27. Brief Office Interventions for Anxiety and Depression: Treating the Cause Rather Than the Symptoms

Focus Areas: Integrative Approaches to Care, Mental Health Anxiety and depression are among the most common disorders seen in medical practices. Physicians often have limited resources with which to help patients in a primary care setting. Pharmacologic treatments with selective serotonin reuptake inhibitors have not been shown to be more effective than placebos and have significant risk. Integrative treatments such as relaxation and mindfulness training can be effective but usually require referral to a program and tend to target the symptoms rather than the root cause. Anxiety and depression are not primary processes but are symptoms caused by emotional reactions to stressful life events. Stressful life events frequently create emotional pathways of fear. In addition, other emotions, primarily anger, guilt, and grief, are typically held in to some degree and the combination of these suppressed emotions create the symptoms of anxiety and/or depression. It has been shown that experiencing, expressing, and releasing these emotions is very effective in reducing symptoms of anxiety and depression. This workshop will offer a model for helping patients understand that the symptoms of anxiety and depression have been learned by their brains and bodies through a neuroplastic process. It provides a model to explain how their life events and emotional reactions to those events have led to neurologic sensitization that can be reversed by changing the emotional reactions to those events. A method for quickly identifying the stressful events that have created anxiety and depression will be presented. Then a paradigm derived from a form of psychotherapy known as Intensive Short-Term Dynamic Psychotherapy will be presented. Video of this method will be shown and taught using a live demonstration. Trainees will be given an opportunity to practice this method during the workshop. There will be ample time for questions and discussion of the topic, these methods, and issues presented by patients.