Pharmacological treatment for Anxiety

Medications are a common treatment for anxiety disorders in adults, and research supports their efficiency. Anxiolytic drugs have been shown to reverse specific abnormalities in the neurotransmitter system of anxious people. Benzodiazepines (BZs) have been shown to be effective in treating adults with panic disorders, agoraphobia with panic, social phobia, and generalized anxiety disorder. Required dosage varies considerably across individuals and recommended practice is to start with a low dose and build up until a therapeutic effect is achieved, thus avoiding unnecessary toxicity and side effects. Physical dependence on BZs is concern, and discontinuation of BZ treatment can be associated with a rebound in symptoms, so a gradual fading and augmentation of the medication with psychological treatments is recommended. Tricyclic antidepressants (TCAs, especially imipramine  and clomipramine) adn especially monomine oxidase inhibitors have been shown effective with panic disorder and social phobia. The advantage of these medications are that they can also produce an improvement in comorbid depressive symptoms. However, both of these antidepressants have significant side effects. Thus they are rarely a first choice for the treatment of primary anxiety. The selective serotonin reuptake inhibitors are widely used as antidepressants and have been shown to have potential for the treatment of panic disorder, social phobia, obsessive compulsive disorder, and post-traumatic stress disorder. However, little information is available about the long-term efficacy of these agents and the side effects, which can include agitation, insomnia, gastrointestinal problems, and sexual dysfunctions.

A number of important clinical issues have been identified regarding medication treatments for anxiety disorders. The long-term outcomes and effects of medication are not clear and the therapeutic benefits once medication has been discontinued remain dubious.  Most clinicians, therefore, consider a combination of drug and cognitive behavioural treatment to be optimal for handling anxiety disorders.

With regard to children, there is a lack of well controlled and well conducted research studies into psychopharmacological interventions, and there is little support for their use as sole treatments for anxiety disorders with younger people. BZs, which have received the most empirical support and are most commonly prescribed for children and adolescents with anxiety disorders, they are tolerated by most children with minimal side effects, although these can include unsteady gait, blurred/double vision, reduced mental acuity , sedation, slurred speech, tremor, drowsiness, and irritability . BZs are comparatively safe in overdose, but the risks associated with tolerance and dependence in children are unknown. Studies of the efficacy of TCAs with anxious children have focused on separation anxiety and school refusal and have produced conflicting results. Only one of four published studies has provided support for the efficacy of TCAs in the treatment of separation anxiety. However, one of the three negative studies used an arguably sub-therapeutic medication dosage while the remaining two had small sample sizes. The most frequent side effects of TCAs include blurred vision, sedation, lightheadedness, dry mouth, urinary retention, and constipation.  Overdosage can result in severe medical complications. There is some evidence that buspirone may be effective in the treatment of generalized anxiety, and further controlled trials are merited, especially given it’s lack of major side effects, its limited potential for abuse, and its low probability of producing withdrawal symptoms following cessation. Fluoxentine (prozac) has shown promise in the treatment of childhood obsessive compulsive disorder and generalized anxiety in children. In one study,81% of the children given fluoxetine showed moderate to marked improvement in their anxiety symptoms with few side effects.

Psychological Treatment for Anxiety

When considering the success of any particular treatment, it is useful to discriminate between efficacy and effectiveness. The former refers to the outcomes associated with a treatment when it is delivered in its optimal form. The latter refers to the outcomes associated with the treatment in the real world, and thus includes consideration  of many factors such as resources needed, skills of the clinicians in the community, and acceptability of the treatment to consumers, as well as the efficacy of the treatment. While psychodynamics and family therapies have been used in the treatment of childhood anxiety disorder, the lack of controlled studies prohibits conclusions about their efficacy or effectiveness. In contrast, a wealth of evidence is available about the efficiency and, to a lesser extent, the effectiveness of cognitive-behavioral and pharmacological interventions.

Cognitive-behavioral treatments incorporate a range of treatment strategies, and most clinicians recommend a combination of procedures based on conditioning/exposure, reinforcement, physiology, and cognition. Common to all learning-based treatments in the premise that anxious patients can, through learning, minimize the threat value of the things they fear  and learn to regulate their emotions and psychological reactions more comfortably as they explore life. Exposure techniques involve having the patient, under the support and guidance of a therapist, face the fear in order to learn that the feared stimulus is not in fact so threatening,thereby breaking the cycle of avoidance. Often, some exposure is undertaken in imagination prior to exposure in the real world. The underlying mechanism that account for the success of exposure based procedures are still controversial. Originally Joseph Wolpe explained it as the inhibition of anxiety through relaxation learned as part of the exposure treatment. More recent views emphasize changes in thinking processes that occur during exposure. David Clark and his colleagues  use exposure treatments that help the sufferer to rethink and devalue the threat associated with the things they fear as they face them.

Psychological strategies for dealing with anxiety include muscle relaxation skills and breathing techniques to help patients manage uncontrollable arousal, especially during exposure exercises. Most of this techniques were developed with anxious adults but can be used with children and adolescents. A number of other strategies have been developed more specifically for children.  Modelling procedures often include the use of films, whereby the child learns to devalue the threat of the fear after watching other people confidently handle the feared situations. Modelling is an important procedure with children who may be manifesting a fear that is shared by other family members. The child is prompted to imitate the performance of the model who is demonstrating nonfearful behaviours and is reinforced for coping behaviour. The efficacy of modelling procedures is both the treatment of childhood phobias and in the preparation of children for stressful events has been supported.

Treatments for anxious children often incorporate reward-base programs, especially in the treatment of school refusal, socially avoidant children, and specific phobias. In general, therapeutic success is enhanced when these programs are combined with other techniques  such as exposure  and cognitive reappraisal.

Some evidence has emerged to indicate that the provisions of learning programs (scheduled as part of the school curriculum) for anxious children can assist in preventing the development of anxiety disorders in a significant proportion of children.

Instagram makes it clear

Instagram To sell or not to sell. To delete or not to delete. This are the questions.

The questions that bothered many people this days. I’m talking about the new policy of Instagram which will be introduced in January of 2013. The change happened after this photo/social app was bought by Facebook, and after the announcement of this new client policy the world revolted and many people decided that until January they will delete their photos and they will close their accounts. Indeed, anybody would be revolted when money are made from their work, but they don’t receive nothing in return. Well, the truth is not really like this, because after all nothing in this world doesn’t come for free, and until now the beauty of the Instagram came for free, so nobody paid nothing, and no advertise bothered the users during their experience. Now after hundred of million of dollars have been spent on this, a decision had to be made, and there were two options, one to introduce advertisement in the application, or second to do what they just did, and that to commercialize somehow the content of the Instagram (which in this case are the photos that all the user uploaded every day). Indeed the issue appeared when a personal photo could be used without any notice and without asking your permission. After all this noise, Instagram officials came forward and said that the things aren’t really like this and they will try to explain better the situation and the clauses of the new agreement. One thing Kevin wanted to clarify before the release of the new policy, that no photo will be commercialized without any compensation.

The new policy will change things, so Instagram will be able to financially auto sustain itself. (they also have to pay bills, salaries, and many other things)…

Anxiety Disorders

The experience of fear and anxiety are common, typically temporary, and have survival value in that they motivate “flight-flight” responses to danger. Normal anxiety and anxiety disorders vary along a continuum, with the degree of distress and interference with daily life distinguishing between what is normal and adaptive and what is dysfunctional. For some people, anxiety can become so problematic that they can be said to have an anxiety disorder. Disorders of this type are among the most common mental health problems, and a large proportion of health resources are spent on dealing with anxiety and its associated problems.

The most common diagnostic system in use are the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association and the International Classification of Diseases of the World Health Organization. In determining whether a problem warrants a formal diagnosis as an anxiety disorder, the clinician using these systems will consider the specific symptoms, the duration of the problem, the interference caused by the problem, and whether the anxiety can be better explained by another problem such as drug abuse or a medical condition. The DSM-IV discriminates between anxiety disorders that typically begin in childhood or adolescence and those usually diagnosed in adulthood. However, children can be diagnosed with any of the adult categories, and only one disorder is specific to children and adolescents: separation anxiety disorder. This disorder results from undue anxiety regarding separation from significant figures in the child’s life. The child’s reaction to such separation is beyond that expected for his or her development level.

This anxiety disorder of adulthood include: agoraphobia, panic disorder, specific phobias, social phobias, and generalized anxiety disorder. Agoraphobia is a morbid fear and avoidance of public places such as shopping centres and public transportation. Although the problem may be based on a previous experience of having suffered a panic attack in such places, panic is no longer a feature; a long standing pattern of avoidance is the primary manifestation. Panic disorder is the repeated experience of uncontrollable panic attacks not associated with specific phobic stimuli characterized by heard palpitations, sweating, breathing problems, nausea, and shaking, as well as thoughts of losing control, having a heart attack or stroke, and dying. Those individuals who exhibit panic disorder without agoraphobia show no secondary avoidance of particular places associated with the phobia avoid certain places because they fear the onset of a panic attack, which they associate with those places. Sufferers develop a sensitivity to internal arousal that signal the possibility of a panic attack. Thus, any signs of  bodily changes due to exertion, loss of breath, excitement, anger, and so on can come to elicit panic; often described as “fear of fear”. Specific or simple phobias result from specific stimuli. These phobias tend to parallel the fears people normally have throughout the life span, except the phobias lead to a greater degree of fear and significant impairment. The most common stimuli for specific phobias include medical procedures, needles, blood , injury, heights, water, small spaces such as elevators, insects, and animals. Social phobia results from the morbid anxiety associated with being scrutinized by others. Sufferers show high levels of self consciousness and exaggerate other people’s negative reaction to them  on the basis of their own state of anxiety, Thus, sufferers find it difficult to attend social gatherings and perform tasks in front of people, which often makes them unable lead normal social and work lives. Generalized anxiety disorder involves undue anxiety or worry about a range of areas that may include well-being  of family members, self-consciousness, future or past events, performance and competence. The worry is experienced as uncontrollable and is therefore ineffective as the worry is a narrowing of attentional focus that screens out all non-worry related events. Others argue that the worry may function to protect the worrier from other more distressing forms of cognitive activity, such as mental images of scenes that elicit unpleasant emotional states.

There are a number of other disorders in the psychological and psychiatric literature, but more controversy exists about whether their categorization is correct. Three such disorders are obsessive-compulsive disorder, post-traumatic stress disorder, and hypochondriasis. An individual who suffers from obsessive-compulsive disorder feels compelled to perform rituals over and over to prevent tragedy from occurring. The most common forms of obsessive-compulsive disorder involve repeated checking to make sure mistakes have not been made and repeated washing to avoid contamination. The rituals rarely bring any relief, so normal life is often  sacrificed to a cycle of never ending ritualization. Post-traumatic stress disorder involves a range of symptoms that are directly attributable to the previous experience of a traumatic event. Hypochondriasis, or health anxiety, is a preoccupation with the belief or fear that one has a serious illness, even in the absence of organic pathology and despite medical reassurance. As in panic disorder, some who suffers from hypochondriasis becomes sensitized to and fearful of bodily sensations that are incorrectly taken as evidence of serious illness. Such worries are also common in depression, so assessment must try to disentangle the primacy of the various symptoms. The validity of the above categories of anxiety disorders is still controversial. As new research and clinical practice evolves, so do the way scientists categorize disorders, and it is reasonable to predict that the diagnostic system may look markedly different in the future. The American Psychiatric Association has placed increasing emphasis on research and resulting evidence is used in further developing the diagnostic system. For example, the childhood category of avoidant disorder was omitted from DSM-IV after research indicated that it did not differ sufficiently from social phobia.

Most sufferers of anxiety disorders have more than one type of anxiety disorder, and thus it is difficult to argue that the subtype of anxiety disorder are really discrete entities. Further, anxiety disorders also tend to overlap with other emotional and behavioural problems, in particular depression and substance abuse. The latter may simply be due to people using drugs to anxiety and depression is more complex, and the similarity of the two problems had led a number of researchers to argue they are one and the same. A consensual view holds that anxiety and depression are distinct yet overlapping events that share the common experience of negative affect but show distinctions in patterns of symptoms and respond to treatment.

Malware predictions for 2013

2013 Predictions

#1. Spam, yes we didn’t get rid of it yet. In the last trimester of 2012 the spam looked like is getting less aggressive, which is kind of true. The big problem is that the spam that is still out there and in 2013 we will have to deal with the most dangerous one that are left.

#2. Bad apps for Facebook. Because everyday we look to make ourselvesmore comfortable  we start to use different apps that promise to provide us with statistics and useful tools that will make our page attractive and easier to customize. This are big scams that will try to redirect us to dubious websites that invite us to install dangerous toolbars – which is the actual gate through which they will enter and will invade your personal life.

#3. Today everybody can translate texts, messages or even whole websites from a foreign language to their native language with just few clicks. In 2013 viruses will also use this simple trick to translate they malicious information so any person from this Earth to be a potential victim.

#4. In 2013 hackers will redirect their attention to Windows 8 vulnerabilities, since many people travel to this new OS, from 7, Vista, or XP. The main target will be the kernel of Windows 8.

#5. The virtual world, more exactly the Cloud servers will make another main attraction for the attackers. Especially now when so many user prefer this as a storage option.

#6. Another big threat for all of us were, are and will be the applications that can access remotely our infected computers, and from there you can only imagine what will happen further. (eg.:they can easily collect your personal information and data.)

 

My simple advice is to keep your eyes wide open all the time when you’re surfing the internet. Don’t download applications that don’t have a good reference, and always try to read the agreements that you “sign”. Also don’t trust Ads or people who promise a new, better life over the night (there’s not such thing), the only thing this pirates will do is to drive you on a dark alley and stole everything you have.

Advertisement for Marijuana

After the Marijuana have been made legal, all the people of the Colorado State (with the legal age – over 21) will have access to the “relaxing” and “recreational” products. The question that comes with this is, once the Marijuana is out there on the legal market, is how this product will be promoted? We will see big banners on the streets and/or in the bus stations? Or we will see advertisement on TV that will promote the consume of this hallucinogen substance?  If it will be like this, what exactly they will tell us about it, how they will sell their lies?

In the meantime I thought to give them a hand, by presenting my idea, about how the Ad should look like. (they can feel free to use it.)

powerd by marijuana

Do you have any other ideas? If you do, please send them to me, and I’ll make sure to promote them here.

BTW, what’s your opinion about this “big” step, do you think legalizing marijuana will solve some problems, and if so, what problems?

Another question is, where they will cultivate it, because by January 2014  retail marijuana establishments should be up and running . Will they contract the ex illegal dealers, or will they create new spaces like some farms, where they will “improve” the product so the production to be made faster and bigger?

 

Do you need marijuana to feel better? Why? 

2012 Winners in App Store

Best of 2012

The best apps of 2012 for iPad and iPhone were announced by Apple in a special section in the App store.

So here are some of the top apps:

 

iphone5

iPhone

Editor’s Choice App of the Year: Action Movie FXGame of the Year: Rayman Jungle Run

Runner-UP: -Figure

-Letterpress-Word

Casual Games Super Monster Ate My Condo!Catapult King

Shark Dash

Bad Piggies

Supermagica

Fibble HD

Disruptive Services AirbnbHailo

Songza

Hotel Tonight

Square Register

Grocery Gateway

New Ways to Play LiliSlingshot Racing

Total War Battles

Hero Academy

Puzzle Craft

Call of Snakes

Photo & Video Magic VycloneFuzel – Collage Made

iPhoto

Cinemagram

Game your Video

GroupShot

Fun Runners Rayman Jungel RunSki Safari

PITFALL!

Agent Dash

Granny Smith

Run Roo Run

Intuitive Touch ClearPrismatic: Always Interesting

Languages

Any.DO

Flipboard: Your Social News Magazine

Weathercube – Gestural Weather

Free to Play CSR RacingMonster Life – Collect and battle cute mini monsters!

Happy Street

Pocket Planes

Clash of Clans

ZOOKEEPER BATTLE

Discover with Friends PinterestSnapguide

Highlight

Pose

Showyou

Ban.jo

Showpiece Games NihilumbraThe Sandbox

Triple Town

Organ Trail: Director’s Cut

GHOST TRICK: Phantom Detective

Wizorb

Ipad

iPad

Editor’s Choice App of the Year: Paper by Fifty ThreeGame of the Year: The Room

Runner-Up: – Green Kitchen-Healthy vegetarian recipes

– Waking Mars

Casual Games Catapult King

OLO game

Mini Motor Racing HD

Tiny Wings HD

Shark Dash

Skylanders Cloud Patrol

Best of Newsstand NYTimes for iPad

Bloomberg Businessweek+

TIME Magazine

Vogue

National Geographic

Martha Stewart Living Magazine for iPad

New Ways to Play The Room

Waking Mars

Splice: Tree of Life

Outwitters

Autumn Dynasty

Beat Sneak Bandid

Sous Chef Panna

Nigella Quicq Collection for iPad

Hello Cupcake!

Mastering the Art of French Cooking: Selected Recipes

Pat LaFrienda’s Big App for Meat

Appetites’ Easy As Pie featuring Evan Kleiman

Fun Runners Rayman Jungle Run

Ski Safari

PITFALL!

Agent Dash

Granny Smith

Run Roo Run

Post-PC Creation Cards

Adobe Photoshop Touch

DM1 – The Drum Machine

DocuSign Ink

vjay

iA Writer

Free to Play CSR Racing

Monster Life – Collect and battle cute mini monsters!

Happy Street

Pocket Planes

Jurassic Park

Clash of Clans

Lifelong Learning iTunes U

Barefoot World Atlas

Brian Cox’s Wonders

Creatures of Light

The Sonnets by William Shakespeare

Nova Elements

Showpiece Games Eufloria HD

Triple Town

Nihilumbra

Gasketball

GHOST TRICK: Phantom Detective

Incoboto

 

What’s your 2012 iPad/iPhone app Winners?