Delightful and hilarious.

Here's a couple of Brit high schoolers singing a song about CBT:

Darwin's panic.

Charles Darwin suffered for much of his life from a mysterious illness, which caused him gastrointestinal distress, heart palpitations, vertigo, dizziness, and a variety of other symptoms, and caused him to avoid leaving home for years. There's plenty of speculation about the identity of the illness:

Over the century since Darwin's death, proposals for an organic aetiology for his symptoms have ranged from Chagas' disease and arsenic poisoning to narcolepsy and diabetogenic hvperinsulinism and myalgic encephalomyelitis. Others argue for a psychiatric determinant, finding Darwin's somatic complaints to be a manifestation of a repressed hatred for his overbearing father. A third group posits a combination of organic and functional forces.

I even came across one guess that Darwin's real problem was lactose intolerance. But after reading the following passage from Darwin (which I found here), my bet is that the illness was panic disorder:

Fear is often preceded by astonishment, and is so far akin to it, that both lead to the senses of sight and hearing being instantly aroused. In both cases the eyes and mouth are widely opened, and the eyebrows raised. The frightened man at first stands like a statue motionless and breathless, or crouches down as if instinctively to escape observation. The heart beats quickly and violently, so that it palpitates or knocks against the ribs... That the skin is much affected under the sense of great fear, we see in the marvellous manner in which perspiration immediately exudes from it... The hairs also on the skin stand erect; and the superficial muscles shiver. In connection witih the disturbed action of the heart, the breathing is hurried. The salivary glands act imperfectly; the mouth becomes dry, and is often opened and shut.

I'm not the only one who believes that's true.

Interview with an agoraphobic.

This is an interview with an agoraphobic. A snippet:

Q. Are you able to leave your house?


A. Most of the time yes, but with discomfort. Agoraphobia has a wide range. Some people can't leave a room in their home while others can stay at home and go to work only. It really depends on the person. For me I don't go out unless I have too and when I have to go to the supermarket for example I go at very early or very late hours so it will not be busy.

Photo borrowed from this blog.

Video games as anxiety treatment.

This sounds like very cool research:

It’s too soon to load Tetris onto the equipment that soldiers carry into battle, but there’s an intriguing hint that playing that geometric game might act as what scientists are calling a “cognitive vaccine” against the horrible flashbacks that characterize post-traumatic stress disorder (PTSD), which more and more of those returning home from Iraq and Afghanistan are suffering.

The idea of using Tetris to vaccinate soldiers against PTSD rests on two facts. One, the brain has a finite processing capacity for each of two kinds of information: sensory/visual/spatial and narrative/meaning. Two, there is a window of about 6 hours to disrupt memory consolidation. What this implies, scientists led by Emily Holmes of the University of Oxford write in a new paper in the open-access journal PLoS One, is that a sufficiently demanding visuospatial task will keep the brain from retaining other spatial/visual information--that is, images, including traumatic ones. Tetris should be such a task, since recognizing the shapes and moving the blocks around places demands on the brain’s spatial-processing channel.

I'm imagining there might be ways these findings could be used to fight agoraphobia. By eliminating some of the "spooky mojo" that a panic attack can attach to a specific location or situation, playing Tetris after an attack might make it less likely that you'll panic the next time you're in a similar location or situation.

Play on, panicky gamers! Yours may yet be the last laugh!

Fear in the brain.

This is one writer's depiction of having his head scanned by a functional magnetic-resonance imaging (fMRI) machine to see how fear works in the brain:

My head was recently scanned by clinical psychologist Philippe Goldin, a researcher in the lab of James Gross, director of the Stanford Psychophysiology Laboratory. Goldin and his team are studying 30 "healthy controls" and about 60 social phobics in an effort to plot the pathways of anxiety—and, more important, how people are able to damp down their impulses to fight or flee.

On the monitor, the story of my mortification is interrupted by a single line of words in bold:

I AM A LOSER

I read more of my story, then this line pops up:

I'M TOO INSECURE TO STAND UP FOR MYSELF

Two primary regions of the brain show increased blood flow in the scanner—to use the vernacular, they "light up"—in response to an anxious or frightening situation. One is the amygdala, which is associated with emotions; the other is the hypothalamus, which gets you ready to take action by increasing your heart rate, respiration, and sweating.

Next, the write is asked to regulate his emotions with reason:

I do what Goldin has asked: I tell myself in the scanner that I'm not a loser; that I do stand up for myself.

In fact, back in the managing editor's office, I did speak up, telling him I'd worked hard on that story and deserved to write it. I also suggested that next time he tell me first before announcing it to the staff. The editor responded by looking me over like he'd never noticed me before.

He said I was right, he should have come to me first, and that I was ready to write the story. But changing his mind didn't change his decision—I'd get a reporting byline, but the other guy would write it. "Next time, though, the byline will be yours," he said.

I kept my cool long enough to casually walk out of his office. Then I ran to the men's room, and nearly threw up. This episode is a key moment for me in learning to push down my anxiety to the point that it bothers me far less today—though it took years of similar episodes.

My struggle to overcome anxiety is exactly what Goldin and Werner are measuring in the f.M.R.I. They can actually see the pathways lighting up from the frontal lobe—the seat of rational thinking, and where we make decisions—essentially telling the amygdala to settle down.

"The amazing thing is that the brain can make changes," says Goldin. "Most of this happens in the amygdala, and it can be tempered to learn and adapt."

My results did show adaptation in action. When I read my story and saw the lines about being a loser, my brain grew anxious. But I was able to modulate its reaction—to tell my amygdala to chill out.

Meditation, cognitive-behavioral therapy...some of the best tools for coping with panic and anxiety depend on exactly this idea: while it might be a struggle, with mindful focus reason can mediate anxiety.

Panic and politics.

I just read a Time article from late 2007 called "The Roots of Fear", which looks at the ways politicians use fear for political gain (citing, for example, Rudy Giuliani, who "rarely misses a chance to evoke images of crashing planes, collapsing towers and 2,973 dead Americans") as well as the reasons why invoking fear is so politically effective:

It's as pointless for Obama or anyone else to rail against the use of fear to sway voters as it is to bemoan humans' inability to hear pitches as high as dogs can. The brain structure that processes perceptions and thoughts and tags them with the warning "Be afraid, be very afraid!" is the amygdala. Located near the brain's center, this almond-shaped bundle of neurons evolved long before the neocortex, the seat of conscious awareness...

The evolutionary primacy of the brain's fear circuitry makes it more powerful than the brain's reasoning faculties. The amygdala sprouts a profusion of connections to higher brain regions—neurons that carry one-way traffic from amygdala to neocortex. Few connections run from the cortex to the amygdala, however. That allows the amygdala to override the products of the logical, thoughtful cortex, but not vice versa. So although it is sometimes possible to think yourself out of fear ("I know that dark shape in the alley is just a trash can"), it takes great effort and persistence. Instead, fear tends to overrule reason, as the amygdala hobbles our logic and reasoning circuits. That makes fear "far, far more powerful than reason," says neurobiologist Michael Fanselow of the University of California, Los Angeles.

In a way, I'm actually thankful for my panic disorder. It's given me a chance to really understand the science and psychology of anxiety, which I believe makes me better-equipped to recognize when someone's trying to use fear to manipulate me. Here's hoping Obama doesn't lean on this Bush-league tactic to the same extent as did the administration whose term is about to expire!

If you're interested in the biology of panic, I've discussed it before.