Anxiety and Stress

An article I wrote today for a local newspaper…

Stress and Anxiety – Why do I feel this way all the time?

             I feel so nervous at work and at home every day. I can’t seem to get it under control.  My boss might ask me to do something that I don’t know how to do, or my kids may get into trouble at school. These feelings are always there and I don’t know why…

            Many of us feel stress and anxiety during the day – yet we cope with it in different ways, and while we don’t always understand why we feel it, it is usually manageable.  However, an alarming number of Americans experience anxiety, frequently due to stress. Nearly 40 million people, or about 18% of Americans each year experience nervousness, uncertainty, fears, and restlessness. For these people, the feelings are not a normal reaction to stress, but instead may feel like panic, and it affects their daily life at work, at school, and at home.

            Feelings of anxiety may be felt most in the social situation, or plague us when we have to participate in a classroom experience or answer the teacher’s question. Often, it is not clear why we have the feelings – the anxiety may come up in a meeting, all of a sudden, with little warning. Anxiety, and the stress that we experience, is perhaps the most common of mental difficulties that people experience – and there are several different kinds or types of anxiety disorders.  In addition, anxiety can also be part of, or exist alongside, other disorders – such as depression, physical illness (headaches, stomach problems), sleeping difficulties – and may also trigger behaviors like substance or alcohol abuse. 

            Symptoms include:

• Constant worrying
• Trouble sleeping
• Nausea, sweating, rapid heartbeat
• Concentration or focusing problems
• Feeling easily startled or fearful
• Avoiding social situations

Both adults and children may also exhibit other symptoms, such as striving for approval, needing constant reassurance about performance, lacking confidence, and needing to be perfectionistic.  

The stress that we feel in our work, at our home, or in the school situation can interfere with our daily activities to the point that we feel unable to function normally.  It is at this time that one needs to seek out some help,  and get some assistance in understanding why we are experiencing the difficulty, and how to find different or better ways of coping. 

Anxiety disorders are classified into 5 different types or areas, each of which has different symptoms, coping mechanisms, and treatment recommendations.  You may experience frequent panic attacks (Panic Disorder), or fear dirt and germs, and needing to wash their hands incessantly (Obsessive-compulsive Disorder). Alternatively, you may not want to go outside of your home or go to the school function because you’re frightened of the social situation (Social Anxiety or Phobia). Individuals with Post-Traumatic Stress Disorder have experienced trauma – often repeatedly, and need a safe environment to recall the events and reduce their fears.  (As I pointed out in a previous article, PTSD is common in soldiers, women and children that have experienced domestic violence, rape or sexual assault victims). 

The causes of anxiety disorders are complex, and there is no research that shows just one factor being involved. Rather, the causes may be environmental (domestic violence or reactions to disaster), genetic in nature, or due to psychological and developmental factors.  Most individuals that experience post-traumatic stress disorder have experienced some trauma in their life, and interestingly, genetics may play a role in whether someone then develops PTSD, or some other disorder as a way of coping with the trauma. 

Treatments are many, and are varied – depending on how the anxiety, or the reaction to stress is experienced. Different types of treatment are called for depending on the specifics of your difficulties.  Medications may be helpful, and may be recommended by your physician or mental health provider. However, an important point is that medication alone will not solve the difficulty – and psychotherapy, or a ‘talking therapy’ will be necessary.  Certain types of therapy are currently being researched (cognitive behavioral) for some of the anxiety disorders.  Many of the psychotherapies will include learning about relaxation approaches, such as breathing exercises or making changes in your lifestyle.  The therapeutic relationship with your mental health provider is of utmost importance, as this relationship will be the key to helping you cope differently with the stress and the anxiety.  

 Please email me with questions or comments.

  Rudy Oldeschulte, M.A., J.D. is a Del Rio psychotherapist, specializing in individual psychotherapy and parent guidance.  He has served on the faculty of the University of Arizona College of Medicine and taught at the British Association of Psychotherapists. Post- graduate training and education was done in London and at the University of Michigan.

Email address is: roldeschulte@gmail.com and his website is: http://www.rudyoldeschulte.com

Perspectives…

Psychological and philosophical point of view, brought to you in plain language…

http://www.raptitude.com/2010/10/9-mind-bending-epiphanies-that-turned-my-world-upside-down

 

A mad world A diagnosis of mental illness is more common than ever – did psychiatrists create the problem, or just recognise it?

When a psychiatrist meets people at a party and reveals what he or she does for a living, two responses are typical. People either say, ‘I’d better be careful what I say around you,’ and then clam up, or they say, ‘I could talk to you for hours,’ and then launch into a litany of complaints and diagnostic questions, usually about one or another family member, in-law, co-worker, or other acquaintance. It seems that people are quick to acknowledge the ubiquity of those who might benefit from a psychiatrist’s attention, while expressing a deep reluctance ever to seek it out themselves…

…While a continuous view of mental illness probably reflects underlying reality, it inevitably results in grey areas where ‘caseness’ (whether someone does or does not have a mental disorder) must be decided based on judgment calls made by experienced clinicians. In psychiatry, those calls usually depend on whether a patient’s complaints are associated with significant distress or impaired functioning. Unlike medical disorders where morbidity is often determined by physical limitations or the threat of impending death, the distress and disruption of social functioning associated with mental illness can be fairly subjective. Even those on the softer, less severe end of the mental illness spectrum can experience considerable suffering and impairment. For example, someone with mild depression might not be on the verge of suicide, but could really be struggling with work due to anxiety and poor concentration. Many people might experience sub-clinical conditions that fall short of the threshold for a mental disorder, but still might benefit from intervention.

See link for interesting article on psychiatry…and bits about the importance of psychotherapeutic intervention…

http://aeon.co/magazine/being-human/have-psychiatrists-lost-perspective-on-mental-illness/

Happy Heart – Healthy Heart

Panel Discussion

Earlier this week, Circulation, an online journal published the newest findings of a 12-person panel of experts who went on record determining that depression should be listed as a risk for heart disease along with already known risk factors such as obesity, smoking, high blood pressure and diabetes.

The recommendation was made to the American Heart Association (AHA), after Robert M. Carney, PhD, and Kenneth E. Freedland, PhD, both professors of psychiatry at Washington University School of Medicine in St. Louis and ten other experts in the field performed an extensive review of hundreds of studies in the scientific literature that looked specifically at correlating depression and heart attacks and eventual death from heart disease.

Depression

Doctors Caney and Freeland have been studying the effects of depression on heart disease for more than 25 years when they reported the increased risk of more severe cardiac problems in patients with pre-existing heart disease, who also were diagnosed with depression. A very high percentage of all the studies they conducted since beginning in 1988, support their findings that depression is a risk factor for death in people with heart disease.

Unlike definitive findings that are found when obese people lose a significant amount of weight in a healthy way, or people who successfully quit smoking or manage to lower their blood pressure; there are very few studies that support lowered risk of heart disease in people who undergo treatment for depression.

Heart Disease

A large cause for this might be that for most people who suffer from depression don’t ‘quit’ depression the way they quit smoking. Even with proper treatment, depression isn’t known to ‘lower’ the way blood pressure lowers when treated properly. And as with many psychological issues, neither cause nor effect is as clear cut and easy to draw conclusions from.

Carney and Freeland are undaunted, however. They are ready to begin new studies with different approaches to treatment for depression so they can determine if these new approaches conclusively show a decrease in lowering heart problems. For now, it is clear that treating depression might effectively impact both the health and quality of life of a person and so, the commitment to continued research lives on.

Citations Circulation, Feb. 24, 2014

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

And The Winner Is…..

Children’s Mental Health

I used to work in a mental health hospital that was a 19-bed unit for children and adolescents that required temporary hospitalization. Many times, we saw the effects of acting out due to anger issues. And on many occasions, there were absolute mental health issues that included behaviors with depression, bipolar disorder and obsessive compulsive disorder.

During the time I worked there, I had the honor of meeting a real gem of a child psychiatrist who not only involved himself with the medication component of these children’s care, but also who helped us to become better therapists and counselors as well, having a positive impact on this aspect of their therapy while they were with us, as well.

One of the children admitted to our care during my time there, came face to face with this amazing man, regarding a major blow-up he had with another patient. He showed his true colors and caused a huge disruption on the floor after something happened, that angered him severely. The issue required more than just a brief sit-down and involved this man, who was in charge of the ward.

I recall the incident as if it were yesterday, although it is many years later. But the part I recall the most, involved this Doctor talking with the young, angry boy afterward in which he explained to him that there were really only two different scenarios that could play out for the remainder of the young man’s life. He began by telling him that he could promise him there would be many more times that this young man was going to come face to face with situations that angered him. Sometimes he would become exactly as angry as he had just become. Other times, he wouldn’t be nearly as angry and more than likely, there would be other times when he would become even angrier than he was here. Doctor Z. stated clearly, three or four times, that he could guarantee this young man of this.

No Choice

He emphasized that this young man had absolutely no choice in this. There was nothing that any of us could do, no matter who we were and how much we may want to help him, that could prevent the situations from happening in the future and then he surprised this young boy by telling him that he wasn’t going to do anything to try and prevent the young boy from getting angry in the future over these things. He told him that if anybody expected to be able to prevent their anger was a fool.

I had never heard of this type of a technique when it came to dealing with anger or any emotion for that matter. I was young and fairly wet behind the ears and I though my job was to help these children from becoming too angry or too anxious or too sad. But I learned from Doctor Z. that if I intended to prevent such things, I not only was foolish, but I would fail miserably.

The Winner Is

That day, Doctor Z. taught me and that young man that there is indeed a choice, but that the choice is about whether that feeling rules us or whether we rule that feeling. It isn’t about having the feeling or about how strong the feeling is. It is about who ends up in control – us, or our feelings?

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

Sadness and Depression

“It’s so difficult to describe depression to someone who’s never been there, because it’s not sadness. I know sadness. Sadness is to cry and to feel. But it’s that cold absence of feeling— that really hollowed-out feeling.”  J.K. Rowling

Mindfulness and Trauma

Stability

Mindfulness is about stabilizing. Studies have shown that people who have experienced trauma can benefit highly from this type of work. (Cullen, 2011). When people have experienced trauma, they can be challenged with high levels of stress, anxiety and depression at any time.

When we increase focus, stress and anxiety decreases, and as insight increases, depression may also be reduced. The implications of effective mindfulness on these specific features are truly significant and the more studies that are being done, the stronger the evidence of effective results of mindfulness.

When a person experiences trauma, racing thoughts and chain reactions of distressed thinking and intense emotions are more frequent, more intense and can last for longer periods of time. The thought pattern easily becomes negative and thereby creates greater levels of anxiety and depression, especially if ignored.

What mindfulness does is brings us into the present moment. Being in the present is provides direct opposition to the racing thoughts which are based in the past, thoughts about things that have happened, or based in the future, worrying about things that might happen. When we practice mindfulness, we pull away from these past and future thinking patterns and redirect ourselves into the moment, grounding ourselves in the present where we regain the ability to address the negative emotions of anxiety, stress and depression that are associated with our thoughts.
We can, for example, tell ourselves that in the present moment, there is nothing bad or harmful occurring to us. We are most likely sitting or lying quite comfortably in a safe place where we can focus on slowing down our breathing and letting the negative feelings go as we exhale. We can ground ourselves and regain our stability, acknowledging the feelings but proving to ourselves that in this present moment, we are okay…we are fine…and we are safe.
We have managed to regain control over the intense emotions that were beginning to overwhelm us. We have become more aware, more able to calm ourselves and less of a victim to our run-away thoughts.

Kabbat-Zin (1994) provides this definition of mindfulness: “paying attention in a particular way; on purpose, in the present moment, and non-judgmentally.” We are actually doing an awful lot although it seems we are doing nothing. We are freeing ourselves and giving ourselves permission to just be in the moment. And it is extremely soothing. It is like allowing our mind to float and just immerse itself in now.

It is very important for people to work out their own form of practicing mindfulness, something that works for them. I strongly advise people to do some research on it and see what feels like it might be a way to begin your personal journey.

Attention

Remember that the point is NOT to empty our thoughts but rather to pay attention to them in a purposeful way without judging them and then refocus attention onto whatever it is you were focusing on prior to the thought popping up. Mindfulness is a journey of exploration, discovering sounds, textures, shapes, temperatures, things that always exist but that we don’t focus on because we are not being mindful to them.

If you are just starting out, I suggest just a 10 minute exercise in which you find something to focus on, an object to look at or hold perhaps. It is wonderful if you become adept enough at it to practice it when you begin to notice any negative thoughts or symptoms that you are trying to decrease such as depression, racing or distressing thoughts, etc.

Snoopy Writing

There is a wealth of information available on mindfulness as more and more people are finding it beneficial to many different situations they encounter. I would love to hear from you about your mindfulness journey and results. Feel free to comment or contact me directly.

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

A Veteran to Gratitude

Soldier with family

It is hard to find a page on the internet today where there isn’t some mention of showing gratitude and appreciation for those people who have put their lives on the line and volunteered to represent us in times of war, volunteering to protect and defend. And we are reminded of how many instances it is not just one person making the ultimate sacrifice, but their family as well.

We’ve seen pictures of mothers who come face to face with the worst of their fears, when they get word that their son has been wounded or even worse, will not be returning from battle. We’ve seen wives who live the difficult life of a single mother, holding her young family together while harboring fears and worries about the safety of her loved one overseas.

One thing we know we all share in common is a sense of gratitude on days like today. We acknowledge, appreciate and hopefully, stop and get in touch with the gratitude we feel for these people, the ones halfway across the world, as well as the ones here.

So I take from that the lead in for the importance of gratitude in all of our lives. Some therapists swear by getting their clients to write a gratitude journal to help with depression and anxiety. By seeing all we have that is good in our lives, by moving the focus off of all that goes wrong onto how much there is that is right, it can help us regain a more balanced perspective in which our tendency to ‘believe the worst’ is not given the leading role.

Negative Thinking

According to Hara Estroff Marano in Psychology Today the negative, pessimistic thinking that people do, is a major contributor to depression. There are a lot of negative thinking patterns people get into and gratitude is s sure-fire antidote to pessimism that professionals have found works.

I can think of no better tribute or honor to the countless brave men and women who we honor today than to commit to a practice of gratitude in our own lives. If we can better our own lives because we have learned to think differently and improve the quality of our relationships with each other due to our healthier way of thinking, then we truly have been given the gift of a lifetime.

Gratitude Journal

Veterans Day is a wonderful time to begin to practice gratitude. It is a wonderful reason to look around and take on a more grateful, appreciative perspective to our lives and all the wonderful things we have. Start now. Make this year’s Veterans Day the beginning of a better life for all. There’s no Veteran who wouldn’t be proud to know their sacrifice contributed to that cause!

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

Singing “Bye-Bye Blues”

Sadness

Do you beat your blues or do you let your blues beat you?

That is a question people who are down in the dumps need to take a look at early on in order to disrupt the process of basic blues traveling much further along the depression continuum.

By patting attention to the initial feelings that accompany the blues, we can start to explore the things we’re doing or not doing that can help us feel better and nourish self-worth.

The idea of depression existing on a spectrum is something Diane Tucker, Ph.D., a professor of psychology at the University of Alabama at Birmingham, has written about.

When you reach the end of the spectrum, you are dealing with full-on depression, which impacts appetite, sleep, concentration and overall thinking processes. Acknowledging and “treating” the blues early on is critical to assuring that they don’t grow into something much more difficult to deal with.

“When people feel down, they’re less likely to be doing things that help them feel centered and personally efficacious,” Tucker said.

She also spoke about how important it is to reach out to a support system of good friends and contacts that help validate our strengths. They help provide feedback that can help us see things through a different lens and remind us of what is good in ourselves and that we are not alone.

Although people are not the same biologically and everybody’s brains work differently, the overall issue with depression is getting stuck psychologically. We tend to review the things that make us unhappy over and over again and lose perspective of all the things we have going for us in our lives.

Journaling is a wonderful way to help beat the blues because it presents us with a place to dump the repetitive negative thoughts that block our perspective.

Finding what floats our boat and provides us with a sense of accomplishment and satisfaction and spending time doing that activity is also a great natural pick-me-up.

And pumping the ‘feel-good’ hormones that run through our brain when we exercise is also a great way to say ‘bye-bye blue.’

Yes, we all get the blues sometime but we need to recognize them and do what we can while they are in the early stage of development in order to avoid having them become damaging to our overall sense of well-being.

The good news is that even if it becomes more than just a mild case of the blues, most depression can be helped by medication, psychotherapy or a combination of the two.

Source: <a href="http://www.uab.edu/&quot; title="University of Alabama at Birmingham" target="_blank"

ABOUT THE AUTHOR:
Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

Stressed or depressed?

downboyblog

“Tomorrow I will get up early, work late, catch up and things will be OK.” Sound familiar? My wife and I, both young professionals working overseas, thought that some degree of burnout came with the territory. We were paying our dues, becoming used to working evenings and weekends, and not having energy for much else.

This most recent period of burnout was the third in my short career. As eye drops to hide the redness and escalating coffee consumption became my new normal, I became vaguely aware of a sense of panick. Not making it. And eventually, little by little, loosing hope that I was ever going to make it again.

In the last weeks before I was diagnosed, I noticed that hours of work yielded few results. I was falling behind and couldn’t find the energy to catch up anymore. We talked about getting a prescription for a mild…

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