Stress: A Case Study

Read the story of a women who thought she was having a heart attack, but was instead diagnosed with panic disorder, panic attacks.

Read the story of a women who thought she was having a heart attack, but was instead diagnosed with panic disorder.A young woman sought psychological services after her cardiologist referred her for stress management and treatment of "heart attack" symptoms. This 36 year old woman had the world by the tail. Marketing director for a local high-tech firm, she was in line for promotion to vice president. She drove a new sports car, traveled extensively, and was socially active.

Although on the surface everything seemed fine, she felt that, "the wheels on my tricycle are about to fall off. I'm a mess." Over the past several months she had attacks of shortness of breath, heart palpitations, chest pains, dizziness, and tingling sensations in her fingers and toes. Filled with a sense of impending doom, she would become anxious to the point of panic. Every day she awoke with a dreaded feeling that an attack might strike without reason or warning.

On two occasions, she rushed to a nearby hospital emergency room fearing she was having a heart attack. The first episode followed an argument with her boyfriend about the future of their relationship. After studying her electrocardiogram, the emergency room doctor told her she was "just hyperventilating" and showed her how to breathe into a paper bag to handle the situation in the future. She felt foolish and went home embarrassed, angry and confused. She remained convinced that she had almost had a heart attack.

Her next severe attack occurred after a fight at work with her boss over a new marketing campaign. This time she insisted that she be hospitalized overnight for extensive diagnostic tests and that her internist be consulted. The results were the same--no heart attack. Her internist prescribed a tranquilizer to calm her down.

Convinced now that her own doctor was wrong, she sought the advice of a cardiologist, who conducted another battery of tests, again with no physical findings. The doctor concluded that stress was the primary cause of the panic attacks and "heart attack" symptoms. The doctor referred her to psychologist specializing in stress.

During her first visit, professionals administered stress tests and explained how stress could cause her physical symptoms. At her next visit, utilizing the tests results, they described to her the sources and nature of her health problems. The tests revealed that she was highly susceptible to stress, that she was enduring enormous stress from her family, her personal life, and her job, and that she was experiencing a number of stress-related symptoms in her emotional, sympathetic nervous, muscular and endocrine systems. She wasn't sleeping or eating well, didn't exercise, abused caffeine and alcohol, and lived on the edge financially.

The stress testing crystallized how susceptible she was to stress, what was causing her stress, and how stress was expressing itself in her "heart attack" and other symptoms. This newly found knowledge eliminated a lot of her confusion and separated her concerns into simpler, more manageable problems.

She realized that she was feeling tremendous pressure from her boyfriend, as well as her mother to settle down and get married; yet, she didn't feel ready. At the same time, work was overwhelming her as a new marketing campaign began. Any serious emotional incident--a quarrel with her boyfriend or her boss--sent her over the edge. Her body's response was hyperventilation, palpitations, chest pain, dizziness, anxiety, and a dreadful sense of doom. Stress, in short, was destroying her life.

Adapted from The Stress Solution by Lyle H. Miller, Ph.D., and Alma Dell Smith, Ph.D.

 

next: Terrorism Fear: What You Can Do To Alleviate It
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~ all anxiety disorders articles

APA Reference
Staff, H. (2007, February 18). Stress: A Case Study, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/stress-a-case-study

Last Updated: July 4, 2016

Reducing The Stress in Your Life

What is stress and techniques to reduce stress in your life.

What is Stress?

Stress is the way that we respond to change in our lives. It is the way our bodies react physically, emotionally, cognitively, behaviorally to any change in the status quo. These changes do not have to be only negative things; positive change can also be stressful. Even imagined change can cause stress.

Stress is highly individual. A situation that one person may find stressful may not bother another person. Stress occurs when something happens that we feel imposes a demand on us. When we perceive that we cannot cope or feel inadequate to meet the demand we begin to feel stress.

Stress is not all bad. We need a certain amount of stress in our lives because it is stimulating and motivating. It gives us the energy to try harder and keeps us alert. When we find ourselves in situations that challenge us too much we react with the fight or flight stress response. Stress actually begins in our brains and it is expressed in our body. Once we perceive stress, our body sends our chemical messengers in the form of stress hormones to help our bodies handle the stress.

Chronic Stress

Stress hormones are important to help us meet the demands of stress occasionally but if they are repeatedly triggered disease will occur. Our body does signal us when we are we are experiencing the effects of chronic stress.

Physical Symptoms

  • Headaches
  • Tension
  • Fatigue
  • Insomnia
  • Muscle aches
  • Digestive upset
  • Restlessness
  • Appetite change
  • Alcohol, tobacco, drug use

Mental Symptoms

  • Forgetfulness
  • Low productivity
  • Confusion
  • Poor concentration
  • Lethargy
  • Negativity
  • Busy mind

Emotional Symptoms

  • Anxiety
  • Mood swings
  • Irritability
  • Depression
  • Worrying
  • Little Joy
  • Anger
  • Resentment
  • Impatience

Social Symptoms

  • Lashing out
  • Decrease sex drive
  • Lack of intimacy
  • Isolation
  • Intolerance
  • Loneliness
  • Decrease in social activities
  • Desire to run away

Spiritual Symptoms

  • Apathy
  • Loss of direction
  • Emptiness
  • Loss of life's meaning
  • Cynicism
  • Unforgiving
  • Feelings of martyrdom

Managing Stress

Being able to manage stress is important in order to live healthy, happy and productive lives.

Negative Coping

Ignoring the problem, Withdrawal, Procrastination, Alcohol/drug use, Smoking, Overeating, Inactivity, Overcommitted, Buying things.

Positive Coping

Become aware of your reactions, Maintain a healthy balanced diet, Exercise regularly, Balance work and play, Practice relaxation techniques, Meditate Develop a support system, Pace yourself, Simplify your life.

Self-Care Techniques

Daily choices to care for oneself helps one?s feelings of worth, and increases a sense of well-being.

  • Deep slow diaphragmatic breathing
  • Listen to relaxation tapes
  • Avoid caffeine
  • Use positive affirmations
  • Do something you love
  • Allow extra time for projects
  • Leave work at the office
  • Do not ruminate over the past
  • Try to live in the present
  • Take brisk walks
  • Listen to your body's signals
  • Finish what you start

Do less, enjoy more

APA Reference
Tracy, N. (2007, February 18). Reducing The Stress in Your Life, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/reducing-the-stress-in-your-life

Last Updated: June 29, 2019

Anxiety Disorders Statistics And Facts

Statistics and facts about anxiety disorders; the most common mental illness in the U.S.Statistics and facts about anxiety disorders; the most common mental illness in America.

  • Anxiety Disorders are the most common mental illness in the U.S. with 19.1 million (13.3%) of the adult U.S. population (ages 18-54) affected.
  • According to "The Economic Burden of Anxiety Disorders," a study commissioned by the ADAA and based on data gathered by the association and published in the Journal of Clinical Psychiatry, anxiety disorders cost the U.S. more than $42 billion a year, almost one third of the $148 billion total mental health bill for the U.S.
  • More than $22.84 billion of those costs are associated with the repeated use of healthcare services, as those with anxiety disorders seek relief for symptoms that mimic physical illnesses.
  • People with an anxiety disorder are three-to-five times more likely to go to the doctor and six times more likely to be hospitalized for psychiatric disorders than non-sufferers.

NUMBERS AND PERCENTAGES REFER TO ADULT U.S. POPULATION AFFECTED.

Generalized Anxiety Disorder: 4 million, 2.8%.

  • Women are twice as likely to be afflicted than men.
  • Very likely to be comorbid with other disorders.

Obsessive Compulsive Disorder: 3.3 million, 2.3%.

  • It is equally common among men and women.
  • One third of afflicted adults had their first symptoms in childhood.
  • In 1990 OCD cost the U.S. 6% of the total $148 billion mental health bill.

Panic Disorder: 2.4 million, 1.7%.

  • Women are twice as likely to be afflicted than men.
  • Has a very high comorbidity rate with major depression.

Post Traumatic Stress Disorder: 5.2 million, 3.6%.

  • Women are more likely to be afflicted than men.
  • Rape is the most likely trigger of PTSD, 65% of men and 45.9% of women who are raped will develop the disorder.
  • Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.

Social Anxiety Disorder: 5.3 million, 3.7%.

  • It is equally common among men and women.

Specific Phobia affects: 6.3 million, 4.4%.

  • Women are twice as likely to be afflicted as men.

Any Phobia (Social Anxiety Disorder, Specific Phobia, Agoraphobia) affects 11.5 million (8%) of adult Americans.

next: Anxiety: Do's and Don'ts
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Gluck, S. (2007, February 18). Anxiety Disorders Statistics And Facts, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/anxiety-disorders-statistics-and-facts

Last Updated: July 3, 2016

New Hampshire Considers Banning ECT on Children

HB406, which prohibits ECT on children under age 16, has a floor date of March 8, 2001.

If you are an electroshock survivor, you are urged to contact those involved and tell your stories/voice your opinions.

From someone involved, a report on the last committee meeting:

Complete coverage on the Paul Henri Thomas forced electric shock treatment case from Newsday.eThe HB406, anti-shock, insulin shock and psychosurgery bill on kids under age 16 was interesting. NAMI stayed out of the picture and the NH Consumer Council came forward in favor of the bill. Three legislators testified in favor of the bill and none against it. Five shock psychiatrists and the Human Services Dept. came out against the bill. Without the NAMI buffer, it was clear that the patients didn't like the psychiatrists.

BAN ECT, INSULIN SHOCK AND PSYCHOSURGERY ON CHILDREN UNDER AGE 16 IN NEW HAMPSHIRE. CALL NOW!!!!!!!

New Hampshire House Bill 406, "AN ACT prohibiting electro-convulsive therapy on children under 16 years of age" had a public hearing February 20th. This bill would also ban insulin shock and psychosurgery on kids.

The New Hampshire Consumer Council came out in force with three legislators in favor of this bill. FIVE psychiatrists came out in favor of electroshocking children. They were listened to. Now it's your time to be heard.

Please help the New Hampshire Consumer Council by contacting the following members of the New Hampshire Health, Human Services & Elderly Affairs Committee and telling them:

VOTE IN FAVOR OF HB 406. ECT CAUSES PERMANENT BRAIN DAMAGE AND CHILDREN HAVE NO POWER TO REFUSE PSYCHIATRY'S MOST HARMFUL AND BARBARIC PROCEDURES.

Here is the most updated list:

House of Representatives
Health, Human Services ?
Chairman:
Peter L. Batula
12 Paige Dr.
Merrimack, NH 03054-2837
(603)424-6091
stoj@juno.com

Vice Chairman:
Andre A. Martel
237 Riverdale Ave.
Manchester, NH 03103-7301
(603)622-8411
(no email listed, try andre.martel@leg.state.nh.us)

Clerk:
Margaret A. Case
44 Beach Head Rd.
Nottingham, NH 03290-4921
(603)895-2718
(no email listed, try margaret.case@leg.state.nh.us)

Members:
Robert F Chabot
73 Joseph St.
Manchester, NH 03102-5617
(603)625-5617
bob.chabot@leg.state.nh.us

Martin Feuerstein
801 Central St.
Franklin, NH 03235-2026
(603)934-3849
martyfeuerstein@aol.com

Fran Wendelboe
238 Lower Oxbow Rd.
New Hampton, NH 03256-4648
(603)968-7988
mattwenfran@cyberportal.net

James R. MacKay (this guy is a psychotherapist)
139 N. State St.
Concord, NH 03301-6431
(603)224-0623
jamesmackay@sompuserve.com

Cecelia D. Kane
391 Colonial Dr.
Portsmouth, NH 03801-4706
(603)436-3454
(no email listed)

Stephanie K. Micklon
163 Brady Ave.
Salem, NH 03079-4812
(603)893-6677
smicklon@worldnet.att.net

Joseph P. Manning
9 Bradley Ct.
jaffrey, NH 03452-5400
(603)532-8083
(no email listed, try joseph.manning@leg.state.nh.us)

James P. Pilliod
504 Province Rd.
Belmont, NH 03220-5379
(603)524-3047
jimp@together.net

Walter D. Ruffner
10 Benjamin Rd.
Stratham, NH 03885-2101
(603)772-9558
walterl709@juno.com

Susan Emerson
571 Rte. 119
Rindge, NH 03461-3704
(603)899-6529
(not email listed, try susan.emerson@leg.state.nh.us)

Barbara C. French
17 Fairview Ave.
Henniker, NH 03242-3310
(603)428-3366
(no email listed, try barbara.french@leg.state.nh.us)

Sandra C. Harris
43 Ridge Ave.
Claremont, NH 03743-3166
(603)542-6973
scharris@turbont.net
sandra.harris@leg.state.nh.us

Phyllis M. Katsakiores
1 Bradford St.
Derry, NH 03038-4258
(603)434-9587
(no email liste, try phyllis.katsakiores@leg.state.nh.us)

Janeen Dalrymple
7 Penobscott Ave.
Salem, NH 03079-4527
(603)898-4527
janeen76@aol.com

Alida I. Millham
426 Belnap Mtn. Rd.
Gilford, NH 03249-6814
(603)524-1278
amillham@worldpath.net

Daniel M. Burnham (this guy is a newspaper pulisher)
PO Box 496
Dublin, NH 03444-0496
(603)563-8629
danburnham@pobox.com

Gloria Seldin
54 Church St.
Concord, NH 03301-4550
(603)225-3787
seldglo@com.con (WRONG e-mail - DOESN'T GET THERE)

Hilda W. Sokol
6 Storrs Rd.
Hanover, NH 03755-2410
(603)643-2702
h.w.sokol@dartmouth.edu

HB406 - for up to date info, type in HB406 under "Bill Number" and click submit.

next: Online Audio and Videos on ECT, Electroconvulsive Therapy
~ all Shocked! ECT articles
~ depression library articles
~ all articles on depression

APA Reference
Staff, H. (2007, February 18). New Hampshire Considers Banning ECT on Children, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/depression/articles/new-hampshire-considers-banning-ect-on-children

Last Updated: June 23, 2016

What Is Separation Anxiety Disorder?

Separation anxiety disorder defined along with symptoms, duration and onset of separation anxiety disorder.

Separation anxiety disorder defined along with symptoms, duration and onset of separation anxiety disorder.

Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following:

  • recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated
  • persistent and excessive worry about losing, or about possible harm befalling, major attachment figures
  • persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped)
  • persistent reluctance or refusal to go to school or elsewhere because of fear of separation
  • persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings
  • persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
  • repeated nightmares involving the theme of separation
  • repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated

The duration of the disturbance is at least 4 weeks.

The onset is before age 18 years.

The disturbance causes clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.

The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder With Agoraphobia

Sources:

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

APA Reference
Tracy, N. (2007, February 18). What Is Separation Anxiety Disorder?, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/separation-anxiety-disorder

Last Updated: July 6, 2019

Anxiety: Do's and Don'ts

A list of what to do and what not to do to control anxiety. Pay attention to your feelings and don't isolate yourself are one of the main issues.A list of what to do and what not to do to control anxiety.

Do's

  • Notice how it is affecting you and pay attention to how you would rather be feeling.
  • Remember to breathe.
  • Focus on something interesting and engaging: a hobby, a project, a conversation with a friend, an activity.
  • Play with a pet. Arrange flowers. Play a sport. Watch a movie.
  • Stay active in your life. Continue going to work and/or school. Take care of children. Keep your house clean. Take care of your personal hygiene.
  • Surround yourself with people who care about you. Spend time with your spouse, children, parents, colleagues, friends, neighbors.
  • Engage in conversation that is interesting and meaningful.
  • At other times, engage in trivial talk!
  • Try to limit discussion about the anxiety to less than 5% of your conversation.
  • Pay attention to whether what you are doing or thinking is what you want to be doing or thinking and whether or not it fits for you.

Don'ts

  • Don't isolate yourself. Anxiety will try to get you to think you should be alone. Don't listen to it.
  • Don't spend time thinking about how you feel. Anxiety will take over.
  • Don't talk about anxiety more than 5% of the time and then only about your successes over it.
  • Don't let anxiety get you to second-guess yourself.
  • Don't let anxiety get you to imagine what others are thinking.
  • Don't fall prey to anxiety's ploy to engage in repetitive behaviors.
  • Don't let it put images of disaster in your head

next: Anxiety: The Other Disorder
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Gluck, S. (2007, February 18). Anxiety: Do's and Don'ts, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/anxiety-dos-and-donts

Last Updated: July 3, 2016

Couples and Anxiety

Anxiety can cause serious relationship problems. Since it typically robs people of self-confidence and turns life into a struggle, people think they don't have much to offer in their relationships. Read more about this.Anxiety can cause serious relationship problems. Since it typically robs people of self- confidence and turns life into a struggle, people think they don't have much to offer in their relationships. Sometimes they spend so much time with the struggle they are not as involved in their relationships as they might want to be. Anxiety often causes feelings of shame, so people try to hide the anxiety and its effects from their partners. When that happens, their partners may think that they are withdrawing from them.

Alternately, if partners are told about the anxiety and how it operates they can be involved in working against it. For example, the voice of anxiety usually has people focus on what might go wrong. A partner can counter that voice through gentle and consistent reassurance. It is important for the reassurance not to become pushy, since anxiety often begins because of the pressure of cultural messages to perform. Reproducing that pressure in the couple relationship may exacerbate the problem. Instead, the partner can help the person focus on what is going well and what is most interesting and pleasurable. If the partner is aware that anxiety stands in the way of certain goals, they can join together in reaching these goals a little bit at a time.

See Also:

How to Develop Relationships When You Have Social Anxiety

Questions for Couples

  • Has anxiety come between the two of you? How?
  • Have there been times that it could have come between you but didn't? What did each of you contribute that helped you keep anxiety from coming between you? Are there things you could generalize from that experience that may be helpful again?
  • If you were to think of yourselves as a team against anxiety, what might that lead you to do?

next: Hanging Tough During Bad Economic Times
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Tracy, N. (2007, February 18). Couples and Anxiety, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/couples-and-anxiety

Last Updated: March 25, 2019

Minnesota Forced Shock

STATE OF MINNESOTA.
FOURTH JUDICIAL DISTRICT
DISTRICT COURT
COUNTY OF HENNEPIN
PROBATE/MENTAL HEALTH DIVISION

In the Matter of the Civil Commitment of: File No: P8-02-60415

FINDINGS OF FACT, CONCLUSIONS OF LAW AND ORDER AUTHORIZING ELECTROCONVULSIVE THERAPY

Respondent DOB: XX-XX-54

hp-articles-depression-225-healthyplaceThis matter was heard by Patricia L. Belois, one of the Judges of this Court, on September 12, 2002, pursuant to a Petition for Authorization to impose Treatment Electroconvulsive Therapy, filed herein on August 20, 2002.

Petitioner, Michael Popkin, M.D., was represented by Elizabeth Cutter, Assistant Hennepin County Attorney, A-2000, Hennepin County Government Center, Minneapolis, MN 55487, (612) 348-6740.

Ruth Y. Ostrom, Attorney at Law, 301 Fourth Avenue South, Suite 270, Minneapolis, MN 55415, 612-339-1453, was present on behalf of Respondent, who was present in court. Barabara Jackson, M.D., the Court-appointed examiner, and Derrinda Mitchell, Respondent's Court appointed Conservator of Person and Estate were present. No guardian ad litem was appointed for Respondent because her Conservator provides that function pursuant to an existing Court order from another jurisdiction.

Based upon the file and record in this matter, the evidence received, including testimony from Charles Pearson, M.D., Derrinda Mitchell, and Barbara Jackson, M.D. and one exhibit, the court makes the makes the following:

FINDINGS OF FACT

1. Respondent is 48 years old. She was committed dually to the Heads of the Hennepin County Medical Center and the Anoka Metro Regional Treatment Center as a person who is mentally ill by Order of this Court filed September 6, 2002. In that Order, the Court found that Respondent was mentally ill with Paranoid Schizophrenia. Respondent's present diagnosis is Paranoid Schizophrenia and Depression, NOS. Her treating physician has also diagnosed Respondent with Anxiety Disorder, NOS. Respondent is currently hospitalized at the Hennepin County Medical Center.

2. The Medical Director of Inpatient Psychiatry/Chief of Psychiatry for the Hennepin County Medical Center, Michael Popkin, M.D. (hereinafter Popkin) has petitioned the Court for authority to administer up to 15 treatments of electroconvulsive therapy (ECT) per week for a period of up to five weeks to Respondent, followed by maintenance treatments at an unspecified frequency for the duration of the current commitment. Testimony in support of this Petitioner's Petition was given by Respondent's treating physician, Charles Pearson, M.D. Petitioner believes that ECT will relieve the symptoms of Respondent's mental illness and provide other benefit to her, in particular, ECT is expected to: resolve Respondent's psychosis which is refractory to treatment with neuroleptic medication; improve Respondent's social withdrawal; and lead to simplification of her medication regime by reducing the number of neuroleptic medications she will need to take to control her symptoms.

3. Krishna Mylavarapu, M.D.,(herein after Mylavarapu), is the staff psychiatrist at the Hennepin County Medical Center who will administer the ECT to Respondent. Respondent will be anesthetized prior to the administration of the ECT. The only pain Respondent should experience from the ECT would be the minimal pain from the injection of the anesthetic and perhaps a transitory headache. There is a very remote risk of an adverse reaction to the anesthetic in the range of 1:20.000-50,000. Respondent may experience a short-tern memory loss as a consequence of the proposed treatment This memory loss may be permanent, but the effects of it can be fully mitigated by relearning the lost information, such as what she had to eat during the meal before the procedure. ECT does not involve surgical intrusion. The intrusion comes from electrical impulse directed into Respondent. s brain to induce a specific type of seizure activity.

4. The use of ECT during inpatient hospitalization is the best treatment, according to contemporary professional standards, that could render further custody, institutionalization or other services to the Respondent unnecessary. ECT is not an experimental treatment. It has not been prescribed for Respondent as part of any research project. Its use is widely accepted by the medical community of this state.

5. The Court's examiner, Barbara Jackson, M.D. (hereinafter Jackson), believes that the use of ECT to treat Respondent's mental illness is both necessary and reasonable. She testified that the benefits Respondent is likely to experience from ECT outweigh its risks to her. Jackson also testified that Respondent is not competent to weigh the benefits and risks associated with ECT treatment for herself.

5. Respondent's Conservator, Derrinda Mitchell, testified that she believes that the benefits of the proposed treatment, most particularly the possibility that Respondent's medication regime could be simplified and the exposure to medication side effects better controlled that way, outweigh the risks involved and that the use of ECT to treat Respondent's mental illness and that the use of ECT could be in Respondent's best interests.

6. The Court has considered less intrusive methods of treatment for Respondent's illness including the use of various psychotropic medications both alone and as part of augmented pharmacological regimen. This was rejected because the use of psychotropic medications to treat Respondent to date has not sufficiently relieved the symptoms of Respondent's mental illness so that she can be released from the acute care facility safely to which she is now committed.

7. Respondent cannot rationally weigh the risks and benefits involved in the use of ECT to treat her mental illness because she does not believe that she is mentally ill and she has an irrational fear of ECT fueled by information that her mother provides to her about what the mother believes is the lethal nature of ECT.

CONCLUSIONS OF LAW

1. The evidence is clear and convinces the Court that treatment of the Respondent's mental illness using electroconvulsive therapy is necessary and reasonable.

2. Respondent does not have the capacity to give or withhold consent to the use of electroconvulsive therapy to treat her mental illness.

3. The benefits to Respondent from the administration of electroconvulsive therapy to treat her mental illness outweigh the risks associated with the treatment and justify the intrusion into her privacy as needed to conduct the electroconvulsive therapy without Respondent's informed consent.

ORDER The Heads of the Hennepin County Medical Center and the Anoka Metro Regional Treatment Center are authorized to administer to Respondent up to 15 treatments of electroconvulsive therapy per week for up to five weeks, foIIowed by maintenance treatments as often as once per week for the duration of the commitment ordered September 6, 2002, pursuant to Price v. Sheppard. 239 NW2d 905 (Minn, 1976) and Minn. Stat §253B,03, Subd. 6b.

BY THE COURT: Patricia L. Belois Date Judge of District Court Probate/lMental Health Division 9/16/02

next: Misleading Report Overstates Prevalence of Mental Illness
~ all Shocked! ECT articles
~ depression library articles
~ all articles on depression

APA Reference
Staff, H. (2007, February 18). Minnesota Forced Shock, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/depression/articles/minnesota-forced-shock

Last Updated: June 20, 2016

Anxiety and Depression After A Heart Attack

Anxiety and depression after heart attack is normal

What Is This Feeling Of Depression About?

Anxiety and depression after heart attack is normal. Many survivors of a heart attack experience feelings of helplessness and depression.Although better treatment and earlier rehabilitation programs help people recover swifter from a heart attack, adjusting to the psychological impact can take longer. Many survivors of a heart attack experience feelings of helplessness and depression.

The survivor and his or her family need to confront potential underlying fears and anxieties. Don't keep feelings bottled up inside. He or she should be encouraged to:

  • Be patient. Feelings of fear, anxiety, depression, or anger are common after a heart attack and usually are temporary.
  • Discuss feelings with his or her medical team, family, and friends.
  • Keep a journal. Often, writing about feelings can help a heart attack victim feel better.
  • Arrange for counseling if depression, anger, or withdrawal persists for more than four weeks. Their doctor can be helpful in arranging this.

Why do I feel anxious?

It is estimated that as many as 30% of patients report feeling anxious or depressed after a heart attack or heart surgery. You may feel depressed when you get back home, just when you're expecting to start feeling better. Your feelings may be due to a variety of reasons. You may be worried that you're going to have another heart attack, or you may have doubts about the success of your operation. These fears are a natural reaction to the stress of the event, they often resolve as time passes and should not cause you undue concern. It takes time for the implications of the condition to sink in, and the uncertainty of work prospects may worry both you and your partner.

How do I know if I'm depressed?

If you experience fatigue, tiredness, irritability, or you start to lose your temper easily, it may be a sign of depression. Your symptoms may vary from day to day. If you experience sexual difficulties after a heart attack, this may also cause anxiety. Returning to gentle sexual activity around three to four weeks after a heart attack or surgery is usually quite safe provided you've made a good recovery. There may be loss of libido or impotence for men, which may be due to anxiety or depression, the chest discomfort after surgery, or else due to certain medications such as beta-blockers or diuretics. If you think your medication may be affecting you in this way, it can be worth asking your doctor about changing it.

What can I do?

Making friends and family aware of possible problems can help their understanding of your situation. It can also be reassuring for you and your family to know that problems are usually temporary.

You may like to join a cardiac support group as it can be useful to share your concerns with people who have been through the same experience. Contact the American Heart Association chapter in your community.

Rehabilitation programs are another option. They provide information on healthy eating and managing risk factors for coronary heart disease, they also run exercise programs. Also available are counseling and stress relieving activities for people who have had heart attacks or heart surgery. You will usually be contacted by a rehabilitation nurse before you leave hospital. If you find it difficult to attend a rehabilitation program, you may be offered a self-help Heart Manual from your local hospital to use at home. It is important to discuss any problems with your doctor as he or she may be able to help you resolve your anxieties. If your anxiety or depression becomes severe, and there is no sign of improvement, you may need treatment from your doctor or a professional counselor or therapist

Sources:

  • National Heart, Lung and Blood Institute, "Life After a Heart Attack"
  • American Heart Association

next: Anxiety Disorders Research at the National Institute of Mental Health
~ anxiety-panic library articles
~ all anxiety disorders articles

APA Reference
Tracy, N. (2007, February 18). Anxiety and Depression After A Heart Attack, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/anxiety-panic/articles/anxiety-and-depression-after-a-heart-attack

Last Updated: July 3, 2016

Involuntary and Illegal Electroshock in Michigan

A report submitted to the Department of Community Health Recipient Rights Advisory Committee on June 14, 2001, by committee member Ben Hansen.

Michigan law prohibits the administration of involuntary electroconvulsive therapy (ECT, electroshock) to an adult who has no guardian. Judges ignore it.Michigan's Mental Health Code prohibits the administration of involuntary electroconvulsive therapy (ECT, electroshock) to an adult who has no guardian. Section 717 (1) (a) of the Code states, "A recipient shall not be the subject of electroconvulsive therapy or a procedure intended to produce convulsions or coma unless consent is obtained from ... the recipient, if he or she is 15 years of age or older and does not have a guardian for medical purposes."

Unfortunately, this section of the Code is ignored by probate judges who sign court orders authorizing involuntary ECT in direct violation of Michigan law.

In October 1, a petition was filed in Lenawee County Probate Court by Dr. Daniel F. Maixner, who wished to administer ECT to a patient who had been involuntarily committed. The doctor's petition asserted "that the individual is a person suitable for electroconvulsive therapy pursuant to 330.1717."

Probate Judge John Kirkendall found "by clear and convincing evidence, the individual is a person requiring treatment because the individual has a mental illness, pursuant to order entered 10/6/99; it is advisable and reasonable to administer electroconvulsive therapy and diligent effort has been made to locate individuals eligible to give consent." The judge ordered "that the individual receive electroconvulsive therapy pursuant to the following schedule: maximum number of treatments: 12. Time within which such treatments shall be administered: over a 30 day period from the date of initial treatment."

An appeal was filed by Michigan Protection & Advocacy, and on May 31, 2000, 39th Judicial Circuit Court Judge Timothy Pickard issued an order which declared, "The statute is clear in identifying those individuals authorized to give consent. Competent adults, for whom a guardian has not been appointed, retain the right to make decisions about the administration of electroconvulsive therapy. It is apparent that Appellant is an individual for whom a guardian has not been appointed and that she is an adult. Under those circumstances, MCL 330.1717 does not authorize forced administration of electroconvulsive therapy. This Court therefore holds that the Order entered on October 12, 1999 be VACATED."

Two weeks after the circuit court decision cited above, a petition was filed in Calhoun County Probate Court by another psychiatrist who wished to administer ECT to a patient who had been involuntarily committed. Filling out a form entitled "PETITION AND ORDER FOR ECT TREATMENT," Dr. Ravinder K. Sharma asserted that "it appears that the individual is in need of a course of ETC. It further appears that the individual will not or cannot consent to such a course of treatment and that there is not a guardian to give such consent. I therefore request that the court permit that the individual undergo a course of ECT."

Probate Judge Phillip Harter granted the petition on June 16, 2000, ordering that "ECT may be performed upon the patient at Oaklawn Hospital, Marshall, Michigan. The number of treatments shall not exceed 12 and the last treatment shall be performed on or before 9/14/00."

Again Michigan Protection & Advocacy filed an appeal, this time in the 37th Judicial Circuit Court, and on October 23, 2000, Circuit Court Judge James Kingsley issued an order which echoed, almost word for word, the order which had been issued by 39th Circuit Court Judge Pickard five months earlier: "The statute is clear in identifying those individuals authorized to give consent. Competent adults, for whom a guardian has not been appointed, retain the right to make decisions about the administration of electroconvulsive therapy. It is apparent that Appellant is an individual for whom a guardian has not been appointed and that she is an adult. Under those circumstances, MCL 330.1717 does not authorize the forced administration of electroconvulsive therapy. This Court therefore holds that the Order entered on June 16, 2000, be VACATED."

The circuit courts have ruled with language that is unequivocal: Michigan's Mental Health Code prohibits the administration of involuntary electroshock to an adult who has no guardian. Unfortunately, some probate judges continue to ignore and/or defy the law.

Replying to an email query regarding court protocol as it pertains to ECT, Probate Judge Phillip Harter wrote the following in an email which he sent on May 14, 2001:

"There are generally two ways that ECT can be authorized without the consent of the patient. First, a guardian can be appointed for the patient and the guardian can give permission for the treatment. Second, a court can under the Mental Health Code find that the individual does not have the ability to consent and the treatment is necessary. Such a court could then give a hospital the authority to use ECT treatment for the patient."

When a follow-up email asked Judge Harter to clarify his interpretation of the law, the Judge wrote the following in an email which he sent on May 25, 2001:

"...in the context of a mental hearing, a judge may make a finding that the individual is not competent to give or withhold consent. This would be similar to a finding that the person meets the criteria for the appointment of a guardian. Once that finding is made, I believe the court can inquire as to whether or not ECT treatment is appropriate and order it if it is appropriate. The same thing would be accomplished by holding a guardianship hearing, appointing a guardian and authorizing the guardian to consent to ECT. I believe the better procedure is to have the guardian appointed for the purpose of consenting to ECT treatment."

Judge Harter seems to openly defy the circuit court rulings on involuntary ECT. Moreover, his remark that a guardian may be appointed "for the purpose of consenting to ECT" is most troubling, for it appears to be yet another example of how probate judges use guardianship as a way to circumvent competency standards, involuntary commitment procedures, involuntary treatment requirements and other laws designed to protect individual rights. This may be one reason why Michigan leads the nation in the number of adults who have been assigned legal guardians.

Consent laws are made a mockery by judges who rule that individuals are competent when they consent to treatment, but incompetent when they refuse treatment. The recipient rights system is a farce if the Mental Health Code is systematically violated and the Office of Recipient Rights takes no action in response.


On this question, ORR Director John Sanford wrote in an email which he sent on May 16, 2001:

"...Our mandate is to ensure that providers of mental health service maintain a rights system consistent with the standards established by the Mental Health Code. Administrative rule 7001(L) defines a provider as the department, each community mental health services program, each licensed hospital, each psychiatric unit and each psychiatric hospitalization program licensed under section 137 of the act, their employees, volunteers, and contractual agents. The courts are not considered a provider. Thus, ORR has no control or jurisdiction over them."

The fact that ORR has no jurisdiction over the courts is no justification for looking the other way when the Mental Health Code is violated. At the very least, ORR should provide rights officers and others with a correct interpretation of 330.1717, instead of contributing to the confusion by promoting contradictory and misleading information, as it did at "The 2000 Recipient Rights Conference" held at the Grand Traverse Resort in October of last year.

Conference participants received an information packet which included a document entitled, "A Mental Health Professional's Guide to Michigan Mental Health Procedure," authored by Probate Judge John Kirkendall. In a section on electroshock and the requirements for its use, the document states the following:

"The probate court may grant consent. This can occur if 1) No one can be found after diligent effort who meets the criteria above; 2) There is a petition and hearing. Once you believe ECT is indicated and you can find no one to give consent, you must cause a petition to be filed with the probate court. Call the prosecuting attorney in the county who handles these matters to take care of this for you."

The Office of Recipient Rights should make a concerted effort to inform all who attended last year's conference that the information quoted above is contrary to the Mental Health Code. Failure to do so will put ORR in the embarrassing position of appearing to endorse an interpretation of the Mental Health Code which has been ruled unlawful by the circuit courts.

*******

Attachments:

1. Michigan Mental Health Code, "330.1717 Electro-convulsive therapy; consent."

2. "Initial Order Following Hearing on Petition for Admission," Lenawee County Probate Court, File No. 99-438-M, October 12, 1999.

3. Order, 39th Judicial Circuit Court for Lenawee County, File No. 99-8390-AV, May 31, 2000.

4. "Petition and Order for ECT Treatment," Calhoun County Probate Court, (Probate Court No. 99-033MI) June 16, 2000.

5. Order, 37th Judicial Circuit Court, File No. 00-2429AV, October 23, 2000.

6. Email correspondence between Ben Hansen and Calhoun County Probate Judge Phillip Harter, May 22 - 31, 2001.

7. "A Mental Health Professional's Guide to Michigan Mental Health Procedure," Hon. John N. Kirkendall, Judge of Probate, Washtenaw County Probate Court, pages 1, 4 and 5.

next: Letter to Julie Butler
~ all Shocked! ECT articles
~ depression library articles
~ all articles on depression

APA Reference
Staff, H. (2007, February 18). Involuntary and Illegal Electroshock in Michigan, HealthyPlace. Retrieved on 2024, December 19 from https://www.healthyplace.com/depression/articles/involuntary-and-illegal-electroshock-in-michigan

Last Updated: June 20, 2016