THIS MONTH’S PROFESSIONALS

Barry J. Jacobs, Psy.D.

Barry J. Jacobs, Psy.D.

Clinical Psychology

Barry J. Jacobs, Psy.D. Barry J. Jacobs, Psy.D. is a clinical psychologist, family therapist and the author of the book, The Emotional Survival Guide for Caregivers—Looking After Yourself and Your Family While Helping an Aging Parent (Guilford, 2006). As a clinician, he specializes in helping families cope with serious and chronic medical illnesses. As an educator, he works as the Director of Behavioral Sciences for the Crozer-Keystone Family Medicine Residency Program in Springfield, PA and has had adjunct faculty positions with the Temple University School of Medicine, University of Pennsylvania School of Nursing and the Department of Psychology of the Philadelphia College of Osteopathic Medicine.

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This Month’s Questions & Answers

  • Shehzad
    Shehzad, SUPPORT NETWORK Member Asks
    Q.

    "I’m 18 years old and I have high blood pressure due to anxiety. My hands shake all the time due to this anxiety and when I’m stressed my blood pressure goes as high as 170 even though I’m just sitting and overthinking. Some days I feel lonely and it gets bad. I hardly sleep and I sleep 4-5 hours daily I can’t sleep more. How to cope with anxiety"

    A.

    Severe anxiety—usually defined as nearly constant worrying--can rob life of nearly all enjoyment. It is often accompanied by feelings of depression. And, as you point out, it can have numerous physical effects, including muscle tension, digestive problems, rapid heart rate, shaking and increased blood pressure. There are many treatments for anxiety, including behavioral therapies (such as breathing exercises, meditation and cognitive behavioral therapy) and medications (such as selective serotonin reuptake inhibitors). I recommend you talk with your primary care provider about what, if any, treatments are most appropriate for you. In my professional experience, these treatments are often very effective and allow anxiety sufferers to get some relief.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers

  • SandyBeaches
    SandyBeaches, SUPPORT NETWORK Member Asks
    Q.

    "My wife recently had her second heart attack and bypass surgery. With each event, her depression has deepened. The Drs all say it is common, but don't tell you how to deal with it. She sees a psychiatrist and therapist, but my wife just seems to exist these days. My heart is broken. She used to be so vibrant and outgoing. The weight is heavy on me also. I mean, she got a third chance at life, at being with ME, but she doesn't seem to care. I don't know how to help her any more."

    A.

    Depression can sap all joy, initiative and hope. It can also be very hard to remedy, despite medications and psychotherapy. Have you talked with your wife’s mental health professionals about changing her treatments to better improve her symptoms? She might benefit from a different medication regimen, alternative treatments or even a partial hospitalization or inpatient hospital stay. I also recommend that you consider contacting your local NAMI (National Association for the Mentally Ill) chapter to learn about its Family-to-Family educational program. It can teach you how you and your wife can live as well as you can with this terrible intruder in your lives—chronic depression.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers

  • hgonzalez
    hgonzalez, SUPPORT NETWORK Member Asks
    Q.

    "I´ve been diagnosed with metabolic syndrome (thankfully with no diabetes); I´m working on my health and taking my meds; yet fear and anxiety of getting a Heart Attack invade me and sometimes give me false symptoms; how do I cope?"

    A.

    Many people have fears about their health. Some of those fears are beyond what is warranted. When that occurs, we say they have “health anxiety.” If health anxiety becomes so distracting or overwhelming as to detract from the quality of their lives, then we recommend they see a healthcare provider--not for a physical evaluation but for an assessment of their emotional state. If you can’t push away the fear of a heart attack, then I would recommend that you see your primary care provider to be evaluated for an anxiety disorder. He or she has treatments that could be very helpful for you.—Barry J. Jacobs, Psy.D., AHA volunteer and co-author of AARP Meditations for Caregivers

  • KimiT
    KimiT, SUPPORT NETWORK Member Asks
    Q.

    "Is it normal to feel tired and depressed after a heart attack?"

    A.

    Unfortunately, yes on both counts. Feeling fatigued after a heart attack may be due to decreased blood flow throughout your body, a side-effect of one of the medications you are now taking or a sign that your body is still recovering from the physical trauma of a heart attack. A fourth possibility is that the fatigue is due to the depression you may be experiencing. I suggest meeting with your primary care provider for an evaluation to help identify what cause or causes are responsible for your fatigue and depression and to consider appropriate treatments—changing your heart medication regimen, adding an antidepressant or referring you for counseling.—Barry J. Jacobs, Psy.D., AHA volunteer, co-author of AARP Meditations for Caregivers

  • Sangpanh
    Sangpanh, SUPPORT NETWORK Member Asks
    Q.

    "My boyfriend of over 5 years had a heart attack at the age of 27. He isn’t on any drugs just a young man with a poor diet who was chain smoker. He had his heart attack on march 9th and had 2 arties clogged. Thankfully we made in into the ER in time where he then had to get a stent placed in. I understand he is struggling with this new life style now that he has to adjust his entire life. He’s quit cigarettes cold turkey since then. But I feel that his diet and his alcohol intake could be better. I tell myself every single day that it will get better. But emotionally it’s been getting harder. I can’t stress it enough on how he should’ve be grateful that he’s able to wake up and see another day. But it kills me inside that he isn’t concern about his diet and alcohol intake. The doctor gave us specific details tht he should only have 1 beer. But. I find him drinking 4 occasionally. I can’t sleep because I am always worried about his health. I just wish that this happened to me because when it comes to health he’s very ignorant nor cares to making any adjustments with diet and finding a new job that fits his health. I can’t stress enough and I can’t stop thinking about me not being able to live with myself if another episode to recurrent."

    A.

    Your boyfriend is very fortunate to have you in his corner. This sounds like it has been a time of crisis and change for both of you. He has changed significantly—quitting chain-smoking is a tall order—but not enough to give you the assurance he is doing all he can to safeguard his health. Rather than remind him constantly about his eating and drinking and probably make him feel like you are nagging him, I suggest two strategies:
    --Write him a hand-written letter in which you express how much you care for him and how much his health and happiness mean to you. Ask him to take better of himself for his sake and yours.
    --If you don’t think that direct approach would work, then I suggest you send a letter or leave a voicemail for your boyfriend’s cardiologist to inform him about your concerns for your boyfriend’s diet and alcohol intake. Let the doctor then do the dirty work of confronting your boyfriend about his health habits.
    As the Serenity Prayer says, though, you will have to ultimately accept what you cannot change. If your boyfriend is ready to do more to help himself, then he will. If he isn’t and has more health problems, it will be extremely regrettable but not your fault. Really.
    Thank you, Dr. Barry Jacobs

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