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Home , Confusion

March 2016

National Institutes of Health • Department of Health and Human Services • newsinhealth.nih.gov

Inside News: 3 & Balance Problems in Kids... 4 ... Benefits of Walking... Mind Your Risks Understanding Disorders When , , and Worries Overwhelm Many of us from time to realize there’s little cause time. We fret over finances, feel for concern. They startle anxious about job interviews, easily, can’t relax, and can’t or get nervous about social concentrate. They find it hard gatherings. These can to fall asleep or stay asleep. be normal or even helpful. They They may get headaches, may give us a boost of energy muscle aches, or unexplained or help us focus. But for people . Symptoms often get with anxiety disorders, they can worse during times of stress. be overwhelming. People with Anxiety disorders have sudden, repeated bouts nearly 1 in 5 American adults of fear—called panic attacks— each year. People with these that last several minutes or disorders have feelings of fear more. During a panic attack, and uncertainty that interfere they may feel that they can’t with everyday activities and last breathe or that they’re having for 6 months or more. Anxiety a heart attack. They may fear disorders can also raise your loss of control or feel a sense risk for other medical problems of unreality. Not everyone such as heart disease, diabetes, One of the most common types who has panic attacks will develop substance abuse, and . of anxiety disorder is social anxiety panic disorder. But if the attacks recur The good news is that most anxiety disorder, or social phobia. It affects without warning, creating fear of disorders get better with therapy. The both women and men equally—a having another attack at any time, course of treatment depends on the total of about 15 million U.S. adults. then it’s likely panic disorder. type of anxiety disorder. Medications, Without treatment, social phobia Anxiety disorders tend to run in psychotherapy (“talk therapy”), or can last for years or even a lifetime. families. But researchers aren’t certain a combination of both can usually People with social phobia may worry why some family members develop relieve troubling symptoms. for days or weeks before a social these conditions while others don’t. “Anxiety disorders are one of the event. They’re often embarrassed, No specificgenes have been found most treatable mental health prob- self-conscious, and afraid of being to actually cause an anxiety disorder. lems we see,” says Dr. Daniel Pine, judged. They find it hard to talk “Many different factors—including an NIH neuroscientist and psychia- to others. They may blush, sweat, genes, stress, and the environment— trist. “Still, for reasons we don’t fully tremble, or feel sick to their stomach have small effects that add up in understand, most people who have when around other people. complex ways to affect a person’s risk these problems don’t get the treat- Other common types of anxiety for these disorders,” Pine says. ments that could really help them.” disorders include generalized anxiety “Many kids with anxiety disorders disorder, which affects nearly 7 will outgrow their conditions. But million American adults, and panic continued on page 2 Definitions disorder, which affects about 6 million. Both are twice as common in Genes women as in men. @ Stretches of DNA, a substance you People with generalized anxiety Subscribe inherit from your parents, that define disorder worry endlessly over characteristics such as eye color and everyday issues—like health, money, newsinhealth.nih.gov your risk for certain diseases. or family problems—even if they 2 March 2016 http://newsinhealth.nih.gov/issue/Mar2016 continued from page 1 Whitfield-Gabrieli is launching an most anxiety problems we see in NIH-funded study to create detailed Web Links adults started during their childhood,” MRI images of the brains of more Pine adds. than 200 teens, ages 14-15, with and For more information on anxiety disorders, “Anxiety disorders are among the without anxiety or depression. The click the “Links” tab at: most common psychiatric disorders scientists will then assess what brain http://newsinhealth.nih.gov/issue/Mar2016/Feature1 in children, with an estimated 1 in 3 structures and activities might be anxiety at some point dur- linked to these conditions. The study ing childhood or adolescence,” says is part of NIH’s Human Connectome them. “We want to understand not Dr. Susan Whitfield-Gabrieli, a brain Project, in which research teams only how can help us but imaging expert at the Massachusetts across the country are studying the also how they can create difficulties if Institute of Technology. “About half complex brain connections that af- they’re of the wrong intensity or the of diagnosable mental health disor- fect health and disease. wrong type for a particular situation,” ders start by age 14, so there’s a lot of Whitfield-Gabrieli and colleagues says Dr. James Gross, a clinical in uncovering the factors that have shown that analysis of brain psychologist at Stanford University. might influence the brain by those connections might help predict We all use different strategies to early teen years.” which adults with social phobia will adjust our emotions, often without likely respond to cognitive behav- thinking about it. If something makes ioral therapy (CBT). CBT is a type of you angry, you may try to tamp down Wise Choices talk therapy known to be effective your to avoid making a Troubled by for people with anxiety disorders. scene. If something annoys you, you Anxiety? It helps them change their think- might try to ignore it, modify it, or ing patterns and how they react to entirely avoid it. If feelings of anxiety seem over- But these strategies can turn harm- whelming or interfere with every- anxiety-provoking situations. But it ful over time. For instance, people day activities: doesn’t work for everyone. Of 38 adults with social phobia, with social phobia might decide to n See your family doctor or nurse those who responded best after 3 avoid attending a professional con- practitioner. months of CBT had similar patterns of ference so they can keep their anxiety n The next step may be talking to a brain connections. This brain analysis in check. That makes them lose op- mental health professional. Con- led to major improvement, compared portunities at work and miss chances sider finding someone trained to a clinician’s assessment alone, in to meet people and make friends. in cognitive-behavioral therapy predicting treatment response. Larg- Gross and others are examining who is also open to using medi- er studies will be needed to confirm the differences between how people cation if needed. You may need the benefits of the approach. with and without anxiety disorders to try several medicines before “Ultimately, we that brain regulate their emotions. “We’re finding the right one. imaging will help us predict clinical finding that CBT is helpful in part n Consider joining a self-help or outcomes and actually tailor the because it teaches people to more support group to share problems treatment to each individual—to effectively use emotion regulation and achievements with others. know whether they’ll respond best strategies,” Gross says. “They then to psychotherapy or to certain become more competent in their n Stress management techniques medications,” Whitfield-Gabrieli says. ability to use these strategies in their and mindfulness meditation may Other researchers are focusing on everyday lives.” help relieve anxiety symptoms. our emotions and our ability to adjust “It’s important to be aware that many different kinds of treatments are available, and people with anxi- NIH News in Health Editor Harrison Wein, Ph.D. ety disorders tend to have very good ISSN 2375-6993 (Print) Managing Editor Vicki Contie responses to those treatments,” Pine ISSN 1556-3898 (Online) Contributors Vicki Contie, Alan Defibaugh adds. The best way to start is often by National Institutes of Health (illustrations), and Harrison Wein talking with your physician. If you’re a Office of Communications parent, talk with your child’s pediatri- & Public Liaison Editors Reprint our articles and illustrations in your own cian. “These health professionals are Building 31, Room 5B64 publication. Our material is not copyrighted. Please acknowledge Bethesda, MD 20892-2094 NIH News in Health as the source and send us a copy. generally prepared to help identify [email protected] such problems and help pa- Tel: 301-402-7337 For more health information from NIH, visit tients get the appropriate care they need,” Pine says. n newsinhealth.nih.gov http://health.nih.gov http://newsinhealth.nih.gov/issue/Mar2016 March 2016 3 Dizziness and Balance Problems in Kids Spinning Sensations and Unsteadiness Most people feel dizzy now and then. problems are fairly common among Kids, like adults, may occasionally children,” says Dr. James F. Battey, Jr., feel lightheaded or unsteady. But if a pediatrician and director of NIH’s such feelings repeat or interfere with National Institute on Deafness and everyday life, it could be a sign of a Other Communication Disorders. balance disorder. Our sense of balance is a complex Most balance problems are tempo- process. It’s managed by signals rary and easy to treat. But these prob- between the brain, ears, eyes, and lems may also signal a more serious sensors in the joints and other body condition that could have a lasting parts. This intricate system helps your impact. Learn to recognize the signs body monitor and maintain its posi- of dizziness or balance problems that tion as you move throughout the day, may warrant a trip to a doctor. without you even having to think Experts have long suspected that about it. But if any of these many sen- dizziness and balance problems are sory signals go wrong, it can weaken often overlooked and untreated, but your sense of balance. the scope of the problem wasn’t fully Balance disorders can make you understood. That’s why NIH sup- stagger when walking. You might ported the largest national survey to teeter or fall when trying to stand. date to uncover information about Affected people might feel like they these disorders in children. The study themselves or the world around them included data on nearly 11,000 kids, is spinning or moving—a condition ages 3 to 17. known as . Other symptoms “Parents who notice dizziness and The researchers found that more can include blurred vision, vomiting, balance problems in their children than 1 in 20 kids in the U.S. had a diz- diarrhea, confusion, and anxiety. should consult a health care provider ziness or balance problem, and only Common causes of balance prob- to rule out a serious underlying con- one-third of them received treatment lems in children range from ear dition,” Battey says. in the previous year. “The findings infections, severe headaches, and Your child’s pediatrician will likely suggest that dizziness and balance certain medications to more serious ask questions about when the symp- neurological disorders, head or toms first appeared, how long they neck injuries, and genetic conditions. last, how often they occur, and what Wise Choices In many cases, the study’s researchers medications the child is taking. Your Tell Your Doctor found, an underlying cause wasn’t child’s eyes and ears will be exam- Dizziness and balance problems may reported. ined, and hearing and balance may be hard to spot in children. Younger Balance disorders can be difficult be tested. You may be referred to a kids may lack the vocabulary to to recognize and understand. They specialist, such as an otolaryngolo- describe their symptoms. Talk with a can be especially hard to diagnose in gist—a doctor with expertise in the health care provider if your child: young children. Kids may not know ear, nose, and throat. the right words to describe their Treatment will depend on the n falls frequently. symptoms. Affected children may talk underlying cause. The good news n seems unsteady upon standing about a “spinning .” They may is that most dizziness and balance or walking. say their tummy or head feels bad or problems in children are temporary weird. They may walk unsteadily or and treatable. Still, it’s important to n feels as if the room is spinning seem clumsy. check with a health professional if around him/her. you notice any problems. n n feels as if moving when standing or sitting still. Definitions n feels as if she’s falling. Web Links n Neurological Disorders feels lightheaded, or as if he For more about dizziness and balance, might faint. Diseases that affect the body’s nervous system, which is made up of the brain, click the “Links” tab at: n says that vision becomes blurred. spinal cord, and nerves throughout http://newsinhealth.nih.gov/issue/Mar2016/Feature2 the body. 4 March 2016 http://newsinhealth.nih.gov/issue/Mar2016

For links to more information, see these stories online: Health Capsules http://newsinhealth.nih.gov/issue/Mar2016/Capsule1 Researchers Find a Mechanism for Schizophrenia Scientists uncovered a mechanism with the strongest link to schizophre- Experiments in mice showed that behind genetic variations previously nia risk. They noted associations near C4 tags synapses for pruning. The linked to schizophrenia. The findings the C4 gene. This gene is needed to higher the levels of C4, the greater may lead to new clinical approaches. make a protein called C4, which plays the synaptic pruning. Schizophrenia is a severe mental a role in the immune system. “Normally, pruning gets rid of ex- disorder that affects how a person Human C4 exists in different forms. cess connections we no longer need, thinks, feels, and behaves. It can The researchers first developed a streamlining our brain for optimal cause , , and way to distinguish these. They found performance. But too much prun- other mental problems, making the that one form in particular, C4A, was ing can impair mental function,” says person seem to have lost touch with produced at high levels in the brains Dr. Thomas Lehner, an NIH expert in reality. The condition affects about of schizophrenia patients. Further genomics and mental health. “Inter- 1 in 100 people. experiments showed that the C4 pro- ventions that put the brakes on this Schizophrenia tends to run in fami- tein is found at sites called synapses, pruning-process-gone-awry could lies, so much research has focused on where nerve cells connect. prove transformative.” n genetic variations that affect disease These findings, along with evi- risk. Past studies have tied more than dence from other studies, suggested 100 genetic regions to schizophrenia that C4 might work to promote a Featured Website risk. However, the specific genes and process in the brain called synaptic Mind Your Risks sequences that contribute to risk pruning. In people, this occurs in the remained largely unknown. late teens to early adulthood—the To learn more, NIH-funded scien- same period when schizophrenia https://mindyourrisks.nih.gov tists examined the genetic region symptoms begin. Many people with high blood pressure know they could be at risk for The Benefits of Walking and heart attack. New studies also link Thinking about adding more physical center or park. Bring along someone high blood pressure—especially in activity to your day? Walking can be a to chat with, or listen to some of your midlife (ages 45 to 65)—to an increased great way to get more active. favorite music (but keep the volume risk for in later years. Don’t Walking is the most popular physi- low enough to hear the sounds take unnecessary risks. Learn how to cal activity among adults, and it’s around you). keep blood pressure under control. easy to see why. It requires no special Think about safety as you plan clothes or equipment, and it’s free. when and where to walk. Walk with Regular walking can have many others when possible, and take a health benefits. It may lower your risk phone and ID with you. Let someone of high blood pressure, heart disease, know your walking time and route. If and diabetes. It can strengthen your it’s dark outside, wear a reflective vest bones and muscles. It can help you or brightly colored clothing. And al- maintain a healthy weight. It might ways be aware of your surroundings. also help lift your mood. For more tips to help make walking Make walking fun by going to a part of your daily routine, visit www. places you enjoy, like a shopping win.niddk.nih.gov/publications/walking.htm. n

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