Talk:Anxiety disorder/Archive 1

Archive 1

Alprazolam is superior drug for anxiety disorder

yes,yes it is correct

17% of Americans

Why is the statistic US and not global? This is a global site and the issues within this page apply to all nations of the globe. —Preceding unsigned comment added by 79.71.123.194 (talk) 18:12, 11 April 2009 (UTC)

We are all kind of the same people reacting in normal ways to abnormal situations. There are cultural differences that will show different percentages, but what applies to one people applies to all. Having said that, if that is a concern to you, 79.71.123.194, you should be motivated to get that stat yourself.--John Bessa (talk) 13:41, 27 September 2010 (UTC)

Adrenaline and blood sugar

Anxiety and Panic Disorder may also be understood in terms of excess seceretion of adrenaline. This hormone is produced when the brain is threatened by a energy stavation - for instance in rapidly descending low blood sugar levels. Adrenaline functions to covert glycogen (stored glucose) in the liver and muscle tissues back into glucose. This condition is likely to occur when a person suffers from prediabetic insulin resistance, also known as hyperinsulinism, glucose intolerance and the hypoglycemic syndrome. This condition causes unstable blood sugar levels feeding the brain, which is completelty dependent on glucose as its only source of energy. Hence this metabolic disorder may manifest intself in various forms of mental illnesses, such as depression, drug addiction and anxiety attacks. The treatmemt aims at stabilizing blood sugar levels by going on a high protein, low carbohydrate diet having frequent small snacks plus some vitamines and minerals, especially vitamin C, zinc and chromium picolinate.

This is fake —Preceding unsigned comment added by 76.214.122.3 (talk) 18:59, 30 September 2008 (UTC)

Jurriaan Plesman Free Web Site www.hypoglycemia.asn.au

No it is not a fake concern at all. However although I am myself hypoglycemic, I would add a qualifier like "for some people" since hypoglycemia is not indicated in all anxiety dorders. On the other hand mention of hypoglycemia does belong in the article.

75.253.85.243 (talk) 21:55, 21 November 2009 (UTC)

ab:Yeah. JFW | T@lk 09:12, 16 August 2005 (UTC)

The following section is flawed: Causes and contributing factors

This section does not mention any of the well established and/or well researched theories of anxiety and anxiety disorders, e.g., behavioral, cognitive, evolutionary and psychodynamic theories; it focuses on a miniscule finding from somebody's own research that has not been accepted widely and that does not even appear in any major textbook on abnormal psychology and psychiatry. Major rewriting and revising is needed. —Preceding unsigned comment added by 72.89.106.187 (talk) 05:42, 10 September 2008 (UTC)

I completely agree. I think someone is trying to push their own agenda, possibly to add weight to their own hypothesis and commercial products. Colliver55 (talk) 09:07, 10 September 2008 (UTC)

Perhaps it would be best to rename the section as "Etiology of Anxiety Disorder." The GABA reference is acceptable so long as it is in context with other theories, including, but not limited to, references to cognitive, behavioral, conditional learning, and other biological factors. Given that a lot of this research is rather new, staying objective could be best achieved by mentioning as many theoretical explanations as possible. Feedback is greatly appreciated. Beej19 (talk) 16:43, 17 December 2008 (UTC)

"Poisoned brain" is not a good medical explanation of the causes of anxiety disorder - there's an article referenced for this para but it must be a poor source. —Preceding unsigned comment added by Jdart (talk • contribs) 20:52, 19 April 2009 (UTC)

I deleted poisoned brain from the article.--Literaturegeek | T@1k? 21:03, 19 April 2009 (UTC)

This section really stands out badly. Forget what SHOULD be there - before we can expect, as suggested, someone to do a major edit (writing about major psychological, physiological, etc. theories) what IS there needs to be fixed. Basically, it only deals with biochemical causes (Western Psychiatry's antiholistic focus) and not psychological ones - so this limitation should be stated. And nearly half of what's there probably should go because. The worst is merely opinion sometimes related as information which is inaccurate and/or unverifiable - especially regarding benzodiazopines and alcohol. Even from a psychiatric perspective, the other information given is definitely selective, other than the mention of GABA, and SSRIs, but it is verifiable - still the new research should be qualified as experimental and merely a recent biological research finding that has not been confirmed.

I could do some editing - if others agree in principle.

Melbadog911 (talk) 10:11, 1 July 2009 (UTC)Melbadog911

I say you should boldly go for it, as long as you're prepared to back up your edits with good sources, meaning review articles whenever any exist. Looie496 (talk) 22:02, 1 July 2009 (UTC)

if you start, I can help - especially with psychological models of anxiety, including sources. Earlypsychosis (talk) 22:25, 1 July 2009 (UTC)

I have shortened and refined the info on alcohol and benzos. I think expanding on environmental factors, genetic factors, social factors etc would be welcome and of benefit. I have better sources for the effects of alcohol and benzodiazepines on anxiety. I have added a psychiatric psychology text book (can add more secondary sources). Also it is notable because 20% of individuals with anxiety drink to excess. As alcohol misuse worsens anxiety this is very relevant. See Long-term_effects_of_alcohol#Nervous_system.--Literaturegeek | T@1k? 00:25, 7 July 2009 (UTC)

Note: the comments below were inserted into the middle of the section above, making it impossible to understand the flow of editing. I have extracted them and placed them here rather than deleting them. Looie496 (talk) 17:26, 28 August 2010 (UTC)

Here, we see a typical example of Wikipedia's bias against nutritional medicine. Just because it is NOT in any well-established text book, does not mean that it is unscientific. All editors of Wikepedia have to do is follow the rules of Scientific Method and not their instincts of personal bias. The question is: "Is a statement supported by peer reviewed evidence or not?" Have a look at: http://www.hypoglycemia.asn.au/articles/ref_mood_disorders.html

Nutritional medicine does not exclude "psychological" factors in contributing to anxiety, but it tends to emphasize on the biological aspects in treatment, then followed by "psychological" factors. The reality is that if an anxiety attacks is caused by an endogenous biological factors - such as overproduction of adrenaline due to insulin resistance (hypoglycemia) - no amount of psychological therapy (ie.s talk therapy) is going to solve the anxiety attacks. You need to first address the biological aspects before addressing "psychological" issues. Please read:

Anxiety web sites at: http://www.hastingspress.co.uk/hypo/ http://www.hypoglycemia.asn.au/articles/beating_anxiety.html http://www.alternativementalhealth.com/articles/hypoglycemia.htm http://www.hypoglycemia.asn.au/articles/silentdiseases.html http://www.hypoglycemia.asn.au/psychotherapy/anxiety_phobias.html http://www.hypoglycemia.asn.au/articles/anxiety_SNS.html By Jurriaan Plesman: www.hypoglycemia.asn.au Jurriaan Plesman: www.hypoglycemia,asn.au—Preceding unsigned comment added by 220.244.130.97 (talk) 06:58, 28 August 2010 (UTC)

Nutrients are sometimes used in medicine. Magnesium is often used in intensive care for example, folic acid is used in pregnancy to reduce spina bifida risk, omega 3's are recommended or prescribed by some doctors for ADHD and other conditions and so forth. However, the majority of claims made by alternative medicine lack any evidence of benefit or have even been demonstrated to be false. If a nutrient is demonstrated in controlled clinical trials then it will gain acceptance by the medical profession.--Literaturegeek | T@1k? 10:04, 8 September 2010 (UTC)

Does it not seem strange to anybody that over fifty percent of a paragraph devoted to the causes of anxiety is devoted to explaining how anxiety is caused by withdrawal from anxiolitycs. I thought anxiety had something to do with the fight-or-flight response that is so crucial to survival. Turns out, people are merely anxious because they consumme substances to alleviate anxiety and that these substances backfire. It makes one wonder what ever possessed the fundamentally non-anxious users of these substances to try them in the first place. In any case, I suspect the zealots at benzo.org or their followers to be behind this medical breakthrough.—Preceding unsigned comment added by Temesta (talk • contribs) 01:35, 9 September 2010 (UTC)

It is strange you say 50%, only about 5% of the causes section of the article covers alcohol and benzo dependence and withdrawal and anxiety. I don't think it is undue weight either as alcohol abuse and alcohol self medication is very common and benzos are a commonly prescribed drug. The sourcing could do with improvement, I will look into that later. I don't agree with your theory that only anxious people take alcohol or benzodiazepines. Benzodiazepines are often consumed for seizures, muscle relaxation and insomnia and also for short lasting stressful events, eg divorce, bereavement etc, not always a life long anxiety disorder. Alcohol is often inappropriately used for self medicating insomnia, for its recreational intoxicating effects and so forth, not just self medicating for a life long anxiety disorder. It has nothing to do with benzo.org.uk coming up with a novel hypothesis; infact benzo.org.uk is not even cited in the article. Medical literature on anxiety due to sedative-hypnotic dependence and withdrawal predates benzo.org.uk, infact predates the world wide web.--Literaturegeek | T@1k? 10:28, 9 September 2010 (UTC)

I think it is obvious that the understanding of the brain is still in its infancy, and that it is even probable that nutrition will play a role in anxiety treatment in the future. But it is also true that Wikipedia depends on medical articles written in the top few journals, which means that one of the top few American research hospitals has to have a good double blind study. Doctors are increasingly suggesting nutritional support for anxiety, and doctors have even told me to take Epsom baths. It is fine for researchers and doctors to take these positions, but in Wikipedia it is not mainstream enough to expect MEDRS support. I am guessing that some of those nutrients have been studied and are considered promising as they are starting to better understand and study the genetics and biochemistry of neurological dysfuncton.Bob the goodwin (talk) 05:47, 8 March 2014 (UTC)

Plaigarism

Parts of this article are directly quoted without acknowledgment, although there is a link to the source. There needs to be citation quotes. I quoted some of these areas but did not write the article and have no idea how much of this was taken from other pages. It's helpful information so a quote would be fine. Jeni Mc 18:34, 3 August 2007 (UTC)

Unrealization is one symptoms of panic attack. I will condense this material and move it into the panic attack article. (todo) MegaHasher 06:54, 18 August 2007 (UTC)

Merge

No, anxiety is a symptom and anxiety disorder is a condition of which the main symptom is anxiety. It would be incorrect to merge these. Anxiety is a "normal" physiological response to uncertainty, apprehension etc etc. The disorder is where this phenomenon occurs inappropriately. JFW | T@lk 09:12, 16 August 2005 (UTC)

But see: 86 JOM studies linking anxiety with hypoglycemia at: http://www.orthomolecular.org/library/jom/search_results.shtml?cx=012934609838436511334%3Aeuo7oo38sqc&cof=FORID%3A11&q=anxiety+AND+hypoglycemia&sa=Search&siteurl=orthomolecular.org%252Flibrary%252Fjom%252Findex.shtml —Preceding unsigned comment added by 220.245.26.121 (talk) 04:49, 21 September 2010 (UTC)

In that case, the content on anxiety disorders on the anxiety page should be moved to this page. This would, however, leave the anxiety page almost completely devoid of content, although perhaps some could be written. Certainly the two pages should at least acknowledge eachother. Scott Ritchie 16:51, 16 August 2005 (UTC)

Agree with Scott. Don't really see what could be put on the new Anxiety page. Would an encyclopidia have an article on just a fealing? --Banana04131 02:56, 17 August 2005 (UTC)

Tarret (talk · contribs) has been trying to merge the pages in the face of disagreement and various merges. I think a merge is a very bad idea, and have therefore reverted. JFW | T@lk 22:41, 24 September 2005 (UTC)

Stage fright

Stage fright is usually classified under Social phobia with DSM-IV. --MegaHasher 06:28, 10 January 2006 (UTC)

DSM-IV fragmentation

The DSM-IV classifications have fragmented from DSM-III styled classifications for anxiety disorders. The DSM-III styled classifications are usable as is, so I just fixed the version reference. -MegaHasher 07:41, 6 March 2006 (UTC)

I am about to study the DSM for my degree. Going into it, I think it is unsupportable (actually absurd). Maybe my opinion will change--John Bessa (talk) 13:45, 27 September 2010 (UTC)

Exposure Anxiety

This term is likely to be a newly coined term, and probably does not belong in an encyclopedia entry. MegaHasher 21:52, 17 July 2007 (UTC)

Further google search revealed a book titled with 'Exposure Anxiety' by author of Donna Williams. Top hits were promotional materials written by Donna Williams, and this heading is probably associated with Donna Williams as well. MegaHasher 22:09, 17 July 2007 (UTC)

(Archived) Exposure Anxiety was first described in the book, Exposure Anxiety; The Invisible Cage by autistic author Donna Williams and referred to the anxiety associated with feeling one's own existence too extremely to withstand. Exposure Anxiety was described as triggering a pervasive self protective state of involuntary avoidance, diversion and retaliation responses resulting in a struggle to do things 'as oneself', 'by oneself' or 'for oneself'. By learning to do things as a 'non-self' those with it could sometimes still do things by taking on other characters, roles and voices. Exposure Anxiety was further distinguished from Avoidant Personality Disorder, Oppositional Defiance Disorder and Demand Avoidance Syndrome in the book The Jumbled Jigsaw. However, unlike the preceding categories of anxiety disorders, Exposure Anxiety does not appear in the DSM IV and is not yet recognized as a distinct category by the APA. It also does not appear in the ICD by the WHO.

Donna Williams also wrote the Jumbled jigsaw. MegaHasher 09:24, 21 July 2007 (UTC)

Controversy

Can this material be edited and saved, or is it revert time? MegaHasher 06:54, 18 August 2007 (UTC)

My main problem is that conspiracy theories are a dime a dozen, since the controversy is about doubting the diagnosis of doctors, it has to be supported by credible claims. MegaHasher 20:35, 18 August 2007 (UTC)

Seperation Anxiety

Seperation Anxiety does not only effect school aged children. Someone change it? —Preceding unsigned comment added by 72.211.130.123 (talk) 23:58, 2 November 2007 (UTC) Fixed. I hope this is more appropriate. I also distinguished between the anxiety and the disorder.

PTSD

Can someone please go through and reword this section? I have no problems with it, but I wouldn't mind more detail. For example, one may go on to list the possible "stressors" that may cause this disorder; family, friends, etc. It's really not that important, but like I said, it just feels like there could be more detail considering what we are talking about, and I don't think the way it is now does it justice. Just my 2 cents. 76.180.55.81 (talk) 06:11, 1 June 2008 (UTC)

If you can possibly broaden your mind here is a physiological explanation of PTSD:

Post Traumatic Stress Disorder (PTSD): a Disease of Body and Mind at:

http://www.hypoglycemia.asn.au/articles/PTSD.html

Jurriaan Plesman: www.hypoglycemia.asn.au —Preceding unsigned comment added by 220.244.130.97 (talk) 07:46, 28 August 2010 (UTC)

PTSD is far more complex than this material suggests. It involves diverse neural trauma, and if you understand neuropsychology, you may understand why I say its complexity is under-appreciated.--John Bessa (talk) 13:47, 27 September 2010 (UTC)

Definition

My psychology text book describes anxiety disorders as "a group of conditions which share extreme or pathological anxiety as the principal mood disturbance [sic]". I don't quite understand it, but it seems to differ from the definition in the article. Can someone explain this and should it go in the article?--82.152.177.208 (talk) 20:45, 15 June 2008 (UTC)

IT IS IMPERATIVE THAT A SEPARATE SIDE HEAD OF "DEVELOPMENTAL TRAUMA" BE ADDED TO THIS SECTION. See Van Der Kolk and Peter Levine and the entire host of neuroscience trauma experts publishing for over 15 years now. Van Der Kolk heads up the Boston Trauma Center. We now know -- science is incontrovertible even if controversial -- that anxiety and ALL the physical complaints listed here are a direct result of the perverse wiring of the brain from various traumas while the brain/body is developing -- hence the name. Heart palpitations, bowel problems, autoimmune, bad heart rate variability and the loop of anxiety/depression as well as "serial obesity," low blood pressure/low pulse/low thyroid, are all part of the constellation conclusively caused by the brain neurology that is permanently (until reversed) derailed from childhood trauma. And this includes FAR more types of incidences than the most egregious we can readily bring to mind. These also affect mood, emotional affect, cognitive ability, focus, concentration, sequencing, judgment, ability to access creativity, attention, and etc.

In a nutshell, the entire brain apparatus, down to the entire bioelectrical synergy of the brain, its sections, its neurotransmitters, and how it interacts with the "abdominal brain," to borrow a term from Chinese Medicine, as housed in the VAGAL NERVE, is "hijacked" (Van Der Kolk's accurate term) into a brain constantly wired to either freeze (collapse), fight, or be frozen or angry in fear. Helpful neuroscience: "What fires together wires together." There's nothing more powerful in the body than that limbic brain.

Every human on the planet should be required to read Van Der Kolk's THE BODY KEEPS THE SCORE as they will never view themselves or any human the same way again. That's what a paradigm-busting neuroscientist he, et al. are. AND they treat these issues WITHOUT drugs for the most part, since drugs simply aren't efficacious, as we've known for decades, while amoral Big Pharma grows fat on the agony of sufferers leaving them in worse shape than ever. Also in a nutshell, it is the clinical experts' opinion that EMDR and Neurofeedback (including Low Energy Neurofeedback) are the most effective for treatment, and personal improvement is so often revolutionary. Now you know why the Big Pharma men hire armies of obfuscation/counter studies bullshit to oppose the science that could liberate the millions of sufferers.

I'm not sharing this for attribution or glory. I could care less if you know my name. I'm sharing information that will ease the needless suffering of millions, and millions of their loved ones. It is irresponsible to NOT include DEVELOPMENTAL TRAUMA and TRAUMATIC BRAIN INJURY (called "the silent epidemic" for a reason and a major cause of anxiety) IN THESE SUBHEADS, AND I'M HELPING YOU BE MORE CONSCIENTIOUS as well as more accurate.

Feel free to actually write the real state of the world instead of always quoting ridiculous DSM volumes which freeze studies/conclusions in 15-yr snippets and actively contribute to more suffering by being so fixed in time and actively ignoring proof of great NONDRUG-based successes. There's a crush of evidence supporting what this is all about. You owe it to readers who depend on you to get it right, not just fear-based safe.

This does not meet your "standards" of institutional citation and that is a GREAT thing. Now those who do wish to get some "credit" for contributing here can do more honest and legitimate research by people who are not shills for drug companies. What a concept, eh??

Enjoy and do the research! You will help millions. It's the least we owe people. — Preceding unsigned comment added by 65.129.104.137 (talk) 06:43, 18 March 2015 (UTC)

Book Review

There was a link to a book review at the bottom of the page but I have removed it as Wikipedia is not here to advertise books. 90.212.93.59 (talk) 18:59, 18 July 2008 (UTC)

Yep, good catch. An odd book to have cited in Anxiety disorder in the first place, given that it's apparently about fear and depression, not anxiety disorder. Cosmic Latte (talk) 16:58, 19 July 2008 (UTC)

Charles Linden

I removed the paragraph dealing with Charles Linden. Wikipedia is NOT here to advertise products. Colliver55 (talk) 10:56, 24 August 2008 (UTC)

Thats rubbish - that's like saying your not having a page about penicillin because it advertises Alexander Fleming's product.Officially Mr X (talk) 15:01, 11 October 2008 (UTC)

Maybe I should point out to you that Charles Linden's article was deleted by consensus of Wikipedians. Also you have no idea what I removed. Colliver55 (talk) 23:16, 11 October 2008 (UTC)

Even so I still think he should be given some sort of mention in recognition of being the man to unlock the key to stopping anxiety, ocd, depression and panic attacks. In years from now I think it will be important. Not trying to advertise, but he has helped over 110,000 people worldwide overcome anxiety for good. He has a 97% success rate for those who used his Linden Method.Officially Mr X (talk) 18:45, 12 October 2008 (UTC)

If you can get impartial and verifiable references for those statements, than I agree with you. However, the reason the Charles Linden article was removed is because such statements were used with no valid references that did not originate from Charles Linden, the Linden Centre or other persons involved with Charles Linden. Thankyou. Colliver55 (talk) 19:01, 12 October 2008 (UTC)

Colliver, you are very pretentious and quick to jump to conclusions. The thousands of users of his treatment do count. I had anxiety three years ago. Severe anxiety, I stayed up for a week once, and constantly thought obsessive thoughts. I used his method as a last resort after medicine and professionals. It works, because his reasoning and logic is correct. I have no anxiety whatsoever now other than typical stress. If you have never suffered from anxiety don't be so quick to discredit someone who does offer such great services. Following your logic we should not see anything about any product because any mention could be deemed advertisement. Comparing Charles Linden to Alexander Fleming is a joke. Linden's method is not penicillin, and most qualified experts in anxiety do not endorse it. —Preceding unsigned comment added by 86.177.16.109 (talk) 16:38, 2 May 2009 (UTC)

Hi! It's good to read that you feel so much better, and I understand that you wish to add some text about Charles Linden. So please, instead of biting Colliver, find good, secondary sources and you can write about Linden, without being reverted. Lova Falk talk 10:21, 16 July 2010 (UTC)

Unreferenced assertions

In the list of different anxiety disorders, there are numerous unreferenced statements. It might be ok if they were then expanded on in the relevant article, but many of them are not. For example the statement;

"Since occasionally there are artists or performers with social anxiety disorder who are able to perform publicly without significant anxiety, their love of performing and practicing their art may be diminishing their anxiety. Although some high-functioning phobics such as Glenn Gould are able to perform despite anxiety, most people with social phobias become so anxious that performance is out of the question"

Is unreferenced. Citations are obviously needed for these types of assertions, and if they are not provided, then the summaries IMO need to be rewritten.80.229.27.251 (talk) 14:31, 2 December 2008 (UTC)

Removed that part, as it adds nothing of significance. There is some uncertainty regarding Gould's health issues, too. This article needs a lot of work. Guido den Broeder (talk, visit) 01:27, 17 December 2008 (UTC)

Is PSTD an axiety disorder or not?

At the first paragraph of the article adjustment disorder it says:

"The condition is different from anxiety disorder which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder which usually are associated with a more intense stressor."

However, if you read the article about anxiety disorder, it lists PTSD as being a type of anxiety disorder. Therefore, I found this paragraph on the article about adjustment disorder to be confusing with this article. Does anxiety disorders lack the presence of a stressor or not? If they do lack a stressor, why is PTSD classified as an anxiety disorder then, since it says in the adjustment disorder article (and others that mention PSTD) that PSTD is associated with an intense stressor?

It is worth mentioning that in this article about anxiety disorder, the only type that mentions a stressor is PTSD. --Pinnecco (talk) 05:04, 15 October 2009 (UTC)

Grammar

The article says, "Another area the adjacent central nucleus of the amygdala that controls species-specific fear responses its connections brainstem, hypothalamus, and cerebellum areas." This is not grammatically correct. Can someone please update this? I'm not sure what the original author was getting at. --1000Faces (talk) 00:34, 2 January 2010 (UTC)

I have copyedited to make it grammatically correct (I think). See difference here. Please feel free to edit it more to clarify it further. This section seems vague. Difu Wu (talk) 00:53, 2 January 2010 (UTC)

Looks good now. Regards, Looie496 (talk) 16:14, 2 January 2010 (UTC)

Testimonial

As an anxiety disorder patient myself I have to say that many of the causes, the ones that I can identify that go further than the metabolic or whatever ones, are very accurate. I have had separation anxiety since I was a very small child and all assortment of phobias and anxieties, as described in the article. —Preceding unsigned comment added by Cobolsaurus (talk • contribs) 14:31, 17 March 2010 (UTC)

From a psychonutritional point of view PTSD, depression and anxiety attacks share the overproduction of stress hormones, due to an inner biological abnormality. This is usually associated with hypoglycemia - a pre-diabetic condition marked by unstable blood sugar levels that trigger the release of stress hormones such as adrenaline. Adrenaline functions to convert glycogen stores in the body into glucose so as to feed the brain again with biological energy called ATP. This is normal Biochemistry tech book information (See Stryer and Lehninger) — Preceding unsigned comment added by 220.245.24.206 (talk) 06:35, 12 November 2011 (UTC)

Image choice

Although the use of the van Gogh painting as the title image is justified in the 'bipolar disorder' page (and I think is unobtrusive to boot), I don't feel this one is. And, honestly, I think that while this page may be used by those gathering information on anxiety disorders for their own peace-of-mind, or interest about their own condition, this was a horrendous painting to choose as an exemplar of anxiety! I would recommend changing it to something less...alarming, perhaps? — Preceding unsigned comment added by Go rators (talk • contribs) 16:54, 22 February 2011 (UTC)

I absolutely concur with the above. As someone living with a fairly mild case of an anxiety disorder, I'm going to go ahead and say that I was offended by the image choice. Quite honestly, I'm not sure that the article even needs an image... if it must have one, however, I would suggest something along the lines of what you might see in a pharmaceutical commercial. Bakershuksan (talk) 03:52, 1 May 2014 (UTC)

I had the same thought as you two. As there seems to be a consensus I'll go ahead and change it to the image currently on the Anxiety page, which is more appropriate. Gzabers (talk) 05:01, 18 July 2015 (UTC)

Globalize

Section “Epidemiology” needs to be globalized. Even U.S. is a valuable country, why should write more globally, at least by citing European status, U.K., China and so on. Alex ^{discussion ★} 07:17, 13 March 2012 (UTC)

IP edit warring

I agree with Doc James that the addition of an article from 1973 is inappropriate (per WP:MEDRS) and the IP's admitted goal (on their talk page) of promoting a specific author does not seem to comport with WP:NPOV. I suggest the IP stop edit warring lest they be blocked. Yobol (talk) 23:07, 11 August 2012 (UTC)

Yes not really a suitable source for the content in question. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:51, 11 August 2012 (UTC)

Agreed. Dbrodbeck (talk) 00:10, 12 August 2012 (UTC)

Use of older references

From the 5 pillars of Wikipedia:

"The principles and spirit of Wikipedia's rules matter more than their literal wording, and sometimes improving Wikipedia requires making an exception to a rule!

s--87.114.156.18 (talk) 20:02, 12 August 2012 (UTC)

While exceptions can be made, we need good reasons based on sources to make them. The fact you personally think it is important to use is not sufficient. Yobol (talk) 20:14, 12 August 2012 (UTC)

THere is no reason to include ancient (by psychology standards) references. Dbrodbeck (talk) 20:25, 12 August 2012 (UTC)

NPOV point by Yobol

NPOV definition from Wikipedia: "Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources"

Yobol states: "the IP's admitted goal (on their talk page) of promoting a specific author does not seem to comport with WP:NPOV"

If Yobol reads the 2007 reference that I have put in this wikipedia article(reference 44) he will see that the book and author I am trying to reference in the article have been part of a survey on self help books on anxiety disorders published in The Psychiatrist (which is published by the Royal College of Psychiatrists). The author Claire Weekes and her books came out top in this survey of self help books on anxiety disorders. I am not just promoting a specific author that I myself particularly like, I am trying to reference an author who has been shown to be the most useful writer of self help books on anxiety - even decades after she first published. No one has surpassed her since. I am representing a significant view that has been published by a reliable source.

Wikipedia is not written just to be like a scientific paper with all the rules that go with publishing scientific papers. It is for a worldwide audience of both experts and lay people.

Anybody suffering from anxiety who comes to read this page looking for help, and who is not used to reading scientific papers and who is not used to looking up references, will come away - if my edits are not included - without knowing about the most significant help that they can get in the way of self help books. That seems against the spirit of wikipedia to me. It also seems like a real waste of an opportunity to help people.

I would say to Yobol. Jmh649 and DBrodbeck that they are treating Wikipedia like it is a strict scientific journal and not a source of useful information to people of all levels of education worldwide. They need a little flexibility in their thinking and must move away a little from any very strict scientific publishing training they have had.

And as I quoted before:

From the 5 pillars of Wikipedia:

"The principles and spirit of Wikipedia's rules matter more than their literal wording, and sometimes improving Wikipedia requires making an exception to a rule!"

I am not on an ego trip, I am trying to help any people I can who have this devastating illness.

--87.114.156.18 (talk) 20:55, 12 August 2012 (UTC)

I would recommend you look around Wikipedia at other high quality medical articles like schizophrenia. Notice the writing style and referencing standards and follow that. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:31, 12 August 2012 (UTC)

Ref 44 highlights a number of authors and books. There is no particular reason to highlight the one this IP wants to highlight. While it is laudable to want to help people, our goal here is to build an encyclopedia article, not to promote self-help resources beyond what would be expected from a high quality encyclopedia. Promotion of specific authors or works is best left to other sites on the internet. Yobol (talk) 01:54, 13 August 2012 (UTC)

To Doc James:

1.You have not addressed my argument pointing out that Wikipedia is not a strict scientific journal for the scientific community only - you are treating it like this. 2.Your removal of the edit goes against the pillar of Wikipedia statement below. "The principles and spirit of Wikipedia's rules matter more than their literal wording, and sometimes improving Wikipedia requires making an exception to a rule!" 3. I have one further point - but no time yet to write. Will do soon.

To Yobol: No time to address your point. Will do so soon.

I am using my work computer - but I am same person as IP address 87.114.156.18 who has been arguing the points with you above.

163.1.23.226 (talk) 10:41, 13 August 2012 (UTC)

Sure but this case is not one of the exceptions. Four editors oppose your addition of the BMJ article from the 1970s. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:43, 13 August 2012 (UTC)

If Doc James is the same as Jmh649, then I count 3 editors not 4 who oppose me. Or have I overlooked another commentator or misunderstood Doc James and Jmh649 as being one and the same?

If a more widespread discussion found 3 people who agreed with me then your statement "this case is not one of the exceptions" may not be true - as a Wikipedia novice can you tell me if this is true? I hope that this Wikipedia article is not the personal preserve of the 3 editors who oppose me.

--163.1.23.226 (talk) 11:59, 13 August 2012 (UTC)

Wikipedia's Mission Statement

To Doc James and Yobol I found this and hope it is correct. Wikipedia's mission statement:

"to provide free access to the sum of all human knowledge" That is a statement that is pretty inclusive. I would say that that allows for information about the best self books available to be included in the Anxiety Disorders article.

The article doesn't exist to be just the most up to date information on high tech scientific research. It is for all knowledge about anxiety disorders. --163.1.23.226 (talk) 13:11, 13 August 2012 (UTC)

Please read WP:MEDRS. If you would like us to cite everything ever written this is not the place, you would want a vast change in policy. You might want to also read WP:IDIDNTHEARTHAT, assuming you are the same person as the other IP above. This is getting quite tiresome. Dbrodbeck (talk) 13:32, 13 August 2012 (UTC)

Alternative Medicine not Alternative Medicine

The alternative medicine section contains a lot of "medicine" which does not seem to be alternative to me. If exercise and natural remedies have been shown to be effective in clinical trials and are scientifically plausible as the article and the linked peer-reviewed papers claim, then they are not alternative. Conventional medicine is more than just synthetic drugs. I do not know much about the efficiency of these treatments, so maybe I am missing what is alternative about them but if that is the case, then there should be explanations why these treatments are not considered to be part of conventional medicine.

In case these treatments can be considered part of conventional medicine, there should be another section. I am not sure how to call it, maybe natural treatments?

Xedi (talk) 10:36, 13 September 2012 (UTC)

Meredith Harper: First-time editor, Clemson University

Hi! My name is Meredith Harper. I am a senior, Psychology student from Clemson University, as well as a first-time editor. I will be modifying this article as part of the APS Wikipedia Initiative.Harper5 (talk) 15:18, 21 February 2013 (UTC) — Preceding Harper5 comment added by Harper5 (talk • contribs) 14:52, 21 February 2013 (UTC) 15:15, 21 February 2013 (UTC)15:15, 21 February 2013 (UTC)~~ — Preceding unsigned comment added by Harper5 (talk • contribs)

Hi Meredith, and welcome! Let me give you my text about secondary sources, as many students tend to use WP:primary sources, that is, results of single studies. However, Wikipedia is not an academic paper or essay. Wikipedia articles should be based on reliable, published secondary sources (for instance, journal reviews and professional or advanced academic textbooks) and, to a lesser extent, on tertiary sources (such as undergraduate textbooks). WP:MEDRS describes how to identify reliable sources for medical information, which is a good guideline for many psychology articles as well. With friendly regards, Lova Falk talk 20:10, 22 February 2013 (UTC)

Additions

I am working on adding an entire section on Situational Psychology. Though it is not a continuous disorder, like GAD, it is still debilitating for the time an individual suffers from it. I am also adding a section on Childhood Anxiety Disorders. Though there are similarities between Child and Adult Anxiety Disorders, there are significant differences that I believe should be accounted for in a separate section. I will be adding to the Caffeine Elimination, as well. Harper5 (talk) 14:17, 12 March 2013 (UTC)

Hi Harper5, I don't have time to read what you have written tonight (it's night here now), but I took a quick glance and saw that you had only added one source. I would advice you to insert sources as soon as possible, before you have forgotten which text came from which source. With friendly regards, Lova Falk talk 20:54, 13 March 2013 (UTC)

I have now added the information that I mentioned above. The section on childhood anxiety is quite long after my additions. I felt that the information there was good information, but that it was very general. So, I added some more specifics. I couldn't really figure out the best way to integrate my information into the already existing information, so I pasted mine onto the end of the existing information. It may not make perfect sense right now, but if anyone has any suggestions as to how to integrate everything, I would really appreciate the feedback! — Preceding unsigned comment added by Harper5 (talk • contribs) 13:57, 28 March 2013 (UTC)

I've just done an extensive copy-edit of the longest section there, which I think is generally good but was in some ways not written in an encyclopedic style. Please always when you add material to an article take responsibility for integrating it -- there will hardly ever be a person better able to do it than you. (I think you did okay here.) Regards, Looie496 (talk) 16:40, 28 March 2013 (UTC)

Editing page for APS Wikipedia Initiative

Hello my name is Wes Jackson a student from Shenandoah University here in Virginia, working on getting my bachelors in the arts and sciences department. I am currently a junior majoring in criminal with a psychology minor. My classmates and I are working on editing and reviewing different topics in wikipedia for our history of psychology class. I choose anxiety disorder based of the information individual misinterpret about anxiety. My first secondary source I will be using is a case study book that gives a lots of statistics about individuals with anxiety disorders and also gives bits and pieces of an autobiography for these individuals. My other secondary source is an article called Two Faces of Anxiety from the New York time magazine. From these source I have been given lots of accurate information on anxiety and I hope to share it with you all. — Preceding unsigned comment added by 71.62.37.118 (talk • contribs) 18:58, 21 February 2013

Hi Wes, and welcome! Good thing that you plan to use secondary sources, however, a New York time magazine article is not a reliable source for medical articles, including psychiatry/psychology articles such as this one. You can read WP:MEDRS on how to identify good secondary sources. With friendly regards, Lova Falk talk 20:13, 22 February 2013 (UTC)

In DSM-5, PTSD is a Trauma- and stress-related disorder and is no longer an Anxiety disorder

A new category has been created for those disorders that explicitly list in their criteria exposure to a traumatic or catastrophic event. Farrajak (talk) 20:17, 9 June 2013 (UTC)

Caffeine

I am looking to add some information into the section dealing with caffeine. I want the reader to be able to have more information to look at when viewing this section. My proposal is to add in a line about how caffeine is extremely common, and the another with a link to an article that the reader can go to if he/she wishes to learn more about caffeines relationship with anxiety issues.

Here is what I plan to say: Caffeine is one of the most commonly used substances in the world. With 82-92% of adults worldwide using it, [1], it is no wonder that we see caffeine and anxiety issues linked together. Numerous studies have been conducted to show this relationship. One in particular was conducted by a program called Neuropsychopharmacology. This team showed relationship between A2a Receptor Gene Polymorphisms and Caffeine-Induced Anxiety. Click on thelink to learn more about this study. Courttt32 (talk) 19:16, 6 April 2014 (UTC)

Please use review articles per WP:MEDRS. This wording also needs a little bit of work.

We already state "Ingestion of caffeine may cause or exacerbate anxiety disorders" so unclear why you wish to add the above? Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:17, 7 April 2014 (UTC)

Mindfulness for prevention

I am not seeing were these two refs support this "and mindfulness therapy.

Roemer L, Williston SK, Eustis EH (Nov 2013). "Mindfulness and acceptance-based behavioral therapies for anxiety disorders". Curr Psychiatry Rep 15 (11): 410.

Lang AJ (May 2013). "What mindfulness brings to psychotherapy for anxiety and depression". Depress Anxiety 30 (5): 409–12. doi:10.1002/da.22081.

Doc James (talk · contribs · email) 05:19, 1 January 2015 (UTC)

If you read the articles, you will see that both articles explore factors that contribute to the development as well as the maintenance of anxiety disorders, so the articles are addressing prevention as well as treatment. Both papers cite studies that used healthy individuals as well as individuals who have been diagnosed with an anxiety disorder by a physician and explore evidence for mindfulness as a “psychotherapeutic change agent.”

The practice of mindfulness involves paying attention to the present moment and noting for oneself that anxiety related thoughts (as well as all other thoughts) as transient events (arising and ceasing, when the conditions are there). Observing this way can be done regardless of whether an individual has been formally diagnosed with an anxiety disorder by a physician or not.

By the way, I noticed that the article by Patel and Fancher (2013) did not include mindfulness interventions, and I was wondering if this needs to be mentioned as well, especially considering this Wikipedia article makes the global statement “As of 2013 there are no effective measures to prevent GAD in adults.”

Happy New Year!

Nandinik (talk) 17:38, 1 January 2015 (UTC)

Can you provide a quote from one of the sources that supports mindfulness therapy as a preventative effort for anxiety disorder? Thanks Doc James (talk · contribs · email) 05:18, 2 January 2015 (UTC)

Here’s one quote from the Roemer et al. (2013) article: “a recent experimental study found that instructions to accept emotions during a distressing film led to a decoupling between reports of emotional distress”- if you look up this study, you will see that it used individuals who were healthy (i.e., not individuals who have been diagnosed with an anxiety disorder).

Nandinik (talk) 16:07, 2 January 2015 (UTC)

So the articles themselves do not comment on the use of mindfulness for prevention of anxiety disorder? Doc James (talk · contribs · email) 21:22, 2 January 2015 (UTC)

As I mentioned above, in presenting theoretical underpinnings of mindfulness, both articles present tentative evidence on how mindfulness interventions could prevent anxiety. (Note that this Wikipedia article states that “there is tentative evidence to support the use of cognitive behavior therapy.” Mindfulness interventions also have tentative evidence.)Nandinik (talk) 18:01, 3 January 2015 (UTC)

Can you quote text from either of the references you provided that support this? This is the basis of WP:V Doc James (talk · contribs · email) 19:48, 3 January 2015 (UTC)

It would take me too long to go through these papers looking for quotes that support prevention. The alternative is to have different reference/s that directly address prevention. A quick search found the following:

(1) Sharma M, Rush SE. (2014). Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review. J Evid Based Complementary Altern Med. Oct;19(4):271-86. doi: 10.1177/2156587214543143.

(2) de Vibe, M., Bjørndal, A., Tipton, E., Hammerstrøm, K. T., & Kowalski, K. (2012). Mindfulness based stress reduction (MBSR) for improving health, quality of life and social functioning in adults. Campbell Systematic Reviews, 2012, 3. http://dx.doi.org/10.4073/csr.2012.3.

Also, I think the phrase “As of 2013 there are no effective measures to prevent GAD in adults” is inappropriate considering that this article does not even mention mindfulness interventions.

Nandinik (talk) 16:44, 4 January 2015 (UTC)

This is what I am looking for "currently there is no evidence on the effectiveness of preventive measures for GAD in adult". It is from the Annals of Internal Medicine. [1]

So you added the above text even though the refs you used didn't support the content in question? Doc James (talk · contribs · email) 18:17, 4 January 2015 (UTC)

I do not understand your comment. The previous two references also support the claim that there is ‘tentative evidence’ to support the use of mindfulness to reduce anxiety - because these two articles explore factors that contribute to the development as well as the maintenance of anxiety disorders. I used these two same references for “prevention” section, because I had added them to the “treatment” section of the same article.

I see that you insist on keeping the other reference (Patel and Fancher, 2013) – that is fine with me. I will now add the above two articles to the “prevention” section.

Nandinik (talk) 19:29, 4 January 2015 (UTC)

• This ref [2] does not comment on anxiety disorders just anxiety.
• This ref [3] also does not appear to comment on prevention of anxiety disorders?

Will ask for further opinions. We do have an article on anxiety itself. Doc James (talk · contribs · email) 19:54, 4 January 2015 (UTC)

In the first article (Sharma, et al., 2014) in the abstract itself it is stated “Of the 17 studies, 16 demonstrated positive changes in psychological or physiological outcomes related to anxiety and/or stress.” Also, if you look at the actual paper, in the methods section, under ‘inclusion criteria,’ it is stated that the study looked at healthy adults (i.e., not individuals who have been diagnosed with an anxiety disorder). Also, they examined outcome measures related to stress as well as anxiety.

In the second article (Khoury, et al., 2013), in the abstract, it is stated that Mindfulness-based therapy (MBT) “is an effective treatment for a variety of psychological problems, and is especially effective for reducing anxiety, depression, and stress.” In the methods section, it is stated that they used “non-clinical populations” (i.e., not individuals who have been diagnosed with an anxiety disorder).

So, in other words, both of the above references support the claim that “there is tentative evidence to support the use of mindfulness” – which is what I had added. Actually, there is more than “tentative evidence” – when you look at these studies.

Anyway, I find it a waste of time to keep arguing, if you do not want these added, that is fine with me.

Nandinik (talk) 20:34, 4 January 2015 (UTC)

it is not about who wants what added or not, its do the refs support the statement in/for the article?--Ozzie10aaaa (talk) 20:55, 4 January 2015 (UTC)

It is "anxiety" not "anxiety disorder". They are different. Maybe there is enough to say "tentative" though. Doc James (talk · contribs · email) 21:34, 4 January 2015 (UTC)

I find myself agreeing with "tentative" as neither[4] nor [5] are concrete as to "anxiety disorders"--Ozzie10aaaa (talk) 22:08, 4 January 2015 (UTC)

UpToDate says:

"Mindfulness-based (ie, nonjudgmental observation of moment to moment experiences) psychotherapies have been shown to be efficacious in decreasing anxiety symptoms in an uncontrolled study of individuals with GAD and panic disorder. Acceptance and Commitment Therapy (ACT) combines mindfulness with acceptance of internal states and orientation of actions towards valued goals....A preliminary randomized trial of 16 patients supports the efficacy of an ACT approach for GAD."

So yes, it may be sufficient for GAD, pending further studies and reviews. -A1candidate (talk) 22:14, 4 January 2015 (UTC)

Image

The Scream (long standing image) ref to support it in the article

Emperor Traianus Decius (Mary Harrsch)

It appears we need a discussion regarding the lead image. Are there others images people think we should consider? Doc James (talk · contribs · email) 16:09, 20 July 2015 (UTC)

OCD is not an anxiety disorder?

The new DSM-5 removed OCD from the anxiety disorder category, so I'm not sure if we should have the disorder listed as one. William2001^(talk) 21:30, 26 December 2015 (UTC)

It has historically been an anxiety disorder but is no longer. We should keep it somewhat but mention this IMO. Doc James (talk · contribs · email) 21:51, 26 December 2015 (UTC)

Meditation

• We have a decent 2006 review by Cochrane.[6]

• This review from 1989 is a little old [7]

• This 2014 review is done by someone in the religion [8] and is published in a journal with a lowish impact factor (1.5) Journal of Alternative and Complementary Medicine while Cochrane is about 6 and is done independently. Additionally the Orme paper is not about anxiety disorder.

Doc James (talk · contribs · email) 14:11, 4 February 2016 (UTC)

Assessment comment

The comment(s) below were originally left at Talk:Anxiety disorder/Comments, and are posted here for posterity. Following several discussions in past years, these subpages are now deprecated. The comments may be irrelevant or outdated; if so, please feel free to remove this section.

"The Point of Exit Methodology" seems to be a link with an error in it. Looks like something proprietary?Mbwoody (talk) 16:00, 8 December 2008 (UTC)

Last edited at 16:00, 8 December 2008 (UTC). Substituted at 08:04, 29 April 2016 (UTC)

Please add buspirone in medication

There is no mentioning of buspirone. Please somebody add it. — Preceding unsigned comment added by 116.48.133.206 (talk) 08:22, 22 September 2016 (UTC)

 Done Jytdog (talk) 05:48, 23 September 2016 (UTC)

Possible additions to section on alternative medicine

Hello all, new editor here! After doing a bit of research for a paper in an undergrad lecture class I found uses for the essential oils derived from lavender to treat anxiety; I hope this helps.

Lavender oil was used in Shirodhara, an oil dripping technique, and was found to have significant effects on the reduction of anxiety in Japanese women (Xu et al., 950). It can also be taken as an oral supplement to lower anxiety and restlessness as it was shown to do in some German men (Baldinger et al., S305). Finally it was shown to reduce anxiety in mice who were exposed to lavender essential oil via inhalation (L. R. Chioca at al., 414).

Here are my sources:

• Xu, Fenghao, Kazuo Uebaba, Hiroko Ogawa, Takeshi Tatsuse, Bing-Hong Wang, Tatsuya Hisajima, and Sonia Venkatraman. "Pharmaco-Physio-Psychologic Effect of Ayurvedic Oil-Dripping Treatment Using an Essential Oil from Lavendula Angustifolia." The Journal of Alternative and Complementary Medicine 14.8 (2008): 947-56. Web.

• Baldinger, P., A. Hahn, C. Rami-Mark, M. Spies, W. Wadsak, A. Höflich, M. Mitterhauser, R. Lanzenberger, and S. Kasper. "P.1.i.015 Neural Correlates of the Anxiolytic Effects of Silexan." European Neuropsychopharmacology 24 (2014): n. pag. Web.

• Chioca, Lea R., Marcelo M. Ferro, Irinéia P. Baretta, Sara M. Oliveira, Cássia R. Silva, Juliano Ferreira, Estela M. Losso, and Roberto Andreatini. "Anxiolytic-like Effect of Lavender Essential Oil Inhalation in Mice: Participation of Serotonergic but Not GABAA/benzodiazepine Neurotransmission." Journal of Ethnopharmacology 147.2 (2013): 412-18. Web.

Bandxgeek123 (talk) 00:15, 26 October 2016 (UTC)

those are all "primary" sources, as defined in the definitions section of MEDRS. We use secondary sources - literature reviews or statements by major medical/scientific bodies. Also it saves everyone time if you cite the PMID - for example the first one is PMID 18990044. -- Jytdog (talk) 00:20, 26 October 2016 (UTC)

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Suggested changes from OTRS request

I have been in discussion with a reader who contacted the Volunteer Response Team with some suggested changes to this article. They have suffered from depression and some anxiety disorders and do not feel able to make these suggestions personally, so I agreed to post here on their behalf. Here is there suggestion for the introduction:

I will start with the first sentence as that is poorly worded and has falsehoods.

Anxiety disorders are a group of mental disorders characterized by feelings of anxiety and fear. Anxiety is a worry about future events and fear is a reaction to current events.

I do not think that characterizing Anxiety Disorders using the word anxiety helps no one. And saying Anxiety is a worry about future events and fear is a reaction to current events is pretty close to nonsense.

Anxiety is a worry about events from the past, present and future as well as imagined events such as the worry that when a friend looked at you once and did not smile means they are angry with you. Irrational stuff. Once can experience fear in the same way.

I wrote an opening that combines my knowledge (supported by my Psychiatrist's affirmation of it) and a little paraphrasing of the Mayo Clinics description.

Anxiety disorders are a group of mental disorders characterized by feelings of intense worry and fear. People with anxiety disorders frequently have intense, excessive and persistent worries and fears about everyday situations. Some, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. A person with an anxiety disorder can experience intense worry and demonstrate physical symptoms for reasons that are not apparent to them and may be what is referred to as free floating anxiety.

That is a far more accurate introduction. I am sure judicious editing would help.

References

I would appreciate it if regular editors of this page could consider this request. If you have any questions, please do ping me for further input. Cordless Larry (talk) 16:13, 10 July 2017 (UTC)

The current text is based on the DSM5. I have unhide the references in the lead to make this more clear.

The DSM5 does support this on page 189 in the first paragraph "Anxiety is a worry about future events and fear is a reaction to current events." Doc James (talk · contribs · email) 17:08, 10 July 2017 (UTC)

This is not true about all anxiety disorders "People with anxiety disorders frequently have intense, excessive and persistent worries and fears about everyday situations" and is presented without a clear source. Doc James (talk · contribs · email) 17:10, 10 July 2017 (UTC)

User:Cordless Larry I think the article this person is looking for is this one Generalized anxiety disorder. Doc James (talk · contribs · email) 17:16, 10 July 2017 (UTC)

Thanks for your speedy response, Doc James. If I sent you the ticket number, would you be able to explain this to the reader directly? I am a bit out of my depth in this topic area. Cordless Larry (talk) 17:25, 10 July 2017 (UTC)

Sure no worries. Doc James (talk · contribs · email) 17:27, 10 July 2017 (UTC)

Genetic basis for anxiety- "The Worry Gene"

I am a board certified Otolaryngologist with a lifetime interest in anxiety, initially as it impacts patients in my specialty, especially with headaches and facial pain. I now recognize the far-reaching impact of anxiety that impacts multiple organ systems. The practice of medicine has become very specialty oriented. Specialists tend to stay versed in narrow areas of interest and might have little awareness of developments in other areas. I welcome collaboration, re-inforcement and criticism that is the very spirit of Wikipedia.

A single enzyme, COMT (catecholamine O-methyltransferase), appears to be key to understanding the degree of worry or anxiety exhibited by an individual. It has been established that levels of estrogen and levels of testosterone have opposite effects on COMT activity and degradation pathways of norepinephrine and dopamine. Similar effects are observed with the well known enzyme, MAO (monoamine oxides.) These effects account for observed differences in female and male reactions to stress. The levels of catecholamines effect our central nervous system and cardiovascular system primarily but have far reaching effects to multiple other systems. Females tend to have a natural vigilance when it comes to protecting their offspring, which is ideal for our species during ages of childbearing. Their auditory system never "sleeps." They are innately tuned in to listen for the sounds that babies make and attend to the child's needs. A male in the same cave can sleep through a child's cries but hear a sabre tooth tiger a mile away! His catecholamines make him fearless and risk death to fight a menacing beast. Cave men and women died when they were 30 having procreated and raised their children to teenagers of childbearing ages. Because of inherited variants, some females are more anxious than others, and become protective or over-protective mothers. Some males are greater risk takers and may be over-aggressive. In modern times, females can worry about our entire globe in real time. Men can risk their lives in vehicles that go over 100 MPH and might not make it past their teen years.

It appears that greater than 30% of women have inherited a gene(s) for worry. Not all are impacted to the same degree. If there are 3 sisters in a family so impacted, one may have severe anxiety and the others less so. They mean well but become fretful mothers that have fretful babies. The word "colic" was coined to describe this condition! The expression of worry is often that of an overprotective or controlling mother. The ultimate expression of worry is manifested by obsessive-compulsive disorder. Mild OCD might be observed in folding towels with the label in a certain placement or reloading dishes that have not been "properly" placed in a dishwasher. More severe OCD is typified by repetitive actions that can be disruptive to life. The "worry gene" causes sleep disturbance. Some creative persons make incredible breakthroughs during sleeping and dreaming. Most sufferers, however, have cumulative sleep deprivation that negatively impacts simple day to day thoughts and activities. Cumulative sleep disturbance caused by anxiety often ends up causing clinical depression.

My early days were spent observing and researching TMJ dysfunction as a frequent cause of headaches. Dr. Costen described a syndrome of facial pain and headaches attributed to the temporomandibular joint and muscles of mastication. In more recent years, the effects of dental occlusion and bruxism or clinching were explored as causes. The now recognized official name of the syndrome is temporomandibular joint myofascial pain dysfunction. Myfascial pain dysfunction refers to the exquisite trigger point tenderness observed. Dental malocclusion has been extensively studied. Mal-position of the mandibular condyle and meniscus has been postulated as a cause. What has been overlooked is the trigger point tenderness of neck and back postural muscles, and in fact trigger point tenderness of nearly every striated muscle in the entire body. Dr. Janet Travell, a reknowned physiatrist, spent her entire career, and wrote her treatise, on the physiology of observed trigger points in muscle groups. Her book, Myofascial Pain and Dysfunction: The Trigger Point Manual, is the seminal work on the subject. She theorized that the spindle cell units, the specialized units in long muscles that are responsible for stretch and tension central feedback, were subject to contracture, or failure to relax, which caused painful knots observed in tender muscle areas. Those with TMJ pain typically have trigger tenderness throughout the entire body, not just in the muscles of mastication. Those with horrible bites or ill-fitted dentures might not have any observed tenderness. Those with stress related muscle pain have exquisitely tender bites and muscles of mastication. The general condition of muscle pain that is often overlooked or not recognized is termed myofibrositis or fibromyalgia. There is seldom a dental cause of TMJ dysfuntion. Stress and sleep disturbance contribute to the symptoms. The specific trigger points that were described so accurately by Dr. Travell correspond exactly to Chinese acupuncture points or French acupressure points. As an aside, a brachioradialis trigger point described by Dr. Travell is labeled Large Intestine 7 on Chinese acupuncture charts and misdiagnosed as "tennis elbow" by many of our orthopedic colleagues. Surgery can be recommended on a dominant side that is tender when in fact the other elbow has equal tenderness!!

To be continued More discussion of fibromyalgia. Next will be discussion of costochondritis, mitral valve prolapse and panic attacks attributed to "worry." SarahTonin (talk) 01:22, 5 September 2017 (UTC)

Please don't continue -- my intention is not to be rude, but you don't seem to understand that a) no original research is allowed in Wikipedia; and b) this talk page is strictly for discussing improvements to this article, based on reliable sources (defined in WP:MEDRS) and the policies and guidelines; this page is not a general forum for discussing the topic. Jytdog (talk) 08:19, 5 September 2017 (UTC)

Is omega-3 for anxiety alternative medicine?

I recently added a brief summary of a new meta-analysis which shows that omega 3 fatty acids might reduce anxiety.

I added this summary to a separate section but User:Doc James moved it afterwards to the section on alternative medicine. According to wikipedia's definition, alternative medicine are "practices which are unproven, disproven, impossible to prove, or excessively harmful in relation to their effect" and "The scientific consensus is that alternative therapies either do not, or cannot, work".

I don't think that the cited meta-analysis fulfils any of this criteria. Omega-3 has a potentially plausible mechanism of action and this is a good meta-analysis with clear results. Of course the effect sizes are modest (as for all treatments in anxiety disorders) and further evidence is needed, in particular with patients where anxiety is the main symptom.

Instead of adding it to the section 'alternative medicine' once could add it to a new section 'Dietary supplements'.

Thanks for your comments and thoughts on this.

Lucleon (talk) 08:22, 27 September 2018 (UTC)

Doc James was correct to move this content to the alternative section because it is not accepted, as of yet, by mainstream medicine and is not a licensed/approved medication that a doctor could routinely prescribe, even if it might exert a therapeutic effect according to the cited source.--Literaturegeek | T@1k? 22:30, 28 September 2018 (UTC)

I agree that it's not mainstream medicine that is routinely used. However, none of these points are in the definition of alternative medicine. Instead WP defines alternative medicine as "practices which are unproven, disproven, impossible to prove, or excessively harmful in relation to their effect" and "The scientific consensus is that alternative therapies either do not, or cannot, work". I think none of this applies to the cited Omega-3 study. Apart from that I do find it important to clarify that the effectiveness of omega3 in treating anxiety remains unclear (personally I'm still skeptical but that's not relevant here) and that omega3 is not in the treatment guidelines for anxiety. Maybe there is another way of providing this information to the reader instead of putting this under alternative medicine where it doesn't belong in my opinion? Lucleon (talk) 09:09, 29 September 2018 (UTC)

Some more food for thought: Edzard Ernst has a blog post on this paper and also doesn't think it falls under the umbrella of alternative medicine. He has an additional blogpost on omega-3 that concludes "So, here we have an alternative, ‘natural’, dietary supplement or diet that is supported by reasonably sound evidence for efficacy, that has very few adverse effects (the main one being contamination of the supplement with toxins), that generates a host of potentially useful effects on other organ systems, that is affordable, that has a plausible mechanism of action…. Hold on, I hear some people interrupting me, FO is not an alternative medicine, it is mainstream! Exactly, an alternative medicine that works is called….MEDICINE" . Lucleon (talk) 11:00, 29 September 2018 (UTC)

Okay moved to lifestyle and diet. Doc James (talk · contribs · email) 23:37, 29 September 2018 (UTC)

References

What the frack? (Cannabis?)

A source with, "Pharmaceutical THC (with or without CBD) improved anxiety symptoms among individuals with other medical conditions (primarily chronic non-cancer pain and multiple sclerosis; SMD −0·25 [95% CI −0·49 to −0·01]; seven studies; n=252), although the evidence GRADE was very low." as its ONLY anxiety-specific finding is cited <sic> as support <sic> for the sentence, "As of 2019, cannabis is specifically not recommended as a treatment." What the frack? (I didn't pull up more than the freely available summary, but still, this appears to be contrary to the authors' stated interpretation of the studies reviewed, though it (their interpretation) does have a far more measured statement, "There remains insufficient evidence to provide guidance on the use of cannabinoids for treating mental disorders within a regulatory framework.") {{fv}}, right? --50.201.195.170 (talk) 04:28, 31 January 2020 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 24 August 2020 and 11 December 2020. Further details are available on the course page. Student editor(s): Softballgirl33. Peer reviewers: Justyss Chi, Arionnar3, Mledx.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 14:31, 16 January 2022 (UTC)