About Traumatic Stress

People respond in various ways following a traumatic experience, like sexual assault, combat, accidents, childhood abuse, mass violence, or losing a loved one. However, the common responses include intense and unpredictable feelings of nervousness, anxiousness, and irritability. Your thoughts and behavior patterns may also change, and you may think about the event out of the blue, which can cause panic attacks, a rapid heartbeat, and sweating.

Environmental factors may trigger panic attacks. Depending on the nature of the traumatic event, common triggers include loud noises, sirens, and sounds like a car engine misfiring. All of these can stimulate memories of the event and fear of recurrence.

Traumatic stress often affects interpersonal relationships. You may experience increased conflicts with friends, family, and colleagues, and in cases where the traumatic event involved sexual abuse, a strenuous relationship with your partner. Lastly, the trauma may manifest physically as frequent headaches, nausea, back pain, and chest pain. These can require medical attention to alleviate. Also, traumatic stress exacerbates pre-existing conditions like cardiovascular ailments, diabetes, and cancer.

Psychologists and psychiatrists recommend several measures to deal with traumatic stress. One involves leaning on loved ones for support. The support includes listening, discussing the event, and assisting with daily activities like house chores, babysitting, and driving. However, the road to healing starts with facing your feelings and fears.

While it’s normal to experience the aforementioned signs and symptoms, deliberately oversleeping, avoiding people, and substance abuse only prolong the stress. Other than taking steps to ease back into a routine, prioritize extra self-care habits like healthy nutrition, exercise, and sufficient sleep.

Creative Activities Can Boost Mood and Relieve Stress and Anxiety

A Rhode Island psychiatrist from Providence, Dr. Robert Kohn, MD, entered the field in 1989. Outside of helping patients at his private practice, Dr. Robert Kohn is a member of the American Psychiatric Association (APA), which studies mental health and mood.

Findings from a poll published in July 2023, the APA found that Americans who engaged in creative activities weekly described their moods as excellent or good. Morning Consult’s July Healthy Minds Poll, focused on creativity and mental health, sampled 2,202 adults.

In general, 77 percent of adults reported their mental health as excellent. Of that percentage, 71 percent engaged in creative activities more often than those who reported good (50 percent) or fair/poor (46 percent).

The study also reported that 46 percent of those who participated in creative activities did so to relieve stress, and 14 percent did so during crisis. Activities for stress relief included listening to music, creative writing, solving puzzles, crafting, singing/dancing, or drawing/painting/sculpting.

According to APA President Petros Levounis, MD, MA, these are stressful times when jobs or responsibilities can be energy drainers. Creative activities allow individuals to step back from the daily and relax.

Study Links Sleep Deprivation to Increased Alzheimer’s Risk

A physician with decades of experience as a geriatric psychiatrist, Dr. Robert Kohn is a temporary advisor for the Pan American Health Organization/World Health Organization. Dr. Robert Kohn also serves as a professor of psychiatry in a local medical school in Providence, Rhode Island. In his solo practice clinic in Providence, Robert Kohn, MD, treats older adults with intellectual and developmental disorders, such as Alzheimer’s disease and other forms of dementia.

A team of scientists has found that sleep deprivation may cause impairment in the brain, and lack of sleep over long periods may be linked to an increased risk of Alzheimer’s disease. The study was published in the American Chemical Society’s Journal of Proteome Research.

The researchers used mice to discover that sleep deprivation can cause neurologic damage to the hippocampus, the part of the brain primarily involved in learning and memory. During the study, the mice were evaluated based on how well they navigated through a maze and how they recognized new objects in the maze after being deprived of sleep for two days. Then, proteins were extracted from the mice’s hippocampi and noted how the abundance of such proteins had changed. They also compared the mice’s performance with other animals not involved in the study.

The researchers found that the pleiotrophin (PTN) of the mice that lacked sleep declined, which may eventually lead to the death of the hippocampus. PTN is a protein-coding gene associated with growth factors. Compared with human genetics studies, PTN is implicated in neurodegenerative diseases such as Alzheimer’s.

Researchers Find New Method for Early Prediction of Dementia

Experienced geriatric psychiatrist Dr. Robert Kohn is a temporary advisor to Pan American Health Organization/World Health Organization (PAHO/WHO). A recognized presence in geriatric psychiatry, Dr. Kohn has written or co-authored more than 200 articles, research papers, abstracts, book chapters, and presentations. Robert Kohn, MD, maintains a solo practice clinic in Providence, Rhode Island, where he sees older adults with intellectual and developmental disorders, including dementia.

Early prediction of dementia is now possible. Researchers from the University of Florida College of Medicine found a new tool that may predict the likelihood of a person getting dementia.

The team analyzed the data of about 13,000 participants. The researchers used the rating given by interviewers about each participant’s cognitive health over 15 years. The researchers analyzed the data of participants who had their first interview in 2006 and were interviewed again between 2008 and 2020.

It is to be noted that the participants did not have any cognitive impairment at baseline, were at least 50 years old, and had participated in the University of Michigan Health and Retirement Study (HRS). The researchers used the data from the HRS as the initial point of reckoning and the succeeding interviews as points of comparison.

During the interview, the participants were rated on how much difficulty they had remembering things already asked them before. On a scale of 1 to 5, the participants were rated as “having no difficulty at all” (1) and “cannot remember anything at all (5).

The researchers said that every point of increase in poor memory is associated with a 40 percent higher risk of getting dementia over the research period. The association is similar regardless of age, gender, education, ethnicity, or race.

Traumatic Stressors and PTSD

An experienced psychiatrist with a clinical focus on geriatric psychiatry, Dr. Robert Kohn earned his MD and completed his psychiatry residency at the University of Illinois in Chicago and Brown University, respectively. Dr. Robert Kohn has also conducted research on the rates and risk factors among adults and children for various conditions. His research in geriatric psychiatry has examined the rates of mental illness and its risk factors, including neuropsychiatric risk factors, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).

Exposure to stressful events can result in post-traumatic stress disorder (PTSD), a mental disorder characterized by reliving traumatic events through flashbacks and nightmares, and feelings of guilt, irritability, and isolation. PTSD is typically associated with traumatic stressors that are extremely severe and challenging to cope with, such as rape and combat. These experiences typically overwhelm an individual’s stress response system.

The likelihood of developing PTSD due to subsequent exposure to trauma is high when someone has already experienced a traumatic event. Vulnerability is particularly high when the pathological mechanisms of PTSD manifest before the later stressor. If an individual has experienced a traumatic event but has not developed signs or symptoms of PTSD, this demonstrates that they have successfully managed the previous experience from a psychological perspective and are less likely to develop PTSD if they undergo a similar event later. Most people achieve this by seeking mental health support and modifying their daily routines and lifestyle.

APA Lauds the Passage of the Consolidated Appropriations Act of 2023

A geriatric psychiatrist, educator, and researcher, Robert Kohn, MD, treats older patients with intellectual and developmental disorders. A recognized presence in the medical profession, Dr. Kohn serves as a temporary advisor to Pan American Health Organization/World Health Organization (PAHO/WHO). Dr. Robert Kohn maintains membership in the American Psychiatric Association (APA), where he is also a distinguished Fellow.

APA is a premier psychiatric association that promotes equitable access to the best available healthcare for people with mental disorders and substance disorders. APA’s advocacy includes working with Congress on the passage of significant bills that affect the practice of psychiatry.

APA lauded the passage of the Consolidated Appropriations Act of 2023, which provides for a $1.7 trillion omnibus package, including investments in the psychiatric workforce, enforcement of mental health parity, and collaborative care. The bill was signed by President Joe Biden on December 29, 2022. APA has advocated heavily for the passage of this bill.

Under the bill, 200 new graduate medical education residency slots will be created. Half of these positions are designated for psychiatry and its subspecialties. The bill will also enforce the Mental Health Parity and Addiction Equity Act of 2008 by granting funds to state insurers. The bill also provides funds for grants and technical assistance for the enforcement of the Collaborative Care Model in primary care settings, thereby increasing early intervention for treatment or prevention of mental and substance use disorders.

Extrapyramidal Symptoms of Antipsychotic Medications

A resident of Providence, Rhode Island, Dr. Robert Kohn is a geriatric psychiatrist who draws on more than four decades of experience in his field. With an MD from the University of Illinois Chicago, Dr. Robert Kohn is also well-versed in family therapy and psychotherapy.

Antipsychotics, a group of psychiatric medications, are used for treating psychosis, which is associated with mental disorders like schizophrenia, bipolar disorder, and personality disorder, among others. Sometimes, these medications can cause serious side effects called extrapyramidal symptoms.

Extrapyramidal symptoms are triggered by a reduction in the level of a chemical called dopamine in the central nervous system. Extrapyramidal symptoms can manifest as acute or tardive dyskinesias (characterized by erratic muscle spasms in the face and limbs), akinesia (loss of ability to voluntarily move certain muscles in the face, hands, legs, or other areas), and neuroleptic malignant syndrome (characterized by fever, dysautonomia, body rigidity, and mental status change), among other similar symptoms.

Extrapyramidal symptoms sometimes stem from non-antipsychotic drugs. Clinicians must identify the exact cause of the symptoms to determine the appropriate treatment.

Cogwheel Rigidity in Patients with Psychiatric disabilities.

The recipient of an MD from the University of Illinois College of Medicine in Chicago, Dr. Robert Kohn is a respected psychiatrist who has been in practice for more than four decades. Dr. Robert Kohn owns and operates a private practice in Providence, Rhode Island, where he treats adults with psychiatric disabilities.

Some patients suffering from psychiatric illnesses are vulnerable to the side effects of certain antipsychotic drugs, which are supposed to cure their symptoms. One of these side effects is cogwheel rigidity.

Also known as the cogwheel phenomenon or cogwheeling, cogwheel rigidity is characterized by involuntary stiffness of the muscles in the limbs. The hands are the most commonly affected. Doctors assess patients for cogwheel rigidity by extending and flexing their hands and legs at different speeds. Cogwheel rigidity may be present if a limb feels stiff and inflexible or causes discomfort during motion.

Cogwheel rigidity can be treated if the cause is known. Often, doctors prescribe dopamine agonists to help alleviate symptoms. Symptoms of cogwheel rigidity can also be managed through exercise, stretching, yoga therapy, and stress reduction.

Assessing the Impact of Culture on Mental Health

Dr. Robert Kohn is a health care provider based in Providence, Rhode Island, with nearly forty years of experience and an MD. He is a consultant to the World Health Organization and the Pan-American Health Organization and a distinguished fellow of the American Psychiatric Association. With a primary specialty in psychiatry, Dr. Robert Kohn focused his academic work on geriatric psychiatry, global mental health, psychiatric epidemiology, and cultural psychiatry.

Cultural psychiatry is concerned with the interplay between cultural diversity and mental health services. There are various ways in which culture shapes and influences mental health.

Cultural or ethnic background influences the aid individuals receive from family and friends. It also impacts their access to therapy when they deal with mental health issues. Different ethnicities recognize stigmas shaping how their members embrace mental health services. In the United States, minorities also have limited access to health care providers.

Culture equally affects mental health access in the area of reporting. A health care provider may not be able to render the requisite care to minorities due to a lack of records of members who previously experienced the condition in question. This invariably affects the therapy sessions that follow.

New Study Finds Yoga and CBT Helpful in Treating Worry in Older Adults

Dr. Robert Kohn, a physician specializing in geriatric psychiatry, is recognized in the profession. Robert Kohn, MD is a temporary advisor for the Pan American Health Organization/World Health Organization and an author of articles, papers, and presentations. Dr. Robert Kohn maintains his membership in various professional organizations such as the American Association for Geriatric Psychiatry (AAGP).

AAGP is a professional association with about 2,000 geriatric psychiatrists and allied health workers from the US, Canada, and other countries. Its mission is to promote the mental health of older adults through public advocacy, education, and career development of its members. its members can access its scientific journal, the American Journal of Geriatric Psychiatry, where its publications are published.

A new study published in the Journal contained an analysis of secondary data on the long-term effects of yoga and cognitive-behavioral therapy (CBT) delivered by phone on worry, anxiety, depression, sleep disorders, fatigue, and social participation of older adults.

In the study, 500 community-dwelling adults aged 60 and above went through randomized preference trials which compared weekly CBT and bi-weekly yoga for treatment of worry. Six months after the interventions were completed, the participants reported that their baseline worry, anxiety, depression, sleep disorders, fatigue, and social participation have improved. The researchers concluded that yoga and CBT have long-term benefits for treating worry in older adults.

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