Tag: anxiety

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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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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Guided Meditation for Stress Relief | My Peace of Mindfulness


Guided Meditation for Stress Relief | My Peace of Mindfulness welcome to this relaxing session that guides you out of anxiety and into the Sea of Tranquility sometimes our anxious thoughts can carry us away to feeling emotions that are not desirable these feelings can end up keeping us awake for hours on end when we are laying down to rest this is because we tend to fight them wanting nothing more than to not feel anxious rather than honoring them so let's begin by getting into a comfortable position on your back ensuring you will not be distracted for the duration of this session this time is for you you have nowhere else to be right now and no one needs you gaze in front of you and allow your eyes to find a spot to fixate on and do not look away in a moment as I count down from ten you will slowly blink your eyes with each number I say when I reach zero allow your eyes to close and remain that way for the rest of the recording ten blink your eyes nine blink eight seven six five four three two one and zero lay your eyes closed feel a gentle wave of relaxation sweep over your entire body good now allow your focus to become centered on your breath when you think about your breathing you usually take a big deep breath in filling your body with oxygen as you take another full breath in notice how your body expands when you exhale pay close attention to how your body contracts on the next breath in imagine that the oxygen is filled with a calming effect and as you exhale feel tension in the body relax and melt away inhale serenity exhale any stress now bring your hands up to the very center of your chest and lay them on top of one another breathe in slowly and deeply and strain your spine making your head aligned with your body when you exhale imagine there is a special point of contact the size of a golf ball in the very middle of your chest slowly apply some pressure to the center point of your chest if you notice any worrisome thoughts pop into your mind be aware of them and acknowledge them then take a nice full breath in focusing on how breathing deeply feels notice how the stress is intertwined with the tension and connected to restricted breathing breathing in now feeling your body expanding breathe out applying this comforting pressure feel the worries rise and then drift away breathe in and say I acknowledge that I feel anxious it's just a passing moment the more I try to hide my stress the more it causes tension lay your breath flow naturally now and just watch it what does your breath want to do and how is it behaving if you notice your breath becomes stagnant or restricted inhale very slowly and fully and say to yourself I let this go as you exhale nice now one more big deep breath in let go of the pressure but keep your hands here on your chest imagine that you are breathing in the power of relaxation and exhale feeling this heart point which naturally releases anxiety from deep within you repeat this one more time keeping your spine aligned inhale lifeforce exhale and release wonderful let your hands fall back down by your sides and become aware of your hands can you feel a gentle tingling sensation or a slight warmth beginning to grow in your hands noticing these sensations relaxes you making you feel cozy and safe can you allow this relaxing warmth to increase feel the tingling sensation grow and expand Oh now notice how those same sensations are in your feet let the warmth grow and expand do you have any anxieties right now I bet not you are so focused on this beautiful sensation that your mind cannot worry or stress you I'm going to count down once more but this time I want you to imagine that you are walking down a beautiful flight of stairs these are the stairs of relaxation with each number I say you become more and more relaxed with each step you take ten stepping off the first step feeling that lovely wave of relaxation 9 allowing your level of relaxation to double 8 feeling safe and secure 7 comfortable and cozy 6 you have nowhere to be right now except your bed five more and more deeply relaxed for each step feels like a long relaxing bath three each step takes you further in to tranquility two one and zero you are more relaxed than you have ever been how you feel right now is your natural resting state that you should always return to automatically if you find yourself being carried away by the worries of life remember to acknowledge your true feelings and then breathe deeply into the anxieties melting them away the pressure point on your chest is referred to as CV 17 in acupuncture but also called The Sea of Tranquility it got this name simply because of how much bliss a person can experience after having this release in their body and mind so the next time you find yourself anxious or stressed remember point CV 17 the Sea of Tranquility is always there for you to place your hands upon good you have probably heard the phrase life is a journey not a competition not only should we stop competing with each other but also competing with ourselves the more we deny how we feel deep within the more we hinder our journey towards authentic success you have the power to feel completely relaxed and at ease upon command simply honor yourself and breathe deeply as you enjoy this relaxation you have achieved today let your mind drift and float to thoughts of beautiful places such as beaches with turquoise water Oh Mountains with crisp skies and deep forests with majestic trees the sound of my voice gently fades away and you find yourself fully ready for a long night's sleep allow yourself the rest you deserve good night




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Deep Sleep Music 24/7, Sleep Meditation, Relaxing Music, Delta Waves, Spa, Study Music, Sleep Music

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Sadhguru Shows Us How He Stays Fit For Life #FitnessChallenge

Sadhguru responds to the #FitnessChallenge from Col. Rajyavardhan Singh Rathore, and shows us a few processes that he puts his system through to stay fit for life! Download Sadhguru App 📲 http://onelink.to/sadhguru__app Yogi, mystic and visionary, Sadhguru is a spiritual master with a difference. An arresting blend of profundity and pragmatism, his life and work serves as a reminder that yoga is a contemporary science, vitally relevant to our times. Subscribe to our channel here: https://www.youtube.com/user/sadhguru?sub_confirmation=1 Official Sadhguru Website http://www.isha.sadhguru.org Official Social Profiles of Sadhguru https://facebook.com/sadhguru Free Online Guided Meditation by Sadhguru http://www.ishafoundation.org/Ishakriya Free Onlilne 5 minute Upa Yoga Practices http://isha.sadhguru.org/5-min-practices/

Oxford Handbook of Psychiatry

The Oxford Handbook of Psychiatry is directed at medical students, doctors coming to psychiatry for the first time, psychiatric trainees, and other professionals who may have to deal with patients with psychiatric problems. It is written by a group of experienced psychiatrists and is designed to provide easy access to the information required by psychiatry trainees on the wards or on-call. It closely follows the familiar format of the other Oxford Handbooks, andprovides coverage that is comprehensive, evidence based and practical. The content of the handbook is written in the concise, note-based style characteristic of the series, with single topics confined to single pages.

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Don’t Let Fear of Suffering Limit Your Possibility – Sadhguru

Most humans, Sadhguru says, never walk full stride, but take only half-steps due to the fear of suffering. If you go against the natural aspiration to be as much as you can be simply out of fear, then the immense possibility of being human is lost. He discusses inner management and how to handle thoughts and emotions. Tamil version – https://youtu.be/abb28UvTxQk **************************************** Download Sadhguru App 📲 http://onelink.to/sadhguru__app Yogi, mystic and visionary, Sadhguru is a spiritual master with a difference. An arresting blend of profundity and pragmatism, his life and work serves as a reminder that yoga is a contemporary science, vitally relevant to our times. More Videos & Blogs on Website http://www.isha.sadhguru.org Subscribe to our channel here: https://www.youtube.com/user/sadhguru?sub_confirmation=1 Free Guided Meditation by Sadhguru at http://www.ishafoundation.org/Ishakriya Free Yoga Tools For Transformation at http://isha.sadhguru.org/5-min-practices/ Official Facebook Page of Sadhguru https://www.facebook.com/sadhguru Official Twitter Profile of Sadhguru

Cognitive Behavioural Therapy for Dummies

“We all have aspects of ourselves that we would like to change, but many of us believe that a leopard can’t change its spots – if that’s you, stop there! Cognitive Behavioural Therapy for Dummies will help identify unhealthy modes of thinking – such as “a leopard can’t change it’s spots”! – that have been holding you back from the changes you want. CBT can help whether you’re seeking to overcome anxiety and depression, boost self-esteem, lose weight, beat addiction or simply improve your outlook in your professional and personal life.”

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Descriptive Psychopathology

In order to accurately describe and diagnose psychiatric illness, practitioners require in-depth knowledge of the signs and symptoms of behavioral disorders. Descriptive Psychopathology provides a broad review of the psychopathology of psychiatric illness, beyond the limitations of the DSM and ICD criteria. Beginning with a discussion of the background to psychiatric classification, the authors explore the problems and limitations of current diagnostic systems. The following chapters then present the principles of psychiatric examination and diagnosis, described with accompanying patient vignettes and summary tables, and related to different diagnostic concerns. A thought-provoking conclusion proposes a restructuring of psychiatric classification based on the psychopathology literature and its validating data. Written for psychiatry and neurology residents, clinical psychologists, behavioral neurologists, clinical psychology students and psychiatric nurse practitioners, it is invaluable to anyone who accepts the responsibility for the care of patients with behavioral syndromes.

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