Anxiety Really Sucks!

[Today marks the first ever guest post on Anxiety Really Sucks! I haven’t touched on the topic of depression yet, so I was happy to see this post from Jared Friedman.]

If you know that your depression has reached a point that you would call severe, keep reading!

Every day, millions of Americans struggle with the symptoms of depression that can be debilitating when left untreated. You are not alone. Depression, even when it has become severe, does not mean that you will be living like this forever. With appropriate tools, what you are experiencing can become manageable. Many people who find the right treatment program for them go on to lead the lives they wanted to live, and always knew they could live.

The fact that you are reading an article like this is a great sign. You recognize that your symptoms indicate depression and that you can no longer handle this on your own. You should be proud of yourself for looking into ways that can change your current life circumstances, and for acknowledging.

There are many resources that can help you answer the question:

I am severely depressed, how do I find help?

Step 1: Talk with a friend or family member who you trust.

Discuss how you have been feeling and that you can no longer manage the repercussions of your severe depression anymore. Ask this person to help you, first with finding the best set of treatment procedures, and then with whatever happens along the way during and after treatment. It is important to know that you are not alone in this process.

Isolation, which you may have already been participating in, only adds fuel to the fire of severe depression. What might seem like the hardest thing for you to do right now, may actually be what is the best next step in finding help to alleviate the severe depression that has taken over your life.

Step 2: Identify, if you can, the Cause or Causes of Your Severe Depression.

The more you can start to identify and understand what initially caused, and then perpetuated, your severe depression, the better equipped you are to make good decisions on how to treat the depressive symptoms.

Common causes of depression are:

• Loneliness
• Lack of social support
• Recent stressful life experiences
• Family history of depression
• Marital or relationship problems

• Financial strain
• Early childhood trauma or abuse
• Alcohol or drug abuse
• Unemployment or underemployment
• Health problems or chronic pain

If you can pinpoint one or a few of these, or other causes, of depression, then you can better communicate what you need to a trained professional. Also, if you can, talk about these and other causes of depression with the trusted friend or family member you chose in Step 1.

Step 3: Talk to a Trained Professional.

A formal assessment conducted by a mental health professional is the first external step in seeking the treatment that you need for your severe depression. Treatment has to be catered to your individual set of needs, and a mental health professional conducting an assessment will know how to distinguish that unique set of needs.

From there, the assessment conductor can discuss treatment options with you. Individual, group therapy, medications, forms of alternative treatment, an exercise regime, a shift in diet and lifestyle, and many combinations of these forms of treatment can be pieced together to find what will work best for you.

Step 4: Enroll and Participate in Formal Treatment.

Whatever you have decided will be most practical and helpful for you, based on what you and the mental health professional discussed, do it! Start every aspect that you can start right away. If you said that you will walk outside for thirty minutes each day, then start walking today. If a diet alteration was needed, take steps to change the way you eat today.

When a formal inpatient or outpatient treatment program is beginning, show up and be as present as you can. Try to step outside of your comfort zone to form connections with the treatment team, your individual therapist or counselor, and your fellow treatment mates.

Make an effort, as best you can, to believe that you will no longer be severely depressed.

Image author owned

Jared Friedman is quality improvement manager for Sovereign Health Group a dual diagnosis center providing help with mental health with depression treatment as well as addiction treatment.

I almost included a picture of a lotus pod (a potential trigger), but I thought that was cruel. Here are some cute puppies instead.

Earlier today, I was microwaving a leftover piece of salmon. When the salmon came out of the microwave, my entire body convulsed in a wave of fear and disgust. Little air pockets had formed on the edges of the salmon, giving the appearance of miniature tumors growing out of the piece of fish. Even now as I write this post, I am shuddering at the mental image.

Sounds pretty ridiculous, right? I have similar reactions to a host of other things – potato eyes, groups of large pimples, animals that have really noticeable pores. For a long time, I thought it was just a very peculiar personality quirk. But it appears that there may be something more to this intense aversion than I’d thought. My extreme reaction to these oddities indicates that I may be suffering from trypophobia, an intense fear of clusters of holes, bumps and other shapes.

I can trace back my own trypophobia to this awful children’s nature show I was watching one day at the age of 8 or so. In this particular episode, they were highlighting a species of frog (or some other amphibian) that lays eggs in the skin of its mate. The baby frogs pop out of pores in the parent’s back when they mature. EW. EW. EW. Ever since then, the idea of things growing on other things or holes in skin really, really, really creeps me out. Did I mention EW?

Here are some other things that may elicit a visceral response if you have trypophobia: wasp nests, ant holes, bubbles in dough, crumpets, lotus seed pods, bug tunnels, Aero bars, pockmarks, and Swiss cheese. You can check out this article in Popular Science for pictures of potential triggers. Be warned: I started crying after a minute of watching the video at the end. It’s not for the faint of heart.

At first I thought this was a big joke – it sounds too bizarre to be a real affliction. But specific phobias are actually quite prevalent, estimated to occur in about 5.3% of  U.S. adults at some point in their lives. More common specific phobias include arachnophobia (fear of spiders), acrophobia (fear of heights), and of course, agoraphobia. But beyond the common specific phobias lies a list of hundreds (maybe thousands) of uncommon phobias ranging from fears of clowns to fears of particular numbers.

While trypophobia is not officially recognized by the Diagnostic and Statistical Manual of Mental Disorders, it has a definite online presence. The condition has a dedicated Facebook page with over 7000 members and an active online forum. Maybe some day the American Psychiatric Association will recognize trypophobia as a psychiatric illness. For now, we will have to rely on online communities for support.

An affliction like trypophobia brings up an interesting issue in modern psychiatry – when does a behavior transcend the line of normalcy and become pathological? In other words, when is a phobia considered an illness and when is it just a personality quirk?

The DSM of the American Psychiatric Association stipulates that a condition must interfere with day-to-day life before being considered a psychiatric illness. In my case, trypophobia does not really interfere with the inner workings of my life. Clusters of holes and other shapes don’t actually prevent me from doing anything. I may experience extreme discomfort when I see these images, but at the end of the day, it’s not really something that I think about very often.

But that’s just my experience. For many people, trypophobia could become an incredible burden. We all experience the world in very different and unique ways; the experience of mental illness is no different.

Do you suffer from trypophobia? I’d be interested to hear your reactions to some of the triggering images. I know I can’t look at a lotus pod seed for more than a couple seconds without having an intense visceral reaction.

I’m not a real big sports fan. I avoid team sports at all costs, I find the gym to be a scary environment, and I cringe when someone asks me if I “saw the game last night” (what game?). I think my natural aversion to everything sports is at least partly responsible for the fact that I’ve never been as fit as I’d like to be. I rely on internal motivation to keep myself exercising every day, which is a lot tougher than I’d like it to be. That’s why I tried Tribesports – and why I suggest that you give it a try too.

First off, lets get the obvious stuff out of the way. Exercise is good for you. Many studies have explored exercise as an effective treatment for anxiety disorders and life stress. Research suggests that even small amounts of exercise can be beneficial in the treatment of anxiety and other mental illnesses. But this post isn’t meant to be a lecture on getting more exercise.

No, today I wanted to explore how I’ve overcome my natural aversion to organized exercise. See, I don’t like joining exercise classes because I find them intimidating, and thanks to my wonderful social anxiety, I’m constantly imagining how idiotic I must look flailing around like a dead fish in a pair of neon red shorts. Exercise classes make me more anxious, which kind of defeats the purpose in my opinion.

But being in a social environment is encouraging. If you’ve taken intro psych, maybe you’ve heard of social facilitation, the tendency to perform better on simple tasks when you’re surrounded by other people. When you’re alone, you can do as much (or as little) exercise as you’d like, and no one will know the difference. But when you’re out in public, you know other people are watching you, subtly trying to run just a minute longer than you or lift just a few pounds more than you (or is that just me?).

Enter the world of Tribesports. You create a profile, join tribes, engage in athletic challenges, and watch the encouragement roll in…all from the comfort of your home. It’s like being part of a network of virtual fitness classes, except you work at your own pace. There are hundreds of tribes to choose from, each with different focuses – from trail running to kickboxing. You can take challenges, like “do 10 push-ups every day for a week” or “run your first 5k”.

Tribesports is kind of like Facebook for athletics. You can follow people and watch their progress. Instead of “liking” status updates, you “encourage” activities and progress. Taking a “challenge” is a great way to become accountable for your exercise – all your Tribesports followers are watching to see when you’ll be able to hold the bridge for 5 minutes. You even get to level up as you progress with your account. The more challenges you complete, followers you accumulate, and tribes you join, the higher your ranking on the scoreboard.

I’m not usually one to promote individual sites like this one, but honestly Tribesports has renewed my interest in general fitness. Instead of forcing myself to get on the treadmill, I’m now excited to be able to push my athletic limits just to be able to click “Challenge Complete” and see my rankings improve. “Drop and do 15 push-ups right now.” You’re on!

In our technologically driven society, what could be better than a social media site geared towards exercise? I’ve already found Tribesports to be more addictive than Facebook . It’s a win-win situation – you have another social media site to join, and you’re exercising more. Give it a try – there’s really nothing to lose.

Have you tried Tribesports before? Tell me what you think! Are you as addicted as I am?

Promote better sleep hygiene to cut down on the sleepless nights.

I think I was born to be an insomniac. Starting in my preteen years, I developed a complete aversion to falling asleep before midnight. I also developed this amazing talent where I feel sleepy all day and perk up as soon as I should be going to sleep. I can spend hours upon hours on Facebook, but only after the sun sets. I also tend to discover new passions when the rest of the world is asleep – it’s 2 am and I just have to learn to speak Japanese by tomorrow morning!

So how does a guy like me get any sleep? Well, the answer to that question is still in the makings. But I can offer you some tips that I’ve found helpful over the years in my quest to overcome my nocturnal nature and embrace the wonders of sleep hygiene.

How to avoid BAD sleep hygiene 

1. Do NOT consume caffeine close to bedtime. Obvious, right? Well, I bet you’re still doing it. I’ve spent many a night lying in bed with my eyes glued open, staring at the ceiling fan as I count the number of pages I have to read in the next week because of that extra cup of coffee I just had to have at 10 pm. There are many alternatives to caffeine to give you a little energy boost – I recommend that you become familiar with them. 

2. Do NOT go to bed after drinking copious amounts of alcohol. This is another common tip, but you’ve probably ignored it because it sounds paradoxical. Alcohol makes you sleepy, right? Sure, in the short term. But if you’re looking to get a good night of sleep, don’t turn to alcohol. It may put you to sleep faster, but once it is metabolized from your system, it will disrupt your sleep. Alcohol has a pretty complex relationship with sleep, so it’s best to just not mix the two.

3. Do NOT spend hours on the computer right before sleep. You’ve been told a million times before – don’t surf the web before bedtime. But how often do you listen? It’s tough, because often, our computers are what keep us entertained. Shut off the computer at least two hours before bed, and pick up a book or take a bath or something. Life goes on even when you’re not constantly checking your email.

4. Do NOT spend time in bed when you’re not sleeping. As much as we love watching TV, surfing the web, and playing Skyrim while lying in our comfy beds, these behaviors perpetuate sleep problems. You should keep your bed for two things: sleeping and sex. That way, you will develop a stronger association between lying in bed and falling asleep.

5. Absolutely, whatever you do, do NOT plan for the future right before bed. This is often my biggest downfall. I’m up late, worrying about something, and so I decide to make a plan. Sounds reasonable, right? WRONG. Planning for the future is very stimulating and will keep you up all night obsessing over details. “Maybe I should read that chapter Tuesday instead of Wednesday, and then that will leave Wednesday open for finishing my essay, oh but wait, I also have to start my proposal outline, so maybe I should finish my essay Tuesday, and oh….damn it, I’ll just get out of bed and start now!” Insomnia: 1. Justin: 0.

How to promote GOOD sleep hygiene

6. Stay physically active throughout the day. While the exact relationship between sleep and exercise is not really clear, years of research have shown that physically active people do sleep better, on average. Whatever the real cause, I find that I sleep much better when I’ve been going for regular runs or hitting the gym at least 3 times a week. If you’re not an exercise fanatic, don’t worry. Physical activity can be as simple as walking briskly with your dog or doing 20 crunches before a meal.

7. Stay mentally active throughout the day. Part of the reason some of us can’t sleep at night is because we’re just not active enough during the day. Yes, physical activity is a big part of that, but something that often goes overlooked is mental activity. Activities that require intense concentration or problem solving skills wear down your energy reserves just as much as exercise. Instead of watching three hours of TV in your free time, try playing a video game, writing poetry, or whatever you enjoy doing that requires brain power.

8. Try to have a regular sleep-wake cycle. I always want to scream when someone shares this tip with me. Get up and go to bed at the same time EVERY DAY? Are you delusional? But alas, from personal experimentation (and I use the word “experimentation” in the loosest sense for you science buffs), I’ve found that I do in fact sleep better when I stick to a fairly regular sleep-wake cycle. Go to bed at 12, wake up at 9. Repeat. Repeat again. And so on. Eventually, your brain starts learning when you should be falling asleep and when you should wake up. It sucks, I know. But give it a try.

9. Practice relaxation techniques. My last post was about practicing mindfulness in conversations. Well, lo and behold, I will argue again for the benefits of mindfulness – one of which is better sleep. Practicing some form of mindfulness (meditation, Tai Chi, yoga, eating without distractions, etc.) every day will help you sleep better.

10. Get lots of natural light throughout the day. If you weren’t aware, your entire body works on a close-to-24-hour cycle. This is called your circadian rhythm. It’s partially controlled by your suprachiasmatic nucleus (SCN), a part of your hypothalamus that is directly connected to your eyes and thus senses light. Your SCN controls the release of the hormone melatonin, which you may know is involved in sleep. To make a long story short, get lots of natural light throughout the day and avoid getting any bright light for a couple hours leading up to bedtime in order to keep your circadian rhythm in check. This is a simple way to listen to take advantage of your body’s natural sleeping mechanisms to overcome insomnia.

Were these tips helpful for you? Have you already heard all of them? Do you have any other tips? Leave me a comment; I’m interested to see your answers.

Are you being mindful in conversations?

If I haven’t mentioned it before, I have social anxiety. I’m afraid of things like having to make small talk and being assertive. My social fears often prevent me from fully engaging in conversations. I fall into self-perpetuating cycles; I’m so anxious that I won’t be able to hear what someone is saying that I completely miss what they were saying because I was so worried I’d miss what they were going to say. I know it sounds ridiculous, and it is, but that’s my brain for you (I’m sure many of you can relate!).

This issue leaves me with two problems: I’m not actively partaking in conversations, and I’m anxious as hell about it. I would love to just turn off my anxiety, but alas, that is not a realistic solution. It seems the only other way to bypass the problem is to force myself to engage in the conversation. Well how could I do that, you ask? The answer is through mindfulness.

If you’ve never heard the term before, mindfulness is about staying focused on the present and refraining from judging your thoughts and feelings. Being mindful really just means living life as it is happening, rather than worrying and obsessing over things that have happened or may (or may not) happen in the future. It’s a simple concept, but an incredibly difficult skill to master. Activities like yoga and Tai Chi draw on principles of mindfulness.

Being mindful in conversation requires you to focus on what the other person is saying. This sounds quite obvious – it’s what you’re already doing, right? My bet is no. Most people are often caught up in their own thoughts while in conversation. We all want to sound interesting and intelligent, so instead of actually listening to what the other person is saying, we often are planning what we’ll say next or trying to guess how this person will end their sentence. Sometimes, we’ve even moved past the conversation in our minds, and we’re planning what we’re going to do when it’s over (“As soon as he’s done jabbering away, I’m going to go get Starbucks”).

We live in a fast-paced world. It seems like we never have enough time in the day to get half of our to-do lists done. And we make it very clear to the rest of the world – we’re constantly checking our phones, storming around like we’re always late for something, honking our horns when someone isn’t speeding. I’ve argued before for the benefits of relaxation and slowing things down. Mindfulness is the most simple way to go about being more calm.

The next time you’re having a lengthy conversation with a close friend or family member, here’s what I want you to do:

• Let go of your worries and focus on what is being said. Instead of worrying about bills that need to get paid, notes that need to be read, and calls that need to be returned, just focus on the conversation. Being mindful in a conversation requires that you focus all your attention on what your conversation partner is saying. You shouldn’t be noticing people walking by or listening to music off in the distance.
  
• Acknowledge when your mind wanders and bring it back. If your thoughts do wander, acknowledge it, and bring yourself back to the conversation. You will probably find your mind wandering quite often; that’s okay. Just keep bringing yourself back to the conversation.  
• Speak in turn. If you do have social anxiety, you may not have too much problem with this one, but it’s worth noting anyway. Wait for your turn in the conversation – don’t interject if you think your point is more important. Ideally, you should wait until your conversation partner is done talking before you even think of your response. If you’re formulating your own thoughts while your partner is talking, then you’re not really listening, are you?
• Don’t judge yourself if you can’t keep focus. If your mind does wander or you can’t help but think about what you want to say, that’s perfectly okay. Mindfulness isn’t a skill you learn over night. Accept that your thoughts wander from time to time, and don’t judge yourself for it. Mindfulness is also about acceptance: acceptance of our flaws and quirks that make us unique.
• Try to appear calm. If you’re socially anxious, having conversations may not make you overly calm. But appearing calm is different altogether. What I mean is that you shouldn’t be twitching uncomfortably or fidgeting like you’re bored. You also shouldn’t be checking your phone every few minutes or responding to texts. I don’t know when we got to the point in our society where texting while have a serious conversation with someone else is considered appropriate, but I don’t like it (even though I’ve definitely done it before).

Being mindful is an incredible skill to master. It takes time, but you’ll see it can used in any aspect of your life. Mindfulness has many medical benefits, and for years it has been encouraged for patients of all different types of mental illness. I suggest that you find a mindfulness resource online and really try it. If you can practice mindfulness for a few moments every day, I really think you’ll see a difference.

Are you mindful in conversations? I would be interested to hear if any of you do this unconsciously.

Some days, it seems like you can just never get a break. You know, those days when a passing car splashes muddy water into your face, you’re late for work, and you spill your coffee all over your boss? Or maybe the bus breaks down on your way to a final exam, you sprain your ankle running to get there in time, only to realize that you forgot your student ID card and can’t get into the building. Most of the time, you can look back on such days and find humor in them.

But sometimes you can’t. Like this one day, a few months ago, when I was just starting to get daily panic attacks for the first time, and I’d hit my breaking point. I remember that day vividly – I was walking around in circles, avoiding going back to my apartment. I made my way up to a park on a hill in the middle of the city, hidden behind an array of dense trees. And I contemplated my suicide.

What saved me was a quick call to my parents. They forced me to talk about what was really bothering me, to get to the root of the problem, and they encouraged me to use the coping techniques I’d learned in therapy. They also got me crying – which it turns out was all I really needed. I could have easily thrown away years of treatment and self-discovery all in a sudden moment of weakness, but it was my social support network that kept me grounded. It was the accountability that comes with having close friends and family that saved me.

I have a great social support network. I have two incredibly understanding parents who have seen me at my worst and have never judged me. I have amazing friends scattered across the country who treat me with more respect than I probably deserve. I even have outstanding authority figures in my life – bosses, supervisors, counselors, advisers. And it’s these people who have kept me on my path to recovery.

Social support is a crucial element of any journey to recovery. Our support network encourages us to stick to our treatment plan, lends a helping hand we need something we can’t do for ourselves, and provides us with one or many shoulders to cry on if need be. Going beyond the obvious benefits, social support also has a biological basis too. Socializing facilitates the release of a hormone called oxytocin that helps us stay calm and relaxed. Low levels of oxytocin may contribute to illnesses like depression and anxiety.

Social support acts as a sort of buffer against stress and illness. It has been linked to lower rates of heart disease, lower stress hormone release, and better immune function. Unequivocally speaking, science has shown that having a support network is crucial to any recovery program – whether it be from mental illness or physical illness.

So why don’t we all open up about our illnesses? Usually the answer surrounds stigma (I’ve written about what perpetuates stigma before). Our society stigmatizes mental illness, and thus we fear being judged if we open up. We fear losing friends, becoming estranged from family members, maybe even losing jobs. It’s a scary thing to open up and let very personal parts of yourself out. But hopefully we know and trust those people that we’ve invited into our lives enough to be able to share ourselves.

Here are a few tips that you might find useful in your quest to broaden your social support network.

• Start small. Opening up about your illness is never an all-or-nothing process. If you’re not comfortable with labels, then just talking about how you get anxious from time to time is a great start. Tell your mom that it makes you uncomfortable to meet new people. Open up to your best friend about your fear of public transportation. Just getting your emotions out on the table can be incredibly cathartic.
  
• Practice online. If you’re not ready to talk about your illness in person, then start by joining an internet forum to discuss your thoughts and feelings (you can try Anxiety Zone or just do a quick Google search).
• Role play with your therapist. If you happen to be receiving professional help, role playing can be a great way to work out fears you have. Your therapist will likely have a lot of insight into possible reactions you may get and how to deal with them.
• Send an email. If you happen to have social anxiety like me, then having a serious emotional conversation in person can be difficult even if you practice online first. An easier approach would be to send your thoughts by written word (email, Facebook, or even snail mail if you’d like). That way, you have more time to choose your wording and you’re giving the other person time to digest the information and decide on an appropriate response.

Having a social support network is incredibly important if you want to stick to your journey to recovery. If you’re not ready to open up to your own support network about your anxiety, then feel free to leave me a message through my contact page – I read and respond to all my messages!

Silence spreads stigma.

Yesterday, I opened up to the world of Facebook and told my story of mental illness. I was astounded by the overwhelming response I received. It turns out that many people I know can relate quite readily to my story. For some reason, this shocked me. But why? According to the Canadian Mental Health Association, about 20% of Canadians will experience a mental illness in their lifetime. Similar numbers are reported in other developed countries. That’s about 1 in 5 people, a statistic that I’ve heard many times before. So why should it shock me that personal friends of mine had suffered mental illness as well?

I think the answer lies in our society’s obsession with statistics. Numbers give us facts, concrete ideas about how the world works. “1 in 5 people will suffer from a mental illness.” That’s a neat fact to know. It sounds like it’s getting some sort of point across – look, mental illness exists! But the real issue is that it doesn’t seem to be getting any point across. In a 2008 survey conducted by the the Globe and Mail, 42% of respondents said they would no longer socialize with a friend diagnosed with a major mental illness. Almost half of the respondents believed that mental illness is just an excuse for “poor behavior and personal failings.”

Statistics are cold. You can’t relate to a statistic, you can’t talk to a statistic, you can’t find comfort in a statistic. Our obsession with numbers creates an almost tangible veil over society. We appear to be open and accepting, but we’re not. We think that by spreading around how common mental illness is, we’ve done our part in fighting stigma – there, the battle’s won.  But that couldn’t be farther from the truth. Knowing how common mental illness is without being able to reach out and talk about it leaves us feeling even more alone than before.

I don’t want to sound like I’m criticizing anyone. I am grateful for every stigma campaign that exists, and I’m happy those numbers are so widely known. At least mental illness isn’t just the ever-present elephant in the room, looming in the corner, but never being mentioned. We do talk about it – just not in the right way. At fault is social desirability: our other obsession. Everyone wants to appear like they’re “doing the right thing,” but no one wants to open up and share their secrets. Sharing personal parts of yourself leaves you open for judgement and hurt. We go to great lengths to avoid these things. We share personless facts, but not personal stories.

And hey, who can blame us? Does anyone really like being naked in front of the world, no secrets to hide behind? Of course not. Many individuals suffering from a major mental illness are simply not able to speak up. It’s too hard on an already damaged psyche. Some of us can’t speak up for fear of losing work, losing friends or losing children. But without these stories, our society falls into the dark. We see the mentally ill as the homeless people on the streets, as the perpetrators of vicious crimes, and as characters in our movies. We don’t see them as our friends, our mothers, and our first-grade teachers.

This is not a rally to get everyone suffering from a mental illness to write a memoir. This is not a lecture on “doing the right thing.” (What is the right thing anyway?) All I want is to open a dialogue. Even if you don’t have a diagnosable mental illness, talk about your mental health with your friends. Stop using words like “bipolar”, “panic attacks” and “schizophrenia” if you’ve never experienced them – recognize that these are serious conditions. Talk about those times when you’ve felt depressed after being dumped or losing a grandparent. Open up about that panic attack you had that one time – but please don’t overuse the term!

Communicate. We’re social creatures, and yet sometimes communication is what we fear most. Nothing will ever change if we don’t take action. I urge you not to hide in the dark. There’s no need to open up to the world at large, but at least tell your close friends and family. Before we can understand a problem, we must first identify it.

If you want to share your story with me personally, visit my contact page and drop me a line. I will keep everything confidential – and I’m told I’m a pretty good listener.