Anxiety: More than Nerves

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Everyone feels anxious sometimes. It’s completely normal and healthy to feel anxious before/during/after a life event. What’s not normal is when this feeling persists and begins to overtake your thoughts. Anxiety is more than someone overreacting, and generally the person experiencing it knows they are catastrophising, they just can’t control it. Sometimes feelings of panic come, seemingly, out of nowhere for reasons a person is not aware of.

I’m sure everyone has heard of “triggers”–especially due to the popular use of the term in the social justice warrior crowd. A trigger is something–anything–that brings back a memory or feeling of a traumatic event. This can be smell, touch, taste, words, sight…really anything. Often times the person is unaware that the trigger happened or what caused it. Sometimes there’s no trigger at all, stress in general can bring about the chaos of anxiety.

If anxiety is severe enough and unresolved it can result in a panic attack or anxiety attack. We’ve had numerous people come into the ER with symptoms of a panic attack thinking they are dying. Because it absolutely feels like it. A panic attack is a physical response to substantial anxiety that causes a person’s heart rate to increase, hyperventilate, lose concentration, disassociate, chest pain, dizziness, numbness…as a nurse I can tell you that a lot of those symptoms are secondary to the increase in heart rate and breathing. You can actually put yourself into what’s called “respiratory alkalosis” meaning the carbon dioxide ratio in your blood is skewed. This can result in serious physiological effects…and definitely makes a person feel like they are dying.

Please remember:
If you can’t relate to a person’s emotions or experience, this doesn’t make it any less valid. Your understanding of their experience is irrelevant to how they are feeling.

So what do you do?

-If you see someone looking panicked, catch their attention. While experiencing a panic attack the person feels completely out of control and letting someone know they are not alone can help ground them and bring them back to feeling safe.
-Get them to a quiet area. During a panic attack you feel completely overwhelmed and your environment can absolutely make this worse.
-Get them to breath. Slowing down breaths can get their attention on something other than their thoughts and physical feelings as well as keep them from hyperventilating.

Tips to preventing a panic attack or stopping it:

Believe me, I’m very well aware of the horrible sensation a panic attack creates. The feelings of being completely out of control and in immediate danger…yet not knowing why this is happening. However if you pay attention to your body you can start to recognize when an attack is brewing. You’ll notice feeling irritable, chest tightness, trouble concentrating, increased heart rate. Here’s what to do:

-Take time out. Find a quiet place where you can be alone.
-Breath. Take slow deep breaths. It helps to close your eyes and concentrate only on your breathing. I like to use the 5,6,7 rule. 5 seconds to inhale, hold for 6 seconds, 7 seconds to exhale. I cannot accentuate the importance of breathing enough! This is imperative to preventing and stopping a panic attack.
-It’s OK to cry. It’s OK to hurt. It’s OK to need to take care of yourself. You can’t pour from an empty cup. Let it out, gather yourself, and get back to what you were doing.
-If you can distract yourself by doing something you enjoy–a walk, music, scents…anything that’s calming to you.

Anxiety is a horrible feeling and coupled with depression, this makes for an ugly two-headed monster. Often both conditions cause a person to exhaust their ability to cope and self-medicating through alcohol and drug abuse can add a third demon to the already debilitating conditions. Depression, anxiety, and addiction are difficult to talk about separately because of the marriage between the three. To be continued.

Don’t be afraid to seek out help. There’s nothing wrong with medication–sometimes it’s the leg up you need to gain control over your mind.

You got this.

 

If you are feeling like self-harming or suicidal please call 911 or head to your nearest Emergency Room.

The 211 Helpline is available for crisis support. They are open 24/7 and are judgement free.

I love you. Please reach out if you need help. Hope does exist.

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Depression: More than Sadness

I came across the idea of the “Black Dog” to personify depression years ago. I loved the illustration as I feel it captured well how depression feels in a way others may somewhat understand. You can watch the video here:

Depression is much more than feeling sad. People will often say they feel depressed or have felt depressed over a situational sadness. Everyone feels sad. Everyone has experienced grief. Not everyone knows the dark pit of depression.

Depression Statistics Inforgraph

Depression is a dark hole that a person falls into and seems to never be able to crawl out of. Depression is an all consuming fire burning the person alive. Depression is a large wave drowning you as you fight for your life. Depression is NOT a choice. One cannot simply “snap out of it”. “Just think about all the good thing you have”. “How can you be depressed, your life is so good”. “You’d feel better if you strengthened your relationship with God”. “You’re letting the devil control your life”. “You just need to ______”. Words I’ve heard over and over, and words that are so very far from helpful.

Depression is beyond situations…granted situations can make depression feel worse and situation grief or sadness can evolve into depression, but often it persists despite what is going on in a person’s life. Research into the cause of depression has shown it is a very complicated disease created from genetic dispositions and the way a persons brain is wired. I could go on and on about the neuroscience behind depression, but rather I’ll provide a link if you’re interested:

http://www.health.harvard.edu/mind-and-mood/what-causes-depression

Depression is defined in the DSM-V (psychology diagnostic manual):

Depressed mood or irritable– A person must feel depressed the majority of the time and can be subjective (reported by person) or objective (observed by another).

In my life I become very tearful and feel very empty. This is a consuming feeling and persists for days, to weeks, to months…to years.

Decreased interest or pleasure– A substantial loss of interest in what a person used to like to do.

One of my warning signs for heading into a depressive episode is that I start to lose interest in doing thing I normally love. I quit reading, I quit working out, I quit cooking, I start to just stay inside, I limit social contact, even my job seems difficult to enjoy.

Significant Weight/Appetite Change- Generally a change of 5% of body weight in 3-4 weeks.

For many eating is a coping mechanism. For me, I quit eating. I completely lose interest in food and things I normally love to eat taste bland and unappealing. In nursing school I lost 30lbs in three months because I couldn’t eat. I try to force myself when this happens, but with food not tasting well it’s hard to do.

Change in Sleep- Insomnia or hypersomnia. Can’t sleep or sleep way too much.

Mine shows up as insomnia. I cannot fall asleep and once I do I wake up constantly. However I’m always exhausted. Others sleep too much and struggle to stay awake.

Change in Activity- Psychomotor agitation or retardation. Think fidgeting too much or unable to move.

My depressive episodes are definitely mixed with anxiety so I will experience both. At times I cannot sit still. Other times I cannot move or move very slowly. I’ll walk slower and respond slower…sometimes it takes all day to take a shower.

Fatigue or loss of energy- I feel this ties in with the previous one. However the loss of energy is more than feeling “blah” or a normal “tired”.

At it’s worst I have to remind myself to breath. The loss of energy is so severe that breathing seems “too much”. Moving seems impossible…I’ll sit or lay in one position for hours…the entire time trying to convince myself to move. It’s as if your body is made of lead.

Guilt/Worthlessness- Excessive or inappropriate feelings of guilt and worthlessness.

Note: “Inappropriate”. Meaning irrational. Meaning the thought process and perception of the person is affected and you cannot reason a depressed person out of depression. Instead they often find themselves feeling very guilty for feeling the way they are. I will feel like I’m letting everyone down around me…I will feel useless, worthless. A burden.

Concentration- Indecisiveness, diminished ability to think.

Talking is difficult for me, I’ll struggle with expressive aphasia. Meaning I can’t get words out and I can’t get them out in the right order at times. When severe I can barely drive…I’ve almost wrecked my car many times because of this. It’s worse than driving drunk…you just cannot think right.

Suicidality- Thoughts of death or suicide. Has a plan.

If you’ve been following me at all it’s no secret this has been something I’ve definitely struggled with. And suicide deserves a post to itself. It’s a very complicated topic. For now I’ll explain that in these pits of darkness death seems to be the only way out. It’s not necessarily that the person wants to die, but rather escape.

To be diagnosed with Major Depressive Disorder one must possess 5 of the 9 symptoms listed above nearly every day for more than 2 weeks. The symptoms need to interfere with daily living-jobs, social life, relationships, etc.

Depression is often a co-morbid diagnoses most often with anxiety and addiction. Both of which I will touch on later.

Treatment for depression involves psychotropic medications such as SSRIs (Zoloft, Prozac, Celexa, Lexapro, etc) and therapy. I often tell people treatment is much like dating–you have to go through a lot of bad apples before finding “the one”. Not every medication is for everyone and neither are therapists.

If you haven’t had luck with therapy I’d encourage you to try again. Being able to connect with the person is very important and often therapy is unsuccessful because the relationship between the therapist and patient doesn’t mesh well. Therapy can help identify precipitating factors that cause depressive symptoms and help you rework the mis-wiring of your brain. It’s not a short term process nor a quick fix. Medications aren’t either. They can help, but do not cure. Ultimately you learn to live with your symptoms, learn to lessen them, and cope with them.

Anxiety and Substance Abuse/Addiction are next. Then we’ll finish of Mental Health Awareness Month with the difficult subject of Suicide and an overall discussion of coping skills, therapies, and resources.

If you are feeling suicidal please call 911, go to the ER, or go to your nearest behavioral health facility for an assessment. Your life is worth it. I promise.

Helpline 211 is also available 24/7 to chat or talk on the phone, they are here to help.

Descent into Madness

With every passing hour as the sun comes closer to the earth

I am reminded of my imminent descent into madness

I try to distract myself with pretty little things

With knick-knacks…

I fill my time with those I enjoy all the while hearing the

“tap tap tap” of the finger reminding me the clock is ticking

I smile, I laugh, pretending the panic rising within doesn’t exist.

Just maybe this time I can will it away, maybe this time I can run

But, you see, you cannot run from your own mind

So as the leaves begin to turn, the night seeps into the daytime

So do does my mind decay into a writhing pain

Emotion swallows my reality; I’m shrouded in the darkness


I fade.

WHO AM I!?

Know Thyself

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Going through everything I’ve been through the last several months the phrase “Know Thyself” has been circling in my mind…specifically the scene from the Matrix when the Oracle points the sign out to Neo which states:

“Temet Nosce”

Or Know Thyself in Latin. (Future tattoo idea??) As I progress in my journey towards wholeness I realize more and more how little we spend getting to know ourselves. We spend so much time wrapped up in social media or Netflix binges that we forget to spend time with ourselves. Silence, reflection, and meditation seem to be things we run away from…as if we are afraid that something ugly from within might surface. Here’s the thing though–whatever it is that we are afraid of is exactly what we need to accept. If we don’t truly face ourselves and learn and grow into who we are we just end up being reflections of those around us…never really reaching our full potential or truly being able to love.

I think about those around me that hate their appearance, hate who they are…thinking “If I could just lose another 15lbs I would finally be happy with myself” “If I could just get him to like me” “If I could just get that promotion…or job”…but the thing is our identity is not what we look like…it’s not what we do…it’s not how we feel.

Our identity is complete acceptance of who we are right now, in this moment, warts and all.

Your appearance does not define you, nor does your job, nor does your spouse…Our world is all about change. Constantly improving, which is fantastic don’t get me wrong, however when it comes to looking inwards we’ve got it all wrong. We should never try to change who we are…but rather grow into who we are. There is nothing wrong with you.

“This moment is as perfect as it can be”
–Richard Rohr

We are all on a journey and we are all in different places, and where we are right now is completely OK. Meet yourself where you are. Embrace it and begin to know thyself. Spend time alone in the quiet…reflect on the “whys” behind feelings and actions, know that sometimes you may feel those “whys” are ugly, but also know it’s ok. Accept it for what it is, learn from it and move on. Lean into yourself, lean into your gifts…your strengths. Embrace you.

Now this is all easy for me to say…but to turn it all back onto myself is a different story. But that’s the beauty of it, isn’t it? As I keep saying–it’s a journey. And I’m OK with that.

Feelin’ Good and Ready to Rock

During the past two weeks I’ve done my Preceptorship for nursing on top of working and have not had any days off until yesterday…I LOVED IT. Being able to spend 12 hours pouring myself into other people was exactly what I needed and it brought me back. For now. I’m praying I can find a way to balance where I am now with where I was so I can keep from the edge of that cliff. Meanwhile I’ve started working out again and started a new group on Facebook that focuses on the wholeness of health. I’ve learned how important mental, physical, and spiritual healths are for the entirety of our well being. If I’m going to be whole, I need to be whole in each of those areas as well. So I invite anyone reading to join me on this journey! It’s a new year…let’s make this the beginning of a new life.

Here’s video that explains what I’m doing. I’m kind of funny…just watch.