A Book Review: Loving Someone with Suicidal Thoughts

  • I just don't want to live anymore
  • If only I could fall asleep and never wake up
  • One well-placed bullet would solve all my problems
  • You'd be better off if I were dead



Oh my gosh, words you don't want to hear from somebody you love. It is tempting, so very tempting to say something that will get your loved one to take it back.

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

Is Stress Good or Will My Brain Explode?

What if I told you that stress is not a bad thing?

What if I even told you that stress is good?

Okay, you have to understand what I'm talkin' about. Modern lives are so driven by stress that we're all walking around like ticking time bombs. Except for those meditators out there. (But are they even for real?)

via GIPHY

It turns out that a little bit of stress is just the ticket to feel good and accomplish a lot of good things.

I'm talking about challenge. I'm talking about excitement. Yes, I'm even talking about...


Deadlines

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


Interpersonal Social Rhythms Therapy: Good, Bad, and Ugly (Mostly Good)

Following #bipolar on Twitter for the last few years, I am often dismayed. So many people seem to spend so much time struggling with their medications and so little time focused on anything else that could help.

Don't get me wrong. Medication is an important tool for managing bipolar disorder. But it can't do the whole job. Education and life style changes are crucial for getting off the roller coaster of constant med adjustments to address the episode du jour.

I decided it was time to revisit my 2011 review of Ellen Frank's Treating Bipolar DisorderIt was a four-part review. The last three posts describe the treatment itself, Interpersonal Social Rhythms Therapy, IPSRT.

Part I laid the educational foundation, describing the relationship between circadian rhythms (our interior physiological clocks) and mood disorders.

Part II outlined Frank's Social Zeitgeber Theory and the treatment that proceeds logically from it, a process of establishing regular daily rhythms that set our interior clocks and keep them running on time. (Zeitgeber means timekeeper.)

Part III explained how work on interpersonal issues helps people reduce stressors and prevent disruptions to their social rhythms.

This last post will pull together my appreciation, my reservations and my hopes for future directions.

Social Zeitgeber Theory


How Does Interpersonal Therapy Help People with Bipolar Disorder?

Ellen Frank - Treating Bipolar Disorder, Part 3

Lately I have been reposting my 2011 review of Treating Bipolar Disorder by Ellen Frank. It was originally recommended to me by a friend who was researching hypomania. Part I described the basis of Interpersonal Social Rhythms Therapy (IPSRT) in circadian rhythms that control the many physiological symptoms of mood disorders. Part II outlined the Social Zeitgeber Theory and described the early stages of the therapy process, history taking and stabilizing social rhythms. Today I pick up with the later stages, interpersonal therapy and maintenance.


Interpersonal Social Rhythms Therapy came to Ellen Frank in an epiphany on her birthday, July 14, 1990. Personally, I like that. I especially like that it was the day that she participated in a conference for people with bipolar, and listened to them.

Frank and her colleagues were already using interpersonal therapy for people with recurrent unipolar depression. Their theory was that certain life events, particularly losses could result in lost social zeitgebers, (timekeepers), with subsequent disruption of circadian rhythms, leading to eventual relapse into another episode of depression.

IPSRT took up from there as an adaptation specifically for people with bipolar disorder, integrating the work on issues (as in, you've got issues) with greater focus on behavioral changes to achieve and maintain daily rhythms, time of rising, time of first human contact, work, main meal, etc. The purpose of IPSRT is to help people achieve stability and then to avoid relapses into either depression or mania/hypomania.

Why Do People Relapse?

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