MENTAL HEALTH MINUTE GUIDELINE: PANIC/ANXIETY/WORRY

Panic disorder, agoraphobia, generalized anxiety disorder, social anxiety

•Reduce, review or stop substances or foods that worsen anxiety
-caffeine-coffee, tea, cola
-energy drinks containing taurine, guarana, yereba ,gingko, ginseng
-decongestants, stay awake or diet pills
-amphetamines, cocaine, ecstacy-E, crystal meth
-alcohol- it causes rebound anxiety when it wears off

•Caution with downers, calming, anxiolytic, or sleeping pills- use of benzodiazepine medications (e.g.valium, ativan, lorazepam, clonazepam) can be used as a short term adjunct to other treatments
-can be addictive or habit forming
-are sedating-caution with driving or other sedating agents
-should not be the main or stand alone treatment

•Learn what’s happening in your body and runaway thoughts-educate yourself about how panic and anxiety causes physical and emotional reactions
-Physical symptoms of anxiety/worry are real, not in your head

•Make sure your physical health and medications have been checked
- thyroid hormone or blood sugar problems might cause or worsen anxiety

•Specific anti-anxiety counselling (CBT) and stress management-Cognitive Behaviour Therapy (CBT)-teaches you thinking habits and skills and behaviours to treat anxiety/worry and Mindfulness Based Stress Reduction classes and techniques
-don’t stop doing the things that cause worry, keep exposing yourself to your feared situations and keep practicing-it helps
-self help books on CBT or Mindfulness Based Stress Reduction
-improved thinking habits and behaviours prevent recurrence of anxiety/worry
-exercise helps reduce anxiety

•Recommended anti-anxiety/anti-panic medications-check with your health care provider for current recommendations that are best for you
-often SSRI’s or SNRI’s-start low doses and increase slowly
-usually take three or four weeks to start working
-are not addictive-take regularly as recommended, if lowering dose go slowly

Seek emergency/urgent help if thoughts/plans to hurt yourself/suicidal

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MENTAL HEALTH MINUTE GUIDELINE: BIPOLAR/MANIC/HYPOMANIC

Bipolar disorder, manic or hypomanic episode

•Reduce or stop substances or foods that elevate or alter mood
-caffeine-coffee,tea, cola, energy drinks with taurine, guarana, yerba, gingko
-amphetamines, crystal meth, cocaine, ecstacy-E, alcohol, marijuana

•Make sure your physical health and medications have been checked
-thyroid problems, neurologic conditions, infections can mimic mania/hypomania
-steroids, methylphenidate, decongestants, diet or stay awake pills, St.John’s wort
(hypericum), ginseng, supplements may cause/worsen mania/hypomania

•Caution with use of antidepressant medications
-antidepressants may cause, bring out or worsen a hypomanic or manic episode
-can be used cautiously as an adjunctive add-on to mood stabilizing medications
-if stopping –must taper some down gradually to prevent withdrawl

•Mood stabilizing medication for acute episodes and future prevention
-Lithium-well proven-need to monitor blood level, kidney and thyroid counts
-Valproic Acid-need to monitor blood level, liver and blood cell counts
-Atypical Antipsychotics- many indicated for treatment and prevention
of bipolar manic and depressive episodes-not only used for psychosis
-Lamotrigene-effective for depressive phase only-watch for rare but serious rash
-benzodiazepines (valium,lorazepam,clonazepam)-useful as adjunctive or short
term add on to above first line recommended mood stabilizers

•Safety first, prevent damage to yourself, family, friends, job, finances
-prevent or stop uncharacteristic risky behaviour-fast driving, extreme sports,
unsafe sex, fighting, gambling, excess spending, drug and alcohol use
-protect your job security-consider the need for illness leave for health reasons
-protect finances- limit access to funds, credit cards, bank accounts, stock trades
-you, family, society to consider brief hospitalization to get well and for safety
-appoint someone to look out for you if you have an episode and can’t yourself
(power of attorney for personal care, advance directives)

•Healthy lifestyle, thinking habits and peer support
-regular sleep and wake times, regular meals, exercise, peer support groups
-Cognitive Behaviour Therapy(CBT)-a type of talk therapy to develop thinking
skills and habits to keep you accurately grounded in your decisions and actions
Seek emergency/urgent help if thoughts/plans to hurt yourself or others

mentalhealthminute.com

MENTAL HEALTH MINUTE GUIDELINE: BLUES/DEPRESSION/DOWN/SAD MOOD

Clinical Depression, Major Depressive Episode or Disorder

•Reduce or stop substances that worsen mood
-alcohol, it’s a downer to mood
-marijuana, hashish, and party drugs can lower mood
-depression can be effectively treated even if still using alcohol or drugs

•Make sure your physical health has been checked
-review any prescription or over the counter medications or supplements
-thyroid hormone or blood sugar problems might cause depression symptoms
-low iron, hemoglobin or vitamin B12 levels might cause low energy

•Learn what’s happening in your body, sleep and eating rhythms
-clinical depression causes real physical symptoms such as lo energy, disturbed
sleep and appetite, difficulty concentrating, feeling irritable or agitated
-it doesn’t mean you’re weak, crazy, or not trying hard, it’s not you fault

•Specific anti-depression counseling talk therapy-CBT or IPT
-depression distorts and exaggerates the negative, making things seem worse or hopeless- you catastrophize, personalize, focus on the negative, unfair to yourself
-Cognitive Behaviour Therapy helps you examine your thinking habits and behaviours and correct these with skills to improve mood and prevent depression
-Interpersonal Therapy helps you figure out how relationship problems (work, family, friends) may be repeating, and causing or contributing to depression
-Self help books on CBT, IPT or peer support organizations, employee assistance can help

•Recommended antidepressant medications and other physical treatments
-check with you health care provider for medications that may be best for you
-most take three or four weeks to start working
-are not addictive-take regularly as recommended-don’t stop abruptly
- helps put brain chemical imbalance back in to their normal natural balance
- exercise helps mood and prevents depression -if and when you’re able
- Light therapy for seasonal depression (only use a special light therapy light)
- ECT-electroconvulsive therapy may be effective (it’s not like in the movies)

Seek emergency/urgent help if thoughts/plans to hurt yourself/suicidal

mentalhealthminute.com