Dr Lee Baer
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Dr Lee Baer |
 Order "Getting Control" |
 Order "The Imp Of The Mind" |
(Dr. Lee Baer's 2nd visit) Dearest: My guest tonight is Psychologist, LEE BAER, Ph.D., an internationally recognized expert in the treatment of OCD (Obsessive Compulsive Disorder) and related disorders. He is an Associate Professor of Psychology at Harvard Medical School and the director of research of the OCD Institute at McLean Hospital. Dr. Lee Baer is also the author of "The Imp Of The Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts", and "Getting Control: Overcoming Your Obsessions and Compulsions". Dr. Baer, it's a pleasure to welcome you back in Power Surge. We've all heard of cases of OCD whereby people have to wash their hands incessantly, or perform certain "rituals," but take someone, for example, who is a stringsaver to the point of accumulating massive piles of magazines he's not likely to ever read or other things he has no real reason to save, but does for the day he may "need them for something". Then, he may decide it's time to discard the "collections," he has serious difficulty doing so. I mean, a real dilemma. Does this fall into the category of obsessive-compulsive behavior, or are these just habits one needs to learn to control? Dr. Lee Baer: First thank you for having me back. Dearest: My pleasure :) Dr. Lee Baer: Hoarding, as you describe is a symptom of OCD, but all OCD symptoms are similar to everyday thoughts and habits. The distinguishing factor is whether they interfere with a person's social or work functioning or whether they take up more than an hour or so a day, or whether they cause distress, so if the person you describe meets one of these tests, then they would have OCD. Dearest: Interesting. Something I was wondering about and that is, can being stressed all the time be or actually become compulsive behavior? Dr. Lee Baer: Since a compulsion is defined as something a person does voluntarily to reduce discomfort, being stressed wouldn't fit as a compulsion. It could however become something that happens a lot, but it wouldn't be called a compulsion. Dearest: I'm confused. A compulsion is something a person does to REDUCE discomfort? Dr. Lee Baer: Right. So, if a person feels very dirty, or guilty, they might wash their hands a lot to feel better, the hand washing is the compulsion. Or if a person feels very nervous and unsure and asks their spouse over and over for reassurance, asking for reassurance would be the compulsion. Does that make sense? Dearest: And the holding onto old magazines and not being able to throw them out, if compulsive, is done to achieve some level of comfort? Dr. Lee Baer: Right. Some people are afraid they may need it one day and throwing it out would make them feel uncomfortable, so they keep it all. Dearest: Very interesting. Thank you, Dr. Baer. Let's go to some audience questions. Jeanne, go ahead. Jeanne: I had a heart attack in January this year and think of death a lot more often now. Is that normal? I don't think like that every day but more than I used to before the attack. Dr. Lee Baer: This is very normal to have worries like this after a serious illness. It would only be a problem if it happened during too much of the day, or didn't go down after a couple of months. Jeanne: Oh good :) thank you. No. I'm thinking that way less and less. Dr. Lee Baer: That is good to hear. Jeanne: Thanks, it sure isn't easy but I'm getting there :) Dr. Lee Baer: Good to hear! Dr. Lee Baer: By the way, I am happy to answer questions about other kinds of anxiety problems or worries as well. Dearest: Thank you, Dr. Baer.. we'll cover the gamut of anxiety, OCD, SAD, depression, et al. We like to cover all the issues associated with menopause and midlife. Dearest: Our guest is having technical problems, so until he returns, let me ask you a few questions. Do you think menopause is just a physical experience? Yes or no. Jbla44: No MaryO: no way! pJ: no KathAZ: No rbncx1: no! carolz: no Sarab: Hardly Lori: NO!!!! Jeanne: no no no no no Grace: No Jackie: NO!!! MarlaG: Not in my experience MaryO: More mental than physical LadyBird: NO!!! froggy4: No, it is a right of passage! a HAPPY event! MsKitty: No Jeanne: I wish it were though Marilyn: Not a chance Carlie: Nope! KathAZ: I agree with MaryO Jeanne: Happy event? MaryJane: Hasn't been so for me LadyBird: Happy event? Jeanne: Well it's an event all righty froggy4: Yup, a time when we won't have to schedule certain things around THAT TIME! Jeanne: I never scheduled things around anything Dearest: How many of you have experienced severe anxiety, panic attacks and/or depression? MaryO: I have LadyBird: Me, Dearest Scout: Yes Sue: I think menopause is a physical experience with the wrong type of diet Jbla44: Here carolz: Yes Lori: ME, many times!! Grace: Some depression but not severe MissFinster: Me too KathAZ: I've been dealing with mainly anxiety so far rbncx1: yes! MarlaG: Lots of it Carlie: Yes terrible depression! Marilyn: Constantly until I started using Revival Jackie: Yes, yes! carolz: me too froggy4: yes, depression and anxiety . . . feeling not "qualified" Cher: Anxiety for me too LadyBird: I started with anxiety and am now in the physical...aches, pains MaryO: And depression. lots of depression Dearest: How many of you are having difficulty finding solutions and coping with the emotional issues associated with menopause? Jbla44: I am on an emotional roller coaster Lori: Somewhat Jeanne: I do! with the darn anxiety MissFinster: Too much anxiety MarlaG: I have Carlie: me too Marilyn: Yes Jackie: Always froggy4: LOL, had to with the discomfort and "heavyness KathAZ: I believe that I'm finally going to get some answers now about how I really deal with things! Scout: Try early menopause, unmarried, no children. Sue: I am also in early menopause, unmarried, no children Dearest: How many of you are taking some form of medication to treat your emotional issues? LadyBird: not me MaryO: I'm not pJ: no KathAZ: I'm taking St. John's Wort - helps some Cher: Xanax Jbla44: Ativan Jeanne: like Xanax? MissFinster: None here carolz: zoloft Carlie: Zoloft Cher: Love it froggy4: The "emotional" part for me is being anxious to get past this irregular pattern! Scout: Zoloft LadyBird: I had worse symptoms with the drugs... Jeanne: irregular pattern of what? froggy4: done prozac, klonazepam, bu-spar Lori: Many meds made me worse froggy4: menstruating . . . and really heavy LadyBird: I agree Lori MarlaG: Xanax Jackie: Revival helps so I don't need anything else MissFinster: Tried several and didn't help. rbncx1: took Xanax for a while but it's very "addictive". Now I'm going thru withdrawals. Don't take xanas Marilyn: natural hormones from Pete Scout: which works best, lease side effects? mary: why not just take the estrogen instead of all those other drugs with it's horrible side effects!! Dearest: Scout, what works best for one woman may not work best for another, or at all! LadyBird: I came in drug free,,,going out drug free.... Sue: froggy4...if you are having heavy menses, avoid all animal products and sodium chloride (table salt) Jeanne: Xanax and I get along fine -had no probs stopping it Dearest: Every woman is different and reacts differently to medication -- even vitamins and herbs. froggy4: in my case, doctor was just dealing with the anxiety & panic attacks MaryO: good attitued, LadyBird :) Jeanne: I just take it when I really need it now Dearest: And remember, what you hear from other woman are *their* experiences. You have to try different things to see what works for you! LadyBird: thanks Mary.... froggy4: argh, no animal products or salt . . . that'll be tough! does that include eliminating dairy? MissFinster: Has anyone tried Kava? LadyBird: I did.. Jeanne: yeah I don't say no to anything if it works for me LadyBird: helped a bit...but not much KathAZ: Kava puts me to sleep and makes me anxious about it at the same time Sue: froggy4...yes..that means all animal products, even dairy Scout: can you mix St John's Wort ladykwak: Hi everyone, I am looking for some natural estrogen but I am not sure what is good and bad Marilyn: I find Revival soy has gotten rid of all of my symptoms. Scout: and SAM_E Jbla44: I can't take HRT froggy4: I don't like fruits/veggies much (wrinkling up nose like child) MissFinster: I'm trying Kava but don't feel anything yet. Sue: I am looking for natural estrogen too Jeanne: froggy it won't be forever :) Dearest: Sue, if you want a natural estrogen, check out the transcripts of pharmacist Pete Hueseman in the Library Sue: froggy4...the fruits and veggies is your key to wellness (eat them raw) Dearest: Ladyhawk and others asking questions, please visit the message boards. So, let's go to another question while we're waiting for our guest to return. What would you say is your "worst" symptom to deal with through this transition? MaryO: itching!! carolz: anxiety Lori: Anxiety and rage Cher: anxiety and weight gain KathAZ: Anxiety Lori: Palps are the worst physical symptom Dearest: Lots of anxiety and rage, I see. LadyBird: the fact that I have no control over menopause...frustrated.... rbncx1: anxiety pJ: me too LadyBird Jeanne: anxiety and having to change the way I eat froggy4: :( <pouting> meat & tater girl! Dearest: Our guest has returned. Irene, go ahead. Irene: Is it possible to be free of anxiety/panic for 20 years and then have it come "slamming" back after my daughter was hit by a Jeep. She is fine now but I'm still fighting the old high anxiety/some panic/agoraphobia. Dr. Lee Baer: Problems like panic, OCD, depression, often come back after a severe life stress. The good news is that it should be easier to get under control the second time around because of what you learned the first. Scout: Early menopause at 40. At 43, depressed. Zoloft not helping much. Blurred vision. Should I try something else? Irene: Thank you!! Dr. Lee Baer: There are certainly other SRI drugs that can be tried but there are non-drug treatments that can be helpful for depression as well. With problems like menopause there are certainly hormonal changes, but there are also changes in other areas of life like increased stress, etc. Have you tried/considered something like cognitive therapy or other counseling? Scout: Not really. Dr. Lee Baer: I would think about it. Many studies have found that these approaches can reduce depression as much as medications, although medications can certainly be helpful too. Dearest: Thank you, Dr. Baer. MsWhimsey, GO AHEAD. MsWhimsey: When an upsetting incident occurs in my life, usually relationship- oriented, I find myself going over and over and OVER the entire incident, dialogue, the whole thing ... for DAYS. Would this fit the periphery of OCD, since, once the dissent has been eradicated, the obsessing stops. Dr. Lee Baer: This would be an OCD-like problem, although since it is about a real-life concern, like a relationship, it would probably be called rumination. It is sometimes helpful to set aside a certain time of the day, say 20 minutes each day for rumination like this and then put off these worries until this time each day. This can give some control. MsWhimsey: Such behaviour occupies me completely and constantly until the item is put to bed; but then can return and begin anew ... after it's all over. Dr. Lee Baer: It can help to ask yourself - what you are afraid is the worst that will happen if you don't ruminate about this and then ask yourself how rational this outcome is. MissFinster: What do you recommend for treating OCD? Dr. Lee Baer: As far as medications, the SRI drugs like Prozac, Luvox, Paxil, etc. are all about equally effective and behavior therapy also is just about as effective. Dearest: Dr. Baer, what actually is the difference between behavior therapy and one on one psychotherapy and can each or both together be effective in treating these disorders? Dr. Lee Baer: Behavior therapy works directly on the obsessions and compulsions and teaches the person how to reduce them. "Talking therapies" generally focus on more general issues like relationship problems, etc. We find it is usually best to use behavior therapy first to get the major problems under control, then the person is free to focus on working on the other issues in their life with less directive therapy. Dearest: Is behavior therapy something someone can do by herself? Say, just by reading one of your books and learning various techniques? Dr. Lee Baer: Some people can do behavior therapy themselves, for straightforward problems. The same is true for some people who use cognitive therapy books, like Dr. Burns' "Feeling Good"; although most people need a therapist to help them along. Dearest: Thank you, Doctor. JBLA, GO AHEAD, PLEASE. Jbla44: I am going through menopause/surgically induced, have tried HRT with bad side affects. I have panic disorder, crying episodes, laughing the next minute, have trouble driving. Help. Dr. Lee Baer: Are there any times during the day you do not feel depressed or anxious? Jbla44: Yes Dr. Lee Baer: That is good. Are you able to relax by using relaxation methods like meditation, breathing, muscle relaxation, etc? Jbla44: I am practicing deep muscle and deep breathing techniques. Dr. Lee Baer: That is good. I would suggest you pick a non-stressful time to drive. Use one of the relaxation techniques that you have learned to get yourself very relaxed, then drive a very short distance to someplace you really enjoy. It sounds like you are moving in the right direction. MsWhimsey: My understanding is that 'control' is the elusive element here ... how is one who is 'ruminating' supposed to gain 'control' enough to daily set aside 20 minutes for the 'exercise' of rumination??? Dr. Lee Baer: The only way to gain control is gradually! You can start by delaying the rumination for 5 minutes at first if that is all you can do. This is the start of getting some control - then increase gradually. Irene: Is it unusual for my recurrence of anxiety/panic/some agoraphobia to last 9 months (although it has improved moderately). I am using CBT, meditation, Reiki and Reflexology for relaxation. Is there anything else I should do? Dr. Lee Baer: In some cases, a low dose of a medication like Klonopin can make the difference. Jeanne: I have agoraphobia as far as I can't travel far from home, like on trips. can traveling a little further from home help me get over this? or do I need medication of some sort? Dr. Lee Baer: The situation with agoraphobia treatment is exactly like OCD. Medications that reduce anxiety, like Xanax and Klonopin, and MAOIs are very effective, but behavior therapy, teaching yourself to go farther and farther gradually, and letting the anxiety subside without your escaping usually produces equal results. Many people use both. DonnaMaria: Is it possible to have an anxiety depression from quitting smoking? have been going through menopause since '93 and now on natural HRT- had severe anxiety and panic symptoms for about 5 months till tests were normal- was overbreathing into the attacks? Jeanne: That's what I was planning but it still scares me to try Dr. Lee Baer: To Jeanne - a therapist could help you get started. To DonnaMaria - yes some people can have the experience you are having after quitting smoking. Cher: Are there therapist who specialize in eating disorders? If so how would you find one? Dr. Lee Baer: There are many therapists who specialize in eating disorders. I am sure there a many listings at reputable web sites. If you are not able to find one, you can contact the Harvard Eating Disorder Program at Mass. General Hospital (617-726-2000) and they can give you a referral. Sasygrl: Have you ever head of 5HTP for depression? Is it safe? Dr. Lee Baer: This is serotonin, which is a neurotransmitter in the brain and is involved with depression (as well as OCD). SRI drugs like Prozac increase 5HTP. There are vitamins that are supposed to increase this as well but this is not really tested. You should ask your doctor before taking anything that can increase serotonin (like St. John's wort). Dearest: What about living with chronic pain -- can't this lead to obsessive thoughts about it -- and/or hypochondriacal symptoms? Dr. Lee Baer: Absolutely... Dearest: Or, I should add can it increase pain? Dr. Lee Baer: The distinction is that in OCD people worry about things that are unreal or very unlikely things. Chronic pain programs usually focus on getting the person back into their regular routines and on their feet which automatically reduces their depression and their thinking about their pain. Dearest: Your books are wonderful. Have you ever written or if not, considered writing a book about anxiety alone? Dr. Lee Baer: Thank you for the complement. You also give me a chance to suggest a book by a colleague of mine in England, Dr. Isaac Marks, who recently revised his classic book on anxiety entitled "Living with Fear". I doubt that I could top Professor Marks' book and I highly recommend it! Scout: What about SAM-E? Dr. Lee Baer: I can say that SAM-E is an over the counter food supplement that increases serotonin. You should ask your doctor before trying this. It is also very expensive. Dearest: Dr. Baer, thank you once again for a very stimulating and thought provoking chat about anxiety, OCD, depression. I highly recommend Dr. Lee Baer's books, "The Imp Of The Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts" and "Getting Control: Overcoming Your Obsessions and Compulsions". You can pick them up at your bookstore or online at amazon.com. Dr. Lee Baer: I have enjoyed answering your questions and apologize for the technical glitches! Dearest: That's the Internet! Thank you, Dr. Baer. Read Dr Baer's first transcript. Disclaimer: Every guest in Power Surge is a highly respected professional whose opinions are his/her own. An appearance in Power Surge does not constitute an endorsement of a guest's views. None of these transcripts may be reprinted or reproduced without the express permission of Power Surge™ and the respective guest. Read other transcripts by returning to the Library. Dearest aka Alice Stamm Power Surge Founder, Facilitator, Host Copyright©1994-2009 by Power Surge. All Rights Reserved.