TIME mental health

The Link Between Mental Trauma and Diabetes

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Women with more PTSD symptoms appear to be at a higher risk for Type 2 diabetes, a new study says

Women with symptoms of post-traumatic stress disorder (PTSD) have a two-fold increased risk for type 2 diabetes, according to a new study.

“When we are under stress we are more likely to get sick, but women with PTSD are in this extreme stress response a lot of the time,” says study author Karestan Koenen, an epidemiology professor at Columbia University’s Mailman School of Public Health. The new study, published in the journal JAMA Psychiatry, looked at 49,739 women participating in the Nurses’ Health Study II to assess the link between PTSD symptoms and type 2 diabetes over 22 years. They found that women with the most symptoms had double the risk of developing type 2 diabetes, and that the association increased based on the number of symptoms women experienced.

“It’s so important that people understand PTSD isn’t just in veterans. Most PTSD is just in regular people in the community,” says Koenen. One of the most surprising findings in the study was that using antidepressants and having a higher body mass index (BMI) accounted for about half of the increased risk for type 2 diabetes in women with PTSD. Past research has linked PTSD to having a higher BMI, with some research suggesting that elevated stress response could result in cravings for highly caloric food and lead to weight gain.

The antidepressant link is the most unexpected. An obvious explanation for the link is that some antidepressants cause weight gain, but the researchers argue weight gain isn’t caused by all antidepressants and therefore cannot account for all of the effect. “It’s probably one of the most interesting findings and I don’t have a good explanation for it,” says Koenen.

The researchers say it’s possible that extreme stress can cause changes in the regulation of the body’s immune system, inflammation markers and hormones, which could contribute to the onset of type 2 diabetes.

Ultimately, Koenen believes the study is important because it provides further evidence that medicine can benefit from a more holistic look at patients that includes not just disease but also mental health and psychology. “Our health care system acts like the brain and the body are two separate things. This is just one of hundreds of studies that have now shown that mental health affects physical health and mental health,” she says. “We need a more integrated medical system where the mind and body are worked on together.”

Koenen, who used to work in veterans affairs, says veterans have been asking for such care for a long time, with studies and surveys showing patients often ask for alternative services like yoga. “Patients understand this but the medical system hasn’t caught up,” she says.

TIME Research

Longer Rest After Concussions Might Not Be Good, Study Says

Research calls into question the five-day waiting period

Concussion patients who wait several days to resume physical activity after receiving a hit may be more likely to suffer symptoms of the condition, a new study suggests. The research calls into question the five-day waiting period for concussion patients recommended by some doctors.

The study, published Monday in the journal Pediatrics, compared patients who waited five days to resume physical activity with those who waited one or two days. Patients who waited longer were more likely to report suffering from headaches and nausea in the first few days after the concussion and emotional symptoms in the 10 days following the blow.

The study looked at almost 100 concussion patients between the ages of 11 and 22 who had been admitted to the emergency room with a concussion. The findings do not necessarily apply to patients with more severe concussions.

None of the patients in the study were hospitalized.

TIME mental health

Depression Could Be More a Physical Than Mental Condition, Say Scientists

The starting point for the theory is that everyone feels down when they are ill

A growing number of scientists are coming to the conclusion that depression is at least as much a physical condition as it has to do with the mind.

One explanation is inflammation, which is caused by a part of the immune system that gets called into action when the body suffers a wound, the Guardian reports.

A set of proteins called cytokines sets off this inflammation in the body. This process is why people tend to feel down when they fall ill.

And so scientists think the brain may be tricked into feeling depressed through a process akin to an allergic reaction.

Read more at the Guardian

Read next: Most Cancer Is Beyond Your Control, Breakthrough Study Finds

Listen to the most important stories of the day.

TIME

7 Mental Health Resolutions for 2015

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Here's how to take care of your mind this new year

When it comes to New Year’s resolutions, our self-improvement efforts often focus on getting a better body. And we ignore that other, equally important part of our wellbeing: our mental health.

Certain health hazards come with warnings, like cigarettes or alcohol, but less obvious ones, like loneliness and rejection, can take just as great toll, says psychologist Guy Winch, author of Emotional First Aid: Healing Rejection, Guilt, Failure and Other Everyday Hurts. Research shows social isolation is linked to shorter lifespans, yet we often ignore our emotional hygiene. “If our dental hygiene were as poor as our emotional hygiene, we’d be all gums and no teeth,” says Winch.

This year, prioritize your mind as well as your body, and make a resolution for better mental health. Here are some of Winch’s tips for prioritizing your emotional hygiene in the new year (and all year long).

1. Pay attention to emotional pain. Psychological pain is much like physical pain—if something hurts for more than a few days, you need to do something about it. If you experience rejection, failure, or have a bad mood that lingers too long, don’t ignore it.

2. Take action when you feel lonely. Chronic loneliness is devastating to your emotional and physical health because it increases your chances of an early death by 14%. Therefore, when you feel lonely, actions like reaching out to family members, connecting with friends or joining a dating website can help. Make a list of people who you’ve been close to in the past (use your phone book, social media friends, and email contacts) and reach out to one of them each day to chat or to make plans. It will feel scary and risky to take those kinds of steps, but that’s what you need to do to break the cycle of disconnection and end your emotional isolation.

3. Stop your emotional bleeding. Psychological wounds tend to create vicious cycles that get worse with time. Failure can lead to feelings of helplessness that in turn can make you more likely to fail again in the future. To break the negative cycle of failure, find ways to gain control of the situation. Our minds are not as reliable as we tend to think, so ignore misleading feelings from your gut that tell you to give up, and focus on the aspects within your control, such as your preparation, planning, effort and execution.

4. Protect your self-esteem. Your self-esteem is like an emotional immune system—it can increase your resilience and protect you from stress and anxiety. Good emotional hygiene involves monitoring your self-esteem and boosting it when it’s low. How? Avoid negative self-talk that damages it further—despite how tempting it might be to indulge these kinds of thoughts at times.

5. Revive your self-worth after a rejection. It’s very common to be self-critical after you get rejected. It’s an unfortunate reaction, since that’s when your self-esteem is already hurting. You’re most likely to call yourself names, list all your faults and shortcomings and generally kick yourself when you’re already down. The most important thing you can do after getting rejected is to treat yourself with the same compassion you would treat a good friend. Make sure your inner voice is kind, understanding and supportive.

6. Battle negative thinking. When something upsetting happens, it’s natural to brood over it. But replaying the scene over and over in your mind will not give you much insight or closure. The best way to break a brooding cycle is to distract yourself with a task that requires concentration, like a game on your cell phone, a quick run or a crossword puzzle.

7. Be informed on the impact of common psychological wounds and how to treat them. You know how to treat a cut or a cold, so you should also know how to treat rejection, failure, loneliness, guilt and other common emotional wounds. By becoming mindful about your psychological health and adopting habits of good emotional hygiene, you will not only heal your psychological injuries when you sustain them, but you will elevate your entire quality of life.

For more tips, watch Winch’s Tedx Talk on how to practice emotional hygiene.

TIME Mental Health/Psychology

5 Email Habits of Very Productive People

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Here's how to practice good email hygiene

Ping! Check email. Ping. Check email again. Ping. Check. Ping. Check. Ping. Check.

If you’re like most people who sit in front of a computer all day, this probably sounds like you: When you’re not currently replying to an email, you’re looking to see if you have any new ones. Then when something new does come in, you read it, debate how to respond, then deem it too time-consuming for the moment. “I’ll get to that later,” you think. And if there’s nothing new, you’re nervously wondering why. “Is it because my inbox is full?!” So you keep checking back every 15 seconds until something pops up—in the meantime deleting all the junk mail that has since clogged your inbox.

HEALTH.COM: 12 Reasons to Stop Multitasking Now!

But a life tethered to your email means those other projects you want and need to do—be they big reports or personal tasks—can get postponed by days, weeks, or months. Not to mention, a new Canadian study found hyperchecking your email can make you (surprise!) more stressed. So we asked five people who have a barrage of emails to answer to tell us how they tame their inbox.

Read on for their strategies to deal with the deep, dark email crevasse.

Set designated “reply times”

“I do many quick checks of email throughout the day to see if there’s something high priority and urgent that has come in, but I only allocate two times a day to fully deal with the email that has accumulated. By batching all of the heavy duty email processing into bigger chunks, I can be much more efficient and reduce the feeling of constantly switching tasks.”

—Jacob Bank, computer scientist and co-founder and CEO of the Timeful calendar app

HEALTH.COM: 12 Unexpected Things That Mess With Your Memory

Pick and choose what’s key

“I respond to priorities as soon as possible, and keep correspondence clear and super positive. Knowing that I’ll still never get through all the emails, I prioritize people who are asking for help and opportunities that support my intention. I’m also not afraid to use the “!” for high priorities or dramatic effect.”

—Tara Stiles, yoga instructor, author of the Make Your Own Rules Diet ($25, amazon.com), and W Hotels’ fitness partner

Email only the quick things

“Email works for quick day-to-day correspondence, but when I have something important to discuss or decisions to be made, I pick up the phone. It is always better to hear the person on the other end—the inflection in their voice. Emails can often be misunderstood.”

Bobbi Brown, makeup artist and Health‘s contributing beauty and lifestyle editor

HEALTH.COM: 13 Ways to Beat Stress in 15 Minutes or Less

Sort all your stuff

“I have found that treating my online mail just like post office mail works wonders. I created folders: Everything from mom folder, workout class folder, celebrity clientele folder, house folder, summer cottage folder, medical folder, kid folders, etc. With emails organized into categories, I can easily do my three steps…find, take action, or delete. You’ll also need to unsubscribe from junk. The volume of junk email is tremendous and spending time deleting each one is taking precious time away from you. Finally, prioritize emails that need attention that particular day. I hit reply and drag them to the corner of my desktop if I can’t get to them at that moment, otherwise I use my other rule, don’t leave an email request—answer asap.”

—Kathy Kaehler, celebrity trainer, author, and founder of Sunday Set-Up, a healthy eating club

Respond—don’t mull

“I try to respond to emails as soon as I see them because otherwise they can get pushed further down the inbox and may be ignored. I recommend you be responsive but not superfluous. By responding quickly and writing short, non-flowery emails, you can create an image of efficiency and attentiveness. Even short words like “Thanks” or “Got it” will help you build a culture of trust and signal that you are on top of your inbox.”

—Roshini Rajapaksa, MD, assistant professor of medicine at the NYU School of Medicine, Health’s contributing medical editor, and cofounder of Tula Skincare

HEALTH.COM: 10 Nervous Habits That Hurt Your Health

This article originally appeared on Health.com

TIME Mental Health/Psychology

How to Not Lose it When People Are Driving You Insane

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Is your family already driving you insane? Read on

This holiday, make it a priority to not rip your hair out.

To help you survive the season, we asked psychologist Pauline Wallin, author of Taming Your Inner Brat, for some tips on how to avoid some of the most common pitfalls of the holidays. (But if Aunt Susie drinks too much egg nog, we can’t help you).

If your family is driving you crazy…
One of the best parts of the holidays can also be one of the worst parts of the holidays. Spending quality time with family doesn’t happen often for most of us, but with the expectations of the holidays and the increased amount of face time, it’s easy for someone to lose their lid. Here’s how to cool it.
For parents: You have guests coming, and the bums you call your children are doing a lousy job at cleaning. To avoid this stresser, lay out your expectations early. “When you feel like other people are driving you crazy, it’s often because they don’t have the same sense of urgency that you do,” says Wallin. Instead, tell your kids ahead of time that the house needs to be clean by 10 a.m., or that you are going to be stressed and would appreciate it if they stay out of your way. It’s an easy way to start out on the same page.
For kids and teens: If you really don’t want to go to Aunt Susie’s for dinner, get over it by finding a way to make it count. Think of it as a gift to your family to spend time with them without giving anyone ‘tude. If you’re really feeling irked, ask kindly for a little time alone. Go on a walk, read a book for an hour, or offer to get out of the house and grab groceries.

If someone spills something or you burn the roast…
Take a picture of it. Seriously, pull out that smart phone and snap a photo of the disaster. “If you’re going to laugh about it later, you might as well laugh about it now,” says Wallin. No dinner party is immune to a rip or spill or the tragic loss of the Christmas goose. Laugh it off, post it to Instagram, and move on.

If you’re stressed about the cost of all those presents…
Do you remember what you received for Christmas last year? Probably not. Wallin says one of the most common stressers she sees among patients around the holidays is financial stress. “But never once have I heard someone say, ‘I’ve never forgiven them for not getting me the new iPhone.'” We tend to put a lot of weight on the presents, but guests are more likely to remember the moments shared than what was in the stocking. So try not to stress about finding the perfect gift, and there’s zero shame in bargain hunting.

If your to-do list alone is freaking you out…
This year, instead of making a “To Do” list, make a “To Don’t” list. “Decide what you’re not going to do, and just let it go,” says Wallin. “It’s a tremendous sense of relief.” If you can’t figure out when you’re going to have time for caroling, just skip it. If you don’t have time (or don’t want to make time) for home-baked cookies, don’t both! You don’t have to do everything. If it’s more stress than it’s worth, it won’t be that fun.

If you’re not feeling any warm, fuzzy, holiday feelings…
Instead of scrambling to make everything perfect, carve out time to just sit and talk to friends and family. “We get so busy that we forget the holidays are about people,” says Wallin. Get everyone off the grid and ask for cell phones to be put away while you play a game or watch a movie. Even just taking 20 minutes to sit with a family member you don’t regularly see is a great way to remember to the real meaning of the season.

MONEY Health Care

Why Getting Mental-Health Coverage Can Be So Tough

Despite rules mandating better insurance benefits, finding care remains a challenge, a new 50-state report concludes.

Even though more Americans have access to health insurance because of the health law, getting access to mental health services can still be challenging.

A new report concludes that despite the 2008 mental health parity law, some state exchange health plans may still have a way to go to even the playing field between mental and physical benefits. The report, released by the advocacy group Mental Health America, was paid for by Takeda Pharmaceuticals U.S.A. and Lundbeck U.S.A, a pharmaceutical company that specializes in neurology and psychiatric treatments.

The report listed the states with the lowest prevalence of mental illness and the highest rates of access to care as Massachusetts, Vermont, Maine, North Dakota, and Delaware. Those with the highest prevalence of mental illness and most limited access are Arizona, Mississippi, Nevada, Washington, and Louisiana.

Among its other findings:

•42.5 million of adults in America, 18.19%, suffer from a mental health issue.

•19.7 million, or 8.46%, have a substance abuse problem.

•8.8 million, or 3.77% of Americans have reported serious thoughts of suicide.

•The highest rates of emotional, behavioral or developmental issues among young people occur just west of the Appalachian Mountains, where poverty and social inequality are pervasive.

Part of MHA’s examination focused on the exchange market and its essential health benefit requirements that guided 2014 coverage. The group found that, while information provided through plans’ “explanation of benefits” might show that there aren’t limits on mental health coverage, limitations including treatment caps and other barriers still exist.

“Parity is in its infancy. Most plans know the numerical requirements around cost-sharing, but few have taken seriously the requirements around equity—around access through networks and barriers to care through prior authorization,” said Mike Thompson, health care practice leader at PricewaterhouseCoopers. “And, in practice, we have a history of imposing much more stringent medical necessity standards on mental health care than other health care.”

However, Susan Pisano, vice president of communications for America’s Health Insurance Plans, an insurance trade group, said the report doesn’t reflect the fact that many health plans have rolling renewals. That means the plans have until Jan. 1, 2015, to fully comply with the parity law.

“Our members are committed to mental health parity, and we’re supportive of legislation, and what isn’t apparent is that benchmark plans represented a snapshot in time … so that doesn’t give us the full picture,” Pisano said. “Our plans have really been working to get in compliance.”

Chuck Ingoglia, senior vice president of public policy at the National Council for Behavioral Health, a Washington-based trade group for community mental health and substance use treatment organizations, said the report’s findings aren’t surprising — though they are troubling. Implementation of the parity law remains a work in progress, he said.

“The law is based on a sound policy premise — that addiction and mental health treatment decisions and management should be comparable to physical health conditions,” he said. “But this also creates a tremendous barrier to proving violations as it requires a consumer to obtain access to plan documents for both types of care, which is frequently handled by different plans,” Ingoglia said.

In addition, the report found that some plans didn’t set out what and how many services were covered. That means consumers would only find out a treatment wouldn’t be paid for by their insurer after they’d already received care.

Americans with mental disorders have the lowest rates of health insurance coverage, so obtaining insurance is a good first step, according to Al Guida, a Washington, D.C.-based lobbyist who works on mental health issues with Guide Consulting Services. But the only way a denial can be reversed is through an appeal, which can be a long and arduous process.

“The vast majority of insurance plans offered on Affordable Care Act federal and state exchanges have close to no transparency, which could lead to abrupt changes in both mental health providers and psychotropic drug regimens with the potential for serious clinical consequences,” Guida said.

Meanwhile, there is a shortage of mental health care professionals—nationally there is only one provider for every 790 people, according to the report.

All of these factors can cause minor mental illnesses to grow more severe, according to Mental Health America CEO Paul Gionfriddo.

He suggested that mental illness should be screened for and covered in the same way cancer, kidney disease, and other illnesses are.

“Right now we’re trapped in a stage where we wait for a crisis, when they’re in advanced stages and then we treat it, and we wonder why it’s so hard to treat it more cheaply,” Giofriddo said.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

TIME Innovation

Five Best Ideas of the Day: December 17

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

1. Independent and third party candidates could break D.C. gridlock — if they can get to Washington.

By Tom Squitieri in the Hill

2. A new software project has surgeons keeping score as a way to improve performance and save lives.

By James Somers in Medium

3. The New American Workforce: In Miami, local business are helping legal immigrants take the final steps to citizenship.

By Wendy Kallergis in Miami Herald

4. Policies exist to avoid the worst results of head injuries in sports. We must follow them to save athletes’ lives.

By Christine Baugh in the Chronicle of Higher Education

5. Sal Khan: Use portfolios instead of transcripts to reflect student achievement.

By Gregory Ferenstein at VentureBeat

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 mental health/psychiatry

Why Some Antidepressants Make You Feel Worse Before Better

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There’s a paradoxical period when a person first starts an antidepressant: they may actually begin to feel worse before feeling better. The underlying cause of this phenomenon is a bit of a mystery, but a new study from researchers at Otto-von-Guericke University in Germany explains why this might occur.

The gap between starting an antidepressant and feeling its positive effects—a time period that’s typically a couple weeks but may last up to a month—can sometimes be characterized by an increased risk for harmful behaviors. Researchers have previously speculated that when a person starts an antidepressant, they may suddenly have a surge of energy they didn’t have before. If that person is suicidal, the effect may provide enough energy to act upon their feelings.

The controversial idea caught on. A decade ago, the U.S. Food and Drug Administration (FDA) issued a “black box” warning—the most stringent of warnings—on all antidepressants warning of possible suicidal thoughts and behaviors. As TIME recently reported, many psychiatrists were (and still are) upset by the label, arguing that it’s led to a drop in antidepressant use among patients. Physicians, fearful of the risks, may also be deterred from prescribing them.

MORE: Do Depression Drugs Still Need Suicide Warnings?

In the new report, published in the journal Trends in Cognitive Sciences, the researchers reviewed several recent studies and found that the issue may stem from an effect of the most commonly prescribed antidepressants: selective serotonin reuptake inhibitors (SSRIs). SSRIs release two chemicals in the brain that kick in at different times, causing a period of negative effects on mental health, the authors report. The first chemical is serotonin, which is released very soon after an SSRI is taken but might not lessen depressive symptoms until after a couple of weeks. The second chemical is called glutamate, which can take a few days longer to be properly released. According to the new study, the serotonin neurons send off a dual signal to the two chemicals, causing the variant time frames for the chemicals, and therefore the problem period.

“There’s a lot you can do [in this period] and it’s important to let patients know that,” says Dr. Donald Malone, chair of the department of psychiatry and psychology at Cleveland Clinic. (Malone was not involved in the new study.) “It doesn’t typically last longer than the first week. But you may need to go down on the dose or switch medications. We’ve always prepared patients for how it can go, and that this was the beginning.”

Depression itself—not an antidepressant—is the greatest risk factor for suicide, and these new findings provide new insight for what patients can expect at the start of their treatment.

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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