Mental Health Monday–Amnesia and Anxiety Disorders

A writerly pal and blogging buddy, Lynn Rush, has some fantastic questions for today! I met Lynn several months ago on the interwebz and have become an avid fan. Not only is her blog, Catch the Rush, fun and engaging with movie trivia quotes, writer’s journeys, and guest spots with her characters, but Lynn herself is upbeat and always encouraging. And she’s written a TON of novels!!!!

Thanks, Lynn, for posing such interesting questions!

1) What is the treatment for amnesia (trauma induced)?

I’m glad you pointed out trauma induced amnesia, because there are several instances where amnesia can occur (perhaps I’ll tackle that in a later post…). Gosh, I wish I could say there was some magical medication available to cure amnesia, regardless of its cause. Alas, we don’t have such a thing.

 Trauma induced amnesia leads me to believe there was some assault (injury) to the brain. A common example would be a car accident where someone hits their head and is knocked out. They could have injury ranging from mild to severe concussion to a fractured skull, coma, or brain bleed.

There are also two main types of amnesia: Retrograde (where the person doesn’t remember memories from before the incident) and Anterograde (where the person can’t make “new” memories after the incident).

Most treatment includes:

• sedatives such as low dose anti-psychotics (if the person is distraught or agitated and needs the aid of a medication to calm them)
• cognitive rehabilitation (in other words working with the person to regain skills)
• TLC (I add this becuase amnesia is a frightening experience and most benefit greatly from support of friends and family)

2) What medications would you prescribe for someone with OCD (Obsessive-Compulsive Disorder)?

OCD is an Anxiety Disorder where the individual suffers from intrusive, recurrent, often unpleasant thoughts (obsessions) and engages in repetitive behaviors (compulsions) to ward off, defend themselves against, and fight those thoughts. It is a disorder when it interferes with the person’s functioning and when it causes significant distress. Severe forms of OCD literally take the quality of life away from someone becuase they are engaging in their thoughts and behaviors for HOURS a day.

I’m gonna amend this by saying we all have had that experience of, “Oh, crap, I left the stove on,” or “Did I lock the door when I left for work?” It’s okay to go back and check, as long as it doesn’t happen for hours a day.

Treatment includes a combination of Cognitive Behavioral Therapy (where the person works with a therapist to identify the thoughts, the emotions behind them, and strategies to break into the compulsion cycle) and medications. The most commonly prescribed medications for the treatment of OCD include anti-depressants such as Prozac, Lexapro, Celexa, Zoloft, Luvox, etc. (I haven’t named all of them here, but suffice it to say they all have some effect in ameliorating symptoms and it comes down to what works best for that individual.) Studies have shown Luvox to be particularly good at curbing symptoms, however, it can react with other medications when metabolized in the liver, so it is used less frequently. Another oldie, but goodie, are the TCA (tricyclic anti-depressants) class. However, they tend to be dangerous in overdose and, since the advent of Prozac and other “SSRI’s” (Selective Serotonin Reuptake Inhibitors–AKA they regulate a chemical in the brain called Serotonin), they have been prescribed less and less.

3) What treatment would you try with agoraphobia? Both meds and behavioral therapy?

Like OCD, agoraphobia is considered an Anxiety Disorder.

Agoraphobia itself means: an abnormal fear of open or crowded/public spaces.

Agoraphobia is commonly associated with Panic Disorder (which occurs when an individual experiences frequent panic attacks, characterized by overwhelming anxiety, sense of doom, lightheadedness, fear of loss of control, tingling of extremities, racing heart, shortness of breath, sweating, upset stomach, etc, that lasts from 5-20 minutes). The fear becomes overwhelming when the person believes there is no way out or they will be completely unable to get help if something bad happens. The general cycle is that someone has a panic attack, then anticiapates it occurring in that location again, so they avoid going there, then another panic attack happens somewhere else and they avoid going there, until finally, they are literally housebound.

Treatment for Agoraphobia, like OCD, is two-fold. While avoidance of anxiety-provoking situations is helpful in the short-term (we all use this strategy, by the way), it tends to have negative consequences in the long-term (ex. becoming housebound because you can no longer go anywhere). So, CBT and something called Exposure Response Therapy is helpful because it helps the person confront their fear with the guidance of a therapist.

Therapy is often supplemented with medications. Anti-depressants again are most effective in these cases because they help regulate Serotonin and help the individual to cope better with their anxiety.

Alrighty, gang, we covered a lot of material here today–I hope y’all made it to the end, LOL! Any questions or clarifying I can do?

And don’t forget to check out Lydia’s post on Medical Monday!