Study: For social anxiety disorder, talk therapy beats meds

Oct. 9, 2014—About 15 million Americans live with social anxiety disorder, a phobia characterized by avoidance of social situations. And though antidepressants are a common form of treatment, the results of a new study published in The Lancet Psychiatry suggest that cognitive behavior therapy (CBT) may be the better choice—especially in the long term.

About the study

To analyze the effectiveness of various social anxiety disorder treatments, researchers reviewed data from more than 13,000 participants with the disorder in 101 studies. Over 4,000 participants underwent psychological interventions, while approximately 9,000 received medication or placebo pills.

Among the psychological intervention group, CBT was found to be most effective. A form of talk therapy, CBT involves learning how to identify distorted or irrational thoughts, why they influence behavior, and how to overcome them. This process involves active involvement from both patient and therapist to focus on the patient’s current problems and determine the best way to resolve them.

SSRIs versus CBT

SSRIs, a class of antidepressants, were found to be the most effective medication included in the study. However, these drugs may come with adverse side effects that include increased agitation and sexual dysfunction—issues that may further complicate social anxiety.

In addition, negative symptoms of social anxiety disorder tend to return when people stop taking SSRIs. CBT, however, provided greater long-term results, as researchers reported those who followed this course of talk therapy had maintained their progress well when researchers followed up with them, and they continued to make positive gains over social anxiety after treatment had ended.

The findings suggest that social anxiety disorder is highly treatable, but that certain treatments may be better than others. While antidepressants can help social anxiety sufferers manage symptoms in the short term, CBT is more likely to teach people to cope with their fears after treatment ends.

For more details, read the study published in The Lancet Psychiatry, here.


The take-home message

According to the National Institute of Mental Health (NIMH), social anxiety disorder—or social phobia—often begins in childhood or adolescence and may be accompanied by other anxiety issues or depression. Often, the disorder is characterized by symptoms such as:

  • Anxiety about being with other people or having difficulty talking to them
  • Feeling self-conscious or embarrassed in front of people
  • Fear of being judged by others
  • Worrying for days and weeks before a social event
  • Staying away from social situations
  • Having a hard time making or keeping friends
  • Blushing, sweating or trembling around people
  • Feeling nauseated around people

Treating social anxiety disorder

The NIMH says antidepressants, especially SSRIs, can help ease symptoms of social anxiety disorder. However, they may also cause side effects such as headache; nausea; difficulty sleeping; and, in some people, suicidal thoughts. What’s more, the medications aren’t recommended for long-term use, and once a person stops taking them, symptoms can reappear.

CBT may be a more effective treatment. With the help of a psychotherapist, people learn skills for coping with their social anxieties. The NIMH suggests this process can help them manage their disorder in the long term.

If you are experiencing symptoms of social anxiety disorder, talk with your doctor. Together, you can determine the best way to address your symptoms—and work to begin to feeling more comfortable in social situations.

Learning more about anxiety can be the first step to seeking help. Find out more about anxiety and how it can affect health and well-being.


Neural Tube Defects

There has been a lot in the news in the past year about birth defects in the Yakima Valley – specifically, neural tube defects. Neural tube defects are relatively common birth defects (about 1/1000) that range in severity. In very severe cases, the skull does not close, resulting in anencephaly, which is always fatal. Spina bifida results if the spine does not close, which also ranges from less severe to more severe.

Susie Ball, Memorial’s genetic counselor, appeared on KIT 1280 on Tuesday, Sept. 30, 2014, to talk about these birth defects, as well as steps moms-to-be can take to try to prevent them.

What causes neural tube defects?

Children affected by neural tube defects have received some genes from each parent. Then, there has been some triggering exposure during the pregnancy. We don’t know what all the triggers are, although low folic acid is one. Usually there is not a family history of the condition. It can happen to anyone.

There seems to be a cluster of birth defects in the Yakima Valley.

Certain birth defects often occur in “clusters,” just by chance, and in these cases, there is not enough evidence to show that that there is a larger problem. We have to take a long view, over many years, to determine if there is a problem.

The Department of Health is investigating to determine if there is a preventable cause. One thing that has come out of the study is that several of the women have had pregnancies with other identified issues (other birth defects in the baby, other genetic causes suspected).

There is no one identified cause for these birth defects about which we can warn residents.

Are there things women can do to prevent them?

Low folic acid seems to be a triggering event in some women who have affected babies. The March of Dimes and health care providers have been advocating pre-conceptional use of folic acid for many years. That means all women of child-bearing age should be taking folic acid.

If a woman takes 0.4 mg of folic acid daily – basically, a daily vitamin with folic acid – prior to pregnancy and through early pregnancy, she will cut her chances of having a child with a neural tube defect by about half.


3rd Healthy Now clinic opens in West Valley

Convenient care clinic treats minor illnesses quickly, comfortably

YAKIMA – Memorial Physicians is pleased to announce that a new Healthy Now clinic has opened in West Valley to meet the demand for convenient care for minor illnesses.

Healthy Now treats a variety of non-urgent illnesses and injuries that might not be serious enough for a trip to the emergency room, but still require treatment even if your own doctor is unavailable. Services offered include treatment for colds, flu, sore throats, ear aches, minor burns and sprains and strains.

The new clinic, which is located at 120 S. 72nd Ave., is the third Healthy Now clinic opened by Memorial Physicians to serve patients. The first Healthy Now clinic opened in December 2013 at 3909 Creekside Loop. A second Healthy Now clinic opened in May at 3904 Terrace Heights Dr.

Healthy Now is open 7 a.m. to 7 p.m. Monday through Saturday. Walk-ins are welcome, and appointments can be scheduled online in advance at

Healthy Now accepts most insurance plans and Medicare. The copayment for your specific plan will be collected during your visit. Please have your insurance card and proof of ID at the time of your visit. If you haven’t met your deductible, don’t have insurance or don’t have a plan, we currently accept cash, credit cards and debit cards.

For more information about Healthy Now, visit our website at

Celebrate National Breast Cancer Month with Pumpkin!

By Lena Gill, RD, CSO, CD – North Star Lodge

Fall has definitely arrived in the Yakima Valley!  One of my favorite vegetables in abundance this time of year is pumpkin.  There are countless varieties of this fun squash, each with a different purpose in mind:
•    Sugar – excellent for baking
•    Jack O’Lantern – most common for carving
•    White Lumina – unusual, medium-sized white pumpkin
•    Mini – great for decoration
•    Gourds – many varieties, used for decorations
Regardless of the size, shape and variety of pumpkin, there are many health benefits when eaten.
Pumpkins are full of beta-carotene which can help prevent heart disease and certain cancers.  Most specifically, pumpkins have been in the news for their benefits in preventing breast cancer.  October is Breast Cancer Awareness month and a newly founded organization, the Pink Pumpkin Patch Foundation, has commissioned farmers to grow pink pumpkins—a portion from every pink pumpkin sold goes to support breast cancer research.  Pumpkins also contain potassium (essential for the proper functioning of the heart, kidneys, muscles, nerves, and digestive system) and Vitamin A (which helps form and maintain healthy skin, teeth, skeletal and soft tissue, mucus membranes, and skin).

Some other fun facts about pumpkins:
•    Pumpkins are actually a fruit (I know, I referred to it as a vegetable earlier!)
•    About 90-95% of pumpkins are grown in Illinois
•    Pumpkin flowers are edible
•    The Native Americans used pumpkin seeds for medicine and for food
•    Pumpkins range in size from under a pound to over 1,000 pounds

Here are some of my favorite pumpkin recipes—Check them out and feel free to share your comments on your favorites, too!

Preparing Fresh Pumpkins to Be Used in Recipes
Roasted Pumpkin Seeds
Pumpkin Chili –  When I made this, I didn’t have lentils, so I substituted a can of pinto beans-Delicious!
Pumpkin Bread
Pumpkin Pie  – Why mess with tradition?  The holidays are coming!
Peter Pumpkin Squares
Pumpkin Peanut Butter Cups – I haven’t made these yet, but I thought they’d make a great addition to holiday baking!

Take steps to reduce your risk for breast cancer

As of yet, there is no sure way to prevent breast cancer, the second leading cause of cancer deaths among women in this country. Even so, there are steps women can take to reduce their risk. And October, which is nationally recognized as Breast Cancer Awareness Month, is the ideal time to take them.

One key safeguard is for women to maintain a healthy weight, especially in midlife and later. After menopause, most of the hormone estrogen in a woman’s body comes from fat cells. Estrogen can spur the growth of many breast tumors, and being overweight or obese can raise breast cancer risk. Women may be especially vulnerable to breast cancer if extra pounds settle on their waist, rather than their hips and thighs.

These additional steps may help women reduce their risk for breast cancer, according to the American Cancer Society (ACS):

• Avoid alcohol. Drinking is clearly tied to a heightened risk of developing breast cancer. In fact, your risk increases the more you drink.

• Be active. A growing body of research indicates that exercise lowers breast cancer risk. Aim for 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week.

• Carefully weigh the pros and cons of hormone therapy. Hormone therapy that uses both estrogen and progesterone can increase breast cancer risk in as few as two years of use. The use of estrogen alone after menopause does not seem to raise the risk of developing breast cancer. If a woman and her doctor agree that hormone therapy is necessary to ease bothersome menopausal symptoms such as hot flashes, it is best to take the lowest effective dose for the shortest possible time.

Since breast cancer can develop even with these precautions, the ACS advises women to have yearly mammograms starting at age 40 and continuing for as long as they are in good health.

Regular mammograms (breast x-rays) can detect cancer in its early stages and give women a head start on potentially lifesaving treatment. If you have a heightened risk of breast cancer—for example, if you have very dense breasts—ask your doctor if you need additional screening tests, such as an MRI scan.

Are you at risk for type 2 diabetes? Get screened

Oct. 8, 2014—Nearly half of adults who ought to be screened for type 2 diabetes aren’t getting the job done, a study from the American Journal of Preventive Medicine found.

Researchers looked at information from two large national health studies involving more than 35,000 people that collected data between 2005 and  2010. They found that the number of people age 45 or older who reported being screened for diabetes in the previous three years was just 53.2 percent. And they estimated that at least a third of people with diabetes have yet to be diagnosed.

The American Diabetes Association recommends that all adults older than 45 get screened for the disease, whether they have symptoms or not.

Read the full study here.

Who’s at risk?

Obesity is closely linked to developing type 2 diabetes. And as obesity rates have risen, so has the number of people with diabetes.

A variety of factors can increase a person’s risk for type 2 diabetes. Some of these include:

  • Being 45 or older
  • Being overweight
  • Having a parent or sibling with the disease
  • Having high blood pressure or abnormal cholesterol levels
  • Being inactive
  • For women: having had diabetes during pregnancy (gestational diabetes), giving birth to a baby weighing 9 pounds or more, or having polycystic ovarian syndrome
The take-home message
Screening is an essential tool in the fight against diabetes.

For instance, if screening uncovers prediabetes, it may be possible to prevent the progression to diabetes by making lifestyle changes such as eating healthfully and exercising more.

And if screening finds that a person already has diabetes, being diagnosed and taking action can help prevent serious, even deadly, complications.

How screening works

Screening for diabetes, which involves a blood test, is fairly simple and may be done in a variety of ways. The A1C test measures your average blood glucose levels over the past several weeks. Other tests may require you to fast (not eat or drink) for several hours before testing. Another type, the oral glucose tolerance test, measures blood glucose levels before and after drinking a sugary drink. This helps show how well your body is processing glucose.

If you are 45 or older and have not been screened for diabetes or you are concerned about your risk factors, talk with your health care team.

Get more details on type 2 diabetes and its risk factors here.

Memorial offers diabetes blood sugar and foot screenings on Tuesday mornings from 8-10 a.m.
A Spanish translator is available on the 3rd Tuesday of each month.

For most accurate blood sugar screening results, do not eat or drink anything 8-12 hours prior to screening.

Screens are held at the Center for Diabetes Prevention and Control, Memorial Hospital Lower Level, 2811 Tieton Drive, Yakima.

No registration needed.

Feeling blue? Take action

Depression may be something you’re tempted to ignore or something you try to explain away. Lots of people do.

In fact, experts estimate that fewer than half of all people who have depression actually seek treatment. There are many reasons why.

Some think depression is just a personal weakness that affects other people. It’s not.

Depression is actually one of the most common forms of mental illness. It can strike people of both genders, at any age, and of every racial and ethnic background.

Others don’t think depression is important enough to address. It is.

Depression is a serious medical illness that can complicate other health issues. It can even lead to suicide.

Fortunately, depression—even serious depression—can be helped. In fact, experts say more than 80 percent of clinical depression cases can be effectively treated.

The most common remedies involve medication and talking with a mental health professional.

As with many illnesses, it’s best to treat depression early on. So don’t hesitate. If you think you may be depressed, talk to your doctor. An examination can help determine if you have depression or some other medical condition with similar symptoms.

You can learn more about the symptoms of depression using this depression assessment tool.

Source: Mental Health America

Why you need to get the flu vaccine

Oct. 7, 2014—Less than half of the people in the United States protected themselves with a flu vaccine during the 2013–2014 flu season, according to a report from the Centers for Disease Control and Prevention (CDC).

CDC strongly advises that people 6 months and older—with only rare exceptions—should get a yearly vaccine against the flu. Despite this advice, the report found only 46.2 percent of Americans in the recommended age group were vaccinated against the flu in the 2013–2014 flu season.

About the report

The report drew on data from random phone surveys in which 400,000 American adults were asked if they’d had a flu vaccine. Researchers then compared the current responses to past survey answers.

Among other things, they found that kids were better protected from the flu than adults. During the 2013–2014 flu season:

  • Almost 59 percent of kids nationwide got a flu vaccine—a rise of 2.3 percent over the previous season.
  • Only 42.2 percent of adults age 18 or older were vaccinated—an increase of 0.7 over the previous season.
  • The lowest rate of flu vaccination was among adults ages 18 to 49. Only 32.3 percent of them got the vaccine.

Read more about the report’s results here.

The take-home message
An annual flu vaccine is the best way to prevent the flu, which can cause serious complications such as pneumonia and can even be deadly. According to CDC, more than 200,000 people are hospitalized every year nationwide with flu complications.

Given that the flu can be quite serious, a yearly flu vaccine is in the best interest of almost everyone 6 months and older. To find out if you’re one of the rare people who shouldn’t be vaccinated—or if you should talk to your doctor before getting a vaccine—read these CDC recommendations here.

Among other things, the flu vaccine can protect you from missing work or school, from being hospitalized, and even from dying. In short, it’s dangerous to skip it.

Here are four things to keep in mind about the flu vaccine:

  1. It’s safe. It has very few side effects, and the most common ones are mild.
  2. It’s best to get vaccinated early. CDC says it takes about two weeks for the vaccine to provide complete protection. Those who get vaccinated before the flu hits their community will have a better chance of being protected.
  3. It won’t give you the flu. That’s a myth—and not a reason to skip the vaccine, CDC cautions
  4. Those who avoid the vaccine because they don’t like shots can ask their doctor about a nasal spray flu vaccine. This option is approved for healthy people ages 2 to 49, except for pregnant women. CDC recommends it for children ages 2 to 8 years when it’s available and notes that it may work better than the shot for younger children.

Want to know more? Here are some additional helpful questions and answers about the flu.