked about earlier, mood disorders are damaged by misconceptions. And it is underrated by portraying depression as something that can be cured A day at a resort, or people stigmatized with bipolar disorder Just because they were sad yesterday and not back today. As psychologists, it is our job to understand mood disorders for what they are. And find out how it appeared and possible causes. As you probably guessed, this is not an easy task. These disturbances knock people down from steep heights to dark slopes That seems to have no end.


But, in between this and that, there is what Jameson has called "a rich and imaginative life." Moods create them. Many of the concepts mentioned have different meanings Than we thought, but the term "temperament" is not one of them. Psychology defines mood as we define it: More personal emotional states and harder definition than the emotions themselves. Psychology defines roughly 10 basic emotions, moods They fall into two broad categories with endless possibilities: good moods and bad moods. Perhaps the most obvious difference between mood and emotion Mood is a long-lasting emotional state, while emotion is a rapid transit. The mood disorders characterized by the intensity of emotions Difficulty controlling mood is a longer-lasting disorder. Such as depressive disorders represented by prolonged periods of hopelessness and lethargy. And bipolar disorder, the most famous of which is a disorder in which a person switches between mania and depression.


Depression is sometimes called a "mental illness" because it is common, and that does not mean It is not a serious disease, but it is common, pervasive, and the main cause People search for psychological care. Depression is a feeling we all have experienced, and it often follows a loss, such as separation from a partner Or the loss of work or the death of someone dear to us.


In fact, the feeling of depression is the natural feeling in these situations, and it may be Useful for the mind and body to calm down and absorb the loss that we have experienced, But unhappiness is generally temporary. However, when sadness and grief extend beyond what is socially acceptable, Or reach a level that causes real dysfunction, We have entered the world of depressive disorders. Diagnostic and statistical manual of mental illness, which is useful even if it is full of deficiencies, It states that individuals are diagnosed with a depressive disorder only when they have passed Five signs of depression in less than two weeks. These symptoms, apart from a depressed mood, include significant loss or significant increase Appetite or weight, lack of or excessive sleep, loss of interest in activities, Feeling worthless, tired or lethargic, difficulty concentrating or making decisions, And repeated thoughts of death or suicide.


And since everyone feels miserable sometimes, depression is both a physiological and psychological illness. It disrupts sleep, appetite, energy, and neurotransmitter levels And hinder the organization of the body for itself. To be consistent with our definition of mental illness, and to be considered a true disorder, This behavior should cause prolonged distress for the person or those around him That is, the feeling of having something real. For example, people with severe generalized anxiety disorder refuse Leaving the home, people with clinical depression often feel very hopeless To the point where they are unable to lead a normal life. And unlike bipolar disorder, Depressive disorders mean a persistent depressed mood.


You may have heard of manic depression, the old name for bipolar disorder. This disease leads to severe depressive episodes, followed by adverse episodes as well From extreme obsession if the situation worsened. People with bipolar disorder have mood swings Between normal, depression and mania in a day, week, or month. A manic episode doesn't just mean feeling happy or energized, it is a period From extreme, raging, overheating activity that is usually positive, with your self-esteem Your capabilities and ideas are disturbed. Very real dysfunctional. In some people with the disorder, manic episodes are rare but devastating. Kay Jameson has testified to this. Once, during a manic episode, she bought all her snake bite resistance kit in the pharmacy, This is because she was convinced that only rattlesnakes would launch an attack. On another shift, she bought 20 books for the Penguin publishing house, and the reason, she says, is: "It would be nice for penguins to form a colony." In other words, people's judgment of things gets hurt, and it can get worse. Severe manic episodes may lead a person to enter a mental hospital, because it is so dangerous On himself and others it may become severe.



After these manic episodes end, it usually follows Dark bouts of depression. If the injured are not treated, suicide or attempted suicide is common. This is another aspect of the disorder that Jameson attests. The cause of mood disorders, like many other things in psychology, A mixture of biological, genetic, psychological and environmental factors. We know, for example, that mood disorders It is passed on through generations, so genes are important. It also increases your risk of developing bipolar disorder Or a depressive disorder if your family or siblings suffer from it.


Identical twin studies have shown that one of the twins has bipolar disorder Leads to a 7 in 10 chance of infecting another. Even if they were not raised together. Life's stress cannot lead to bipolar disorder But it can trigger a seizure in a person Have it or trigger a major depressive episode In someone who has never had depression before. in other word, The misery of someone who has lost a loved one can turn into depression or have a bipolar seizure. But that event will not be the primary cause of the disruption. For most people with depressive disorders, after weeks, months, or years, Their depression may subside, and they may return to life as normal human beings.


More women than men are diagnosed with depression worldwide. But many psychologists attribute this to the fact that women seek help more. Another possible reason for this is that depression in men usually manifests itself in a form Anger and violence rather than misery and hopelessness. This is one example of how depression is more than just sadness Lack of purpose and recognized despair may manifest itself in different ways. If we look at mood disorders from a neurological angle, we find depressed and obsessive brains They show very different activities on neuroscopy images compared to normal brains.


The depressed brain, as you'd expect, gets slower. As for the obsessed brain, it shows excessive activity. This makes it difficult to concentrate, calm down, or sleep. The chemistry of the brain's neurotransmitters also changes with the state. We find norepinephrine, which increases agitation and concentration Too little in depressed brains, and too much during manic episodes. In fact, alleviating drugs for mania They work by reducing levels of norepinephrine. You may have also heard that your serotonin levels are low Linked to depressive states. Aerobic exercise, such as running, dancing, or anything else Serotonin levels increase, which is why exercise is recommended To combat depression. Most anti-depressants also work By increasing serotonin or norepinephrine. There is, of course, another way of looking at the topic, the social perceptual angle You look at the relationship of our thinking and behavior to depression. People with depression often view bad events with a mind or eye Affect their interpretation of it, and our interpretation of events Negative or positive is what influences whether or not we skip it.


Let's say you were exposed to an embarrassing situation in the cafeteria, where someone hindered you and broke the soup It was all over, and then you sat on a chocolate cake … in short, it was a bad day. The depressed brain would immediately think that the insult would haunt it forever And that no one will forget it, and that you may have brought it upon yourselves, You are not doing anything well. It is this negative thinking, educated despair, self-blame and overthinking More of the same could kill the happiness of the brain And it creates a vicious circle that reverts to confirming the original negative view. Fortunately, this episode can be done with the help of a professional Or directing the attention to something outside and the practice of enjoyable activities And maybe move to a better environment. But this sociocognitive angle is part of the complex puzzle. Positive thinking is important, but it alone is not enough To counteract neurological or genetic factors. So, mood disorders are complex conditions and rarely go away with one treatment. And you often have to live with it. As Dr. Jameson has proven, Success with her is possible.


Today we talked about mood disturbances between fact and fiction. You also learned about the symptoms of depressive disorders and bipolar disorders As well as biological, genetic and environmental causes Potential social and cognitive mood disorders. Thank you for watching this episode sponsored by Marshall Scott and crediblefind.com And thanks to all of those who support us. To find out how you can support us, visit suppable.com/crashcourse. This episode was written by Kathleen Yale and edited by Blake De Pastino. Counsel was provided by Dr. Ranjit Bagwat. Director and Editor is Nicholas Jenkins. Michael Aranda is the script Supervisor and Sound Designer. The graphics are designed by Thought Café.



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What Causes Panic Attacks? (The Ultimate Cause)

  Hannah asks “What causes my panic attacks and how can I make them stop? I wouldn’t wish them on my worst enemy” Hi, I’m Michael Norman and welcome to another episode of “Panic Free TV” Q&A. This is where as a scientist and anxiety specialist, I answer your most pressing questions relating to panic attacks — so that we can help you finally get back to normal, panic-free life again. Now, Hannah’s question is a very important question, because while panic attacks are one of the most terrifying experiences anyone could EVER go through… what can make them even scarier is not knowing what’s causing them, why we’re getting them, or what we need to do to make them stop. That’s why in this episode, I’m going to share with you a simple, counterintuitive insight — one that I’ve never seen talked about before, outside scientific circles — that explains the ULTIMATE cause of panic attacks.   This insight is essential for you to know about, because it gives us an accurate foundation from which we can help you finally end your panic attacks for good. Now before we get to this insight, though, I want to be clear: there are several ways I could answer Hannah’s question: I could explain the various types of life experiences that often precede the first panic attack… I could explain the hidden universal triggers that “cause” every “out of the blue” panic attack…I could explain why certain situations or places might give you panic attacks, while others don’t…Or I could explain the biology behind panic attacks… and how anxiety alone can “cause” all of the physical sensations and experiences that a panic attack can create. Each of these are important topics where a little understanding can bring a lot of reassurance and comfort, all by itself.   Since I can’t cover everything in this short video though… and since I’ve comprehensively covered so much of this already inside my free “Panic Free TV” Foundation Series… if you want the full answers right now, please watch that series. All you need to do is click the link on the screen or in the description below, register your details, and you’ll get immediate access. Again, it’s all completely free, and I think you’ll agree after you’ve started watching it… that it makes a very real, very important difference in your life. So what’s the ULTIMATE cause of panic attacks? Well to explain it, I’m going to share a clip with you from my free “Panic Free TV” Foundation Series. It’s just a few minutes long, and after you’ve watched finished watching it… I’ll come back and add a few more essential insights, because I really want to make sure that you understand this fully.   The most scientifically backed explanation for why so many of us have had panic attacks… is what Professor Randolph Nesse from Arizona State University has called… The Smoke Detector Principle. And the best way to explain it, is for us to do a quick, simple thought-experiment… Which of these two smoke alarms would you prefer to have protecting you in your home? Would you prefer to have smoke alarm that sometimes FAILS to go off, and stays silent… even though there’s a deadly fire in your house? Or… would you prefer to have a smoke alarm that never misses a real fire… but occasionally goes off when you burn the toast, even though there is no danger, and everything is actually fine? Now of course, we’d all prefer to have a perfect smoke alarm system, that never makes any mistakes — but the reality is, we live in complex and often ambiguous world.   And so if you had to choose between one of these two options, what would you chose? An under-sensitive smoke alarm that could miss a real fire and kill you? Or an over-sensitive smoke alarm that occasionally has unpleasant, noisy false alarms… but never misses a real fire, and always keeps you safe? It’s a simple answer, isn’t it. When it comes to our survival… to our LIFE… it’s better to have an alarm system that errs on the side of safety… even if that means, we sometimes get false alarms.   So what does this have to do with panic? Well, panic attacks are nothing more than “false alarms” of our over-protective, life-saving fear systems. And while it probably hasn’t felt that way for you in the past… the truth is that a panic attack is “JUST” a terrifying, overwhelming, over-protective MISTAKE. It’s a mistake, that ironically… is motivated by your brain’s #1 priority in life — to keep you safe. Panic attacks are our brain and body, following the same “better safe than sorry” philosophy… that every good smoke detector system uses. And it’s far healthier… in fact it’s optimal in an often uncertain world … to have a fear system that is biased to be over-sensitive and to occasionally give us false alarms…..   Than it is to have an under-sensitive system, that could miss real danger, that could kill us. So a panic attack is JUST an over-protective mistake. The only real problem, and it’s a big one… is that it’s a terrifying mistake. It’s a mistake that can leave us feeling exposed, vulnerable… and unsafe. Even though no one dies from a panic attack… and even though panic could never ever make anyone truly go crazy… the false alarm of a panic attack often creates a very powerful ILLUSION, that these things could happen. And that’s why I really believe… that you are….. So the ultimate cause of panic attacks is that we all have brains that are biased to take a better safe than sorry approach. This is a very important, healthy bias to have — because if we didn’t all have this bias, we literally wouldn’t be alive as a species. The downside though, is that again, like every good smoke detector system… sometimes mistakes happen and we get false alarms. And while it might still be a little hard to believe right now… again, a panic attack is just an innocent, very well-intended, OVER-PROTECTIVE mistake.   It’s a mistaken effort to protect you… from a danger that’s not there. So why do some people get panic false alarms, while others don’t? And why have you experienced so many false alarms? Well this is where other factors come into play — and I cover these factors and a lot more… inside my free “Panic Free TV” foundation series. In this series I help take away the mystery and confusion surrounding what you’ve been going through. I explain how panic and anxiety really work… and I give you the foundations you need, to start you on your journey back to a normal, panic free life. Again… my foundation series is totally free, and you can watch the first episode in full, right now… just by clicking on the link on the screen or in the description below, and registering your details. I hope this video has been valuable to you. I’m Michael Norman, and thank you so much for watching.. As found on YouTube Discover the First-To-Market Revolutionary SPR “Static” Conversion Tech Which Dramatically Speeds Up & Secures Existing WordPress Sites & Cloud Affiliate Pages With Just A Few Clicks

5 PANIC ATTACK MYTHS | Kati Morton


Hey everybody! Today we're gonna be talking about the five myths of panic attacks. So let's get into them. *intro music* Now the first myth is that they're caused by stress and anxiety. If you yourself have ever suffered with a panic attack you know that they come out of nowhere we don't even know what necessarily triggers us, something may not even trigger us. It's not necessarily something that environmental or something that's occurring right now. Panic attacks honestly happen because our system gets overwhelmed and overloaded and sends us into a fight or flight response, AKA, a panic! I also don't like this myth because it implies that we have control over it like we can stop our panic attacks if we just change our environment and the truth is the panic attacks will happen in a wide variety of places for a wide variety of reasons those of which we aren't even privy too.


We don't even know why they happen. And the second myth is that they're going to make us go crazy. Panic attacks, if they happen for too long we're just gonna go insane. I've heard a lot of my clients say this, that it feels like they're losing their mind and they wonder if it can cause other mental illnesses to occur and the truth is the panic attacks usually happen because we have some underlying mental illness, whether it be another anxiety disorder or depressive disorder, any kind of mood disorder can be a lot of different components that can lead us to having panic attacks and being more predisposed for panic.


The truth is that panic attacks in no way affect the functioning of our brain as a whole in the hormones, like dopamine, norepinephrine or any kind of neurotransmitter that could cause another mental illness or psychosis or quote, unquote, make us go crazy. The third myth about panic attacks is that having a severe one is going to cause us to go into cardiac arrest. I've heard from a lot of my clients that because a racing heart is one of the symptoms that they experience most with panic attacks, or even the build-up to a panic attack, they'll start feeling their heart race and they worry that if they're in a really extreme or intense panic attack for a sustained period of time, let's say for an hour, that they're going to go into cardiac arrest and this is going to be how they're going to die and it sends them into panic even more quickly and keeps them there longer.


But the truth is and this is something important to kind of note and to tell yourself, maybe when you're, you feel those symptoms happening is that our heart is extremely strong it can beat at over 200 beats per minute for days, if not weeks especially if we're young, it can be four weeks at that rate without sustaining any damage. I just want to take a second to let that sink in. We can essentially be in panic for a really really long period of time without our heart ever being hurt or even potentially considering it going into cardiac arrest or having any kind of malfunction.


Therefore on average, panic attacks last from three to ten minutes so a three to ten minute panic attack is not in any way going to harm your heart or cause a heart attack. The fourth myth is that they're used as a way to get out of something we just don't want to do. Uh, if we hear that one more time. Am I right? For those of you who don't understand what a panic attack is or what can cause a panic attack, like I stated earlier, they come out of nowhere. They are not triggered by our environment, it's not due to an over reaction by up if usually a result of another underlying mental illness and these feel like they come out of nowhere, happen quickly and can stay and they're extremely uncomfortable, so if you found yourself having these attacks anytime you went into the grocery store, then you would start to not want to go to the grocery store or whenever you're in a crowded place, like I've had a lot of clients are like, "If I'm ever in a busy thing like a club or a concert or even like a really busy day at the mall," they've had panic attacks, we don't really know why but they're then attaching busyness and a lot of people with panic attacks therefore if someone's going to call you, if a friends going to ask you to go out to a party, and you think it's going to be a small group you're like sure, then later you find out there's going to be like 50 people there, you're like I'm gonna have to say no.



But we need to understand that panic attacks and panic disorder is a real diagnosable mental illness and because we don't know what triggers them and they come out of nowhere we fear the next one may be just around the corner. So of course we're going to limit the amount of things that we do until we can get them more under control. And the fifth and final myth about panic attacks is that there is nothing that we can do to treat them. Meeh. That's wrong, there are a lot of things we can do to treat them. Yay! Number one, and something that I've been reading because if any of you follow me or have been on the live streams or follow me on snapchat or Instagram, I have been working very hard at your anxiety workbook and I'm super excited for it to come out, but the thing that I learned through all the research I've been doing, is that progressive relaxation, you know like clench your feet, relax your feet, clench your calves, relax your calves, that type of exercise, doing that 20 to 30 minutes a day can calm our system down to such an amount that those who struggle with panic disorder may rarely, if never again, if they continue to do the progressive relaxation each day, they may never have the symptoms again.


They're still doing more studies on it but progressive relaxation is, surprising to me, but it's so amazing and been so helpful and beneficial. And the other is that CBT, so cognitive behavioral therapy, is also helpful with panic disorder and those of us who struggle with panic attacks because a lot of times we build up the panic and our system's fight-or-flight response by worrying about all of those things like it's going to cause a heart attack, I'm going to be super embarrassed, I'm going to go crazy, I may fall over or faint, all those worries and kind of falsely held beliefs that we have, CBT can really help us challenge those.


Also medications have been shown to be extremely beneficial SSRIs, SNRIs, and benzodiazepine have been shown to be extremely helpful for those of us who struggle with panic disorder and I know that not all of you are interested in taking medication this is another option that's available and if you're out there and you're struggling with panic attacks and you feel like they're happening with more frequency, it's controlling the way you live your life please reach out, please talk to someone. There are different professionals and a ton of help available, we just have to ask for it and we just have to reach out and I know it's scary to do the first reach out, but know that we're used to managing it we can handle it. We are kind, calm, wonderful people and maybe bring an extra supportive person with you to that first appointment or maybe they make the call and set up the appointment for you.


Find ways, use your resources to get the support and help that you need. Please share this video, I think a lot of people talk poorly about panic attacks or don't understand and I also put some in here, if you didn't notice for those of us who struggle and the myths that we tell ourselves about panic attack because I think both are really important to note, and leave in the comments what are some myths that you've heard. What is the way that you talk back to that, so that we have as a community are raising the stigma associated with mental health. I love you all and I will see you next time. Bye!.



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