Psychotherapy sessions are better in the morning when the hormone levels are high


Psychotherapy sessions are best in the morning when levels of helpful hormone are high

Participants in the study were 24 people diagnosed with panic disorder and agoraphobia, a fear of public places where a person feels panic, trapped or helpless. The participants underwent a standard psychotherapeutic treatment “exposure therapy” with those who are morning sessions get improvement. Credit: iStock

Patients make more progress towards overcoming anxiety, fears and phobias when his therapy sessions are scheduled in the morning, new research suggests.

The study found that the morning sessions helped psychotherapy patients overcome their panic and phobic anxiety and avoidance better, in part because cortisol levels -a natural hormone -are at its highest point and then said clinical psychologist Alicia E. Meuret, Southern Methodist University, Dallas.

“The hormone cortisol is designed to facilitate Fear extinction in certain therapeutic situations,” Meuret, lead author of the research. “Drugs to improve fear extinction are being investigated, but can be difficult to manage and have yielded mixed results The results of our study promotes the use of two simple and natural agents – .. Our own cortisol and time of day”

The findings in the article “: the average endogenous cortisol benefits of psychotherapy day early Timing matters” reported

. in the journal Psychoneuroendocrinology

Co-authors of the Psychology Department SMU are David Rosenfield, Lavanya Bhaskara and Thomas Ritz. The co-authors of the Department of Psychiatry at the University of Michigan are Richard Auchus, Israel Liberzon, and James L. Abelson.

The study draws on research that anxiety and phobias are best treated by learning the correct information. Patients with anxiety disorders and phobia overstate the threat that a feeling or situation can cause. But by direct exposure, a patient learns that the probability of an expected catastrophe is very low.

“For example, a patient may think that standing in an elevator could cause him or her to lose control or fainting, suffocation, or you can create physical symptoms that would be intolerable,” Meuret said. “Having to stand in an elevator for a long time, the patient learns that his dreaded result does not occur, despite high levels of anxiety. We call this corrective learning.”

However, since not all patients benefit equally from exposure therapy, researchers try to identify ways to improve the corrective learning. To date, there is a simple way to increase fear extinction has been established.

It is believed

Cortisol, the hormone to help the extinction of fear. It seems to suppress the fear memory established by previous distressing encounters, while at the same time helping a patient to better absorb and remember the new corrective information.

“In a previous study, we demonstrated that higher levels of cortisol during and in anticipation of the exhibition facilitate corrective learning,” Meuret, associate professor in the Department of Psychology at SMU and director of the Research Center professor said SMU Anxiety Depression and Division of clinical Psychology department. “We also know that cortisol is higher earlier in the day. But we did not know if the cortisol act as mediator between the time of day and the therapeutic benefits. This is what our study investigated.”

exposure therapy, in general, resulted in significant improvements

Participants in the study were 24 people diagnosed with panic disorder and agoraphobia, a fear of public places where a person feels panic, trapped or helpless.

For the study, the participants underwent a standard psychotherapeutic treatment “exposure therapy”, in which patients are exposed to situations that normally induce their panic or fear in order that repeated exposure can help reduce disabling fear response time.

Patients received weekly sessions for three weeks each, on average, 40 minutes. exposure situations include tall buildings, roads and bridges, enclosed spaces such as elevators, supermarkets, cinemas and public transport such as metro and intercity trains and boats places. Furthermore, cortisol levels were measured at various times during each exposure session by swabbing inside the mouth saliva.

In the session after exposure, the researchers measured the threat assessments, avoidance behavior, the amount of control they are perceived, and the severity of their symptoms of panic patients.

Evaluation of the results of these measurements, researchers found that exposure therapy generally result in significant improvements in all measures for all periods.

greater profits after the sessions that began earlier in the day

However, patients made the greatest gains in overcoming their fears after the sessions that began earlier in the day. In the next session, patients reported less severe symptoms of error in the assessment of threats, avoidance behavior and severity of panic symptoms. They also perceived greater control over their symptoms of panic.

“In particular, increased cortisol was associated with greater reductions in assessing threats, perceived control and severity of panic symptoms at the next meeting,” Meuret said, “and that was the case years and above the effects of time-de- day, with large effect sizes. ”

This finding suggests that cortisol accounts for some of the therapeutic effects associated with the time of day, she said.

Because cortisol levels are usually higher in the morning, the authors speculate that higher levels of cortisol can help the learning of extinction, and contribute to the benefits of early day improved session exposure through such a mechanism.

However, Meuret warned that the exact mechanism by which cortisol increases the effectiveness of exposure sessions in the morning is still unclear and can not be treated directly from the data of this study. The size of the study sample was small and the findings need to be independently confirmed in larger studies, he said.

Meuret and additional mechanisms are at play team suspects to explain the effect of the time of day. Other factors may include memory and learning and the natural circadian rhythm of the body, the amount and quality of sleep, attention control, and interactions between these factors and others.

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