Monday, April 14, 2014

Self Therapy Hulu Style


I'm alive.  However, the past few social excursions have taken a toll on me so I am not feeling real great, hence the lull in blog posts.  I am just trying to stay as calm as possible to avoid triggering any major shifts in mood or an increase in anxiety.  We are having my daughter's birthday party this Saturday.  It will only be a small gathering of close family members here, but even that has me a little on edge.  Plus, I am PMSing so my temper is on short circuit.  I just want to stuff my face with chocolate and lay around watching Hulu.  I am not a big TV watcher, but in addition to my regulars - The Middle, Modern Family, and The Goldbergs - I have found a show called Pramface that I started watching last night.  These are the shows I catch up on when I can't sleep.  I have other shows that I watch with Douglas before he goes to bed each afternoon (remember, he works night shift) that I just don't feel right watching without him. Our ultimate favorite is Dr. Who :)  

Still, I'd rather choose a book over television, but sometimes when I am not feeling well I can't concentrate to read.  TV doesn't take quite as much effort. The worst times are when I can't even concentrate on that, usually during the mixed states.  

I have been feeling a strong pull to start working on my book again, but when I sit down to work on it I just can't get things in motion.  I am so indecisive, it's ridiculous. And I keep letting that "you suck at this" voice talk me out of my drive to pursue its completion.  I am not giving up, though. I may be moving as slow as a snail, so much so that it can hardly be called progress, but considering everything else I have going on in life, I don't think I am making excuses.  I'm just really overwhelmed!  As I have expressed on here before, I know there will come a time when I will have a little more free time to work on this dream of mine.  And if I never get around to it (for the right reasons) then that just means it wasn't meant to be.  My job is to sift through all the trivial excuses and make sure those aren't the things standing in my way.  Watching TV is not a very good excuse, I know this. But this week I think I need the brainlessness that it provides.  Hopefully I will feel more creative soon. 


Saturday, April 12, 2014

“There is a crack in everything.  That is how the light gets in.”  -Leonard Cohen

Wednesday, April 09, 2014

Happy Birthday, Emily!


Emily, Me, Jacen

Today is my daughter Emily's 12th birthday.  Where does the time go, right??  It seems like just yesterday she was curled up in my lap while I sang lullabies to her.  Children just grow way too fast!  But I am proud of the young woman she is becoming, and I am thankful that she loves me and enjoys spending time with me. She loves for me to come eat lunch with her at school, and while a room full of loud kids is not exactly a walk in the park for me, there's no way I was going to miss this lunch date with her.  After all, she will be going to middle school next year, and as my older daughter has informed me, it's just not cool to eat lunch with your mother there!  So I spent yesterday cooking up several pans of brownies to bring with us today, and luckily they turned out very yummy!  My daughter was allowed to sit with me at a smaller table apart from the loudest part of the cafeteria with a couple of her friends, and my son provided lots of entertainment for us all.  It went well.  I survived.  No panic attacks.  Woohoo! 


Monday, April 07, 2014

Social Phobia (Social Anxiety Disorder): Always Embarrassed

Are you afraid of being judged by others or of being embarrassed all the time? Do you feel extremely fearful and unsure around other people most of the time? Do these worries make it hard for you to do everyday tasks like run errands, or talk to people at work or school?

If so, you may have a type of anxiety disorder called social phobia, also called social anxiety disorder.

What is social phobia?

Social phobia is a strong fear of being judged by others and of being embarrassed. This fear can be so strong that it gets in the way of going to work or school or doing other everyday things.
Everyone has felt anxious or embarrassed at one time or another. For example, meeting new people or giving a public speech can make anyone nervous. But people with social phobia worry about these and other things for weeks before they happen.
People with social phobia are afraid of doing common things in front of other people. For example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people, or use a public restroom. Most people who have social phobia know that they shouldn't be as afraid as they are, but they can't control their fear. Sometimes, they end up staying away from places or events where they think they might have to do something that will embarrass them. For some people, social phobia is a problem only in certain situations, while others have symptoms in almost any social situation.
Social phobia usually starts during youth. A doctor can tell that a person has social phobia if the person has had symptoms for at least 6 months. Without treatment, social phobia can last for many years or a lifetime.

What are the signs and symptoms of social phobia?

People with social phobia tend to:
  • -Be very anxious about being with other people and have a hard time talking to them, even though they wish they could
  • -Be very self-conscious in front of other people and feel embarrassed
  • -Be very afraid that other people will judge them
  • -Worry for days or weeks before an event where other people will be
  • -Stay away from places where there are other people
  • -Have a hard time making friends and keeping friends
  • -Blush, sweat, or tremble around other people
  • -Feel nauseous or sick to their stomach when with other people.

What causes social phobia?

Social phobia sometimes runs in families, but no one knows for sure why some people have it, while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. Some researchers think that misreading of others’ behavior may play a role in causing social phobia. For example, you may think that people are staring or frowning at you when they truly are not. Weak social skills are another possible cause of social phobia. For example, if you have weak social skills, you may feel discouraged after talking with people and may worry about doing it in the future. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

How is social phobia treated?

First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that an unrelated physical problem isn’t causing the symptoms. The doctor may refer you to a mental health specialist.
Social phobia is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating social phobia. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful. It can also help people learn and practice social skills.
Medication. Doctors also may prescribe medication to help treat social phobia. The most commonly prescribed medications for social phobia are anti- anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
Antidepressants are used to treat depression, but they are also helpful for social phobia. They are probably more commonly prescribed for social phobia than anti-anxiety medications. Antidepressants may take several weeks to start working. Some may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
A type of antidepressant called monoamine oxidase inhibitors (MAOIs) are especially effective in treating social phobia. However, they are rarely used as a first line of treatment because when MAOIs are combined with certain foods or other medicines, dangerous side effects can occur.
It’s important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A “black box”—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts.
Anyone taking antidepressants should be monitored closely, especially when they first start treatment.
Another type of medication called beta-blockers can help control some of the physical symptoms of social phobia such as excessive sweating, shaking, or a racing heart. They are most commonly prescribed when the symptoms of social phobia occur in specific situations, such as “stage fright.”
Some people do better with CBT, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.

What is it like having social phobia?

"In school I was always afraid of being called on, even when I knew the answers. When I got a job, I hated to meet with my boss. I couldn't eat lunch with my co-workers. I worried about being stared at or judged, and worried that I would make a fool of myself. My heart would pound and I would start to sweat when I thought about meetings. The feelings got worse as the time of the event got closer. Sometimes I couldn't sleep or eat for days before a staff meeting."
"I'm taking medicine and working with a counselor to cope better with my fears. I had to work hard, but I feel better. I'm glad I made that first call to my doctor."

This NIMH publication is in the public domain and may be reproduced or copied without permission. NIMH encourages you to reproduce it and use it in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated.

Friday, April 04, 2014

“There is in every true woman's heart, a spark of heavenly fire, which lies dormant in the broad daylight of prosperity, but which kindles up and beams and blazes in the dark hour of adversity.”  -Washington Irving 

Monday, March 31, 2014

Interlude

There are a few more posts I want to make on anxiety; for instance, I have yet to address social anxiety, agoraphobia, etc.  But depression has a way of making me lose my focus and drive, so I will resume the anxiety series later ( a soon later I hope).  For now, I want to share a really great blog post written by Christy at Normal in Training. Earlier in the month, she wrote something about depression that really spoke to me.  I wasn't depressed at the time, but I knew it would come in handy when I was.  Indeed,  No Good Reason is a very helpful read.  I hate depression, not only for the obvious pain it entails, but for the added guilt I pile on top for feeling that way in the first place, as if I willed myself to be depressed.  Some well-meaning people really don't help the case when they ask "why are you depressed?" as if it is that simple.  As if a situation caused this and therefore it can be fixed by changing the situation.  We always want a reason for everything, right?  But some things just aren't so black and white. 

I am going to go interact with my family.  My daughters are here and I want to enjoy this time.  It's not fair that depression comes at such inconvenient times.  It's hard to fake being alright when I'm not, and my daughters are old enough to perceive that I am struggling.  But I'm going to make the best of it while they are here.  They will be leaving tomorrow, and that will create a situational depression, but I can't dwell on that now.  One day at a time, please. 

Thursday, March 27, 2014

Obsessive-Compulsive Disorder: It's Not Just The "Neat Freak" Illness

*Possible Trigger* Some of the things I am going to discuss today may be a little disturbing.  I am refraining from the most graphic of details, but if you are sensitive to things of a violent nature or self-harm, then this may not be a good read for you.  I am not intending to shock anyone or cause any negative emotions; I only want to explain what OCD is like for me. Thank you for reading, but if you don't I understand.


A while back, I posted an article about The Nuts and Bolts of Obsessive-Compulsive Disorder, but today I want to share my own personal account of the illness.  As easy as it has become to write about my experiences with bipolar disorder and panic attacks, I still find it hard to articulate exactly what goes on in the mind of someone with OCD.  Not too long ago, I asked myself why I chose to dedicate this blog to bipolar disorder (hence the title Bipolarly) rather than OCD.  And then I realized:  I remember life before bipolar disorder developed and took over; I can remember what I was like before depression, before mania.  But even my earliest memories involve manifestations of OCD.  I didn't know it at the time.  I was not officially diagnosed until the age of 26.  But I do not ever recall a time in my life that I did not have this ongoing noise of OCD bursting through the seams of my brain.  So, I almost view OCD as who I really am; our identities are so intertwined. I can view bipolar disorder for the illness that it is because I know who I am without it.  I do not know who I would be without the internal war of OCD.  Would the silence kill me?  Or would I finally know what it's like to live in peace?

A lot of the thoughts (obsessions) that are a part of my illness are embarrassing and/or terrifying.  I haven't even told the people closest to me about some of them.  Not even my fiance.  Not even a therapist. I suppose this is out of fear that they won't trust me or they will abandon me or I will wind up institutionalized.  Who would feel safe around me if they knew what was going through my mind every second of every day?  So I keep quiet about those things.  The only indication of something a little "off" with my thoughts are the frequent handwashing, the straightening of crooked things, the sanitation of things, the matching of things...all of which are more evident on some days than they are on others. I have learned to hide a lot of my compulsions, and the ones I can't tend to draw more laughs than concern. But there is a darker side to this disorder that I try so hard to keep under wraps.  And that is the more exhausting part of OCD.

 I am not a "neat freak".  Okay, I kind of am, but not to the degree you would think.  If you come to my house unannounced you will not find a pristine home devoid of dust or dirty dishes.  I don't get down on the floor and scrub every inch with a toothbrush twenty times a day. I don't even do that once a day...or ever.  I do like everything to be clean and uncluttered, and when it's not I feel a lot of chaos within myself.  I can barely function in a messy house.  But that doesn't mean it doesn't happen, thanks to bouts of depression and the other occupants in the household.  When I lived alone, sure, you could eat off the floor, but now I really wouldn't recommend that! I do spend a lot of time organizing things, and my methods don't always make much sense to other people. Back when I was an office manager I once organized everything in the front office with an alphabetical label and then printed out a list of what was to be stored at each letter.  I thought it was brilliant...my coworkers not so much. Still, that's not really what makes me "so OCD."

The rules change.  A lot.  When I was a child my mom hated to take me grocery shopping because I had to punch in the plastic on all the paper towel rolls on my level as we walked down the paper aisle.  I don't feel compelled to do that anymore, mainly because I now try to avoid touching as many things as possible due to my fear of germs.  Also, as a child I had to do things to the count of six, and then six sixes.  I am cringing as I write that now, because in more recent years that has become The Bad Number and I avoid it like the plague. When I was young, I recall my Nana nagging at me to stop pulling everything to the edge of the table.  When I ate the edge of my plate had to be perfectly aligned to the edge of the table.  Anything on the coffee table had to be perfectly positioned in the left corner.  It just had to be!  I was so afraid something bad would happen if I didn't, something worse than getting yelled at repeatedly for doing it.  I guess my family just thought I was odd.  They didn't recognize that something more serious was at play.  Whatever the case, I still have to line things up a certain way but the rules of how change a lot.  It's as if there is a big bad wolf on a throne in my head barking out orders, but ever so often he changes the orders.  I act accordingly. 

Those are just a few of the "cuter" parts of my disorder.  Now (deep breath) I am going to talk about some of the bigger parts of it.  First, let me explain that there are different categories of OCD.  The four most common are 

  • Checking things
  • Contamination (inside or outside of the body)
  • Hoarding 
  • Ruminations / Intrusive Thoughts
While I do check things repeatedly (mainly anything that could cause a fire) and fear contamination a good bit, going to great lengths to avoid it at times, the biggest chunk of my illness revolves around ruminations and intrusive thoughts. I cannot even begin to cover every part of it, but I will mention a few:

The Safety of My Family:  Everyone worries about their loved ones.  They want them to be safe.  They may even pray for them daily if they are the praying type.  That is "normal".  But imagine every second of your day being bombarded by very graphic images of your loved ones being harmed.  This is what I live with.  I can't get the images out of my head, and I am so afraid they will come true.  If I drop something and it lands a certain way I am convinced that is a sign that someone is going to die.  Sometimes I burst out crying because it seems so real, like that person has already died.  The only "control" I have over this is to pray.  But not just any prayer.  It has to be The Prayer.  There are certain words I have to say and if I mess up I have to start over again.  If I feel like my heart wasn't in it or I was distracted, I have to do it again.  I cannot say it aloud, because that will undo it.  It must be said silently so only God and I can hear, and it must be perfect.  I've tried counting how many times I say this prayer in a given day, but I lose count, but I estimate probably around 500 times a day. Give or take.  On especially anxious days it's more.  Since I say it in my head and not aloud, no one around me knows I am saying it.  I guess they think I am daydreaming or just not paying attention.  I miss a lot of conversations because of this praying.  And yes, I know the constant praying doesn't make sense.  I know, biblically speaking, that is not the way you are supposed to pray, but I just have to do it. I do my regular praying as well, but it is difficult because I keep having to interrupt it with The Prayer.  

Doing Harm:  I am a mild and meek person.  Very anti-violence.  I believe in treating all people with love and kindness.  So imagine what it is like to constantly have graphic images not only of your loved ones being harmed, but also of YOU being the one doing the harm!  I have a fear of abusing my children, even though I have NEVER actually abused them.  I am afraid to be around knives because I am afraid I will either slash my own wrists or stab someone around me.  I do occasionally have to use knives when I am preparing food, but I am so nervous the whole time.  I hate using them and I hate washing them afterwards.  I envision the dish water being full of blood and I keep checking to see if I have cut myself.  I have to lay the knives a certain way - blade facing left if it is on its side, or blade facing right if it is downward in the dish drainer - or something just doesn't feel right.  Beyond knives, I have a fear of drowning my children in the bath tub, or of them drowning on their own.  Please understand, I am confident meek little me would NEVER do something like that to my children, and that is why these images are so distressing.  

Driving:  Part of this one is an extension of the fear of doing harm to others, because when I was still able to drive I would always have these sudden visions of running off the road to hit a person, an animal, a mailbox, a house, etc.  Likewise, I would see crashes occuring, like me plowing into the person in front of me or the car in the opposite lane swerving to hit me. Sometimes these images would be so real that I would slam on my brakes to avoid an accident.  Afterwards I would realize the danger wasn't real, but the moment before it felt like it was.  I have not driven in three years due to my panic attacks becoming so severe coupled with these visions - I just don't feel like it is safe for me to be behind the wheel!  But even riding in the car is difficult.  I have the same images, only I am the passenger so I have even less control over what happens.  My fiance gets really frustrated with me sometimes and I can't really blame him.  I'm sure it's hard to drive when the person beside you is gasping in fear every few seconds.  Some days I am so convinced a terrible accident will happen that I don't want to leave the house at all.  I try to avoid having my son go somewhere in the car without me, not because I don't trust my fiance's driving skills, but because I just have this horrible feeling there will be an accident and I will never see my son alive again.  The few times I have been at home while they went somewhere I have been on edge the whole time.  I worry about my daughters as well, especially when I know they are going somewhere with their dad or someone else on the interstate.  I don't know how I am going to handle it when they are old enough to get their own license.  I don't even want to think about that.  

Blood:  I hate the sight of blood.  I can't watch anything on television that is the least bit gory, which is nothing all that out of the ordinary; there are a lot of people like that.  But I see blood everywhere.  I see myself in a tub of blood when I take a bath.  I see it in the dish water (as mentioned above).  I see it running down the walls sometimes.  It's disturbing, to say the least.  I have a lot of images of cutting myself, either by accident or on purpose.  I hate feeling the blood move through my veins, I hate looking at veins, reading about them, and writing about them, so that is all I am going to write about that!  

Germs:  It's good to be conscious of germs.  Everyone should wash their hands after they go to the bathroom, handle raw meat, or do anything else that dirties the hands.  But I just tend to go into overdrive about it.  I feel dirty all over sometimes...just because I touched a product on the shelf of a store.  I carry hand sanitizer with me at all times, and while I know all about super germs I just can't stop sanitizing my hands.  When I wash my hands, I have to do it three times in a row most days.  Sometimes more, sometimes less.  I'm the person who will wear gloves to clean something, take the gloves off and wash my hands three times, then use hand sanitizer, then repeat, and still I feel contaminated inside and out.  No wonder my hands look like an old lady's!  If I wash my hands in the kitchen, I have to wash them in the bathroom, and vice versa.  When I am manic, I wash my hands even more.  There are days when I can't really remember doing much more than washing my hands.  Other days, it's not so bad...I could even pass for "normal" in the handwashing department.  I avoid cooking meat as much as possible because the process of decontaminating everything (not only my hands, but the whole freaking kitchen) is so time consuming that it's really not worth it.  We proudly eat a lot of beans and veggies.  It's cheaper that way anyway.  

Sexual:  I'm not comfortable discussing the details of this one, but suffice it to say, I have a lot of intrusive thoughts in this department as well.  'Nuff said!  

Religion:  Too exhausting to go into right now.  Maybe some other day.  

Numbers:  I hate math.  Not only does my brain not seem to comprehend it, but certain numbers irk me to death so it is a very frazzling experience.  I have mentioned The Bad Number, but there are other numbers that give me a bad feeling as well.  I am content with denominations of fives and with the number seven (which is my favorite).  Seven is pure and complete to me.  It brings me a little peace.  

I could go on and on, but I think you get the picture.  Living with OCD is a challenge.  It is hard for me to share this stuff because I am aware of how weird and crazy it may seem to someone who has never dealt with this sort of thing.  I chose not to go into some of it because it would only make me sound weirder and crazier! I am not proud of these thoughts or the actions I try to control them with.  I do try to keep this illness from taking over my life and interfering with my ability to be a good mother.  Some days are easier than others.  Ever so often I will see (mainly on Facebook) those pictures that "will drive your OCD insane" and it makes me mad.  Honestly, those pictures literally hurt me to look at.  It will bother me all day long because I can't fix it.  I am not an easily offended person, and I have a good sense of humor, but seeing someone say they are OCD because they can't stand to have a messy closet kind of irks me.  But, how do you describe an elephant to a mouse?  And that is what fuels stigma, the fact that there are so many misconceptions about mental illness - some seemingly harmless and trivial, while others downright cruel - and the few of us who do actually have the answers are so often incapable or afraid to speak up.  This blog is my small way of speaking up.  It's my little way of saying, yes, I battle these misunderstood problems and it doesn't make me an awful person for doing so.  Mental illness feels really bad, but it doesn't make me a bad person for experiencing it.  I don't want pity or special treatment, but I sure as hell don't want to be made fun of or avoided because of it either.  We all have something in life that we struggle with, a thorn in our flesh so to speak.  I have a few thorns, but so do you.  Let's all try to have some compassion for each other, okay?  



Wednesday, March 26, 2014

Panic Disorder: When Fear Overwhelms

Do you sometimes have sudden attacks of fear that last for several minutes? Do you feel like you are having a heart attack or can't breathe? Do these attacks occur at unpredictable times causing you to worry about the possibility of having another one at any time?
If so, you may have a type of anxiety disorder called panic disorder.

What is panic disorder?

People with panic disorder have sudden and repeated attacks of fear that last for several minutes or longer. These are called panic attacks. Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger. A person may also have a strong physical reaction during a panic attack. It may feel like having a heart attack. Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.
A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store or driving. Having panic disorder can also interfere with school or work.
Panic disorder often begins in the late teens or early adulthood. More women than men have panic disorder. But not everyone who experiences panic attacks will develop panic disorder.

What causes panic disorder?

Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. Some researchers think that people with panic disorder misinterpret harmless bodily sensations as threats. Researchers are also looking for ways in which stress and environmental factors may play a role.

What are the signs and symptoms of panic disorder?

People with panic disorder may have:
  • -Sudden and repeated attacks of fear
  • -A feeling of being out of control during a panic attack
  • -An intense worry about when the next attack will happen
  • -A fear or avoidance of places where panic attacks have occurred in the past
  • -Physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain.

How is panic disorder treated?

First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that another physical problem isn't causing the symptoms. The doctor may refer you to a mental health specialist.
Panic disorder is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating panic disorder. Your doctor should do an exam to make sure that an unrelated physical problem isn’t causing the symptoms.
Medication. Doctors also may prescribe medication to help treat panic disorder. The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.
Antidepressants are used to treat depression, but they also are helpful for panic disorder. They may take several weeks to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness. Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.
Some people do better with CBT, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.

What is it like to have panic disorder?

"One day, without any warning or reason, I felt terrified. I was so afraid, I thought I was going to die. My heart was pounding and my head was spinning. I would get these feelings every couple of weeks. I thought I was losing my mind."
"The more attacks I had, the more afraid I got. I was always living in fear. I didn't know when I might have another attack. I became so afraid that I didn't want to leave my house."
"My friend saw how afraid I was and told me to call my doctor for help. My doctor told me I was physically healthy but that I have panic disorder. My doctor gave me medicine that helps me feel less afraid. I've also been working with a counselor learning ways to cope with my fear. I had to work hard, but after a few months of medicine and therapy, I'm starting to feel like myself again."

This NIMH publication is in the public domain and may be reproduced or copied without permission. NIMH encourages you to reproduce it and use it in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated.



Tuesday, March 25, 2014

Generalized Anxiety Disorder: When Worry Gets Out of Control


Are you extremely worried about everything in your life, even if there is little or no reason to worry? Are you very anxious about just getting through the day? Are you afraid that everything will always go badly?
If so, you may have an anxiety disorder called generalized anxiety disorder (GAD).

What is GAD?

All of us worry about things like health, money, or family problems. But people with GAD are extremely worried about these or other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks.
GAD develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress.
People with GAD may visit a doctor many times before they find out they have this disorder. They ask their doctors to help them with headaches or trouble falling asleep, which can accompany GAD but they don’t always get the help they need right away. It may take doctors some time to be sure that a person has GAD instead of something else.

What causes GAD?

GAD sometimes runs in families, but no one knows for sure why some people have it, while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. Research suggests that the extreme worries of GAD may be a way for a person to avoid or ignore some deeper concern. If the person deals with this concern, then the worries of GAD would also disappear. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role.

What are the signs and symptoms of GAD?

A person with GAD may:
  • Worry very much about everyday things
  • Have trouble controlling their constant worries
  • Know that they worry much more than they should
  • Have trouble relaxing
  • Have a hard time concentrating
  • Be easily startled
  • Have trouble falling asleep or staying asleep
  • Feel tired all the time
  • Have headaches, muscle aches, stomach aches, or unexplained pains
  • Have a hard time swallowing
  • Tremble or twitch
  • Be irritable, sweat a lot, and feel light-headed or out of breath
  • Have to go to the bathroom a lot.

How is GAD treated?

First, talk to your doctor about your symptoms. Your doctor should do an exam to make sure that an unrelated physical problem isn’t causing the symptoms. The doctor may refer you to a mental health specialist.
GAD is generally treated with psychotherapy, medication, or both.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating GAD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and worried.
Medication. Doctors also may prescribe medication to help treat GAD. Two types of medications are commonly used to treat GAD—anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time.
Antidepressants are used to treat depression, but they also are helpful for GAD. They may take several weeks to start working. These medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time. Talk to your doctor about any side effects you may have.
It's important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults. A "black box"—the most serious type of warning that a prescription drug can have—has been added to the labels of antidepressant medications. These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts. Anyone taking antidepressants should be monitored closely, especially when they first start treatment.
Some people do better with CBT, while others do better with medication. Still others do best with a combination of the two. Talk with your doctor about the best treatment for you.

What is it like to have GAD?

"I was worried all the time about everything. It didn't matter that there were no signs of problems, I just got upset. I was having trouble falling asleep at night, and I couldn't keep my mind focused at work. I felt angry at my family all the time.
"I saw my doctor and explained my constant worries. My doctor sent me to someone who knows about GAD. Now I am taking medicine and working with a counselor to cope better with my worries. I had to work hard, but I feel better. I'm glad I made that first call to my doctor."
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Monday, March 24, 2014

Anxiety Week

This week I am going to focus some attention on something I happen to know a lot about firsthand: ANXIETY! Apart from having bipolar disorder, the rest of my diagnosis is based around different types of anxiety, specifically obsessive-compulsive disorder, panic disorder, social anxiety and a mild case of agoraphobia.  Last week I happened to see someone criticizing someone else on Facebook who had admitted to having panic disorder.  The "remedy" for this person was to simply "Buck up and do what you have to do" followed by "Everybody gets nervous.  You have to deal with it.  You think that is something new to people?  Folks just used to deal with it."
At first, these remarks angered me quite a bit.  I had to fight the urge to butt into this online conversation and say some things that may or may not have included "you stupid idiot!" But, after I calmed down, I began to think about this a little more rationally.  The truth is, most people know what anxiety feels like, but not everyone knows what it's like to have an anxiety disorder. And that's the real kicker; when you hear the word anxiety you think oh, that's normal, just take some deep breaths and get over it, but to have an actual disorder in this area means the normal reactions and remedies don't necessarily apply.  If you are familiar with the fight-or-flight response then you know that your body goes through certain physiological changes when faced with a potentially harmful situation.  Under the right circumstances, these changes can be helpful as they equip you with the energy and alertness to protect yourself. Fighting off a mugger or leaping out of the way of a car in just the nick of time are two examples of a good fight-or-flight response. But in some people (approximately 18% of Americans), this fight-or-flight response tends to show up at some really inappropriate times.  If I am sitting on the sofa watching a comedy, I personally don't think my body needs to prepare for attack, but sometimes it does anyway.  And, while a little anxiety can fuel your efforts to do well on a test or give a speech, a lot of out-of-control anxiety can make even the most basic tasks of daily life difficult.  For some, certain memories or social situations will trigger a sense of panic and lack of control.  Some people have an irrational fear of something (like a snake or closed in areas) that alter the places they are willing to go.  Some people get physcially ill at the mere thought of leaving their house.  These are just a few ways anxiety goes from being a normal every day response to something that creates a problem where there shouldn't be one.  
Each day this week I will address a different anxiety disorder in hopes that it will educate someone about what it really means to suffer from one.  But for now, I will tell you what it does not mean: It does not mean you are weak.  It does not mean you will never get better.  It does not mean you deserve the ignorant comments you will receive from time to time.  It does not mean you have reason to give up.  I know how hard it is to combat unruly anxiety.  Just when I think I have it beat, or at least subdued, it seems to come back full force.  Sometimes I notice the triggers and sometimes I don't.  Every day is a new trial of what works and what doesn't.  While I love a lot of the quotes that can be found regarding regular anxiety, I find that most of them don't really apply to things like OCD and panic attacks.  One quote I do find helpful is from Mark Twain: "Courage is resistance to fear, mastery of fear - not absence of fear."  It takes courage to live through a panic attack when every cell in your body is trying to convince you that you are dying from a heart attack.  It takes courage to relive flashbacks of violence or neglect.  It takes courage to listen to the internal dialogue of OCD and have the constant fear that you will do something bad or someone you love will die because you didn't wear matching socks that day. It takes courage to go through all of these things and so much more.  Our goal is to resist those fears, to master them so they no longer rule over us every second of the day.  It may feel like an impossible task, but I am certain that it can be done.  However, these disorders take a more aggressive treatment than just being "nervous" does.