Stress, Trauma and Anxiety Research Clinic (STARC)

Wayne Health’s Stress, Trauma, and Anxiety Research Clinic (STARC – www.starclab.org) is part of the general psychiatry clinics of the Wayne State University School of Medicine department of Psychiatry and Behavioral Neurosciences. STARC’s mission is to bring clinical insight to research and to advance clinical services through leading edge research knowledge. Our clinical work is mainly focused on anxiety and trauma-related disorders, and Post-Traumatic Stress Disorder (PTSD) in civilians, health care workers, first responders, law enforcement,  refugees or victims of torture or human trafficking. Our providers use medication therapy, psychotherapy, exercise and lifestyle modification to help patients achieve their full capacity for a fulfilling life.

• Post-Traumatic Stress Disorder
• General Anxiety Disorder
• Social Anxiety/Phobia
• Specific Phobia
• Obsessive-Compulsive Disorder
• Panic Disorders with or without Agoraphobia

Post-traumatic stress disorder (PTSD): Overview

Post-traumatic stress disorder (PTSD) is a mental condition that can result from being in or seeing a traumatic or terrifying event. These events can include combat, a terrorist attack, a natural disaster, a serious accident, an assault, or a rape. If you have PTSD, you may often relive the experience in nightmares or flashbacks. These are clear and frightening memories of the event. You may also have trouble sleeping.

PTSD affects people in very different ways. It can interfere with daily activities such as work or school, and it can make you withdraw from friends or loved ones.

What are the symptoms of anxiety disorders?

Generalized anxiety disorder

Symptoms may include:

• Feeling worried and stressed about many things almost every day.
• Feeling tired or irritable. You may have a hard time concentrating.
• Having headaches or muscle aches.
• Having a hard time getting to sleep or staying asleep.

Panic disorder

You may have repeated panic attacks when there is no reason for feeling afraid. You may change your daily activities because you worry that you will have another attack.

Symptoms may include:

• Intense fear, terror, or anxiety.
• Trouble breathing or very fast breathing.
• Chest pain or tightness.
• A heartbeat that races or is not regular.

Social anxiety disorder

Symptoms may include:

• Fear about a social situation, such as eating in front of others or speaking in public. You may worry a lot. Or you may be afraid that something bad will happen.
• Anxiety that can cause you to blush, sweat, and feel shaky.
• A heartbeat that is faster than normal.
• A hard time focusing.

Phobias

Symptoms may include:

• More fear than most people of being around an object, being in a situation, or doing an activity. You might also be stressed about the chance of being around the thing you fear.

Worry about losing control, panicking, fainting, or having physical symptoms like a faster heartbeat when you are around the situation or object.

What are the symptoms of obsessive-compulsive disorder (OCD)?

Anxiety is the most common symptom of OCD. For example, you may have an overall sense that something bad will happen if you don’t do a certain task, such as check again and again to see if the stove is on. If you don’t check, you may suddenly feel anxious or have a nagging sense that you left something undone.

Other symptoms of OCD include:

Obsessions.

These are unwanted thoughts, ideas, and impulses that you have again and again. They won’t go away. Examples include:

• A driving need to do things perfectly or correctly.
• A fear of getting dirty or infected.

Compulsions.

These are behaviors that you repeat to try to control the obsessions. Examples include:

• Washing, or checking that something has been done.
• Counting, often while doing another compulsive action, such as hand-washing.

The obsessions or compulsions usually take up a lot of time—more than 1 hour a day.

What causes post-traumatic stress disorder (PTSD)?

Anyone who has gone through a life-threatening event can get PTSD. These events can include combat, sexual or physical violence, serious accidents, and natural disasters. Many people who go through a traumatic event don’t get PTSD. It isn’t clear why some people get PTSD and others don’t.

How is anxiety diagnosed?

To find out if you have generalized anxiety disorder, your doctor will ask questions about your symptoms and how long you have had them. Your doctor also will do a physical exam. He or she will ask questions about your medical history and about medicines you take.

To be diagnosed with this problem, you must have more worry and stress than normal. Having it means that you feel worried and stressed about many things almost every day. And these feelings must last for at least 6 months.

You also will have some physical symptoms. These may include feeling shaky and sweaty and startling easily. You may have trouble sleeping.

How is obsessive-compulsive disorder (OCD) diagnosed?

Your doctor can check for OCD by asking about your symptoms and your past health. He or she may also do a physical exam. You may also get a mental health assessment. This is a check of your emotions and how well you can think, reason, and remember. Your doctor may examine your nervous system and test your blood and urine. You may be given written or verbal tests. The doctor may also look at your appearance, your mood, your behavior, and how you express yourself.

Disorder-specific treatment

• Panic disorder: Requires exposure to physiological symptoms. This may range from teaching you how to recreate specific symptoms to inducing a panic attack. This allows you to gain mastery over your symptoms as opposed to the panic attacks controlling you. Secondly, if you are avoiding situations where panic attacks occur, you are instructed to face those situations to regain confidence that you are safe.
• Social anxiety or phobia: Requires teaching you to face social situations you are avoiding in a controlled manner. Sometimes further social skill development is necessary. Role playing social situations in therapy sessions can be beneficial to attaining success in real life. Through these experiences, you can regain the lost sense of control.
• Post-Traumatic Stress Disorder: In initial stages of treatment, opening up about the trauma in a safe and accepting environment can be helpful. Eventually, exposure to avoided situations that remind you of the trauma is necessary. Exposure to the actual memories that elicit emotional responses is critical. The goal is to reduce the intense emotional reactivity to recall of those memories. Imaginal exposure therapy, Eye Movement Desensitization and Reprocessing (EMDR) and Short-Term Dynamic Psychotherapy are types of exposure therapies that have proven effective.
• Obsessive-Compulsive Disorder: Exposure and Response Prevention therapy has been the effective treatment of choice. The idea is to have you “expose” yourself to the avoided worry thoughts while preventing you from engaging in a behavior (i.e. the compulsion) that has served to provide temporary relief from the worry. An example is purposefully creating a situation where you believe your hands are contaminated and then preventing you from washing your hands.
• Generalized-Anxiety Disorder: Cognitive therapy is the preferred treatment. You are educated on the adaptive nature of worrying, but then learn to tolerate your uncertainty, and work on correcting distortions in your thinking.
• Specific phobia: A response hierarchy is developed to help you gradually develop greater tolerance for an avoided situation or thing. Exposure to the avoided situation can start out as an “imaginal” one and then proceed to real life.

Wayne Health’s Dr. Arash Javanbakht provides more tips for a healthy life in this article here!

Physicians and researchers at Wayne Health are also faculty members of the Wayne State University School of Medicine who conduct research and clinical studies. This makes the latest treatments and clinical trials available to you sooner than other health providers without a medical school affiliation.

STARC research is focused on understanding the epidemiology, neurobiology (genetics and epigenetics, brain imaging, inflammation) and environmental triggers of trauma and stress in adults and children, and intergenerational transfer of trauma, specifically among refugees. We study the use of advanced technologies of telemedicine and augmented reality, as well as body-based interventions, such as dance and movement therapies, in treatment of anxiety and trauma.

For more information, please visit the links below at the WSU School of Medicine.