Anxiety and Depression

Does “mindfulness meditation” really help relieve stress and anxiety?

DEAR DOCTOR K: I've heard a lot about "mindfulness meditation." Does it really help relieve stress and anxiety?

DEAR READER: Mindfulness meditation has become quite popular in recent years. The practice involves bringing your mind's attention to the present without drifting into concerns about the past or future. Many people practice it hoping to stave off stress and stress-related health problems.

Why does my stomach clench up in knots when I’m stressed?

DEAR DOCTOR K: Whenever I'm stressed out my stomach clenches up in knots. Why does it do that?

DEAR READER: A particularly sad experience is described as "gut-wrenching." Hearing about a gruesome crime makes you "feel nauseated." An upcoming presentation gives you "butterflies in your stomach." We use these expressions because anger, anxiety, sadness, elation and other emotions can trigger symptoms in our gastrointestinal tract.

I worry a lot, my psychologist she said I didn’t have anxiety disorder — I can’t believe there’s nothing to do. Can you help?

DEAR DOCTOR K: I've always worried a lot. I saw a psychologist, but she said I didn't have anxiety disorder, so she couldn't help. I can't believe there's nothing to do. Can you help?

DEAR READER: I don't agree with your doctor. I've talked before in this space about how doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. Doctors have certain criteria for what constitutes an anxiety disorder.

I’ve been feeling sad and tired but my doctor doesn’t think I’m depressed. What else could it be?

DEAR DOCTOR K: Recently I've been feeling sad and tired. My doctor doesn't think I'm depressed, but I know something's not right. What could it be?

DEAR READER: Doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. For example, you don't have diabetes until your blood sugar reaches a certain level. You don't have lupus until you have a certain combination of symptoms, physical examination and laboratory abnormalities. The same with multiple sclerosis.

What is agoraphobia?

DEAR DOCTOR K: My daughter's new roommate is afraid to leave a 10-block area around their apartment in New York City. She has something called "agoraphobia." What is that?

DEAR READER: Agoraphobia is the fear of certain situations in which an individual feels threatened and trapped and unable to escape. Most often, the fear is of being in open or public places. In the most severe cases, people with agoraphobia become afraid to leave home at all.

How can I get over my fear of going to the dentist?

DEAR DOCTOR K: I'm a rational person, but I have a deep fear of the dentist that I just can't overcome. Any suggestions?

DEAR READER: I don't know too many people who enjoy a trip to the dentist. But the health of our teeth and gums are an important part of maintaining our dental and overall wellness. So we do it.

How does lithium treat bipolar disorder?

DEAR DOCTOR K: I have bipolar disorder. I've experienced the highest highs and the lowest lows. How can one medication -- lithium -- treat both extremes?

DEAR READER: Bipolar disorder is certainly a condition of extremes -- extreme opposites. On the one hand are episodes of mania. During these episodes people with bipolar disorder feel like they're "on a high." Then there's the other side of bipolar disorder: the sadness and hopeless feelings of depression.

What is the connection between depression and fatigue?

DEAR DOCTOR K: I was recently diagnosed with depression. It turns out that depression has likely caused the fatigue I've been unable to shake for the past few months. What's the connection between the two?

DEAR READER: Everybody experiences fatigue now and then. Yet some people suffer from constant fatigue. There are literally hundreds of different diseases that cause a chronic state of fatigue.