Dr. Jeffrey Strawn currently serves as director of the Anxiety Disorders Research program at the University of Cincinnati, but his experience in medicine and psychiatry started in his childhood while growing up in northern Kentucky. His relationship with his father, a physician, helped spur his interest in the field.
“He would occasionally do house calls and because it might be on a Saturday afternoon or Saturday morning, I remember going with him and seeing the way he connected with his patients, and the way they worked together,” Strawn says. "Even though I wasn’t able to articulate it as a 7- or 8-year-old, I remember being really fascinated by that relationship.”
“Seeing that compassionate side of medicine and the way a physician can reassure someone, to comfort someone was important." - Dr. Jeffrey Strawn
Those experiences have been particularly important for him in psychiatry. Strawn says being part of a patient’s support system is a piece he enjoys about his field, and that has changed the way he interacts with others inside and out of the hospital.
Strawn, who attended the University of Cincinnati for medical school, completed a two-year fellowship at Cincinnati Children’s Hospital with a focus on children and adolescent psychiatry. His research interests are brain imagery and looking at functional activities within the brain.
His major research endeavors focus on anxiety disorders in children and adolescents. He says everyone feels occasional anxiety, but anxiety disorders are characterized by constant or frequent fear and anxiety. Anxiety disorders can also carry symptoms like panic attacks, worrying for weeks or months about something minor and even debilitating fear of leaving safe zones like one’s home.
In order to get a grasp on how to treat patients with anxiety disorders, Strawn says doctors are closely studying the brain, trying to gain a better understanding of gray matter volume and cortical thickness. Doing so provides an opportunity to look at chemical or structural changes within the brain, and use those changes to predict whether or not patients will respond to specific treatments, Strawn says. Currently, doctors use intensive medication, which often requires waiting to see if a person will respond to the medication.
Strawn, who also provides clinical outpatient services at Cincinnati Children’s Hospital Medical Center, says he hopes the research will allow him to harness some of the changes in neuroimaging, and predict within a week or two if someone is likely or unlikely to respond to medication. That way, the patient can quickly move on to beneficial treatment.
Strawn was also involved in a study published in the Journal of Child and Adolescent Psychopharmacology. The study focused on brain imaging in youth before and after mindfulness-based therapy and saw changes in brain regions that control emotional processing. The year-long study involved a small group of children with anxiety disorders, each of whom had a parent with bipolar disorder, with researchers evaluating the neurophysiology of mindfulness-based cognitive therapy in children who are considered at risk for developing bipolar disorder, according to the University of Cincinnati.
Strawn says it’s important to know there are a number of risk factors for anxiety disorders, noting that they are common and affect 5 to 7 percent of children and adolescents. Some of those risk factors are genetic, while there are also temperament risk factors, which involve extreme shyness or timidity.
But Strawn says he enjoys being able to come to work and make a difference through his contributions, whether it involves research or working directly with patients.
“A lot of it, for me, is the diversity in experience,” Strawn says. “It’s that constant shifting that really keeps me excited and helps me understand the relevance of my research to the clinic and also helps me recognize the applicability of the things I’m doing.”
He hopes to continue to make strides with his research efforts moving forward, and stressed that better treatment is needed in the areas of psychotherapy and medication. Strawn would also like to see more evidence-based treatment options rather than trial and error.
“One of the things I’d love to see happen in the next five to 10 years is for us to be able to sit in the office with a patient and say, ‘Based on this, this and this, you need this treatment and it has a higher probability of success than this treatment,’ as opposed to more trial and error or informed trial and error,” Strawn says.
Anxiety Disorders
Though many pieces of anxiety disorders need to be addressed, some anxiety is normal.
“You don’t necessarily want to take away all of someone’s anxiety because it has a role,” Strawn says. “It’s what keeps us motivated, it’s what helps us study and it helps us meet deadlines."
"For some folks, when it crosses over to pathological anxiety, that’s where we see functional impairment.” - Dr. Jeffrey Strawn
For some, anxiety can be so severe they might not be able to leave their homes or interact with their peers.
Strawn’s study with the Journal of Child and Adolescent Psychopharmacology saw changes in brain regions that control emotional processing.
“Our preliminary observation that the mindfulness therapy increases activity in the part of the brain known as the cingulate, which processes cognitive and emotional information, is noteworthy,” Strawn says. “This study, taken together with previous research, raises the possibility that treatment-related increases in brain activity of the anterior cingulate cortex during emotional processing may improve emotional processing in anxious youth who are at risk for developing bipolar disorder.”
Bipolar disorder typically develops in a person’s late teens or early 20s and at least half of all cases start before age 25, according to the National Institute of Mental Health.
For more information on Ohio’s mental health services, visit Mental Health and Addiction Services at mha.ohio.gov.
Mindfulness-based cognitive therapy
Mindfulness-based cognitive therapy, or MBCT, is designed to help those who face chronic depression. The therapy combines mindfulness and cognitive behavioral techniques in a way that helps the patient manage his or her emotions and distress.
When to get help
As with many other mental disorders, it can be difficult for those struggling with anxiety disorders to tell the difference between regular levels of anxiety and levels of anxiety that need addressing. Below are several signs that one’s anxiety is out of control and needs professional assistance.
- Sudden, unexpected panic attacks; characterized by shortness of breath or hyperventilation, chest pain or discomfort, heart palpitations or a racing heart, feeling dizzy, the feeling of complete loss of control, and feeling detached from one’s surroundings.
- Feeling constantly on edge or tense, as if something bad may happen.
- Avoiding everyday situations, such as going out in public.
- Quality of work in school, work or everyday life decreases because of constant worry and stress.
Matthew Kent is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
Dr. Jeffrey Strawn
Dr. Jeffrey Strawn received his medical degree from the University of Cincinnati College of Medicine and completed his residency at the University of Cincinnati and a fellowship at Cincinnati Children’s Hospital Medical Center. He is the director of the Anxiety Disorders Research program and conducts trials and neuroimaging studies in patients with anxiety and related disorders. He also provides clinical outpatient services at Cincinnati Children’s Hospital Medical Center.
