Showing posts with label anxiety. Show all posts
Showing posts with label anxiety. Show all posts

Anxiety My Old Friend - Will I Let It Kill Me?

Anxiety and stress are not the same thing.

Stress is a physiological experience in the face of a change in the internal or external system. It has its plusses and minuses. A little bit of stress over something you can do something about [I need to make that doctor's appointment] provides motivation to get it done and satisfaction (a nice hit of dopamine) once you do it.

via GIPHY

On the other hand, chronic stress that cannot be resolved [I never knew when he would explode] exhausts every resource the body has to maintain homeostasis/balance. And that's not good.

Anxiety describes the negative thoughts and feelings that accompany stress.

via GIPHY

It's not the only feeling that could accompany stress. When faced with changes like a new job, a challenging ski slope, or a date with the person of your dreams, you might also feel excitement.

via GIPHY

Or maybe not. "Good" change and "bad" change are labels we apply from our own perspective. As far as the body goes, they don't really figure in. The physiological response is the same.

Consider a winding mountain road in a snowstorm. Some people default to excitement. [That would be Colorado-raised me.] Some people default to anxiety. [That would be my California-born wife.] The people who can't help but default to it have an anxiety disorder. These are my people.

Anxiety Defined

Anxiety is the intense, excessive, persistent worry, fear, or dread about everyday situations, present, future, and imagined future. It's a normal enough experience. It becomes a disorder when "intense" tilts over into "excessive" to the point of interfering with daily activities.

Insert side comment here: People who have a mental illness, whether social anxiety disorder, depression, or schizophrenia, are not a different kind of people. Almost every symptom of a mental illness is a "normal" experience - shared by people who do not have a mental illness. These experiences do not need to be diagnosed or treated, until they pile up and become so intrusive that they become unmanageable, until they interfere with daily activities.

The physical manifestations of anxiety include fast heart rate, heavy breathing, sweating, and fatigue. How do we get from a thought to a heart rate? The brain - that's how.

Anxiety in the brain


Anxiety involves an interaction of three different parts of the brain in particular.

It begins when the amygdala senses a threat. The job of the amygdala is to leap into action at the sign of a threat. The amygdala initiates a sequence that releases adrenaline and cortisol to gear the body up to address the threat. As with the body's response to other stress, these hormones cause the faster heart rate and heavy breathing. Blood flow increases to the limbs to prepare it for action, and away from the digestive system - when your life is in danger, lunch can wait.

The prefrontal cortex, the "thinking" part of the brain, provides information and interpretation that mitigate or support the threat. [That's a garter snake, not a rattler. It's harmless.]

The anterior cingulate cortex sorts through the sense of threat and the additional information to find patterns and determine whether the current situation is a big deal or not. It tells the amygdala whether to calm down or GET MORE EXCITED!

The difference between anxiety and anxiety disorder

When there is a threat, the amygdala goes into action. When the threat goes away, what is supposed to happen is that the amygdala and all its downstream partners stand down. The body returns to its pre-threat state.

When the threat is chronic or, even worse, unpredictable, then these systems do not stand down. They just keep pumping out that cortisol.

In the brain, the amygdala increases in size.

Under constant assault from cortisol, the hippocampus (memory and emotion) and prefrontal cortex shrink. The hippocampus gets stuck on negative memories and emotions. [I call this the little time machine inside my brain. It plays the worst of my past on an unending loop.]

The connection between the amygdala and the prefrontal cortex that could moderate the fear goes down.

In other words, the brain changes. It changes in a way that reinforces the the problematic pattern, raising the risk for depression and dementia. Yuk!

Everybody gets anxious is not a helpful thing to say to a person with Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, Post-Traumatic Stress Disorder, or Social Anxiety Disorder. These are real things. They have tipped past the experiences of everybody. And a warm bath or deep breathing do not fix them.

Healing the problematic pattern may take many forms: distancing from the chronic stressors, medication, a variety of modalities in psychotherapy, even therapy dogs.

At ProzacMonologues.com I like to focus on what is happening inside the brain, to help me remember that my issues are not mere thoughts. They are experienced in my body. Here's an article with much more detail about the sympathetic and parasympathetic nerve systems and how they function.

A physical therapist friend, encouraging me to take a leave of absence to deal with my tattered brain, once told me, It's just like a broken bone. It takes time to heal.

I do wish it healed as easily as that broken foot is healing. But these issues do respond to treatment. If your anxiety interferes with your life, you don't have to suffer alone!


photo by author
Red Green Show meme from imgur on Pinterest

Tips for Successfully Managing Your Stress and Anxiety

Anxiety and stress are simply parts of life for most people, especially when we try to juggle multiple responsibilities. However, if your stress and anxiety attacks have begun to impact your ability to function in everyday life, then you need to seek out ways to manage these emotions. ProzacMonologues.com explains the importance of finding strategies that help you to manage your anxiety both at the moment it occurs and long-term.

Guest blogger Julia Mitchell, lifestyle expert at outspiration.net contributes this piece about tips to manage stress and anxiety. I (Willa) have added a few links to previously posted pieces from ProzacMonologues.

Develop Skills to Proactively Manage Stress

Raising children, earning a living, maintaining family harmony and wellness, and pursuing your passions can all be stressful. While each of these things may contribute to creating the life you want, they can also undermine your overall well-being, if they cause you too much stress. The Anxiety and Depression Association of America notes that you can equip yourself to manage stress and prevent anxiety attacks by building healthy habits with sleep, exercise, food, work, play, attitude, and self-fulfillment.

You can also pick up a new hobby like gardening, which has been shown to help mitigate stress. Not only do you have the opportunity to get your hands dirty while watching what you've planted grow into healthy edibles, you'll be getting much-needed Vitamin D as you spend extra time outside. For expert advice and pointers, go online and visit Home Garden Hero.

Identify and Manage Your Triggers


It's a good idea to identify the situations that trigger your anxiety so you can take constructive steps when you encounter those things or avoid them. Triggers are external events, large or small, that prompt your body and mind to respond in a seemingly irrational way. The response is generally flight, fight, fawn, or freeze. As Be Calm with Tati explains, you have to learn your triggers in order to disrupt this cycle. Then you need to implement some deep breathing exercises so you can calm down and focus on what happened and why.

This Prozac Monologues post, Tips for Surviving the Holidays, was originally written for the specific event of an extended family gathering. But its suggestions for managing triggers can be applied in a variety of contexts.


Create a Low-Stress Work Environment


There are things you can do to make your workspace less stress-inducing, particularly if you work from a home office. Reduce clutter by putting items in designated bins labeled "to do," "to read," and "to file." Make sure the lighting is adequate and easy on your eyes. Use a planning system that works for you, whether paper or electronic. Evaluate your office desk and chair for ergonomic comfort. It's well worth making the investment in a good office chair that places you at the proper height to use your computer easily.

You can also manage work-related anxiety in other ways. If your current job is what's making you anxious, consider a new position or different career path. Just remember that before seeking new opportunities, creating an updated resume by utilizing a type of free resume maker is a good idea. You can use a free online resume template to customize with your own copy, profile photos, and color scheme.

Dealing with Anxiety in the Moment


When you're in the grip of anxiety or a full-blown panic attack, it can be difficult to know how best to handle the situation, which is why it is best to develop strategies ahead of time. Do some deep, abdominal breathing. Focusing on your breath can have a calming effect. As you inhale, allow your abdomen to expand, and then try to make the exhale slightly longer and allow your abdomen to relax. The University of Texas MD Anderson Cancer Center suggests using guided imagery to fill your mind with thoughts, images, sounds, and smells of positive experiences.

You can also go for a walk, do yoga or tai chi, or engage in vigorous exercise, such as dancing or running. Take a moment to question any catastrophic thoughts that are running through your mind. As the saying goes, "Don't believe everything you think."

Here is a Prozac Monologues post, Recovery in Progress, that walks the reader through my own experience of an anxiety attack at a NAMI conventions, and the tools I (Willa) used to manage the incident.


Find Long-Term Stress Management Strategies


If you're prone to anxiety attacks, then it's important to have a long-term plan for managing the stress of daily life. Establishing an ongoing practice of meditation and/or a slow deliberate movement, such as tai chi, qi gong, or yoga can be helpful. If your anxiety has resulted in sleep disturbances, irritability, difficulty focusing, or ongoing muscle tension that last for more than a month or so, it's time to seek professional help.

Journaling and cultivating your sense of humor may also be helpful. Evaluate your responsibilities and consider whether you can realistically fulfill them; you may find that you need to delegate some tasks. Develop the habit of taking breaks from stressful activities. Make sure to spend some time outdoors whether hiking, running, walking, or simply enjoying a park bench in the sunshine.

In this post, Frazzled Cafe and Ruby Wax, the comedian, with master's degrees in psychotherapy and mindfulness-based therapy, describes how these activities can be used to channel the brain's functioning to relieve stress.


Find and Implement Your Anxiety Solutions


Anxiety can be present at any phase of life, whether you're a parent, student, worker, or retiree. It's important to develop constructive ways to manage stress so that you can live your life and meet your responsibilities. There are many methods of managing and prreventing anxiety, ranging from exercise to finding a less stressful job to journaling and to professional therapy. Figure out what works best for you and build some healthy habits that will be useful in both preventing and managing anxiety when it occurs.

If you are dealing with stress, anxiety, or other mental health disorders, join Willa Goodfellow on her journey to research and process these issues in her own world through ProzacMonologues.com.

Note: Many thanks to Julia Mitchell for this, my first foray into guest contributors. You may have noticed the different voice. Less... loony? Julia is a lifestyle writer, not quite my wheelhouse. But there is a lot of interest in mental health lately that is not about mental illness. Those two terms do get used interchangeably. Julia inspires me to continue the conversation with another post about how stress and anxiety differ and what the brain has to do with it. See ya next week.

photo courtesy of Pexels
clipart by Microsoft online
photo of toolbox by Eric Strandberg and used under the Creative commons license
flair from Facebook

Getting My Brain Back -- I'm Still Excited by BDNF

Learning has been fundamental to my mental health recovery. It started with this blog itself. I wanted to know What the hell happened to my brain?!!! So I read the research and used ProzacMonologues.com to keep track of my notes.

For a while I added piano to my recovery regimen. Not for music therapy, but for brain development. Okay, I didn't keep at it. I can sort of play Desperado. But it did get me a few more miles down the road.

Lately I am learning a new language. Five minutes a day of Irish on Duolingo -- I don't expect to be fluent any time this decade. I don't need to be fluent. For those five minutes a day, I am building my brain.

Which is always a good thing.

I did a search in my blog for BDNF. And found something I wrote in 2011, right after I wrote that review of Ellen Frank's Treating Bipolar Disorder. Now you, kind reader, have no idea the struggle it took back then to write these paragraphs. I am proud of it both for the accomplishment and for the content itself. I present it to you again:

Getting My Brain Back -- In Praise of BDNF


Questions Work Magic: How They Change the Brain

Quick - What does a lemon taste like?

I know what a lemon tastes like. Tell me something else instead:

What just happened inside your mouth?

David Hoffeld asks another one: Want to know what your brain does when it hears a question?

His article from the website FastCompany.com explores the neurological consequences of hearing a question. Questions temporarily hijack the brain. Did you immediately think about lemons? First, serotonin is released, causing the brain to relax. Next you get a hit of dopamine. The question takes over your thought processes while you think about the answer. The technical term is instinctive elaboration.

The hijacking doesn't last forever. The person who was asked the question can choose to ignore it, can argue against it, can go off on a tangent - though for people with ADHD or bipolar disorder, a question that interrupts our train of thought may cause us to derail.

But Hoffeld cites a number of research studies that document when you ask somebody whether they are going to do something, you increase the probability that they will do it - buy a car, vote in an upcoming election, even donate blood.

Questions not only alter your perception. They can even alter your chemistry. Chances are, when you read the lemon question, you started to salivate.

How Will You Get Through This Week?

Self care is not my best subject in the best of times. I can establish a routine, get up, eat breakfast, go to work, walk in the afternoon, and so on. I can hang on to good habits, eat a healthy diet, wear amber glasses at night. But that place in the list where I am supposed to do something for myself? Here is how that goes:

    Therapist: What will you do for fun this week?

    Me:



Okay, so what will YOU do for fun this week? (Clearly, I could use some ideas.)

And now there is this insurrection. How did that word work its way into daily conversation?


Ritual, Stress, and Surviving a Pandemic Thanksgiving

Human beings are pattern-seeking creatures. Place us in an absurd situation, we feel stress. We respond by ritual behavior, or clinging to biases, or even inventing an explanation. Does this sound like anything happening around you for the last several months?

Some of these responses serve us better than others. Biases preserve energy by saving us the time it takes to make case by case evaluations. But they also can be mistaken and rob us of original insights.

Invented explanations are how we manage the terror of acknowledging any bad thing that is out of our understanding or control. Why did Daddy hit me--again? Who is to blame for all these fires lately? How could my candidate have lost? We tell ourselves a story that makes sense of the event, relieving the pain of uncertainty, and thus gaining control over our emotions.

Sanity, the Serenity Prayer, and the Way of Love


Last week I just couldn't. Well, my laptop was dying. And then my printer wouldn't install. But all that within the context of everything that well, you know... So last week there was no new post.

This week, I still can't, not really. I can't find any new research that intrigues me. I can't bear the thought of yet another rant. I am determined not to spread any more pain.

But there's pain out there. There's pain in here. And this blog is about the things I can change. So this I will do.

I have a spiritual discipline that I am using to walk through these days. I am a Christian, and this is a Christian discipline, or series of ancient practices - though my guess is that nonChristians can find something of value here. I will do my best to do some translation.

It's called the Way of Love.

Will This Trauma Never End?

I found this video while trying to survive the cluster f*ck of misdiagnosis, antidepressants, mixed episodes, and a psychiatrist and therapist who didn't know what they didn't know, so it must be me and maybe I had borderline personality disorder - the go to diagnosis for patients that the professionals are tired of.

OK Go - This Too Shall Pass. And in fact, it did. I survived to... today? I offer it to everybody who is trying to survive the current COVID cluster f*ck in the US.

Is It Time to Call a Therapist?

There is a difference between feeling depressed and having depression, which makes it hard to figure out what we need right now when - doesn't everybody feel like crap?

What you are feeling right now might be the entirely normal reaction to this currently abnormal world. Here is what's happening: everybody is experiencing trauma at the same time. Exhaustion, trouble concentrating, insomnia, hopelessness, these are common physical, emotional, and cognitive reactions to trauma. They are also symptoms of a depressive episode. And depression, the illness of depression can lead to serious complications, substance abuse, relationship problems, suicide. Not to mention that it simply sucks the joy out of living. Depression, the illness needs to be treated.
So do you need to see a doctor? It depends. A recent New York Times article can help you sort it out.

Mental Health Innovators Ponder the End of the COVID-19 Honeymoon

Dear Mental Health Innovators: The COVID-19 Honeymoon Is Almost Over.

The title of a recent PsychiatricTimes.com article caught my eye. Honeymoon? Then I realized it was dated May 19, so perhaps the authors could rewrite the title with the "Almost" removed.

The authors identify predictable stages of psychological response to our current pandemic. Unbeknownst to those whose education was really less education and more training for their future jobs (so things like history were deemed a waste of time), the human family has lived through past disasters, including multiple pandemics. There are patterns to these things.

Heroic Stage

Trauma, COVID-19, and Cutting Yourself Some Slack

Are you failing to build your abs while social distancing?
Or learn that new language?
Or clean out that closet (you know which one)?

Are you utterly exhausted while getting nothing done and beating yourself up for it?



STOP. Just stop.
And read on.

Frazzled Cafe and Ruby Wax - Yes, I am a Fan


Ruby Wax is the founder of Frazzled Cafe, a peer support group for anyone who is overwhelmed by the stresses of modern life. As Ruby says, our brains just don't have the bandwidth. If that describes you, check it out. But bring your own coffee. The meetings moved online, a Zoom meeting on account of... you know.

Ruby is an American-born long time television personality in Britain and comedienne whose career pivoted when mental illness caught up with her. She went back to school to study the brain and got a masters from Oxford on mindfulness based therapy. Since then she has written books, toured, lectured, using her prodigious brain and her comic chops to entertain and educate about brain health.

Where Is My Therapist?

I could have talked to my therapist yesterday by phone. She's not on vacation. But this week I decided to forgo an appointment. That may have been a mistake. . .

So I turn to a rerun from eight years ago, For When Your Therapist Goes on Vacation. I think I'll be focusing on humor for the next few weeks. Keep coming back! If you've got any good jokes, put them in the comments (click on the little envelope icon at the bottom.)

Social Distancing and Sabbath


Pandemic

What if you thought of it
as the Jews consider the Sabbath—
the most sacred of times?
Cease from travel.
Cease from buying and selling.
Give up, just for now,
on trying to make the world
different than it is.
Sing. Pray. Touch only those
to whom you commit your life.
Center down.


How to Stay Sane

Shock, rage, fear, despair, depression, hopelessness, apathy, or even how about - drinking the kool-aid, surrender. Do we have a better choice?

Robin Chance, behavioral specialist and therapist, did a little therapy for the nation three years ago with her article, How to stay sane if Trump is driving you insane: Advice from a therapist. She offered a better choice.

Two questions: (1) How do we integrate this crisis into our understanding of the world? and (2) what do we do now? Now that the crisis of three years ago is our new normal, it seems time to revisit her words.

Six Ways to Heal the Holes in Your Head


Do you ever feel like you have holes in your head? Actually, you do. Ventricles are the spaces between the grey matter (brain cells) and white matter (wiring that connects the brain cells) in your brain. Depressive episodes, manic episodes, and psychosis all burn up brain tissue, leading to bigger ventricles. (Image: Effects of Western diet on the brain. See companion image, Effects of Mediterranean diet below.)

This loss of brain cells hits the hippocampus (in charge of memory and emotion regulation) particularly hard. In the early years after my last mental health crisis, I talked about my “Swiss cheese brain.” At my worst, I lost bills, I lost words, I lost everything my wife said to me on the way out the door in the morning. She took to writing down what I said I would do before she got home, never more than two items.

I lost the list.

Return to the Chemistry Experiment

What is it like, this chemistry experiment, you ask.  Somebody did ask, honest.

Prozac Monologues strives to be journalism, not journaling.  I write for education (mine first, then yours), not for therapy.  So when the story turns to the Chemistry Experiment, a topic I write about so often, it gets its own label, I have tried to season my prose only lightly with my personal story.

But the Chemistry Experiment has been excruciatingly personal these last several weeks.  And nowadays, the personal story is one way that journalists frame their reporting.  So here goes.

More on Mood Charts

This is my personalized mood chart.


You can find a larger and clearer image here. It was inspired by the one my mental health insurance provider sent me when I began taking mood stabilizers. Last week I described how their chart works and how people with mood disorders benefit from using any of the great variety out there.

Cigna's chart primarily tracks mood. Using theirs, I learned that lamotrigine made a difference to the course of my symptoms. After years of inappropriate prescriptions of antidepressants, I had moved to rapid cycling. No, rapid cycling means several cycles in a year. More like, I was spinning, from the depths of depression to raging agitation within each week, week after week. Lamotrigine did modify that pattern. It stretched the cycles, down from four to two a month. By recording the pattern, eventually I concluded, and I had the evidence to support it to my doctor, that the costs of the medication (dizziness, fourteen hours of sleep and grogginess a day, losing words) outweighed the benefits.

More Than Mood

But Cigna's chart was missing vital information. Mood dysregulation was only part of my experience. It was the agitation, sense of urgency, poor concentration, lack of sleep that put me on the disability roles. And, I began to suspect, these disturbances in energy levels were driving my suicidal thoughts as much as my depression was.

Project Implicit and the State of One's Soul

Remember, Dumbledore said to Harry, It is our choices that show what we truly are.

Project Implicit

So did you do the homework?  Did you try any of the Implicit Association Tests?  Do you still want to read my blog?

This is how they describe what they are doing:

Project Implicit represents a collaborative research effort between researchers at Harvard University, the University of Virginia, and University of Washington. While the particular purposes of each study vary considerably, most studies available at Project Implicit examine thoughts and feelings that exist either outside of conscious awareness or outside of conscious control. The primary goals of Project Implicit are to provide a safe, secure, and well-designed virtual environment to investigate psychological issues and, at the same time, provide visitors and participants with an experience that is both educational and engaging.

The variety of topics include attitudes toward age, race, disability, ethnicity, mental illness and others.  The tests are constructed to bypass thought, commitment, decision.  They dive deeper into what is known as the lizard brain, the part that evolved before reason, and that simply reacts, by setting one to tasks that have to be accomplished faster than the thinking part of the brain thinks.

Project Implicit is well aware that we may not like what we find in the lizard brain. I don't care for what I find in mine.  But it is important information, for two reasons.

Dopamine - Can't Live Without It

Dopamine -- It's what gets the lab rat turn to left at the T, race down the hallway, make a flying leap at an 18" wall, snag the ledge with its little claws, and struggle over to fall to the other side and win those four food pellets.  If you artificially deplete the lab rat's dopamine, it will turn right at the T and settle for the two pellets lying on the floor.

Dopamine -- It's what got you out of bed this morning and to work on time.  Or if your dopamine levels are depleted, you pulled the covers over your head, while your spouse pleaded with you to go back to your therapist.

Dopamine -- It's what got you out of the house early to redeem that two-for-one mocha coupon at your favorite coffee shop on your way to work, and as long as you were there, might as well order that banana chocolate chip muffin.  Bananas are good for you, right?  Or if you just never got into the habit of that particular coffee shop, and it's not on the way to work, and you really like the French Roast you have at home anyway, then your dopamine never got you fired up, and the coupon went to waste.

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