As noted by Breggin, studies have repeatedly shown antide-

pressants work no better than placebo for mild to moderate depression. Two meta-analyses have also demonstrated that when both published and unpublished trials are included, the placebo response accounts for a whopping 82% of the beneficial response to antidepressants. Most recently, a 2017 systematic review with meta-analysis

and trial sequential analysis of 131 placebo-controlled studies found that “all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed

by harmful effects.” None of the trials, even when reporting a positive result, met the threshold for clinical significance of 3 points on the depression score.

Are You Just Scared or Living in Fear? As explained in my recent article, “You Can Control Fear,”

there’s a difference between being scared and being fearful. Right now, the whole world is holding its proverbial breath in anticipa- tion for what might come next. It’s easy to feel fearful, consider- ing the daily barrage of bad news. However, understanding the difference between being scared

and living in fear can be very helpful, as fear has a paralyzing effect while being scared primarily heightens alertness. Novel threats raise a person's level of anxiety to a greater

degree than familiar threats, even when they have the same or similar consequences. This is thought to be related to activity in your amygdala, which processes emotions. The authors of a 2013 study found that activity in the amyg-

dala increased when participants were shown images of unfa- miliar flowers and snakes, while images of familiar natural objects did not. Ryan Holiday, author of 10 books, including “The Daily Stoic” and “The Obstacle Is the Way,” writes:

“Being afraid? That’s not fight or flight. That’s paralysis. That only makes things worse. Especially right now. Especially in a world that requires solutions to the many problems we face.

They’re certainly not going to solve themselves. And inaction (or the wrong action) may make them worse, it might put you in even more danger. An inability to learn, adapt, to embrace change will too.”

Knowledge and Preparation Boost Courage While fleeting feelings of concern are expected when faced

with new experiences, when such feelings are allowed to con- tinuously dominate, paralysis can set in. To thrive in times of great uncertainty and fear, Holiday stresses the importance of training, education and preparation, which are the foundation of courage. The difference between being fearful and being scared is

that fear paralyzes your ability to evaluate what's happening and make decisions. But preparation and information help you to make decisions and act, even when you're scared. This is the definition of courage — taking action despite being scared. Preparation begins with understanding the long-term con-

sequences of fear and panic to your health — and realizing these health conditions are neither inevitable nor necessary to your survival. There are several strategies you can use to reduce fear and

find your courage. It is important to begin with the understanding that feelings do not have a life of their own. In other words, feel- ings are generated. Your feelings change depending upon your circumstances and your thoughts. Watching a funny movie may trigger laughter and feelings

of happiness. Watching a sad movie brings many to tears. Read- ing the headlines during an epidemic or pandemic can trigger fear. There’s an unknown factor in the situation. You may not have control over the news media, but you do have control over your thoughts and your health. In other words, your thoughts engen- der feelings.

Consider a Media Diet While You Prepare for the Future One of the strategies you can use to reduce fear is to change

the way you think about things. Yes, we’re dealing with many unknowns right now, but focusing on planning and preparation

Robinhood Integrative Health Bruce Lantelme, MD

Weston “Wiggy” Saunders, MD Elizabeth Bozeman, MD

Kelly Carpenter, NP-C • Christen Duke, NP-C Jenny Addison FNP-C • Gina Davis, FNP-C • Daniel Lackey, FNP-C 336.768.3335 www.

3288 Robinhood Road, Suite 202 • Winston-Salem, NC 217106 8

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