The results were presented at the annual meeting of the American Psychiatric Association and represent growing excitement about ketamine’s potential. The study included 72 patients who had previously failed to respond to at least two other medications. After receiving a single intravenous (IV) dose of ketamine, 64% of patients reported fewer depression symptoms within one day compared to 28% of those given midazolam — an anesthetic drug that was used as a control.

“[This research] reports the largest controlled evaluation of the antidepressant effects of ketamine to date,” says Dr. John Krystal, professor of psychiatry at Yale, who published the first study in 2000 suggesting that ketamine could quickly lift depression, but was not associated with this trial.

Antidepressants typically take weeks to improve mood — and that’s a time when people with the disorder are at an especially high risk of suicide. “Among people who respond to antidepressants, it takes on average 7 weeks to produce this response,” Krystal says, “When simply getting through a single day can be difficult, waiting 7 weeks to get better can be daunting.” Ketamine— and similar drugs currently being tested by pharmaceutical companies could help relieve suffering faster and potentially reduce the suicide risk associated with the mood disorder.

And because the doses used were lower than those taken by clubbers or used in anesthesia, most patients didn’t have the extreme experiences of “out of body” sensations or profoundly distorted perceptions of reality.  “Nobody freaked out,” says Murrough, adding that most described the experience of the infusion as being similar to having had a few drinks. About 10%, however, did have some dissociative effects.  “One patient [reported] wondering whether time still existed during the infusion,” he says.

The results are especially noteworthy because ketamine was compared to another anesthetic with similar psychoactive effects, not just a placebo. Such comparisons are important because drugs that result in highly noticeable responses like sedation also tend to have strong placebo effects. Researchers had argued that without such a comparison, it would be difficult to tell whether ketamine was actually relieving depression.

“This design was elegant because midazolam briefly made patients feel better, but did not produce a real antidepressant effect,” Krystal says, “In contrast, ketamine produced the robust antidepressant effects that have been observed in every study of ketamine since our initial preliminary observations.  This is the first direct evidence that the antidepressant effects of ketamine are specific, increasing our confidence in importance of this clinical observations.”

Since the study has not been published, however, the results have not yet been subject to peer review. But Krystal and others are encouraged by the apparently lasting effects of the drug; the study showed that seven days after the infusion, 46% of those who received ketamine were still experiencing significant relief— compared to just 18% of those who received the midazolam.

The findings also follow about half a dozen smaller trials that tested the drug for depression or bipolar disorder. Murrough and his colleagues also published a study last year in Biological Psychiatry that could pave the way for broader use of the drug. In that analysis, his team examined whether ketamine could be used repeatedly for longer term results, perhaps as a replacement for, or addition to, electroconvulsive therapy (ECT). In that study, 24 patients with treatment-resistant depression who were not taking any other medications received several daily doses of ketamine; after 12 days, 71% of the patients showed a 50% reduction in depression symptoms, with relief typically coming within 2 hours of the treatment.  On average, the patients who responded remained well for 18 days following the last infusion.

But because ketamine distorts consciousness, it likely would not be practical as a daily medication, as Prozac is currently used. In cases of profoundly disabling depression, however, it might be helpful if given several days a week, the way ECT is now prescribed.  While ECT is the best existing treatment for cases of depression that do not respond to medication and therapy, the stimulation can interfere with memory and it requires general anesthesia. Murrough envisions ketamine could be administered in conjunction with talk therapy and in combination with other medications to try to maintain recovery.

In fact, since ketamine is already FDA-approved, some clinicians have started to offer infusions to their patients, but that’s not a practice that Murrough condones. “There are physicians carrying out this procedure in nearly every major American city,” Krystal notes, “[But] I think that ketamine infusion is still an experimental procedure.”

Indeed, Krystal’s colleagues recently reported some significant negative side effects in his trial of using ketamine to treat obsessive-compulsive disorder (OCD). Two of three participants who had OCD, who did not have current depression but had suffered from it in the past, developed new symptoms the day after ketamine treatment, which included suicidal thoughts, anxiety and severe distress.

The researchers agree that while promising, ketamine-based therapy is probably still best conducted in an experimental setting— but that any clinicians who use it outside of research must, at the very minimum, carefully monitor patients. Krystal is planning to urge the National Institute on Mental Health to collect more data on all patients currently being treated for mental illness with ketamine. “The largest study of repeated ketamine administration ever published has only 24 patients in it,” he says, “This is an extremely thin and somewhat risky evidence-base to launch a national treatment program.”

With more data, however, researchers may become more confident in how best— and safely— to use the drug. And the latest study is an important first step toward that goal. “It seems that a new antidepressant approach has been identified that may expand the scope of effective antidepressant treatment,” Krystal says, “We look forward to larger and more definitive clinical trials that will help to determine whether more patients will be effectively treated through this mechanism and whether the possibility of rapid improvements in depression substantially reduces the burden of this disease.”

Article source: http://healthland.time.com/2013/05/22/club-drug-ketamine-lifts-depression-in-hours/

By Helen Lavretsky, MD, MS

There is currently extensive use of complementary and alternative medicine (CAM) — also known as integrative or mind-body medicine — in the United States to sustain well-being in both aging baby boomers and in children and adolescents. The National Center for Complementary and Alternative Medicine (NCCAM) defines CAM therapies as “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine,” with “conventional” medicine being defined as the approaches used by clinicians in the routine daily practice of Western or allopathic medicine that are within the currently accepted standard of care.

The most recent comprehensive assessment of CAM use in the United States found that roughly 40% of US adults had used at least one CAM therapy within the past year. In addition, Americans make more visits to CAM providers each year than to primary care physicians and spend at least as much money on out-of-pocket expenses for CAM services as they do for all conventional physician services combined. Patients with mental disorders turn to CAM for relief of symptoms of anxiety, mood, insomnia, impaired cognition, and perceived stress. The most commonly used CAM techniques include prayer for health and the use of multivitamin supplementation. Given widespread use of CAM services among patients, there is an urgent need for greater awareness and familiarity with its applications and outcomes.

As baby boomers age and increase use of CAM, mental health professionals require a working knowledge of CAM techniques intended to address late life mood disorders. An estimated 33-88% of older adults will use CAM therapies, including those with late-life depression and bipolar disorder. CAM treatments of mood and anxiety disorders include acupuncture, deep breathing exercises, massage therapy, meditation, naturopathy, and yoga.

Complementary and alternative medicine encompasses a number of techniques collectively known as mindful exercise (e.g. yoga, Qigong, and Tai Chi), or meditation. This ‘physical exercise executed with a profound inwardly directed contemplative focus’ is increasingly utilized for improving psychological well-being. In general, mindful physical exercise contains the following key elements:

1. a non-competitive, non-judgmental meditative component,
2. mental focus on muscular movement and movement awareness combined with a low to moderate level of muscular activity,
3. centered breathing,
4. a focus on anatomic alignment (i.e., spine, trunk, and pelvis) and proper physical form,
5. energy centric awareness of individual flow of intrinsic body energy, otherwise known as prana, life force, qi, or Kundalini.

Mindful exercise has been shown to provide an immediate source of relaxation and mental quiescence. Scientific evidence has shown that medical conditions such as hypertension, cardiovascular disease, insulin resistance, depression, and anxiety disorders respond favorably to mindful exercises.

There is a growing database of the physiological effects of mindful exercise and meditation. Tai Chi and Qi Gong have been shown to promote relaxation and decrease sympathetic output, and to benefit anxiety, depression, blood pressure, and recovery from immune-mediated diseases. Tai Chi and Qi Gong have been shown to improve immune function and vaccine-response. These practices have also been shown to increase blood levels of endorphins and baroreflex sensitivity, and to reduce levels of inflammatory markers (CRP), adrenocorticotrophic hormone (ACTH), and cortisol, implicating the hypothalamic-pituitary-adrenal (HPA) axis as a mediator of stress and anxiety reduction. Brain wave or electroencephalopathy (EEG) studies of participants undergoing Tai Chi and Qi Gong exercise have found increased frontal EEG alpha, beta, and theta wave activity, suggesting increased relaxation and attentiveness. These changes have not been found in aerobic exercise controls.

Yogic meditation (Kirtan Kriya) for stressed family dementia caregivers resulted in lower levels of depressive symptoms, and improvements in mental health and cognitive functioning. Participants in the yogic meditation group showed a 43% improvement in telomerase activity after 12 minutes of daily practice for 8 weeks, compared with 3.7% in relaxation music control participants. This suggests that brief daily meditation practices can benefit stress-induced cellular aging. Kirtan Kriya reversed the pattern of increased NF-κB-related transcription of pro-inflammatory cytokines, and decreased IRF1-related transcription of innate antiviral response genes in distressed dementia caregivers. This reinforces the relationship between stress reduction and beneficial immune response. In the same study, nine caregivers received brain FDG-PET scans at baseline and post-intervention. When comparing the regional cerebral metabolism between groups, significant differences over time were found in different patterns of regional cerebral metabolism suggesting brain-fitness effect different from passive relaxation.

Studies of meditation also report decreased sympathetic nervous activity and increased parasympathetic activity associated with decreased heart rate and blood pressure, decreased respiratory rate, and decreased oxygen metabolism. Functional neuroimaging studies have been able to corroborate these subjective experiences by demonstrating the up-regulation in brain regions of internalized attention and emotion processing with meditation.

In a recent systematic review of neurobiological and clinical features of mindfulness meditations, Chiesa and Serretti (2010) provided evidence on the neurobiological changes related to Mindfulness Meditation (MM) practice in psychiatric disorders. Meditation practices that focus on concentration of an object or mantra seem to elicit the activation of fronto-parietal networks of internalized attention; meditation techniques that focus on breathing may elicit additional activation of paralimbic regions of insula and anterior cingulate; and meditation techniques that focus on emotion may elicit fronto-limbic activation. Future studies will be needed to disentangle the brain activation patterns related to different meditation traditions.

Given the noninvasive nature of mindful exercise and meditation, these exercises are an appropriate option for consumers and clinicians, particularly for conditions that have been examined in controlled studies. Significant evidence supports the assertion that Tai Chi and Qi Gong and yoga and meditation can improve physical and mental health, and quality of life. Ethical considerations should be taken into account when practicing or recommending spiritual interventions by healthcare professionals to respect patients’ beliefs in choosing mind-body interventions.

Dr. Helen Lavretsky is a Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, a geriatric psychiatrist with the research interest in geriatric depression and caregiver stress, as well as complementary and alternative medicine and mind-body approaches to treatment and prevention of disorders in older adults. She is co-editor of Late-Life Mood Disorders with Martha Sajatovic and Charles Reynolds. She is a recipient of the two Career Development awards from NIMH and other prestigious research awards. Her current research include clinical and translational studies of geriatric depression and caregiver stress, as well as complementary and alternative interventions for stress reduction in older adults.

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Article source: http://blog.oup.com/2013/05/mindful-exercise-cam-mental-health/

A national survey conducted by youth mental health organisation Inspire Foundation, questioned more than 3000 people under 25 years of age.

It found 75 per cent of participants were experiencing high to very high levels of psychological distress when they visited Inspire’s website, ReachOut.com, yet 60 per cent of them had never accessed professional help.

Inspire Foundation CEO Jonathan Nicholas said it was important for young people to have an anonymous, non-confronting place they could trust at any time and the internet provided this.

“Young people sometimes may not recognise that they need help,” he said.

“Asking for help may feel uncomfortable, or they may not know where to find help or what to expect from the range of services that are out there.”

Despite the site being the first port call for the majority of youth, the survey revealed 41 per cent were more likely to seek professional help after visiting the site.

The Foundation says the website is particularly popular with young people identifying as lesbian, gay, bi-sexual or transgender which made up almost one quarter of ReachOut.com’s users.

To get a copy of the full report visit:

http://inspire.org.au/young-people-go-online-for-help-during-tough-times/

Article source: http://www.probonoaustralia.com.au/news/2013/05/youth-reach-out-mental-health-help-online

To estimate the effect of CAT on psychological symptoms and quality of life in cancer patients during treatment and follow-up, Timothy W. Puetz, PhD, MPH, from the National Institutes of Health in Bethesda, MD, and colleagues conducted a systematic review involving 27 studies in which 1,576 cancer patients were randomized to a CAT or control condition.

The researchers found that during treatment there were significant reductions in anxiety, depression, and pain, as well as increased quality of life with CAT. During follow-up, pain was significantly reduced. The most robust reductions in anxiety were seen in (1) studies where a non-CAT therapist administered the intervention compared with studies that used a creative arts therapist, and (2) studies that used a waiting-list or usual-care comparison. Reductions in pain were largest during inpatient treatment and in outpatient settings involving homogenous cancer groups. Heterogeneous groups in outpatient settings experienced significantly smaller reductions in pain.

“The cumulative evidence indicates that CAT can decrease symptoms of anxiety, depression, and pain and increase quality of life among cancer patients after treatment,” the authors write. “The effects are greatly diminished during follow-up.”

Abstract Full Text (subscription or payment may be required)

Article source: http://www.jaapa.com/creative-arts-therapies-up-mental-health-for-cancer-patients/article/293206/

Getty Images / Getty Images

While it might seem that your body and brain aren’t doing much when you’re on break, relaxing triggers a flurry of genetic activity that is responsible for some important health benefits.

When you really relax — using any type of meditative technique such as deep breathing, yoga or prayer — the genes in your body switch to a different mode. Genes that counteract the chemical effects of stress kick in, while those responsible for driving more anxious and alert states take a back seat. And a new study shows that long-term practice of relaxation techniques can significantly enhance these genetic benefits.

Dr. Herbert Benson, director emeritus of the Benson-Henry Institute and an associate professor of medicine at Harvard Medical School, first defined the relaxation response in the early 1970s and led the latest genetic investigation published in the journal PLOS One.

“We have within us an innate, inborn capacity that counters the harmful effects of stress,” says Benson. “And this study has shown its genomic basis: namely that specific hubs of genes are changed when people evoke this relaxation response.”

“It’s fantastic,” says Dr. Mladen Golubic, medical director of the Center for Lifestyle Medicine at the Cleveland Clinic, who was not associated with the study. While other studies have linked the relaxation response to lower stress levels and reduced blood pressure, the current trail details the physiological pathways responsible for producing these benefits. The findings confirm and expand on work Benson’s group published in 2008 in which they showed that people who meditated over a long period of time showed altered expression of the genes involved in the stress response.

In the current study, Benson and his colleagues studied 52 people, half of whom had meditated for four to 20 years using relaxation techniques and half of whom were novices. Both groups had their blood taken and analyzed before and after a 20-minute relaxation session in which they used a CD for guidance. The new meditators agreed to participate in two relaxation sessions; in the first, they listened to a CD that provided general health information unrelated to stress, which served as a control. That way, the researchers could compare any molecular changes captured in their blood after they learned deep breathing, mindfulness and mantra practice, which involved focusing their mind on a single repeated word while ignoring distractions.

After these sessions, the scientists identified four sets of changes in the way genes were expressed; these alterations only occurred after the participants used relaxation techniques. The first involved genes related to mitochondria, the batteries that power the cell. “These changes lead to [mitochondria] being more stable and more controlled,” Benson says. “The word we use in the paper to describe the mitochondrial changes is that they are more resilient.”

That makes sense, says Golubic, since “we know that people engaged in meditation report better moods, more energy and that they sleep better.”

Genes linked to insulin production were also affected, with the relaxation response boosting levels of the hormone that is also involved in energy metabolism. “Insulin facilitates the entrance of glucose into cells and into the mitochondria,” says Golubic.

And it wasn’t just individual genes that Benson’s group identified, but also suites of genes that were likely connected in a pathway. That strengthened the findings, since the changes appeared consistently and therefore were unlikely to be linked simply by chance. “What really matters is if you find genetic changes in hundreds of genes in the same pathway. When you find whole pathways that show change, that’s impressive,” says Golubic.

Meditation also affected genes related to telomeres, which cap off the ends of chromosomes to protect and extend the lives of cells. “The shorter the telomere, the more the aging process is manifest,” Benson says. “What the relaxation response is consistent with is stabilizing the telomeres and making them less likely to break down.” An earlier study found that experienced meditators had about 30% more activity in the enzyme that repairs telomeres following an intensive meditation retreat.

The researchers also saw less activity in genes related to inflammation; in other studies, these genes were overexpressed in patients with hypertension, heart disease and cancer. The data suggest that meditation, or regular relaxation, can downplay the activity of these genes and potentially counteract some of the physiologic processes that drive them.

All of these changes were seen to a much greater extent in the experienced meditators than in the novices. But those new to the practice also showed differences after only two months of training. “The longer you evoke the relaxation response over time — years as opposed to weeks as opposed to once or twice — the more profound the changes,” Benson says.

And there is no right or best way of achieving relaxation, say Benson and Golubic. Each individual can find whatever method works best; the benefits, according to the research so far, are the same.

“The relaxation response is best understood as the opposite of stress or the fight-or-flight response,” says Benson. “There are two steps generally used in evoking it: One is repetition — the repetition can be of a word, sound, prayer, phrase or movement. The other is that when other thoughts come to mind, you disregard them and go back to the repetition.”

Benson recommends practicing the technique for 10 to 20 minutes, at least once a day. “It should be a daily habit,” he says, adding, “People have been doing it for millennia. Now we have a scientific basis to prove its worth. It’s wonderful to be alive to see it.”

Article source: http://healthland.time.com/2013/05/03/relax-its-good-for-your-genes/

Photo Researchers/Getty Images/Photo Researchers RM

The most popular class of drugs used to treat depression, the selective serotonin reuptake inhibitors (SSRIs), may increase risk of bleeding and the need for blood transfusions following operations, according a study.

Previous studies have investigated the dangers of SSRI use among pregnant women and possible associations with suicide among adolescents, but the latest study looked into evidence that correlated SSRIs, which include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil),  with an elevated risk of bleeding and irregular heart beats in patients who were hospitalized for surgery.

The researchers from the University of California, San Francisco took a closer look at SSRI use before surgery and the rate of adverse events in a group of 530,416 patients over age 18 who had operations between January 2006 through December 2008 at 375 different U.S. hospitals.

They analyzed reports of bleeding, transfusions and irregular heart functions during surgery, as well as how long the patients stayed in the hospital. Patients who were taking SSRIs before their operations had a greater risk of bleeding, were more likely to be re-admitted within a month following their procedures, or were more likely to die during the study period than those who were not taking the antidepressants.

To determine whether the effect was due to the medications themselves, or to some other factors shared by the patients taking antidepressants, the scientists adjusted for the potential contribution that depression, age, gender and the condition requiring surgery in the first place might have had on the risk of bleeding and potentially fatal complications. Even after controlling for these factors, the correlation between SSRI use and the higher risk of adverse events remained.

Previous studies suggest that the connection might make sense, since SSRIs prevent nerve cells in the brain from reabsorbing the hormone serotonin, and serotonin can interfere with the function of platelets that are critical for helping blood to clot properly.

It’s still possible, however, that additional factors that the researchers have not yet considered could explain the association; the patients taking SSRIs, for example, were more likely to be obese or have respiratory conditions, which could independently affect risk of complications after surgery. Other analyses also showed that patients who took SSRIs were more likely to experience chronic pain and damage to the peripheral nerves — all of which are linked to a higher likelihood for hospital readmission and mortality.

Because of the increased risk, whatever the cause, some hospitals now recommend [PDF] that patients using the drugs stop taking them for about two weeks or more before a scheduled surgery. The study wasn’t designed to determine the optimal period of time that patients should stay off their medications to avoid complications, but the results point to the need for more research to investigate the link. “Given the ubiquitous nature of SSRIs in U.S. health care and the potential risks of proceeding without adequate evidence for a strategy on how to mitigate risks of perioperative SSRI use, any study costs would seem money well spent,” the authors write.

The study is published in the journal JAMA Internal Medicine.

Article source: http://healthland.time.com/2013/04/30/ssris/

Photo: Tasmanians are using more legally obtainable drugs such as aprazolam. (Lateline)

A study has found Tasmania has the highest rate of drug-related mental health problems.

The annual survey of Tasmanian drug users has also found the state’s drug culture is substantially different to other states.

Researchers from the University of New South Wales surveyed 106 users in Tasmania, as well as users in New South Wales, Victoria and South Australia.

They found local users were less likely to use heroin than users interstate, but there were high levels of users injecting morphine.

Tasmanians were found to be using higher rates of legally obtainable drugs such as the anti-anxiety medication alprazolam.

Researchers say the study shows Tasmanian drug users need better access to mental health support services.

Article source: http://www.abc.net.au/news/2013-04-30/study-finds-drug-culture-differs/4659390?section=tas

John Gass

THIS is the age of anxiety, the era of the benzodiazepine Xanax – “all jumpy and edgy and short of breath,” as New York magazine puts it.

Climate change, terrorism, recession – there’s something for everyone to worry about, and a medication or a book to go with it.

But is anxiety a medical condition or just the new – even not so new – normal?

“Anxiety is a necessary emotion; we need it to perform well,” says Dr Natasha Bijlani, a consultant psychiatrist at the Priory in Roehampton, south-west London, “and life is no more dangerous than it ever was.

“But people’s expectations are different – we’re more achievement-oriented and we want a quick fix.”

A fix such as Xanax (alprazolam)? Yes, though you can’t get it on the NHS in the UK.

Hugely popular in the US (48.7 million prescriptions were written for it there last year), it’s known as the crack cocaine of benzos.

It’s similar to Valium but faster-acting and with a much shorter half-life – Valium stays in the system for 20 to 100 hours, Xanax for only six to 12.

This is an advantage in some ways – less of a hangover – but accounts for its more addictive qualities. You want more and you want it now.

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Anti-anxiety meds are nothing new.

Miltown (meprobamate), the first blockbuster tranquilliser, became the toast of Hollywood in the 1950s. Lucille Ball, Tennessee Williams, Aldous Huxley, Norman Mailer and Salvador Dali’s wife, Gala, were all fervent fans.

Then came the benzos: Librium, followed by the wildly successful Valium, both developed by Leo Sternbach at Roche’s plant in Nutley, New Jersey, and approved by the Food and Drug Administration in 1963.

Perfect for Cold War angst, more potent than Miltown, Librium and then Valium (developed because of Librium’s bitter aftertaste) were also less toxic and sedating and set the way for the “codification of anxiety into medical pathology”, as Andrea Tone puts it in The Age of Anxiety: A History of America’s Turbulent Affair with Tranquilizers (Basic Books).

Paul Gilbert, professor of clinical psychology at the University of Derby and author of The Compassionate Mind, says that “our cognitive abilities are plumbed into an ancient anxiety system”, and that in anxiety disorder, the threat/self-protection system – useful if to avoid being eaten by a lion – seems to be inflamed and easily activated, and that the amygdala, that part of the brain’s limbic system that plays a vital role in the regulations of emotions, has become oversensitive.

And – no surprise there – it’s in the amygdala that the benzos concentrate their soothing, often addictive, magic.

We worry, states The New York Times, which has a whole section of its Opinionator blog devoted to exploring the navigation of the worried mind.

“Nearly one in five Americans suffers from anxiety. For many, it is not a disorder, but a part of the human condition.”

Should this human condition be medicated? “Much better to learn how to tolerate distress,” says consultant psychiatrist Dr David Veale, who recommends compassion-focused therapy (CFT), a type of cognitive behavioural therapy particularly effective with anxiety, “though it’s much harder than benzos.”

In CFT, only just gaining a foothold in the UK with Professor Paul Gilbert and Dr Chris Irons in the vanguard, you learn to build up a “soothing system” that calms and comforts.

But sometimes, meds can tide you over a bad patch – not everyone gets addicted, after all.

Joe, a teacher, whose anxiety achieved an “apocalyptic, political edge” around the time of the American election, when he couldn’t sleep for worrying about whether Barack Obama would get in, calls his form of anxiety the “learnt doom and gloom” – all the long, pessimistic articles he was reading sent him over the edge.

He felt “immobilised by angst” but Ativan (lorazepam), a benzo that’s often prescribed for panic disorder, helped him to cope, short-term, with the daily stress of work, family and money problems and put the latest Atlantic piece in some sort of perspective.

Dee, a gerontologist, became so consumed with worry about her teenage son “lying dead in a gutter when out late” that she started taking a low dose of Prozac to help her to calm down.

She stopped a few years later when her son was older but found herself still so racked by amorphous regret and anxiety that she has started taking it again.

“I can’t get off the track in my brain that goes over and over some bad thing – something I feel certain I should have done or something I fear could happen.”

She describes her anxiety as being like “veins in my brain, iron ore or something. When I’m gripped by it I try to imagine a laser penetrating my brain and zapping the awful thought.”

A search for anxiety self-help books on Amazon yields more than 5,500 titles. Constable Robinson publishes 57 anxiety-related books, including The Compassionate Mind Approach to Overcoming Anxiety by Dennis Tirch, the US guru of CFT.

Anxiety is even a memoir genre: in The Little Book of Anxiety: Confessions from a Worried Life (Robson Press), Kerri Sackville (who is not a fan of meds as they “knock me out so I can’t function”) kicks off with her groundless fear of abandonment by her mother, progresses to teenage acne, skin-picking and fear of public toilets, on to obsessive fears about her husband having a fatal accident, paranoia about her friends hating her, and then motherhood, when she turns strangely calm (she knows child-related worries would take over completely so she blocks off all such thoughts) until her daughter gets an infected chickenpox spot and almost dies, at which her anxiety levels hike up a notch again.

“I believe I was a born a worrier,” says Sackville, who lives in Sydney.

“I have an anxious father, too, so I think it is a combination of genetics and upbringing. When you are around an anxious person you are more likely to feel anxious.” Joe agrees.

“I think I inherited my mother’s brain chemistry. Now I understand her awful anxiety that my dad and I had to dodge and cater to. She was always a very early riser, and I feel I know what she was doing from 4am on – worrying, thinking in circles, consumed with shame.”

Meds may come and meds may go – Xanax now far outsells Valium and Roche will close its Nutley plant next year as part of a streamlining operation – but panic disorder, anxiety, worrying: they’ll go on for ever.

Article source: http://www.cqnews.com.au/news/anxiety-mental-health-disorder-or-part-human-condi/1840340/

Price: AUD$16.12 Save $7.94

Click here to purchase The Buddha and the Borderline with free worldwide delivery

Kiera Van Gelder’s first suicide attempt at the age of twelve marked the onset of her struggles with drug addiction, depression, post-traumatic stress, self-harm, and chaotic romantic relationships-all of which eventually led to doctors’ belated diagnosis of borderline personality disorder twenty years later. The Buddha and the Borderline is a window into this mysterious and debilitating condition, an unblinking portrayal of one woman’s fight against the emotional devastation of borderline personality disorder. This haunting, intimate memoir chronicles both the devastating period that led to Kiera’s eventual diagnosis and her inspirational recovery through therapy, Buddhist spirituality, and a few online dates gone wrong. Kiera’s story sheds light on the private struggle to transform suffering into compassion for herself and others, and is essential reading for all seeking to understand what it truly means to recover and reclaim the desire to live.

The Miracle of Mindfulness explores the notion that mindfulness does not need to be a practice of mediation requiring postures and sitting in an environment of peace and tranquility. Mindfulness is something that can be used on the bus to work, during exercise and even in a conversation with your loved ones.

• Price AUD$11.18 click here to purchase with free worldwide delivery
  
• Publisher: Rider & Co
• Published: 07 February 2008
• Format: Paperback 160 pages
• Categories: Mind, Body, Spirit: Meditation & Visualisation Buddhism
• ISBN 13: 9781846041068 ISBN 10: 1846041066
• Sales rank: 157

In this beautifully written book, Buddhist monk and Nobel Peace Prize nominee Thich Nhat Hanh explains how to acquire the skills of mindfulness. Once we have these skills, we can slow our lives down and discover how to live in the moment – even simple acts like washing the dishes or drinking a cup of tea may be transformed into acts of meditation. Thich Nhat Hanh’s gentle anecdotes and practical exercises help us to arrive at greater self-understanding and peacefulness, whether we are beginners or advanced students. Irrespective of our particular religious beliefs, we can begin to reap the immense benefits that meditation has been scientifically proven to offer. We can all learn how to be mindful and experience the miracle of mindfulness for ourselves.

http://www.bookdepository.co.uk/Miracle-Mindfulness-Thich-Nhat-Hanh/9781846041068?a_aid=MHHub