What Is Anxiety?
Anxiety encompasses feelings of worry, nervousness, or dread. Although unpleasant, occasional bouts of anxiety are natural and sometimes even productive: By signaling that something isn’t quite right, anxiety can help people both avoid danger and make important and meaningful changes.
But persistent, pervasive anxiety that disrupts one’s daily life, whether at school, work, or with friends, can be the mark of an anxiety disorder. Anxiety disorders manifest in different ways and are often diagnostically distinct. Generalized anxiety disorder is a chronic state of severe worry and tension, often without provocation. Panic disorder refers to sudden and repeated panic attacks—episodes of intense fear and discomfort that peak within a few minutes. Obsessive-compulsive disorder is marked by intrusive thoughts or compulsions to carry out specific behaviors, such as handwashing. Post-traumatic stress disorder may develop after experiencing or witnessing a traumatic event.
Anxiety is often accompanied by depression, and the two share an underlying genetic architecture
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Beyond genetics, childhood experiences such as early trauma or parental overprotection can play a role in forming an anxious disposition. In people with anxiety disorders, the brain circuitry that controls the threat response seems to go awry: The amygdala, a structure that detects danger, can become overactive, triggering a threat where none really exists.
Anxiety is often treated successfully using therapy, medication or both. Cognitive-behavioral therapy is one of the most effective options, in which patients learn to identify problematic thought patterns and change how they respond. Mindfulness meditation is another effective technique for some.
Individuals suffering from anxiety may feel restless, on edge, and irritable. They may have difficulty concentrating or controlling their emotions. Physical symptoms can also include fatigue, trembling, trouble sleeping, stomachaches, headaches, and muscle tension.
Anxiety often involves worrying to an intense, excessive degree. Those worries can apply to any aspect of life, from social situations and family dynamics to physical health and professional concerns.
A person’s angst or dread can be drastically out of proportion to the actual challenges he or she is facing. People may also irrationally believe that the worst-case scenario is inevitable.
Anxiety disorders can often be addressed successfully with psychotherapy and/or medication.
People may engage in talk therapy tailored to their specific anxieties. Cognitive behavioral therapy is one of the most effective options for anxiety disorders. The practice teaches patients to challenge distorted thought patterns to change how they respond. Social anxiety can be mitigated by exposure therapy, in which patients are safely and gradually exposed to their fears so they no longer avoid them.
Medication can help patients control their anxiety, but they cannot cure the underlying condition. Clinicians may prescribe fast-acting benzodiazepines for limited periods of time. Beta-blockers offer another short-term solution, as they can curb troubling symptoms such as racing heartbeat or trembling hands for a specific event. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)or less frequently tricyclics, are used as a longer-term treatment and can take a few weeks or months to work.
As with all medications, patients should consult a doctor to understand the side effects of a particular drug and to safely transition on and off of the medication.
Lifestyle changes can help people who experience feelings of anxiety but who don’t meet the clinical threshold for a diagnosis. Habits such as exercising, sleeping well, and limiting the amount of caffeine and alcohol consumed are all be helpful.
Increasingly, researchers argue that mindfulness meditation is a successful technique as well. Taking deep breaths, observing one’s thoughts without judgment, and acknowledging the limits of one’s control can reduce feelings of tension.
Identifying the circumstances that trigger one’s anxiety, and then pushing back against anxious or irrational thoughts, can help to feel better prepared for the future
(Content Courtesy: Psychologytoday)
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Am I Depressed? 6 Signs You Should Know About
- You’ve been feeling low or irritable for most of the day, every day for two weeks or more. You might have found yourself worrying about past or future events for long periods of time, or simply feeling sad, cross or tearful. Sometimes it’s hard to recognize a gradual change – have others noticed that you don’t seem your usual self?
- You’ve lost interest in activities that you used to enjoy. Perhaps you have been seeing less of your friends or family recently, have stopped going to the gym, or cooking balanced meals. This is really about recognizing changes in what’s normal for you – no one is saying you have to exercise five times a week or eat your greens, but changes in your routine can offer concrete indications that your mood is changing.
- You are struggling to concentrate. You might notice that you struggle to focus when reading or watching television, for example, or to follow the thread of a spoken conversation. This could be affecting your performance at work, or limiting your ability to perform routine tasks such as food shopping. Again, we are looking for a change in what’s normal for you, so if concentration has always been something you find tricky there is little cause for concern.
- Your energy levels are depleted. Feeling exhausted is one of the most debilitating effects of depression. Summoning the energy to do anything – even getting out of bed – can be a huge effort, and you might find yourself feeling frustrated at not being able to do things that used to be seemingly effortless.
- Your sleeping and/or eating patterns have changed. Often, it is said that a reduced appetite is a sign of depression. In fact, eating more than usual can be just as indicative of low mood as eating less. The same goes for sleeping: both sleeping more and sleeping less are warning signs that you might have depression. Early morning waking – that is, waking several hours before you would normally expect to, and struggling to get back to sleep – is another common sign
- You’ve been preoccupied with feelings of guilt or worthlessness. This might be a case of feeling like you’re in the wrong or that you’ve let people down, or that you are a burden on those who are close to you. Often, these ideas are disproportionate to the event that has triggered them. A good way to test whether these ideas might be out of proportion is to ask a trusted friend or family member whether they would feel the same way in your shoes.
In three words I can sum up everything I’ve learned about life: it goes on.
– Robert Frost
Bipolar Disorder
Bipolar disorder, also known as manic depression, is a chronically recurring condition involving moods that swing between the highs of mania and the lows of depression. Depression is by far the most pervasive feature of the illness. The manic phase usually involves a mix of irritability, anger, and depression, with or without euphoria. When euphoria is present, it may manifest as unusual energy and overconfidence, playing out in bouts of overspending or promiscuity, among other behaviors.
The disorder most often starts in young adulthood, but can also occur in children and adolescents. Misdiagnosis is common; the condition is often confused with attention-deficit/hyperactivity disorder, schizophrenia, or borderline personality disorder. Biological factors probably create vulnerability to the disorder within certain individuals, and experiences such as sleep deprivation can kick off manic episodes.
There are two primary types of bipolar disorder: Bipolar 1 and Bipolar 2. A major depressive episode may or may not accompany bipolar 1, but does accompany bipolar 2. People with bipolar 1 have had at least one manic episode, which may be very severe and require hospital care. People with bipolar 2 normally have a major depressive episode that lasts at least two weeks along with hypomania, a mania that is mild to moderate and tends not normally require hospital care.
The defining feature of bipolar disorder is mania. It can be the triggering episode of the disorder, followed by a depressive episode, or it can first manifest after years of depressive episodes. The switch between mania and depression can be abrupt, and moods can oscillate rapidly. But while an episode of mania is what distinguishes bipolar disorder from depression, a person may spend far more time in a depressed state than in a manic or hypomanic one.
Hypomania can be deceptive; it is often experienced as a surge in energy that can feel good and even enhance productivity and creativity. As a result, a person experiencing it may deny that anything is wrong. There is great variability in manic symptoms, but features may include increased energy, activity, and restlessness; euphoric mood and extreme optimism; extreme irritability; racing thoughts, pressured speech, or thoughts that jump from one idea to another; distractibility and lack of concentration; decreased need for sleep; an unrealistic belief in one’s abilities and ideas; poor judgment; reckless behavior including spending sprees and fast driving, or risky and increased sexual drive; provocative, intrusive, or aggressive behavior; and denial that anything is wrong.
The duration of elevated moods and the frequency with which they alternate with depressive moods can vary enormously from person to person. Frequent fluctuation, known as rapid cycling, is not uncommon and is defined as at least four episodes per year.
Just as there is considerable variability in manic symptoms, there is great variability in the degree and duration of depressive symptoms in bipolar disorder. Features generally include lasting sad, anxious, or empty mood; feelings of hopelessness or pessimism; feelings of guilt, worthlessness, or helplessness; a loss of interest or pleasure in activities once enjoyed, including sex; decreased energy and feelings of fatigue or of being “slowed down”; difficulty concentrating, remembering, or making decisions; restlessness or irritability; oversleeping or an inability to sleep or stay asleep; change in appetite and/or unintended weight loss or gain; chronic pain or other persistent physical symptoms not accounted for by illness or injury; and thoughts of death or suicide, or suicide attempts.
The symptoms of mania and depression often occur together in “mixed” episodes. Symptoms of a mixed state can include agitation, trouble sleeping, a significant change in appetite, psychosis, and suicidal thinking. At these times, a person can feel sad yet highly energized.
Both genetic and environmental factors can create vulnerability to bipolar disorder. As a result, the causes vary from person to person. While the disorder can run in families, no one has definitively identified specific genes that create a risk for developing the condition. There is some evidence that advanced paternal age at conception can increase the possibility of new genetic mutations that underlie vulnerability. Imaging studies have suggested that there may be differences in the structure and function of certain brain areas, but no differences have been consistently found.
Life events including various types of childhood trauma are thought to play a role in bipolar disorder, as in other conditions. Researchers do know that once bipolar disorder occurs, life events can precipitate their recurrence. Incidents of interpersonal difficulty and abuse are most commonly associated with triggering the disorder.
Because bipolar disorder is a recurrent illness, long-term treatment is necessary. Mood stabilizer drugs are typically prescribed to prevent mood swings. Lithium is perhaps the best-known mood stabilizer, but newer drugs such as lamotrigine have been shown to cause fewer side effects while frequently obviating the need for antidepressant medication. Used alone, antidepressants can precipitate mania and may accelerate mood cycling. Getting the full range of symptoms under control may require other drugs as well, either short-term or long-term.
Nutritional approaches have also been found to have therapeutic value. Studies show that omega-3 fatty acids may help lower the number or dosage of medications needed. Omega-3 fatty acids play a role in the functioning of all brain cells and are incorporated into the structure of brain cell membranes.
Work and relationship problems can be both a cause and effect of bipolar episodes, making psychotherapeutic treatment important. Studies show that such treatment reduces the number of mood episodes patients experience. Psychotherapy is also valuable in teaching self-management skills, which help keep one’s everyday ups and downs from triggering full-blown episodes.
Most people with bipolar disorder develop the condition in their late teens or early adulthood, although symptoms can appear in children as young as six years old. Symptoms in children and teens are similar to those in adults and include the condition’s hallmark mood swings. In some cases, children may display symptoms of irritability.
Children with bipolar disorder undergo extreme changes in mood and behavior, feeling unusually happy and energetic during manic episodes and becoming very sad and less active during depressive episodes. Symptoms are often severe enough to interfere with school activities and personal relationships and can lead to self-destructive behavior.
Treatment for bipolar disorder in children and teens may include medication and family-based therapy.
Bipolar disorder can wreak havoc on a person’s goals and relationships. But in conjunction with proper medical care, sufferers can learn coping skills and strategies to keep their lives on track. Bipolar disorder, like many mental illnesses, is sometimes a controversial diagnosis. While most sufferers consider the disorder to be a hardship, some appreciate its role in their lives, and others even link it to greater creative output.
While the depression of bipolar disorder is hard to treat, mood swings and recurrences can often be delayed or prevented with a mood stabilizer, on its own, or combined with other drugs. Psychotherapy is an important adjunct to pharmacotherapy, especially for dealing with work and relationship problems that typically accompany the disorder. Clinicians are well aware that there is no one-size-fits-all cure: An individual with a first-time manic episode will not be the same as an individual who has lived with bipolar for a decade.
(Content Courtesy: Psychologytoday)
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