Everybody worries sometimes, but some people worry all the time. Worrying is a natural human mental function that allows us to examine problems like we might a tangled ball of yarn. We turn it over and over, looking at it from all angles until we can find a thread that loosens some knots and frees the yarn. With too many people, however, worry becomes a bad mental habit, a preoccupation, and a way of wasting mental energy that could be more much more productive.

Worry can become a form of defense against difficult feelings, and an almost magical way of feeling that we can fend off undesired events. There’s a story about an old woman who would circle her house three times every day, carrying a bundle of twigs and muttering to herself. One day a new neighbor asked her what she was doing, and she replied “I’m keeping my house safe from tigers.” The neighbor said “But we’re in Indiana. There aren’t any tigers in Indiana,” to which the crone replied “See!”

Worry is a natural function of the human mind, but it can turn from a tool into a tyrant. Worrying can become a bad habit, even an addiction, because most of the things we worry about never come true. By not coming true, we are rewarded in the neurological sense of the word, we feel good, we fee; safe, we feel like we are exerting some control over the situation, so we begin to worry about other things we’d like to be able to control. It can become a full-time occupation.

The trouble with worry is that it is mentally and physically taxing, creating unnecessary stress that is exhausting for the worrier, and for the people around her (I say “her” because while worry is certainly not exclusively a female trait, the majority of people who worry themselves sick are female.) habitual worriers often develop significant illness from insomnia to anxiety disorders, irritable bowel syndrome, headaches, back pain and fibromyalgia. Worriers aren’t happy, often get depressed and are more likely than the non-worrried to smoke, drink and get addicted to prescription drugs.

Worry is a function of the imagination and is probably the most common form of mental imagery. Without imagination, there would be no worries. Imagination is the mental function that more than any other separates us from other animals. With imagination we have been given the gift of planning, and of envisioning the possible future. Through imagination, humans have been given the gift of being mobile in time – we can remember that past, and learn from it, and we can envision many possible futures and have the opportunity to choose the one that is likely to work best for us. But this gift comes with a price – we can imagine so many possible futures that we can get paralyzed by them, and if our minds get hypnotized and stuck on fears, we can become immobilized by that function which can give us the greatest mobility. We need to learn to use our imaginations better, and in a way that supports our well-being, not our worries.

The good news is that learning to use our imaginations consciously can be of great help in lessening the grip of habitual worry. Through imagery many people can impact their psychological states, their heart rate, blood pressure, respiration, digestive function, sexual function and even their immune response.

Worry is a bad habit, a distorted use of imagination, and can be overcome by learning to use the imagination more effectively and skillfully. Through guided imagery you may not stop worrying, but you can learn how to worry better. Guided Imagery will help you eliminate unproductive worrying and focus on the issues that can benefit from worrying. It will teach you skills that will help you use your imagination more effectively so that you don’t have to worry all the time, and so that the worrying you do will really help you resolve the problems you have. If you use Guided Imagery, you can go from being a worry wart to a worry warrior.

To see for yourself how you can use your imagination to relax and reduce stress immediately, go to www.thehealingmind.org and download our free 12-minute “Stress Buster” audio. To learn even more about using your imagination to resolve problems instead of creating them, check out our CDs on Stress Relief, Anxiety Relief, or our unique Guided Imagery for Self-Healing program.

Researchers from the University of Florence have found that television viewing can reduce levels of melatonin, the hormone that regulates our sleep patterns. Children who were ‘denied’ television for a week had a 30 per cent increase in their melatonin levels by the end of the experiment, the researchers discovered.

They based their findings on a study of 74 children from the Tuscan town of Cavriglia who watched an average of three hours of television a day. The children were aged between six and 12 years, and researchers found that the effect of television was more pronounced among the younger participants.

Melatonin levels are governed by light, and they start to rise once the sun sets. It’s unclear from the study if the effect is caused simply because of the light coming from the television, or because of the electrical emissions.

The research team also suspects that television viewing might contribute to the onset of premature puberty, but there was insufficient evidence from their study to prove this.

(Source: La Repubblica, 27 June 2004).

Although it is well known that caffeine, in the form of tea, coffee, chocolate or cocoa causes insomnia (Clin Pharmacol Therap, 1976; 20: 682-89), less is known about alcohol. Inspite of a sedative effect at first, drinking alcohol can significantly interfere with the quality of sleep (Electroencephalogram Clin Neurophysiol, 1980; 48: 6: 706-9).

Certain herbal tonics contain botanical stimulants, and numerous over-the-counters and prescription medicines contain caffeine.

When the cause isn’t food or drink, insomnia is often linked to depression. It’s also caused by tension, pain, emotional arousal, discomfort, disruption of one’s surroundings or an change in environment, or even a fear of sleeping.

A very effective over-the-counter remedy is Passiflora Lehning Drops, which contain Avena sativa, Passiflora, Belladonna, Secale and Valerian all in low homeopathic potencies. The usual dosage is 20 drops taken in some water and away from meals, four times a day. This safe, non-addictive combination was recently the subject of a study of 320 women suffering from insomnia linked to depression and related anxiety, who’d been on antidepressants and sleeping pills. The study, which compared the effectiveness of the homeopathic remedy against the orthodox drugs taken, found that the average increase in duration of sleep was “highly significant” (Editions Lehning, 1992, Passiflora: 1-16).

Nicotinamide, a form of vitamin B3, also known as niacinamide, appears to have hypnotic effects comparable to those of the benzodiazepine drugs, at least according to animal studies (Nature, 1979; 278: 563-5). This has something to do with synthesis of the neurohormone serotonin, which plays an important role in the regulation of sleep. It’s wise to have a blood test of your vitamin B3 status, so that if you are low in it, you can take the appropriate dosage of a B3 supplement before bedtime. Magnesium and yeast-free vitamin B6, which are co-factors, should be administered at the same time.

Regular exercise that is, elevating your heartbeat by 50 per cent for at least 20 minutes during the day and not before retiring should also improve sleep quality.

In herbal medicine, although valerian root is known to combat insomnia (RF Weiss, Herbal Medicine, Gothenberg: A B Arcanum, 1988). controversy has centred on its potential dangers. Valerian contains valepotriates and sesquiterpenes, both of which have sedative effects, although valpotriates are known to be toxic to cells and sesquiterpenes to be safe. In a double-blind trial on a preparation mainly containing sesquiterpenes, manufactured by American company Thorne Research, 44 per cent of the people taking the herb reported perfect sleep and 89 per cent, improved sleep. No adverse effects were observed (Pharmacol Biochem Behav, 1989, 32; 1065-6).

In another study, examining depth of sleeping and brain waves, those patients receiving valerian showed an increase in deep sleep over those given a placebo (Pharmacopsychiatry, 1994; 27: 47-51).

Once your normal sleeping pattern has been re-established, you can slowly decrease the dosage.

Harald Gaier

Harald Gaier is a registered naturopath, homeopath and osteopath.

This is a drug that should be prescribed with great care. Its serious side-effects include seizures, bronchospasms, new or worsening ventricular arrhythmias, and an increased risk of death among patients with cardiac arrhythmias that were not previously life-threatening.

But it also comes with a range of lesser side-effects, some of which you have. For example, its common side-effects include both fatigue and insomnia, which explains your disturbed sleeping patterns, and skin rash and other disorders affecting the skin, which could be the cause of your distressing fungal rash, and swollen feet, ankles and legs.

The website http://www.wholehealthmd.com contains the warning that swollen feet, or shaking and trembling in the lower extremities, are serious enough side-effects for you to call your doctor immediately.

Although it seems clear that Tambocor is the cause of most of your debilitating symptoms (other than the sudden weight gain), you should not stop treatment without first consulting your doctor. Nevertheless, your story is yet another example of where doctors either don’t read the drug reference books, or ignore the warnings in them if they do.

I was assured that it was not addictive. When I finally decided to give up the drug, it took me two whole years, one capsule every six months; I felt so bad, I had to wait until I felt up to the next onslaught. When I gave up the last capsule, I began being plagued by bad insomnia which I am still struggling with today.

I am now not depressed, but when I had stomach problems, I was offered antidepressants again and was assured – again – that they are not addictive. I turned them down and, by trial-and-error, have sorted out my stomach problems using those wonderful nutritional supplements they want to take away from us.

Doctors, whose training is blinkered to the utmost, are baffled by patients with non-textbook conditions. When this happens, they can’t admit ignorance. They tell you it is psychosomatic and reach for the prescription pad. How can they know a condition is psychosomatic without any investigation after a few minutes of your sitting in front of them? A member of my family was prescribed antidepressants after a stroke. They are being given away like lollies to keep patients quiet!

Once an antidepressant appears in your notes, every doctor you see will leaf through and light upon it, and you can see the little ‘ah! ah!’ light shine in their eyes. Eureka! Another hysterical woman! It would be laughable if it weren’t so incompetent and dangerous. It takes a lot of horses to get me to see a doctor nowadays. What’s the point? – JF, Kingston

Unexpected side-effects are improved vision and no more insomnia. I am losing a pound a week and my skin texture is better. – Patricia Knox, Holyhead

Insomnia is a symptom resulting from a variety of different causes, including depression, ageing, jet lag and serious undiagnosed illness. Any effective treatment needs to tackle the root cause of the problem.

Over-the-counter (OTC) medications are believed to contain safe dosages of active ingredients and to have a low risk of complications. However, many OTC drugs use powerful agents that, if taken in large quantities, could be equal in strength to prescription-only medications.

Pharmacies stock a cornucopia of various sleep aids available without prescription. One class of OTC sleeping pills contain antihistamines, specifically, diphenhydramine. Widely used for allergies and motion sickness, antihistamines also have sedative properties. However, there’s a price to pay. Diphenhydramine, for example, can induce abnormal muscle spasms (acute dystonia) (Pharmacotherapy, 1994; 12: 492-6). Other antihistamine side-effects are blurred vision, constipation, diarrhoea, nausea and vomiting, dry mouth and general dehydration. To counter this latter effect, make sure you drink plenty of water.

Yet, paradoxically, antihistamines may also cause nervousness and insomnia, especially in the elderly and young children, groups known to be more sensitive to medications in general.

Asthmatics should steer clear, as antihistamines can aggravate the condition, and pregnant women should exercise caution as antihistamines appear to affect the behaviour of the fetus in the womb (J Dev Phisiol, 1991; 15: 33-44). Moreover, antihistamines interfere with lactation, and can find their way into breastmilk (Pediatrics, 1994; 93: 137-50).

Another class of sleeping pills uses the hormone melatonin, produced by the pineal gland at the base of the brain. Melatonin plays a role in regulating the sleep-wake cycle, but does not induce sleep per se (HK Pract, 1997; 19: 669-72). In the US, it’s classed as a food supplement and, thus, is unregulated by the Food and Drug Administration (FDA). In contrast, the UK’s Medicines Control Agency, part of the Department of Health, classifies it as a hormone, making melatonin a prescription-only medicine. However, it’s easily obtainable through the Internet.

Melatonin has a number of side-effects: the more common ones are diarrhoea, abdominal pain and headaches; less frequently reported are nightmares, morning grogginess, fuzziness, nausea, mild depression and low sex drive. It has a complex relationship with the body’s sex hormones – especially oestrogen and progesterone in women – and has been specifically linked with periodic depression and premenstrual syndrome (PMS) (Arch Gen Psychiatr, 1990; 47: 1139-46). A study of the effects of melatonin among night workers, who commonly suffer from insomnia, found adverse effects on both memory and performance (Chronobiol Int, 1993; 10: 315-20).

As melatonin can also interact unpredictably with other drugs, it should not be taken with immunosuppressants (such as azathioprine and cyclosporin), corticosteroids (such as prednisone), antianxiolytics, narcotic painkillers like codeine, sedatives, psychiatric medicines, antiseizure drugs, muscle relaxants or antihistamines such as diphenhydramine, or sedative herbs such as valerian or kava. Melatonin has caused seizures in children with no history of having them, and increases the number of episodes in those predisposed to them (Lancet, 1998; 351: 1254). With no standard recommended dosage, overdosing is easy: symptoms include headache, drowsiness and upset stomach.

In short, self-treat insomnia with OTC drugs only for short-term sleep difficulties. If you suffer from chronic insomnia, it is advisable to consult your physician or alternative practitioner.

Pharmaceutical sleep aids can prevent the restorative and therapeutic effects of sleep, while a few simple steps (see box above) can cure short-term insomnia. If symptoms persist, then OTC self-medication may be doing more harm than good.

* Try homoeopathy. A good combination remedy is Passiflora GHL, which combines Avena sativa, Passiflora incarnata, Atropa belladonna, Secale cornutum and Valeriana officinalis. Tested for 30 days against conventional drugs in women suffering from insomnia, this remedy proved more effective (Carion V et al. Etude de l’Action de Passiflora Lehning sur Insomnie: Une Analyse Statistique. Metz: Editions Lehning, 1992: 1-16). For more information, see http://www.lehning.com or call +33 (387) 76 72 24. Bioforce makes Passiflora Complex, a combination of Passiflora incarnata and Avena sativa (see www. bioforce.co.uk or call 01294 277 344).

* Try acupuncture or acupressure (shiatsu). Acupuncture has been proven to improve sleep (Forsch Komplementärmed, 1999; 1 [suppl]: 29-31), and acupressure can work in the elderly (J Gerontol Med Sci, 1999; 54A: M389-94). There is also evidence that hypnosis helps (J Abnormal Psychol, 1973; 82: 153-8).

* Drink chamomile tea or warm milk before bedtime. Warm milk contains high levels of the essential amino-acid tryptophan, a natural sedative (Z Arztl Fortbild Qualitätssich, 2001; 95: 11-6). According to nutrition expert Dr Dean Ornish, chamomile contains apigenin, which binds to the same receptors as do benzodiazepines such as Valium.

* Try relaxation techniques such as breathing exercises or meditation. These can help to calm the mind and aid sleep. Meditation can also reduce anxiety and panic attacks, which could be stopping you from sleeping (Gen Hosp Psychiatry, 1995; 17: 192-200).

* Try the herb valerian. With no adverse reactions, the herb is a safe and effective alternative (Pharmacol Biochem Behav, 1989; 32: 1065-6). In 1995, Germany’s Commission E recommended 1-3 g/day of dried root and rhizome for restlessness and sleep problems. As an extract, take 450 mg at least an hour before bedtime; for anxiety, take 200-300 mg of extract in the morning. As a tincture, take 1-3 mL once to several times daily; as an infusion, use 2-3 g per cup, and drink up to several times a day. Once a normal sleeping pattern has been reestablished, you can slowly decrease the dosages.

This study from Yale University School of Medicine in Connecticut looked at 426 hospitalised patients, aged 70 years and older, 114 of whom had received diphenhydramine. Those taking the drug had a 1.7 times greater risk of delirium compared with those not taking the drug, and the greater the dose, the greater the risk. These patients also had around twice the risk of disruption of their sleep-wake cycle and abnormal psychomotor activity, three times greater risk of inattention and altered consciousness, and more than five times the risk of disorganised speech and behavioural disturbance.

In addition to delirium, patients using diphenhydramine tend to develop bladder problems calling for catheterisation, and require a significantly longer stay in hospital (Arch Intern Med, 2001; 161: 2091-7).

Has the MHPRA responded to the mounting pressures from concerned consumers? Well, not exactly. Or perhaps the manufacturer has had a rush of conscience? Sorry – is it April 1? No, they acted because of a TV programme that finally highlighted the dangers. Name and shame clearly works better for our watchdogs than listening to the stories of the thousands of patients who have been harmed, or even killed while on a drug, it seems.

We at WDDTY have been highlighting the dangers of Seroxat since the early 1990s, when it was being heralded in the national media as the great new thing to treat depression.

Seroxat is a selective serotonin uptake inhibitor – sometimes known as a 5-HT drug, a family that also includes Prozac – and was supposed to be far safer than the previous generation of antidepressants known as monoamine oxidase (MAO) inhibitors.

Unfortunately, this early promise was never fulfilled. Even at the outset, we knew Seroxat caused nausea, tremor, asthenia (loss of strength) and sexual dysfunction.

And like Prozac, it can cause extremely aggressive feelings. In the USA, one patient shot his wife, daughter and grand-daughter while on Seroxat, so quite why doctors in the UK have been prescribing it to young teenagers is yet another wonder of modern medicine.

But perhaps the pivotal argument, put forward by the manufacturer, was that the drug was not addictive. It took a while, but the manufacturer finally had to admit, some 10 years later, that it could cause severe withdrawal symptoms. In fact, the International Federation of Pharmaceutical Manufacturers Association declared that the manufacturer was guilty of misleading the public over the drug’s addictive qualities.

We also discovered that the drug could cause hepatitis after six cases were reported to another sterling watchdog, the Committee on Safety of Medicines.

So, after 13 years of use, one drug regulator has finally made the first comment about Seroxat, and this only after a television programme brought it to their attention.