Anxiety: There’s a Better Way

Posted on June 7, 2010 by Donna

Why do we worry? What does anxiety do for us? The purpose of fear is to alert us to a threat and motivate us to take action. But anxiety is not productive. Anxiety is fear that has become stuck and repetitive. Sometimes we think worrying accomplishes something, as if we’re somehow making a fearful situation better by our anxiety.

But all we actually do when we’re anxious is repeat worried thoughts that trigger unpleasant body sensations and more fearful thoughts. Often anxiety is just a bad habit that has devloped over time. And we justify it by protesting that it’s normal to worry about important things.

There’s an old saying: “There ain’t no use worrying. There ain’t no use worrying if you got control, ’cause if you got control, there ain’t no use worrying. And there ain’t no use worrying if you ain’t got control, ’cause if you ain’t got control, there ain’t no use worrying.” This saying encourages us to distinguish what actions we can take and when our hands are tied. This is an important first step: becoming clear about our options in any problem situation.

When we have thought clearly about the situation, we have two good choices: 1.Take action to change the situation.  Or, 2.Use strategies to stop the anxious thoughts.

Our third choice, staying stuck in the anxiety, is a waste of time, a waste of emotional energy, and a waste of physical energy. That is hardly a worthwhile payoff.

There are many effective strategies to manage anxiety. And there are many factors that contribute to a person’s tendency to become anxious. Working with a counselor is a good first step to sort out which approach (cognitive therapy, bodywork, guided imagery, or medication) will be most effective for an individual. Don’t accept intense or persistent anxiety as normal or unavoidable. Make your life easier by getting some help.

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The Causes of Depression Are Many . . . And Not Your Fault

Posted on June 3, 2010 by Donna

Depression has many causes: traumatic events of the past, life-stage changes, heredity, physical illness, brain-chemistry irregularities, certain medications, interpersonal conflicts, death or loss of a loved one, substance abuse, or sudden alienation from a family or other key social group.

Even “modern life” can cause depression: As mobile phones and other high-speed, personal-communication technologies become more widespread, life for many people seems to be speeding up (do you have enough time to read and reply to all your e-mails?).

For many, the result can be increased daily stress, or at minimum, less and less chance to reflect on and appreciate the most meaningful elements of our lives.  The irony, of course, is that the communication devices which should be drawing us all closer together are in many cases making us feel more isolated . . . yet another possible cause of depression.

Nearly every one of these depression triggers is beyond a person’s control, or is a situation that most of us would never choose.   So, why then do so many people seem to blame themselves for the depression symptoms they feel?  And worse, why do so few (only about 39%, says WedMd.com) who suffer from severe depression ever seek professional help for it?

Maybe they haven’t heard that the vast majority of cases can be treated with talk therapy and (only when necessary) medication.  Or perhaps they just don’t want to think of themselves as depressed: Many men would view such an admission, even to themselves only, as a sign of weakness.  Many women are so focused on caring for (or trying to please) others that they feel getting help for their depression is somehow selfish.  And even now, when depression carries less stigma than ever, both genders tend to associate depression with people who they view as “sad” or emotionally troubled, not themselves.

Whatever the reason, no one with depression symptoms — frequent sadness for little or no reason, loss of interest in major daily activities, feelings of worthlessness, and fatigue, to name a few — should ignore them.  Get the help you need from a caring, compassionate, professional counselor.

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Post Partum Depression: Think Ahead, Just in Case

Posted on May 25, 2010 by Donna

In the past decade, post partum depression (PPD) has become much more widely known as a condition affecting women who have recently given birth, especially first-time mothers.

Of course, our culture has idealized pregnancy and motherhood for much longer than PPD has been known about, so it still can be difficult for a woman who has given birth, and/or her family, friends, or co-workers, to accept that PPD is not only real, but actually very common.

Even if a mother or those around her have heard of PPD, they may tend to dismiss it as ‘what happens to other people.’ If the mother has always been healthy, possibly even athletic, or successful in her career or other areas of life, she or those who know her might find it hard to believe she could be affected by PPD.

As a pregnancy goes on, both the mother and people close to her naturally focus more on the baby, preparing for its arrival.  Almost no one wants (or has time) to think about the possibility of PPD, so it’s understandable that such thoughts would be be pushed aside.

But a simple fact remains: Shortly after childbirth, the levels of estrogen and progesterone in a woman’s body drop sharply.  Because these hormones regulate mood, this decrease is almost certain to have some kind of emotional impact.  So, PPD is not simply about willpower; it’s bio-chemical.

As a result, researchers estimate, up to 80% of women after pregnancy will experience at least “baby blues,” the common term for the lowest level of PPD. In this state a woman’s mood can shift very quickly, from happy or content to feeling sad, irritable, anxious, fatigued, or overwhelmed.  Typically these “blues” last only a week or two, as the woman’s hormone levels return to normal.  If the symptoms last longer, it may be PPD, and the woman should meet with her doctor about it.

One of the best ways to combat PPD is to know about it well before your due date, or even before your pregnancy, so it doesn’t surprise you.    Talk to mothers who have recently given birth and find out what it was like for them.  Tell your family and friends that PPD is real, and you might need their help with it.  If “baby blues” or PPD happens to you, don’t give yourself guilt over “not feeling happy about the new baby.”  Ask family and friends to help you with household tasks, shopping, or other needs.  You deserve the help!

Another smart approach to PPD is to talk with a professional counselor, preferably one with a strong background in women’s issues.   This kind of counselor knows how to listen and ask the right questions to help you feel better.  She also can recommend strategies to help you cope with your emotions and the daily challenges of mothering a newborn.  Remember, PPD is real, normal, and nothing to be ashamed of.  If you happen to experience PPD, you’ll find it easier to handle if you’ve already thought about it and have a back-up plan.

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What Do You Mean When You Say ‘Depression?’

Posted on May 20, 2010 by Donna

Not all depressed feelings are part of a depressive illness. Any of the following conditions may include depressed feelings:

1. A natural response to an external event. For example, leaving friends behind when moving; a breakup with a partner; not receiving a sought-after promotion.

2. A natural part of grief that heals when coping with a major loss.

3. A stage of psychological/spiritual development addressing “What is the meaning of life?” and “What is my purpose?” Sometimes called “the dark night of the soul.” Often thought of as a midlife crisis, these feelings may occur at various ages.

4. A symptom of a physical illness, such as stroke or thyroid problem; a side effect of some medications; or caused by substance abuse.

5  Dysthymia — a low-level, chronic condition with depressive symptoms that somewhat interferes with a person’s ability to function and enjoy life.

Depressed feelings may be a symptom of a more severe illness that seriously impairs an individual’s functioning at work or school, in relationships, and/or in the community. These are Major Depressive Disorder; Bipolar Disorder (also referred to as Manic-Depression); Post-Partum Depression;  Premenstrual Dysphoric Disorder; or Post Traumatic Stress Disorder.

Points to consider:

1. If you are coping with any feelings of depression, you may have forgotten that life can be easier, happier, and more enjoyable.

2. Realize that there are strategies you can use to help yourself feel and function better.

3. Speaking with a professional is a useful first step to determine whether your depressed feelings are likely resolve by themselves or if supportive treatment is likely to help you.

4. Educate yourself about strategies that work. Consult a compassionate counselor.

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Good Therapy Doesn’t Have to Be Expensive

Posted on May 15, 2010 by Donna

If you are facing a persistent emotional issue or one of life’s difficult challenges, there are several types of professionals available to you: psychologists, clinical social workers, professional counselors, and others.  Each type has a different set of letters after their names.  How do you decide?

As well as asking friends who they recommend, it’s important to know what your health care plan provides (and requires) in terms of mental-health benefits.  Many plans cover only 12 to 18 outpatient therapy sessions per calendar year — after you have met your deductible, of course.

Yes, healthcare plans really should cover more sessions, but the good news is that for many people 12 to 18 sessions is enough to provide a significant level of relief from the issue they are facing.

Another FYI: Your insurance or healthcare plan also may require that you first see an in-network physician about your issue, and allow that doctor to refer you to the appropriate mental-health professional.  This requirement is not unique to mental-health care, of course: one of the key principles of  “managed care” in the U.S. is that a primary-care physician oversees the patient’s total health, including referrals to specialists.

The point here is not to deter you from getting help, but to encourage you to think realistically about the therapy you need and the investment of time and money you are willing to make.  If you need your healthcare plan to cover as much of your therapy as possible, be clear on that point when talking to your primary-care physician.

A master’s-level counselor (LCPC) is one of the most cost-effective sources of therapy because counselors’ hourly rates usually are lower than those of psychologists.  And if you need more therapy than your healthcare plan covers, these lower rates will make it easier for you to continue seeing the counselor.  ”Talk therapy,” also known as psychotherapy, is the primary tool used by counselors, and enables your counselor to determine whether you may benefit from other therapies, such as medication, as well.

If you need help, you deserve help. Take the first step, and make the call to find out your options.

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Panic Disorder: Even Anxiety at Its Worst Can Be Overcome

Posted on May 11, 2010 by Donna

If you have generalized anxiety disorder (GAD), its symptoms may be mild enough that you can maintain your daily routines without anyone knowing what you are feeling.  In essence, your struggle may be entirely (or mostly) internal.

In contrast, panic disorder is the most severe form of anxiety.  Where GAD symptoms tend to come on gradually, panic disorder is marked by sudden episodes of intense fear, producing strong physical reactions which can be hard to hide, including heart palpitations, dizziness, shaking, weakness, and exhaustion.

Lasting only a few minutes or a few hours, panic episodes are sometimes mistaken for heart attacks.  Without treatment, these panic attacks can continue for years, and may become more frequent or last longer each time.  Unfortunately, once the individual has had several attacks, the fear of another can lead to the start of a new one.

However, suffering from panic is not highly unusual.  The National Institute of Mental Health (NIMH) reports that each year, panic attacks strike about 2.4 million American adults.  Panic disorder is more common among women than men, and usually begins in the late teens or early 20s.  It can run in families, but doesn’t always, so it’s not clear why some people have it and others don’t.

If you are experiencing repeated instances of panic, don’t ignore them.  Instead, visit your family doctor, describe what you’re feeling, and let him/her check you to confirm it’s not a physical problem.  Your doctor can prescribe medication, but remember: Medicine won’t “take away” your panic attacks or change what’s causing them, it can only lessen their severity and frequency.  Medication can take weeks to begin working, and its effectiveness varies from person to person.

Counseling for anxiety–that is, “talk therapy”–is your opportunity to dig deeper, understand what’s causing your fears, and learn strategies to cope with them.  It’s not a “quick fix,” but it can be very worthwhile: As you learn about yourself and the techniques to manage your panic, you gain a sense of control over this most severe form of anxiety.

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Is Economic Stress Making Him Angrier?

Posted on May 5, 2010 by Donna

The current economic problems are stressful for many individuals, and this often leads to increased irritability and anger.  For many men, a major source of personal pride and identity is found on the job:  their competence and their ability to provide for their family.  A man’s confidence and feeling of self-worth can be undermined by unreasonable work demands,  job loss, financial pressures, and/or loss of  job-related identity and satisfaction.

If this happens, it may lead to or intensify verbally abusive behavior toward his partner.  Many men are unskilled in expressing anger in a useful manner, and some may think it’s their right to take it out on their partner.  When a man has no effective outlets for anger, he may criticize, belittle,  use name-calling, or attempt to manipulate his partner to manage his anger.  Demeaning or controlling a partner makes a verbal abuser feel more powerful and counteracts feelings of insecurity, irritation, helplessness, or his inability to admit he’s stressed.

It is rare for a verbal abuser to admit to his own destructive behavior.  He is usually secretive and is rarely overheard by others.  Verbal abuse gradually becomes worse over time and can be dramatically worsened by other stressors, such as job loss or financial difficulties.  Since it starts out slowly, his partner may explain away each occurrence and fail to see the pattern for a long time.  Eventually, his partner is constantly doubting herself, very unhappy, unsure why, and finally seeks help.

Often the partner requires an outsider’s perspective in order to see things clearly since a major aspect of verbal abuse is discounting the partner’s perceptions and beliefs especially about the abuser’s damaging behavior and the partner’s legitimate needs.

If you are in this type of situation, consider counseling to learn effective strategies to address the abuser and save the relationship if possible.  If you’re the abuser, challenge yourself to get help.  You will learn to manage your stress and anger, enjoy your life more,  and treat those in your life with care and respect.

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Physical Anxiety Symptoms: See Your Doctor First

Posted on April 27, 2010 by Donna

As noted in my April 23 post about anxiety, Generalized Anxiety Disorder (GAD) tends to manifest itself gradually, and is often accompanied by physical symptoms: tense or aching muscles, headaches, or nausea, among others.

Often a person can be so busy with life that when these symptoms occur, he or she might just tolerate them for awhile, hoping they will go away.  When they don’t, the individual is more likely to seek a physician’s advice–after all, the symptoms are physical.  This is a smart move.

Even if you strongly suspect that anxiety is the ‘root’ cause of your symptoms, it’s always wise to visit your family doctor first.  Be sure to tell the doctor not only about the physical symptoms you’re having, but also about the feelings of anxiety that seem to accompany them.  He or she will consider both sets of factors in examining you.

Knowing your health history, your doctor will already have a “hunch” about whether your symptoms are driven more by anxiety or by a physical condition.  After examining you, the doctor may recommend lifestyle changes (such as increased sleep or an exercise program) and/or counseling therapy.  In many cases medication will not be necessary, but it is always an option, especially if other treatments aren’t effective.

I’m always glad to know that my clients have made their doctor aware of physical symptoms.  In some cases, there are both physical and mental causes of the symptoms, and the doctor and I will confer as needed to provide the best treatment.

When minor ailments persist (fatigue, muscle aches, nausea, headaches, sweating, etc.), anxiety (GAD) is a likely cause, but not the only one possible.  Play it safe and see your family doctor first, to rule out other possibilities.  And even if your doctor does not suggest it, consider counseling.  I offer a free 30-minute consultation to all new patients, with no obligation to continue therapy.

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Worried? Generalized Anxiety Disorder Is Very Common

Posted on April 23, 2010 by Donna

If you often feel worried, anxious,  or tense without a clear reason for these feelings, you may be suffering from Generalized Anxiety Disorder (GAD).

You are certainly not alone in feeling this way: the National Institute of Mental Health reports that about 6.8 million Americans have been diagnosed with GAD, and that women are more than twice as likely as men to experience it.

It’s likely that the 6.8 million figure underestimates the number of GAD cases: Not everyone who has it seeks help, and those who do aren’t officially counted unless they have suffered from it for six months or more.

GAD usually develops gradually, can begin at any point in a person’s life (though it’s most likely to start between youth and middle age), and its severity can range widely.  In mild cases the condition might not even be apparent to other people, depending on the individual’s ability to manage or hide their anxiety.

At the other end of the spectrum, GAD can be truly debilitating, making it difficult or impossible for the sufferer to relax, concentrate, or sleep normally.  Thinking about the future or attempting even simple daily tasks can lead to strong, persistent feelings of fear, stress, or irritability.

The stronger these feelings are, the more likely they are to result in physical symptoms.  The sufferer may often feel tired, have tense or aching muscles,  and have frequent headaches or cases of “light headedness.”   He or she might tremble, twitch, or sweat more than normal, experience nausea,  frequent trips to the bathroom, feeling out of breath, and/or hot flashes.

There are a variety of methods for treating GAD, ranging from mindfulness to cognitive strategies, to medication.  Life’s too short to let GAD hold you back, so please contact me to start feeling better.

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