TIME Exercise/Fitness

Yoga Helps Older Adults Battle Depression and Anxiety

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For many older adults, the thought of stepping into a yoga class swarming with yogis more flexible than Gumby might provoke anxiety. But the practice itself may be just the antidote the over-60 set needs, suggests a recent review of studies about relaxation exercises. Those who did yoga and other calming activities saw greater reductions in their anxiety and depression than people who didn’t.

The body of literature on yoga’s relaxation benefits spans all kinds of people, but the authors thought adults aged 60 and older deserved their own analysis. Up to 40% of older adults report anxiety, they note, and anywhere from 15-20% of the elderly experience depression. So in the review published in the journal Aging & Mental Health, researchers scrutinized 15 studies—12 of them randomized controlled trials—from the past two decades that looked at different methods of relaxation. They gauged the effectiveness of six techniques: yoga, listening to music, tensing and relaxing different groups of muscles, massage therapy and stress management training.

MORE: Is Bikram Yoga Safe?

The most effective ways to alleviate depression were yoga, the music intervention and the muscle tensing and relaxing exercise—called PMRT, for progressive muscle relaxation training. The music and yoga interventions were the best for anxiety.

Yoga had the strongest staying power. Positive effects from the stretching, breathing and meditation exercises stuck around six months later in older adults. “It could help counterbalance the negative effects of ageing, improve physical functioning, postpone disability, decrease morbidity and mortality, stimulate the mind, and increase hope, reducing the risk of anxiety and depression,” the study authors write.

MORE: 15 Ways Exercise Makes You Look and Feel Younger

And good vibes from PMRT lasted 14 weeks after the intervention ended. “It is believed that the PMRT has a tranquilising effect, triggers a sense of peacefulness, helps participants retreat mentally from their problem and curtails negative thoughts, reducing depressive symptoms,” the authors write.

The most effective intervention, of course, is the one you enjoy doing—and these results suggest that it’s never too late to find your favorite way to unwind.

 

TIME Mental Health/Psychology

Mental Health Therapy Through Social Networking Could Soon Be a Reality

While still in the development stage, the peer-to-peer technology had "significant benefits"

An experimental social networking platform intent on helping users calm anxiety and reverse symptoms of depression has received positive feedback.

Panoply is a peer-to-peer platform jointly administered by MIT and Northwestern universities that encourages users to “think more flexibly and objectively about the stressful events and thoughts that upset them,” says a paper published in the Journal of Medical Internet Research.

Researchers found that the network, which is still being studied and has yet to be commercialized, produced “significant benefits, particularly for depressed individuals.”

Panoply works by teaching users a therapeutic tool called cognitive reappraisal, which tries to get people to look at a problematic situation from different perspectives.

When a person is stressed, they write what is causing the problem and their reaction. The “crowd” then responds by a offering a contrasting outlook. Comments are vetted to ensure the original poster is not abused.

The study involved 166 people over a three-week period. Researchers suggested a 25-minute per week minimum interaction to see results.

According to the published paper, the next step is to widen the net and see if the social media platform is as effective over a more diverse audience.

TIME Diet/Nutrition

A High-Fat Diet Could Be Altering Your Behavior and Not Just Your Waistline

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Study finds that heart disease and obesity aren't the only effects of eating too many fatty foods

Obesity, heart disease and other physical afflictions may not be the only negative impacts of consuming fatty foods. According to a recent study on mice, high-fat foods could be affecting behavior, increasing the risk of depression and related psychological disorders.

The study, published in the journal Biological Psychiatry, suggests that a high-fat diet alters the mix of bacteria in the gut known as the gut microbiome. These changes, researchers from Louisiana State University believe, might be affecting one’s susceptibility to mental illness.

The researchers tested their hypothesis by taking organisms from the gut microbiome of mice that had been fed a high-fat diet and transplanting them into non-obese mice. They found that the microbiome associated with greater levels of fat led to problems such as increased anxiety and impaired memory.

“This paper suggests that high-fat diets impair brain health, in part, by disrupting the symbiotic relationship between humans and the microorganisms that occupy our gastrointestinal tracks,” Dr. John Krystal, Editor of Biological Psychiatry, told Science Daily.

Although there is still a lot of research to be done in this field, the study highlights mental issues associated with a high-fat diet regardless of obesity.

[Science Daily]

Read next: 10 Reasons Your Belly Fat Isn’t Going Away

Listen to the most important stories of the day.

TIME Innovation

Five Best Ideas of the Day: March 4

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. We’re measuring family poverty wrong. We should measure access to opportunity to find out what’s really working.

By the Annie E. Casey Foundation

2. Anxiety, depression and more: “Four to five times more” high school athletes struggle with mental health issues than concussions.

By Gary Mihoces in USA Today

3. They provide social order and an economic structure. What if prison gangs actually make life better behind bars?

By Shannon Mizzi in Wilson Quarterly

4. Scientists have released the genetic sequence of the 2014 Ebola virus to crowdsource solutions to future outbreaks.

By Fathom Information Design

5. If new technology really cut jobs, we’d all be out of work by now.

By Walter Isaacson in the Aspen Journal of Ideas

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Heart Disease

This Makes Your Heart Attack Risk 8 Times Higher

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A new study links high levels of anger to an increased risk for heart attack

Getting very angry isn’t just off-putting to the people around you, it may also significantly increase your short-term risk for a heart attack, according to new findings.

Having an episode of intense anger was associated with an 8.5 times greater risk of having a heart attack during the following two hours, a new study published in The European Heart Journal Acute Cardiovascular Care showed. The new findings add to prior research that has suggested high levels of anger may spur a heart attack.

The study looked at 313 people who were being treated in a hospital for a heart attack. The men and women were asked to fill out a questionnaire about the level of anger they experienced in the last 48 hours based on a number scale:

  1. Calm.

  2. Busy, but not hassled.

  3. Mildly angry, irritated and hassled, but it does not show.

  4. Moderately angry, so hassled it shows in your voice.

  5. Very angry, body tense, maybe fists clenched, ready to burst.

  6. Furious, forced to show it physically, almost out of control.

  7. Enraged, out of control, throwing objects, hurting yourself or others.

An anger level greater than five was reported among seven of the people in the study in the two hours prior to their heart attack, and up to four hours prior for one person. An anger level of four was reported among two people within the the two hours before heart attack symptoms, and among four hours before for three people. According to the researchers, the results come to a 8.5-fold increase in relative risk of a heart attack in the two hours following severe anger. People who reported high levels of anxiety, also had a higher risk.

The study is small and therefore it’s still too early to know how great of a factor intense anger is in predicting heart attack onset. The anger levels are also self-reported and could differ person to person. But the study does provide experts with information about what emotional factors could trigger a heart attack. For instance, the researchers found that some of the greatest reported anger was due to arguments with family members followed by arguments with non-family members, work anger and driving anger. “Our findings highlight the need to consider strategies to protect individuals most at risk during times of acute anger,” the authors conclude.

Exactly how anger could trigger a heart attack still remains unknown, but the researchers speculate that the stress may stimulate activity in the heart like increased heart rate and blood pressure, blood vessel constriction, a plaque rupture, and clotting which could eventually lead to a heart attack.

“I think this study is very helpful in many ways because it’s validating to what we already know. Anger is not what we would call a traditional risk factor because it’s so hard to measure,” says Dr. Curtis Rimmerman a cardiologist at the Cleveland Clinic who was not involved in the study. “It highlights the importance of paying attention to a patient’s wellbeing.”

TIME advice

How to Combat Restlessness

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Restlessness isn't necessarily bad, but it could be an important signal from your body or mind

Answer by Mark Schannon on Quora.

First, what is this thing we call restlessness? There is a range of emotional reactions to stimuli that range from pleasure to panic. Somewhere in that long, complex thread exist some reactions that we call restless; they range from mild anxiety, to not be able to sit still, to needing to do something physical or metaphysical (breathing, yoga, meditation) to alleviate the restlessness. What’s interesting is that we all intuitively understand the word, although it may mean something different from a phenomenological point of view to each of us.

Second, whence comes the restlessness? Is there a psychological or physiological cause—or a combination? Restlessness is most often seen as a psychological phenomena. Before going on stage, many actors experience extreme restlessness (e.g. anxiety, fear, stage fright). As a former actor in high school, college, and community productions, I was a nervous wreck before any performance, walking aimlessly, bouncing up and down, generally feeling an almost uncontrollable restlessness. However, the minute I went on stage, that fear, anxiety, restlessness turned into adrenalin which I used to invigorate my role. The same transition occurred numerous times in job interviews, where restlessness (isn’t it a form of anxiety?), which made it almost impossible for me to sit still, was transformed into a positive adrenalin rush when the waiting was over and the interview began.

However, there have been times when my restlessness wasn’t associated with anything concrete; it was a vague, sometimes overpowering sense of discomfort within my own body. Medication, activity, and time usually sufficed to make it go away. Other things mentioned here—meditation et al.—also can work.

But I believe there is a phenomenon that can be called physiological restlessness—you’ve no doubt seen or had yourself the experience of people just shaking their legs up and down, feet on the floor; or walking aimlessly and restlessly. It is sometimes psychological, but it can be attributed to an over-active nervous system, similar to fibromyalgia but without the pain. Medication such as Lyrica, which are not without side effects, can do an amazing job alleviating the feeling of restlessness. It is not anxiety, although it’s very hard to get most doctors to understand the difference; anti-anxiety medication has no effect on it.

Third, “supposed to do” suggests that restlessness is bad and therefore should be eliminated from the various issues going on in your life, as if there’s one and only one solution for anything perceived as a problem. Before you breathe slowly, do meditation, or take drugs, ask yourself the “why” question: What’s going on in your life that could be causing the feelings? Why are you feeling this way? It may be a signal that something wrong is going on. It could also be a signal that you’re like a race horse at the starting gate, anxious to get going. Restlessness isn’t necessarily bad, but it’s almost always (unless is physiological) an important signal from your body.

Good luck!

This question originally appeared on Quora: What am I supposed to do when I feel restless?

More from Quora:

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Mental Health/Psychology

Millennials and Gen Xers Feel the Most Stress About Money

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Even with the improving economy, one population of Americans is more stressed about financial concerns than they were nearly a decade ago

In the latest survey of Stress in America conducted by the American Psychological Association (APA), money remained the top causes of stress reported by a group of more than 3,000 adults aged 18 years or older, followed by work, family and health concerns. Overall, the average level of stress, reported on a 10-point scale, is at its lowest since the APA began the survey in 2007.

But 29% of participants said that their anxiety over money matters increased in the past year, and younger generations and parents seem to be feeling the pinch most. More than one-third of parents reported higher stress levels over the past year (at 5.8) compared to non-parents (at 4.4).

Millennials and Gen Xers (aged 18 to 49 years) felt more stress than the average American about money. “Where Millennials are concerned, we know that the cost of education is pretty high in this country, and student debt is higher,” says Katherine Nordal, executive director of Professional Practice at the APA. “The job market until recently has also been problematic.”

The gap between financial stress between lower and higher income families is also widening; in 2007 both groups reported the same amount of anxiety over money, but in the current survey, those making less than $50,000 a year were twice as likely as those in higher income groups to feel stress about financial matters all or most of the time.

While the overall rate of stress about money is declining, Nordal says the trends involving younger generations and lower income households is concerning, because strategies for coping with stress aren’t improving, despite greater awareness of its health risks. One in five Americans said they did not have anyone to turn to for emotional support; 27% of those in lower income households fall into this category, compared to 17% of those in higher income groups. “Good support systems seem to be good for reducing stress — it’s not an inoculation against stress but it can be a stress reduction factor,” says Nordal.

Lack of emotional support can also drive people to unhealthy coping mechanisms, including over-eating, not sleeping well and becoming more sedentary. Forty-two percent of respondents said they indulged in such behaviors to cope with their stress in the past month. “Excessive alcohol use, smoking, eating the wrong kinds of foods, not exercising and being too sedentary we know are behaviors that lead to disease states, and unhealthy states,” says Nordal. “And these health risks are very real. We’d like to see people doing things that are more proactive to cope with stress, such as meditation, relaxation techniques and exercise.”

TIME advice

How to Not Sweat the Small Stuff

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Learn to use these 4 simple concepts in your everyday life

As a retiring worry wart, there are times I’m faced with minor issues, personal and professional, that seem to drive me crazy, but are really not worth the added stress. I used to destroy myself over every little problem that arose in my life, from completing homework to witnessing unethical behavior to chipping a newly painted nail. But with observation, insight, and honesty, I began to identify what was worth stressing over and what was not. Below are some helpful concepts that I’m learning to use and practice in my everyday life.

1. Think.

Take a moment, breathe, and think again. Think about the issue and what’s causing you more stress. Then think to yourself about how this will really affect your life. Some of the worst decisions come from acting too quickly. Think through the consequences or the possible outcomes of this problem.

2. Question.

How will this event truly affect your life in the long run? I tend to talk to myself in situations like this and ask myself these questions. Saying it verbally out loud makes it more realistic and helps me think through the question and develop approaches and solutions to the problem.

MORE 6 Steps For Handling High Pressure Situations With Grace

3. Remind.

Remind yourself that this isn’t personal and stop acting like it’s the end of the world, because it’s not. Reassure yourself that this too shall pass and there are worse scenarios that could be happening to you; like you could be battling an illness or losing your job. Being stuck behind that school bus on the way to work is not the end of the world.

4. Learn.

Find ways to cope with your stress and learn from this experience. I think I’m a stronger woman today because I learned how to deal with not sweating the small stuff in my collegiate years as a student, sorority president, and part-time worker. I had a lot on my plate and I had to learn how to manage my time and not take everything so personally.

Being able to admit and identify that you worry about too many things is invaluable. Once you identify this, you can use these ideas to resolve it. During my sorority recruitment, I connected with a potential new member (who is now my sorority grandlittle) over our OCD issues. She was experiencing the same things and we could laugh together over our stress. We established a great friendship, and now 6 years later with each of us living on different coasts, we’re still helping one another. It’s easy to talk to someone you know thinks the way you do, and by talking about your issue out loud, you’ll be able to develop a plan to tackle them on your own.

MORE How to Stop Feeling Like You Should be Farther in Life by Now

This article originally appeared on Levo.com.

TIME women

I Am Taking Up Running Again — At 250 Pounds

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What is different about the attempt this time is that I can see my excuses and fears very clearly

xojane

In my dreams, I run without my feet touching the ground.

I’m not quoting a bad motivational poster, that is really how I get around in my dreams — legs churning, hoping no one will notice that I’m sort of levitating.

In reality, it takes a lot of force to shift my inertia from a body at rest to a body in motion. At 250 pounds, I require even more force to get moving than a typical runner. The “typical” runner I imagine is rock-hard and glistening, a lunch-hour runner who makes mortals wonder what breed of insanity motivates her.

I, however, probably make mortals wonder how this body manages to move at a jogging pace at all.

While the need for physical energy to become a runner may be obvious, I require a great deal of mental energy, too. Each day is a battle with my own mind’s powerful attempts to keep me stationary and hidden inside the house. The excuses begin to flow: Is it too hot today? Or maybe it’s going to rain? What if I get a headache? Maybe I will collapse in the street.

In the past, these excuses limited my route to the streets in the direct vicinity of my front yard. I comforted myself by thinking if I had a physical or medical (or emotional) emergency, I would at least be close to home.

Before now, these three fears often kept me from firing my jets:

  1. Fear of judgment: What must people think when they see someone like me bouncing down the sidewalk? Now I just answer, “What people? And who cares?” If anyone is paying attention to me and has mean energy to burn, it can hardly negate the boost I feel from jogging on a nice day with my happy baby rolling along in her stroller ahead of me. (Also, so far, no one has actually said anything mean to me.)
  2. Fear of failure: Running is something I’ve always wanted to be good at, but what if I never am? To fight this fear, I have to define what it means to be good at running. I used to want to be fast. Now I just want to be fast enough. I want to be fast enough to keep up with my (fairly slow) husband. I want to be fast enough to stay in the race, even if I’m dead last.
  3. Fear of pain: What if I end up miles away from home and some part of me really hurts, but I have to retrace those miles to get back? When my confidence to complete a certain distance is low, I have even circled the same few blocks around my house over and over so I could get back quickly in the event of an injury. I don’t know what injury I expected to occur as I shuffled at a near walking pace. The fact is running has never hurt me except for a few headaches due to heat and poor hydration.

As an aspiring runner, I face many more mental challenges than physical ones. Now that I don’t care about speed, and I don’t worry so much about potential injury, I have only one physical challenge to conquer. No, it’s not my weight! My personal challenge is to run farther, longer, and more often, building by tiny increments at a time.

I just started running again in September, as a 39th birthday gift to myself. When I say I started running “again,” you might imagine I was once one of those taut athletic types, and that I’ve only recently found myself in this overweight condition. Not so! I’ve been about this size for at least a decade, and I’ve “started” running at least a handful of times. At my best, I completed a relay half marathon with my husband. At my worst, I dropped out at mile 6 of a half marathon because I was too slow, and they were closing the course behind me. Or you might say the worst moments in my running life were the times I wanted to do it but didn’t have the courage.

I started this time with a fresh short-term goal — to run an entire 5k in March 2015 without walking.

Training Day 1: I insist that my husband run with me to boost my confidence when I try to bail, to help me feel less conspicuous as a very non-runner-looking person, and to distract me as I huff through a minute of running, followed by four minutes of walking.

Day 3: I repeat the one minute running/four minutes walking intervals without my husband-coach. I do, however, rely on my daughter in the jogging stroller to deflect attention from me. I assume people must think I gained a ton of weight while I was pregnant, and now I’m trying to work it off. The truth is I gained only 12 pounds when I was pregnant, and I lost every ounce during birth.

Day 10: OK, I can run two minutes, but can I run another two minutes after catching my breath for four minutes? And then do it again? Turns out I can. I want to say, “Suck it!” to my doubters, a.k.a. myself.

Day 15: Run three minutes, walk three minutes, then run three minutes again? And repeat the whole sequence for a total of 30 minutes? Thank God for riveting podcasts, counting breaths, just getting to the next driveway, the next corner, the next three minutes of walking.

Day 70: After weeks of viruses, travel, cold weather, flat stroller tires, I’m still at the three-minute interval stage. It’s a pace I’ve become submissive to, as the old confidence demon tells me I probably couldn’t last four or more minutes. Each time I stretch the running interval and shorten the walking interval, I drag along that demon. Once I achieve a new goal, I question whether I can repeat it the next day. The only way I can fight my demon is to keep going out and proving him wrong.

What has changed with this most recent attempt at becoming a runner? Not my body — it looks about the same as always, though it does feel stronger and more capable. The difference is that this time I can see my excuses and fears very clearly. Because I recognize them when they try to block my way out the door, it’s easier to slip by them than it was in the past. I used to think they were solid, immovable walls, but now they are paper-thin.

In November the San Antonio Rock ’N’ Roll Marathon and Half-Marathon course passed within a few blocks of my house. We walked over with the baby to watch the runners and walkers at Mile 6, the same point where this race defeated me five years ago. All I could think about this time was signing up again next year.

Anna Lee Beyer is a writer in Texas. This article originally appeared on xoJane.com.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

MONEY Health Care

5 Ways to Save on the Mental-Health Care You Need

Group therapy can be 50% less expensive than one-on-one sessions.

Get the treatment you need at a price you can handle.

Affordable mental-health care has been easier to come by in recent years. Insurance coverage, once riddled with onerous caps and restrictions, is now more widely available. “Things have gotten better for many,” says Andrew Sperling, director of federal advocacy at the National Alliance on Mental Illness.

Still, paying for care can be a challenge. The high out-of-pocket costs that you’re facing for all your health care extend to behavioral coverage too. And low reimbursement rates and billing hassles have led many therapists to not take insurance. A study published last year in the journal JAMA Psychiatry found that only 55% of psychiatrists accept private insurance; for all other medical specialties, that figure is 89%.

Here’s what you need to know about finding the best treatment at the best price.

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MONEY

Insurance Options are Better

Under a 2008 law that took effect in 2010, health plans offered by large employers that include mental-health coverage must treat it like other medical care. So a plan can’t cap annual visits or impose prior authorization rules for behavioral health if it doesn’t do the same for other illnesses, says Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law. Co-insurance rates have to be the same too. As the graphic above shows, the parity law hasn’t discouraged employers from offering coverage.

Any individual plan you buy on a state insurance exchange must include mental-health coverage; it’s one of the 10 essential benefits required by Obamacare. The provision in the law that lets children stay on a parent’s health plan until age 26 is another boon, since most major psychiatric conditions show up in late adolescence or early adulthood, notes Debbie Plotnick, senior director of state policy at the nonprofit Mental Health America.

Medicare coverage is also better. As of 2014, benefici­aries are responsible for only 20% of mental-health costs, down from 50%.

Your Employer Can Often Help

Especially if you have a high-deductible health plan, start with your company’s employee assistance program, says Kathleen Mahieu, leader of behavioral-health consulting at benefits consultancy Aon Hewitt.

About three-quarters of employers offer an EAP. These programs typically provide five or six sessions of no-cost counseling, even for family members. That’s enough for some people to resolve their issues, says Katherine Nordal, the American Psychological Association’s executive director for professional practice. An EAP can help you find a provider or connect you with other mental-health resources. “It’s a one-stop shop,” says Mahieu. And, she adds, EAPs pride themselves on confidentiality. Your boss won’t know, and you don’t even have to give your name.

Your Bill is Negotiable

When your therapist isn’t in your insurance network, you’ll have to pay upfront and submit the bills for partial payment (assuming you have out-of-network coverage) or, if you’re in an HMO, pay in full. Even if you are reimbursed, you won’t get back, say, 70% of the bill. You’ll get 70% of what the insurer considers “reasonable and customary,” leaving you on the hook for the rest.

If you can’t find an appropriate provider in your plan, ask your insurer to negotiate what’s known as a single-case agreement with someone who’s not in your network, says Barbara Griswold, a licensed marriage and family therapist in San Jose. That would let you to pay the in-network rate.

You can also ask about a reduced fee, says Griswold. “Almost every therapist has a sliding scale,” she says. Be realistic about what you’ll be able to afford and how long you’re likely to want therapy.

You Have Other Ways to Save

A university with a graduate psychology program may have a clinic, says the APA’s Nordal. Care is provided by doctoral trainees who are supervised by licensed psychologists. In an urban area, you may be able to find postgraduate training programs in psychoanalysis or cognitive behavioral therapy for experienced psychologists, says Geoffrey Steinberg, a licensed psychologist in New York City. (Google “training clinic” and the specialty you’re looking for.)

Another option: Ask your therapist if your condition might benefit from group therapy led by an experienced psychologist, which can be 50% less expensive than one-on-one sessions. Says Steinberg, “Group is so underrated and can be so valuable.”

Know Which Treatment Is Best for You

“No single therapy works for everybody,” says Renée Binder of the University of California at San Francisco’s School of Medicine. Consider these approaches for five common conditions.

1. Mild to moderate depression: Go for cognitive behavioral therapy (CBT). “A therapist works with you to break negative thought patterns by teaching specific skills,” says Binder. You might learn, for example, to ID overly critical self-talk (“Everything I do gets screwed up”) and reframe it in a positive way (“I flubbed a presentation, but I know I can rock it next time.”)

2. Severe depression: Combining antidepressants with CBT is better than meds alone, a recent Vanderbilt University study found. You need to see an MD or a psychiatric mental-health nurse practitioner for the prescription, but you can get therapy from a social worker or a psychologist.

3. Social anxiety: Your best bet is either CBT or psycho­dynamic therapy (in which you explore how your past experiences and unconscious affect you). In a study published in July in the American Journal of Psychiatry, these methods were equally effective at easing social anxiety.

4. Panic attacks: CBT is usually the treatment of choice. Some research suggests psychodynamic therapy may also work: A Weill Cornell Medical College study found that 12 weeks of biweekly sessions significantly reduced symptoms in more than 70% of patients. Medications may also be used.

5. Trauma: Look for a therapist who offers trauma-focused CBT or EMDR, which stands for eye movement desensitization and reprocessing (you’re asked to recollect the event while doing a motor task such as side-to-side eye movements). “Antidepressants and anti-anxiety meds are helpful in the short term, but therapy works to change thought patterns long term,” says Binder.

 

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