Understanding Unspecified Depression Type Diagnosis

A doctor holding red stethoscope.

The last seven years of my medical history have been confusing. When I looked over my medical summaries, I noticed I was diagnosed with depression, in some way, shape, or form for these years. I guess since I declined to take prescription medicines for my depression, the doctor(s) may have just decided to not look further into my issues. Maybe they just thought I was resistant, or crazy.

Lately, I’ve been getting stressed at work. In most cases, I think I can manage, but sometimes things are beyond my control. For instance, there are times we are required to work overtime- 12 days straight. Also, the expectations of my company keep changing. More is demanded at times, at other times, I feel bored, unchallenged and unappreciated.

In any event, I knew my previous medical practice wasn’t good for me. I felt like I needed a doctor with good reviews. I researched the doctors in my insurance directory and discovered one in town that was a D.O., instead of an M.D. The difference is an M.D. is a Doctor of Medicine, while a D.O. is a Doctor of Osteopathic Medicine. From my understanding, there is very little difference as far as certification and training:

“While osteopathic programs tend to be less competitive than allopathic medical schools, students in both programs receive similar training. However, osteopathic schools have a stronger focus on alternative therapies, holistic medicine, and disease prevention.” (www.gulfbend.org)

  • This factor appealed to me since I am one that has been resistant to taking prescription medications.
  • I went to the new doctor for convenience (he is located in town, as opposed to my previous doctor, who was about 12 miles from my home).

I went to establish a new doctor, but I discovered I have ectopic heartbeats, or, extra heartbeats. Soon, I will have to wear a Holter monitor to find out more information.

Also, my diagnosis included:

  • Anxiety
  • Depression, unspecified depression type
  • Fatigue, unspecified type.

Depression, unspecified depression type is often used at the beginning of medical diagnosis and treatment. This category is used when there is not yet enough information. Once the doctor has my information, he or she may proceed to choose a more specific condition.

As far as the other conditions are concerned, I suppose I could worry. I’ve read that PVC’s- Premature Ventricular Contractions, can be induced by anxiety. Sometimes the PVCs are nothing to worry about if all else is normal. It could also be a sign of underlying heart disease.

My new doctor asked me if I felt any fluttering in my chest, to which I replied that I hadn’t noticed. I’ve been so consumed about mood disorders, I took for granted the fact that just because I have had a long history of anxiety and depression, doesn’t mean that I can’t have other problems. I’ve been accustomed to “invisible” problems for so long that I ignored my “visible” problems.

Such is the case for me. I become blinded by my own thought patterns. I really wanted my doctor to look into this aspect of my health too.

References:

  1.  https://medschool.ucla.edu/body.cfm?id=1158&action=detail&ref=1019
  2. https://www.nchmd.org/education/mayo-health-library/details/CON-20376741
  3. https://www.gulfbend.org/poc/view_doc.php?type=doc&id=12992&cn=5
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A Simple Lesson on Nurturing Ourselves

Lessons On Nurturing

I believe many people regard taking care of themselves as a frivolity, or an act of selfishness. Unhealthy demonstrations, disguised as “self-care” are, indeed, selfish and even destructive. Unhinged shopping sprees may give me a temporary lift, but it isn’t the soulful lift I need to manage myself and others. However, taking the time to replace the drawer of missing and tattered socks isn’t selfish. Not all acts of shopping for myself are selfish.

Bad Lessons

  • The quality of love and care that one gives is circumstantial and conditional.
  • Nutrition is unimportant- grab some junk food and soda.
  • If somebody is behaving badly, keep out of their way or behave badly in return (watch for signals).

Not Trained To Think of Myself As Important

As children, my sister and I never got new clothes or even used clothes very often. Sometimes we got a bag of clothes from an aunt or grandparent. I’m quite sure I never considered the bag of bell-bottom corduroys as a gift or a curse. I got through my high school years wearing jeans and t-shirts- black t-shirts, concert t-shirts, one-size-fits-all shirts. I was happy wearing those clothes and it was very low-maintenance. I still do not treat myself by way of buying clothes, although I am very much in need of the most essential of clothing, jeans, and t-shirts. I long for some dressy clothes sometimes but never make the effort to buy myself such things.

Diet & Nutrition- Taking Care of The Physical Body

Those who lack a strong support system especially need to manage self-care in a balanced fashion. We should not turn to mere substitutes or addictions, no matter how benign they may appear. I am guilty of using caffeine as a crutch. This is probably a factor in my erratic moods and weak food choices (carbs, lots of carbs). A steady stream of caffeine and a depletion of vital, cleansing water leads to an abundance of empty calories and garbage in the body. Perhaps my mood swings are the only way my body can adapt to balancing all the garbage I eat and all the mindless clutter I am consumed by each day? This is something I will explore further.

Leisure Time

Let’s face it- men have their “man-caves”, and some ladies like to get manicures. And then we have the rest of the world. These are ordinary people taking care of their families, working a job, attending school, etc. They may lack the means- time, energy or money- to enjoy “leisure” activities. It is essential to carve out even a little bit of time for yourself each day, whether you have to stay up after the kids go to bed, or get up earlier to go for a walk, read, or whatever else feeds your soul.

Being busy in life sometimes makes us lose ourselves, which can cause us to feel bitter, devoid and empty. Often, it is not until a crisis or conflict when it becomes apparent that self-care is as important as the care we provide for others.

Unpacking the Baggage of the Past

Issues from “the past”, people from our past and messages from the past continue to plague us subconsciously. Both solitude and good company can help us “recharge” and make sense of the world around us. I have suffered frequent episodes of depression in my life, which has made me more isolated at the very times I needed support. I was taught it was embarrassing and “weak” to cry or have emotional needs. As a child, others were told to “not baby me” when I needed to talk or receive encouragement (not criticism). My achievements were not validated by my mother, I wasn’t “validated”. Today, I still battle with such feelings of inadequacies.

My first job as a production artist proved challenging for many reasons- my depressed moods, adjustment to medications, and the stressful work environment (my supervisor didn’t like me, our boss came into work intoxicated, and he and my supervisor had a “love/hate” relationship). In the past decade, I have settled for a more mundane job, but one that provides my family with stability nonetheless. My job does not (always) subject me to harsh attitudes or very much dysfunction, and I have great co-workers.

I’ve had very little training in thinking of myself as important as those around me. Even as I write this, I justify the reasons to take better care of myself so that I can be able to provide a better life for my family. Often, when I project my well-being to others, I’m deeply disappointed when I become depressed or sick.

Today, I will make an effort to ask for help when needed.

There’s nobody to ask- I will pray for strength and endurance.

I’m a weak person and often a weak follower, but I am a believer.

 

Why You Should Take a Break From Technology

woman walking near brown wooden door during daytime

“Technology is, of course, a double edged sword. Fire can cook our food but also burn us.” -Jason Silva

Mobile phones and other electronic devices offer access to an array of entertainment and information. We can access information about anything at any time. We can watch movies, listen to music, and read books with a sleight of hand. But these things are nothing more than distractions. In some regards, distractions can be helpful. When we need to move at a quick pace, listening to music on our iPhones provides that rush of adrenaline we need to hustle.

A diverse group of people who are distracted by cell phones and tasks.

Distractions Are Nothing New

For many years, people have turned to mindless entertainment. Such entertainment is usually wrought little redeeming qualities, but audiences tune in anyway. There’s the stereotypical image of the 1950s, where the man of the house retreats to his den to skim the local newspaper. Women turned to soap operas and television dramas to “escape” their ordinary lives.

In the 1980s, music videos and video games were rolled out to the masses. When people were not watching TV, playing games, or listening to the radio, they passed the time using the phone. Although technology has changed, the concepts are relatively the same. We seek distraction. We seek an escape from reality and our problems. By immersing ourselves in technology, we can feel “engaged” without fully participating in life.

Artificial Happiness

In my experience, I’ve learned that electronics and the various means of communications via electronics (i.e., my phone, laptop, blog, email, social media) provide me with an artificial “high”. Who isn’t delighted to get a new friend request or find some illuminating, esoteric information?

Promises of Opportunity

I was recently seduced by an email invite from a notable online community. I accepted the offer, which involved writing, and realized it amounted to pennies if it amounted to anything at all. Money for impressions, eyeballs, and clicks. The next day I vowed that I wouldn’t let the desire for success or money to cause me to accept such offers.

For others, they may be chasing other promises. The promise of fulfillment, success, friendship, beauty. Advertisers and publishers study our habits and know our desires. Before cell phones and computers, there were magazines, billboards, newspapers, and radio. Now, it is much easier for people to be swept away by advertising.

The Natural Tendency Towards Selfishness And Sin

One could say that greed, not a technology in general, was my flaw. Humans all have a tendency towards sin, whether it’s the promise of easy money (sloth, greed), or the envy of a celebrity, the feeling of adoration (pride), and even gluttony (casually, mindlessly eating while sitting in front of the TV.

Technology, in itself, isn’t inherently good or bad. It is a tool that we use. Unlike “functional” tools, such as an eating utensil, the “tool” of technology lends itself well to human weakness. We love to share our lives with others, yet technology can easily be misused. It also robs us of face-to-face interactions and “real” friends. Too much time online can make people feel lonely and depressed.

Teens Especially Vulnerable To Technology’s Vices

In an article from the Chicago Tribune, titled, “Mobile Phones Linked To Anxiety And Severe Depression In Teens” studies show that feelings of hopelessness and suicide increased by 12% between 2010-2015.

“As smart as phones may be these days, they simply don’t know when to quit. To protect your mental health, experts say you must develop ways of outsmarting them – and often that involves simply turning them off.” (https://yp.scmp.com/news/features/article/108242/mobile-phones-linked-anxiety-and-severe-depression-teens).

For teens, who on average spend 9 hours each day online (Common Sense Research), the use of electronics and technology is especially pervasive. When teens interact on social media, technology can cause harm when they feel excluded from social groups. Additionally, it’s easy to take offense to what others post on Instagram or any of the other myriad of social media.

The Addictive Nature of Technology

It’s important to consider the “feel good” effects of technology, and how we can become addicted to the “reward” our brain receives when we spend too much time online.

“Dopamine is a feel-good neurochemical messenger that carries signals across brain synapses, responsible for motivation and reward-seeking behavior, and essential to neuroplastic change.  Neuroplastic change is what allows a habit or addiction to form in the first place.” (thebestbrainpossible.com).

“All of our technology is completely unnecessary to a happy life.” -Tom Hodgkinson, (British writer)

The Minimalist Approach

In an article featured at Becoming Minimalist “7 Important Reasons To Unplug And Find Space” by Joshua Becker, we can discover some interesting reasons to avoid technology. The reason that resonated with me was  “Powering-down promotes creation over consumption.” Joshua points out that we spend our time in one of two ways: consuming or creating. We spend time reading, watching, playing or browsing. He advises us to power-down so that we can recharge our battery. In doing so, we can inspire the world around us, instead of simply taking in so many distractions.

Shut-Down Technology, Renew Your Soul

Why should anybody fast from electronics and technology? The same reason we should fast from anything in life. Moderation is key. Mindfulness and discipline to keep track of our precious energy and time, and so we don’t become so consumed by worldly pleasures and fleeting things.

Benefits To Your Well-Being

More time for face-to-face interactions.

More Time to create instead of consuming.

More time for personal reflection.

Less time spent clicking unnecessary pages.

Less time worrying about other people’s lives and dramas.

Less time comparing yourself to others.

 

 

When Anxiety Overwhelms: Rules for Purging Things

Noah Purifoy Outdoor Desert Art Museum, Joshua Tree, United States

Problem: It is difficult for me to identify what causes me to purge things compulsively. It is something I do when I feel anxious and overwhelmed. Decluttering- throwing away or giving away things seems to temporarily relieve my anxiety.

Some of the things I’ve discarded or have given away have been perfectly good items, and perhaps, they didn’t take up much room or appear distracting in any way.

In retrospect, I realize that I wasn’t always this way, although I can easily see that I’ve struggled with anxiety, depression, emotions, and disordered eating. Likewise, I can see the times in my life when things were ideal, or when I’ve felt like my true self (euthymic).

Support Systems

During those times, I have coped well and I’ve expressed myself through visual art and writing, exercise and sports. Solid (but imperfect) relationships carried me through adolescence, except for the years when I struggled with anorexia (age 14-18). My grandmother was of great emotional support when I was entering adolescence. Luckily, my sister and I lived with my grandparents during the summer that my parents separated. I was encouraged to draw and go outside to ride my bike while under their roof. Previously, I did not feel free to be a child while living in a dysfunctional home with my parents.

Deciding To “Disappear”

Having a few good friends in high school helped me overcome the misery I experienced in middle school. I was awkward, chubby and lonely before tenth grade. With my friends, I experienced camaraderie and belonging. At home, with the discord of my mom and her boyfriend, I felt invisible at best. At worst, I was awoken by the alcohol-fueled verbal assault of my stepfather towards my mother.

Sometimes I felt I was supposed to be in charge of tending to the emotional wounds of the narcissist in my life who tore me apart with names that caused me to starve myself. I controlled myself and my appearance (at least) by starvation.

muhammad-ruqiyaddin-1367343-unsplash

The more invisible my body became, the more people started to pay attention to me- I was “admired” for my slender physique by the very people I wanted to look like in high school.

From the time I started to become an “adult” (i.e., the period in life that becomes more complex- more responsibilities and learning to focus less on self), my minimalist ways have become the primary thread in the tapestry of life. It is also important to note that at the same time I was becoming an adult, I was more isolated from friends and family.

In reflecting, I realize the following things about being a minimalist (if that is actually the broad stroke that can be applied):

Minimalism and purging for me are cyclic and may be attributed to hormones. During a monthly “cycle” (menstrual), I am wrought with a multitude of emotions and my eating habits become unhealthy. It is during a “cycle” in a woman’s life that we must reflect, regenerate and prepare for the new “phase” in life.

Sometimes simply feeling anxious, overwhelmed or depressed, at any time in the month, brings me to the point of purging things. Two weeks ago, I wanted to chop off my hair for instant relief and regeneration (of a “new” me).

Does purging/decluttering specifically equate to a minimalist lifestyle? When I ask myself about the appearance of the “minimalist” style- the clean lines, simplicity, and functionality of minimalism, I believe the answer is “yes”. But not all minimalists tend to their lifestyle and philosophy because of emotional wounds. Some minimalists don’t soothe their anxiety by way of design choices. Many people choose to live minimally due to religious beliefs, cultural upbringing, even because of thrift, frugality, or poverty.

Going through my “things” (sorting) allows me to think about the needs of myself and family.

For instance, I understand my daughter’s clothing style and choices change over time. It is beneficial for us to go through her closet and decide what should stay and what can be donated. In doing so, I can help her manage her belongings while listening to her needs. Sometimes it takes a while for me to realize that my son will never wear the brand-new jeans in his closet because he doesn’t like the cut- or perhaps I overlooked the fact that his pants are becoming too short!

As a parent, I subconsciously want my kids to remain children forever.

Perhaps sorting and getting rid of stuff- even clothes or toys that are in great condition- is a way to allow them to grow, while allowing me to process this “growth”. Maybe purging and sorting things makes me feel more in control of the process?

 

Not Everyone Approves Of The Minimalist Lifestyle

There are times when other methods or mechanisms may have been better employed. I have purged things of my children’s without discussing it with them (knowing they probably would want to cling onto what I was ready to part with). I should have allowed them time to process the “loss” or have a voice in the matter. In those instances, I could have boxed up the item(s) until a later time.

My minimalist ways have conflicted with the hoarders in my life.

My minimalist ways have also conflicted with the toxic people in my life.

When I shared physical and emotional space with these types, there have been problems with my purging/decluttering compulsion. Compulsion or a lifestyle choice? It is a bit of both for me, hence the compulsion that is the primary aspect of a minimalist lifestyle. The toxic relationships in my life may have exacerbated my habit/disorder (?). It is apparent that it was for the best that the relationships be altered. The process of purging, albeit MINDLESS purging, served as a catalyst for changes in the relationships.

Regret: The process of purging is often sudden and mindless for me. Many things I have discarded have had to be repurchased. Some of the things- drawings, writings, photos and things that have taken time and money to make it into my space- can’t be (easily) replaced. In life, I can sometimes make amends. Other times it is out of my control. But simply “holding onto” things (or relationships, feelings, grudges, wounds) for sake of fear, is unhealthy as well.

Grief Still Remains If You Don’t Handle The Emotional Aspect Of Certain Possessions

I wish I could hold onto some things a little longer. For instance, I would like to keep papers and duplicate photos longer before discarding them. Better yet, I would love to be the kind of person that manages such things creatively- such as making a scrapbook and utilizing them into space, walls, artwork. For this reason, I stay away from talented women on Pinterest. Sometimes I peek into their lifestyles. Other times I follow the other minimalists to see how their managing life. In any event, they may or may not have the same emotions and complexities going on in their minds.

My Minimalism Rules

  • Don’t throw away things when feeling depressed or manic. Wait until moods are “euthymic”.
  • Discuss with children before discarding or donating some things.
  • Read a book on anxiety, stress, spirituality, etc. when feeling the urge to purge.
  • Some notable choices include:

Feeling Good: The New Mood Therapy by David D. Burns

My Age Of Anxiety: Fear, Hope, Dread, And The Search For Peace Of Mind by Scott Stossel

Acceptance, Improvement, And Letting Go

Finally, it is often hard to accept myself when I fail others. When I disappointment those around me with flaws- what seems rational to me is irrational to others. I can’t push my beliefs on anybody else, but when I hurt them through my actions (purging), I need to seek amends, if they are willing to accept my peace offerings. My kids have forgiven me when I got rid of a book of a toy they wanted (I often have re-purchased some items $).

The toxic people– those who value possessions above people, or those who hold others to unattainable standards- I’ve let them go for now. I can’t work on myself if I am trying to contend with somebody else’s personality/character flaws. There is no clarity or benefit in such situations.

Cyclothymia- A Milder Form of Bipolar Disorder

“I am bipolar, and I am a full manifestation of it in terms of my speech, in terms of my energy.” -Mauro Ranallo

After several years of being called, “bipolar” by endearing family members, I set aside my judgment of them and often wondered if there was some validity in the criticisms.

The depression persisted from my teens up until now, however, the mania wasn’t fully manifested until later in life. I can recall one friend telling me that I was the only person they’ve known that exhibited both a melancholic and hyper disposition simultaneously.

As a female, my moods have always been further compounded by the fluctuations in my hormones (i.e., “pms”, and postpartum).

About 7 years ago, I went to my doctor who diagnosed me with depression and PMDD. Every visit since then, the depression notes remain on my summary. Once, when I tried to contact one of my doctor’s, she stated that none of my conditions weren’t applicable because I wasn’t re-evaluated for them- I had missed an appointment and she seemed harsh and unhelpful.

When I went back for a yearly appointment in 2017, the doctor assumed I was there specifically for a prescription. I told her I wanted to have a thorough diagnosis- that meant I had to get blood tests to rule out physical conditions. It also meant she would refer me to a psychiatrist for the full evaluation.

I met with two psychiatrists- the first might have had a different certification because he made my second appointment with the doctor who conducts evaluations. Again, I think I was scheduled with him first because the staff thought I just wanted counseling or pills.

When I had my evaluation, she told me I was, “a little bipolar.” I told her I didn’t want pills, just a diagnosis so I could manage my disorder on my own. She prescribed something that I never took. Weeks later, I requested my records and discovered the notes about my mood disorder- which didn’t explicitly state that I had bipolar disorder.

This diagnosis leads me to research more about bipolar disorder. More specifically, I wish to learn more about cyclothymia- or, as some people refer to it- “mild” bipolar (a “little” bipolar!).

Cyclothymia is a somewhat rare mental disorder, affecting about 0.4-1% of the population, with women being more frequently diagnosed than men by a ratio of 3:2.

“Cyclothymic disorder is characterized by hypomanic and mini-depressive periods that last a few days, follow an irregular course, and are less severe than those in bipolar disorder; these symptom periods must occur for more than half the days during a period of ≥ 2 yr. Diagnosis is clinical and based on history. Management consists primarily of education, although some patients with functional impairment require drug therapy.” (Merck Manuals)

Many people, such as myself, enjoy the hypomania component of the disorder allows me to be “high-functioning”.

It helps those who are achievers, leaders, or those with an artistic bent, to be productive and creative, even influential and admired by their peers. On the other side of the coin- the “depressed” element of cyclothymia, wreaks havoc on relationships and can create conflict due to erratic behavior in the workplace and otherwise.

Many people afflicted by cyclothymia (or other forms of mood disorders) often turn to drugs and alcohol to a feeble attempt to quell their moods.

How can somebody get help if they think they may have cyclothymia? There is no test for cyclothymia. A doctor usually refers to your medical history and sometimes will refer you to a psychiatrist. Since the symptoms of cyclothymia are similar to bipolar 1 and bipolar 2, it is important to seek an evaluation from a psychiatrist.

Since cyclothymia is less severe than other forms of bipolar disorder, you may decide to examine various methods of treatment, with or without medications.

What works well for one individual isn’t always ideal for everybody else.

You can choose to see a therapist at regular intervals, join a support group, etc. Still, many psychiatrists prescribe medication.

Medications Often Prescribed

Lithium– a mood stabilizer

Lamictal– an anticonvulsant

Tegretol– used to treat seizures and bipolar disorder (anticonvulsant)

In conjunction with working with your doctor and psychiatrist, you can find online resources to provide you with information. The ADA has a screening tool to help guide you.

References:

  1. https://ada.com/conditions/cyclothymic-disorder/
  2. https://www.merckmanuals.com/professional/psychiatric-disorders/mood-disorders/cyclothymic-disorder
  3. https://www.psycom.net/depression.central.lamotrigine.html
  4. https://www.psycom.net/depression.central.cyclothymia.html
  5. https://www.drugbank.ca/drugs/DB01356
  6. https://www.everydayhealth.com/drugs/tegretol

3 Important People in Your Anxiety Treatment

“People tend to dwell more on negative things than on good things. So the mind then becomes obsessed with negative things, with judgments, guilt, and anxiety produced by thoughts about the future and so on.” -Eckhart Tolle

In the US, over 40 million people are affected by an anxiety disorder. Although it is highly-treatable, it’s reported that only about 37% of affected individuals receive treatment. (ADAA).

6 Types of Anxiety Disorders

  • Generalized Anxiety Disorder
  • Panic Disorder
  • Social Anxiety Disorder
  • Specific Phobias
  • Obsessive-Compulsive Disorder (OCD)
  • Posttraumatic Stress Disorder (PTSD)

When you consider the various sub-categories listed under “specific phobias”, one can conclude there is a multitude of anxiety types. These subtypes are broadly-defined:

3 Types of Phobias

    1. Agoraphobia– A fear, anxiety, or avoidance of non-specific situations where one may not be able to escape or get help if a panic attack occurs.
    2. Specific Phobia– A fear, anxiety, or avoidance of specific situations or object (i.e, a fear of flying, a fear of needles, or the fear of spiders qualify as specific phobias).
  • Social Anxiety Disorder– A fear, anxiety, or avoidance of social situations. Intense fear in social situations includes the fear of appearing foolish, which can physically by way of blushing, shaking, sweating, etc.

Scientists believe there are a complex variety of factors that cause anxiety disorders, but they can be simplified into two broad categories.

  1. Genetics– A family history of anxiety disorders is a significant indicator of being predisposed.
  2. Environment– Traumatic, stressful, or exposure to violence can cause individuals to develop anxiety disorders. (NAMI).

Identifying the sources of anxiety disorders can be complex and confusing, hence why it is especially important to first see your doctor to eliminate the possible physical cause that mimics anxiety disorders.

It is also important to do whatever you can to reduce or eliminate sources that cause you to feel more anxious or nervous. For instance, you can opt to drink decaffeinated coffee instead of regular coffee. Some dietary choices can improve the physical aspects of anxiety. Simple choices are only the beginning of managing anxiety disorders.

Anxiety Disorders Originate In The Recesses Of Our Brains

“According to the National Institute of Mental Health, there are two parts of the brain that are key players in the production and processing of anxiety – the amygdala and the hippocampus.” (Neurocore Brain Performance Centers).

Our brains- and our specific human experiences- are complex and vast, but the good news is that only you fully understand yourself! Conversely, others on your mental health “team” (i.e., your family doctor, your nutritionist, your spiritual advisor, therapists, counselors, and other qualified mental health professionals).

The Family Doctor

You may opt to schedule an appointment with your family doctor before or after you’ve had time to reflect and write down information on your anxiety disorder. You may have learned from school or work that you don’t like public speaking or crowds. It will be most beneficial of you to have notes and information to offer your doctor when attending your appointments.

Don’t be discouraged if your family doctor seems to focus on the “externals” more than the “internals”. The doctor may offer you unwanted advice, such as losing weight, getting more exercise, or reducing the amount of caffeine or alcohol you consume. These are important steps in the management of your anxiety, although, they are often not the only steps to pursue.

Therapists

As I mentioned earlier, each individual has their own unique and complex brain and set of experiences. There isn’t a “one size fits all” approach to anxiety. Medications may work for one person but may be ineffective for another. Many individuals prefer to manage their anxiety through therapy. Therapy types are as varied as the individuals seeking treatment, so be sure to have a solid good understanding of each type.

Traditional  Psychotherapy

  • Interpersonal therapy
  • CBT (Cognitive/Behavioral Therapy)
  • Psychodynamic Therapy

Non-Traditional Therapies

  • Mindfulness-Based Stress Reduction model (Jon Kabat-Zinn)
  • EMDR- Eye Movement Desensitization Resolution (Often for individuals suffering from PTSD).
  • Interpersonal and Social Rhythm Therapy (IPSRT)- Developed to understand and improve moods, based on biological and social rhythms. (“Taking Charge”, University of Minnesota).

There are other therapies, which include group therapy, family therapy, and emotion-focused therapy. (Types of Therapy).

Help Yourself (And Others) Treat Your Anxiety Disorders

You may be limited in your choices of family doctors, based on where you live or the type of medical insurance you carry. Additionally, your medical insurance may limit the type of therapy or mental health services you can receive. Be sure to obtain a provider directory and handbook from your insurer to ensure you choose providers your insurance will cover, or you may end up paying more than you can afford for your treatment.

Consider what your own preferences are along with what your insurance will offer. Is your local family doctor in your network? If not, you may have to choose another or decide if it’s worth it to pay out-of-pocket.

In addition to receiving medical care and therapy, be sure to consider your own interests, and how they can be applied to help you manage and treat your anxiety.

“To know thyself is the beginning of wisdom.” -Socrates.

  • Are you artistic? Why not try painting when you need to calm down?
  • Are you a kinetic person? Do you have lots of energy? Why not try jogging to release some negative energy?
  • Are you an emotional or sensitive person? Why not channel your inner-poet and write something expressive?

When you know yourself, you have insight and wisdom about yourself, and thus, can make better decisions on how to treat yourself. You will not be able to treat anxiety effectively- at least, not in most circumstances, without the help of others. For some, that includes doctors and therapists. Many people wish to augment treatment by using their faith and spirituality. The most important thing to realize is that you can get the most out of managing anxiety if A) you understand yourself and B) you allow others to help.

References:

  1. https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders
  2. https://www.mentalhelp.net/articles/specific-phobias-and-social-anxiety-disorder-social-phobia/
  3. https://www.neurocorecenters.com/blog/depression-anxiety-stresseffects-of-stress-anxiety-on-brain
  4. https://keltymentalhealth.ca/types-of-therapy
  5. https://www.takingcharge.csh.umn.edu/what-types-psychotherapy-are-helpful-anxiety-and-depression
  6. https://www.2knowmyself.com/The_kinesthetic_personality_type
  7. https://sciencing.com/kinetic-energy-potential-energy-apply-everyday-life-15430.html
  8. https://www.psychologytoday.com/us/blog/changepower/201603/know-yourself-6-specific-ways-know-who-you-are

Simple Ways to Manage Anxiety and Depression

Simple Ways to Manage Anxiety and Depression

“Once a week, I like to slip into a deep existential depression where I lose all my sense of oneness and self-worth.” -Bo Burnham

The most helpful part of managing my mood disorder is the fact that my moods are fairly predictable. In more severe cases, it is much more difficult to manage, at least not without the help of doctors. I’ve battled these moods since I was a teenager.

I’m almost certain, however, that I experienced strange things when I was younger. These things I’m talking about are the symptoms one sees when they have experienced trauma. Dissociation, depersonalization, and even involuntary, but subtle, nervous ticks.

So, I’ve battled these moods for many years- anxiety, depression, GAD, OCD. I am familiar with the alphabet soup of mental illness- although, that doesn’t qualify me to dispense medical advice. It simply means, my conditions are much more manageable, so manageable now that I can tell the psychiatrist I don’t want to take the Lamictal or any other drug.

And, I’ve spent so many years on the prescription-drug rollercoaster, to no avail. Well, that’s not entirely true- Prozac wasn’t too bad, except for the occasional electrical surge. Lexapro wasn’t so bad, either. Definitely a pass on Paxil, Buspar, and Serzone.

You might be able to pick up on the fact that I haven’t written regularly for the past few weeks. Today I began to see an improvement in my mood. Soon I will be scribbling away, hopefully finishing some artwork. Now that I am feeling better, I wish to share some simple things that help me feel “at peace.”

Thrive Mindful- Ways To Feel “At Peace”

Shop when the stores are empty.

Get a haircut.

Study a free online course through Coursera.

Play board games with family.

Prank-call a family member.

Play a musical instrument.

Enjoy an open-air, free concert.

Organize photos.

Visit the library.

Ride a bike.

Adopt an animal from a shelter.

Call a long-lost family member.

Wash the car.

Donate unwanted clothes to charity.

Do some yard work.

Explore other WordPress blogs.

Read a good book.

Write a poem.

Organize computer files.

Go for a car ride at dusk.

Watch the sunrise.

Make a list of goals.

Write down 3 things you enjoyed when you were ages 9-12.

Do a free, online personality assessment.

Draw (or doodle) some pictures for your poetry.

Draw a self-portrait.

Rearrange living room furniture.

Invite the opinions of others on topics with universal appeal (i.e, favorites lists of anything)- Promotes diversity and fresh ideas!

Take the family or a friend out to lunch.

Watch a band at the coffee shop.

Schedule a yearly health exam.

Play tennis with some family or friends.

Mental Health Communities And Forums

Finding relevant information and maintaining privacy are key issues for individuals suffering from mental health issues such as anxiety or depression. I’ve included some resources that may be helpful for questions and answers.

www.uncommonforums.com: Topics include psychology, depression, anger management, addictions, eating disorders, and anxiety/panic attacks.

www.dailystrength.com: Online support groups for anxiety, addiction/recovery, mental health, men’s health, women’s health, teens, children’s health/parenting and many other health issues in general.

www.sane.org: An Australian mental health website that includes a well-organized forum area. The aesthetic appeal and non-spammy feel make the website worthwhile.

www.beatingthebeast.com: “Beating The Beast” touts itself as an online depression support community, but I’ve discovered useful advice on anxiety disorders, as well as bipolar and other mental health issues.

If you were to write a list of things that make you feel happy or relaxed, what would it include? Is there a pattern in your list?

My list includes a little socializing, some solitude, and purging of unused things that others might want to use. Note that much of my joy comes from reading, writing, and drawing.

No matter how depressed or anxious I become, I try to make an effort to pursue my faith (reading the Bible, watching or reading content online about my faith). One key difference between how I handle my moods now, as opposed to when I was younger, is the fact that I pursue my spirituality. Even when I feel I’ve lost hope or control, there is always something more that governs life and the world around me.

How to Give Dignity to Your Emotions!

How To Give Dignity To Your Emotions!

Today, I desire to be unencumbered by organizing my thoughts and structuring my paragraphs before my words settle upon this glowing screen. Sometimes writing requires capricious expression, and other times, it requires much mental effort. What I have to say doesn’t need much research. I just want to draw today. I completed a portrait of Sigmund Freud. It’s somewhat minimalistic, but to me, there is beauty in simplicity.

I also want to write today, simply to express myself- not to impress anybody, not to sell anything. And when I write today, I want to say what a special weekend! My daughter turned 14 yesterday. I am the parent of two teenaged creatures!

I’ve been pretty lucky in the parenting stage of life because my kids have remained, by and large, decent human beings, free of any major character flaws. But, I’m weary in this journey. My emotions are tossed about with conflicting feelings. On one hand, I fear the day when they are grown. Conversely, I also can’t wait for the days when they are grown.

Being a parent with mental health issues is a bit different from being a “regular” parent. No doubt, I experience the same dilemmas as other parents. But what makes my job more complex are the following factors:

When my kids have a problem, the first thing I attribute it to is myself. Did my anxiety cause them this problem? Did my depression bring them down? Did I spoil them when I felt guilty about “not measuring up” to societal standards?

One thing is for sure- I’ve been humbled by my illness, and also by the task of parenting. I am well aware of the way my mind working of my brain-

(my psychiatrist noted my thought process as “circumstantial”)-

Circumstantiality- (also circumstantial thinking, or circumstantial speech) – An inability to answer a question without giving excessive, unnecessary detail. This differs from tangential thinking, in that the person does eventually return to the original point

And as an individual with this type of thought pattern, I do tend to elaborate on insignificant details. My mind wanders in many directions, but it always returns to the original point. I’m a little disturbed that somebody that has spoken to me once can make so many assertions. I guess that’s what a college degree empowers an individual to do (not meant to sound snarky, just expressing an observation).

Today, I write because I feel the need to express myself- my hopes and dreams, and my joy and sadness. For without writing, or even drawing Sigmund Freud today, I’d be riddled with the impulse to start purging stuff in my house again. Anxiety, exhaustion, joy, sadness- it’s too many emotions permeating my mind at once.

I could spend the day trying to improve myself through studying or exercise. Or I can simply reflect on the gift of human emotions. I will honor my emotions by giving all of them the consideration they deserve and require. That’s much healthier than suppression or denial.

How to Channel Anxiety in a Positive Way

Where Are You On Maslow’s Pyramid?

“We may define therapy as a search for value.”

-Abraham Maslow

Abraham Harold Maslow (1908-1970), an American psychologist best known for “Maslow’s Hierarchy of Needs”- a theory that employs the notion that in order to achieve one’s highest potential, one must not be lacking in any of the four essential needs of the pyramid. Of these four needs that precede the self-actualization level of the pyramid, the following must be satisfied:

  • Esteem- The desire to be valued and accepted, power, recognition.
  • Love/Belonging- Family, friends, intimacy, inclusion.
  • Safety- Money, health, stability, and a sense of personal and family safety, property, employment.
  • Physiological- Air, clothing, food, water, shelter, rest.
Maslow's Hierarchy of Needs
Maslow’s hierarchy of needs helps outline the components needed to ensure happiness and self-actualization.

Maslow, who referenced his own work as, “positive psychology”, called the four bottom levels of his five-level model, the “deficiency needs.” These needs are called deficiency needs because, without them, we feel uncomfortable and anxious. However, when these needs are met, we are not likely to notice, or feel any different, simply because they are innate needs.

The highest of Maslow’s “Hierarchy of Needs” is self-actualization. This tier includes things such as morality, creativity, problem-solving, and spontaneity. Self-Actualization is the ability and desire to meet one’s fullest potential or to accomplish as much as one’s ability allows. Self-actualization is achieved when we are equipped and ready to “level up.” In other words, when we don’t have to worry about the basics, we have more resources available to consider our growth and development.

What Things Hinder An Individual’s Personal Growth?

When a person is living with constant fear, it is more difficult to get their needs met. For instance, when an individual feels threatened, their brain prompts the fight-or-flight response. At that state, it is unlikely that the person who is plagued by fear will have to ability to effectively utilize problem-solving skills. Additionally, that person will be so focused on meeting their safety needs, as well as the need for love/belonging and esteem.

In an effort to subdue distress and anxiety, people often use what Freud called, “defense mechanisms.” Furthermore, many individuals who suffer from anxiety may also substitute their deficiencies. Instead of adopting healthy habits that will help us achieve our needs (and thus, self-actualization), we may feel compelled to feel a sense of love/belonging by controlling our appearance or employing unhealthy eating habits. Another example would be family dysfunction or a dysfunctional household. The teenager who lives in an alcoholic family may undertake the role of the nurturing parent. Another person may take a different route- perhaps by running away or seeking solace by withdrawing from the family.

The How And What Of Defense Mechanisms

While Maslow focused his work on the study of what makes humans happy, the Austrian neurologist, and founder of psychoanalysis, Sigmund Freud explored other elements of the human psyche, such as sexual energy being the driving force behind our unconscious behaviors. Freud noted several defense mechanisms people use to protect themselves from anxiety.

  • Repression
  • Denial
  • Projection
  • Displacement
  • Regression
  • Sublimation

Freud's Defense Mechanisms

Sublimation: A “Mature” Defense Mechanism

Psychiatrist and professor at Harvard Medical School, George Vaillant, contends that many of the aforementioned defense mechanisms can be harmful to us, but concluded that more “mature defenses”, like sublimation, can be productive. Vaillant proposed four layers of defense mechanisms:

  • Narcissistic
  • Immature
  • Neurotic
  • Mature

Some common examples of sublimation include channeling aggression into a sports activity, or painting when one wishes to express, in a socially-acceptable behavior, the pain they feel from a broken relationship.

Sublimation can be used to control negative impulses associated with anger, jealousy, disappointment, sadness, and mistrust.

Many notable creative and literary work have been bestowed upon humanity, most likely, as a result of the use of the sublimation defense mechanism. Van Gogh is reported to have painted one of his most prominent paintings, The Starry Night, while hospitalized at Saint-Remy. The painter Jackson Pollock, employed “action painting” into his creations. The use of movement and expression involved in this type of pursuit likely utilized the sublimation defense mechanism to deal with his own internal conflicts and anxieties.

While both artists had personal struggles- Van Gogh had mental health issues and Pollack had a tendency to become violent when drinking, it can be surmised that their ability to express themselves artistically may have helped them channel at least some of their negativity into more positive ways of dealing with their problems. Possibly, life could have been better for these artists, but we can truly never know the depths of their psyches.

Maslow’s pyramid indicates that one characteristic of self-actualization as the ability to be creative and spontaneous, independent, and honest. Pollock was widely regarded for his authenticity in his painting style. Was he true to himself? Could he have been even more successful as an artist, or even, as a husband to fellow artist Lee Krasner?

Other psychologists theorize that self-actualization involves fulfilling an altruistic need, that is, the ability to serve humanity. Perhaps by using sublimation defense mechanisms (sports, art, science, etc.), we can manage our anxieties until all our hierarchical needs are fully met. We can “fake it ‘til we make it.” Although it is challenging at times to consider altruistic endeavors, once we can find a way to overcome ourselves, we can be equipped to use our gifts to serve others.

References:

  1. https://outre-monde.com/2015/10/01/a-philosophical-cure-for-anxiety/
  2. http://www.pursuit-of-happiness.org/history-of-happiness/abraham-maslow/
  3. https://courses.lumenlearning.com/suny-monroecc-hed110/chapter/theory/
  4. https://www.simplypsychology.org/defense-mechanisms.html#why
  5. https://www.verywellmind.com/biography-of-abraham-maslow-1908-1970-2795524
  6. https://www.psychologistworld.com/freud/defense-mechanisms
  7. https://psychologenie.com/understanding-concept-of-sublimation-in-psychology
  8. https://www.britannica.com/biography/Jackson-Pollock

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How to Manage the Wave of Depression

A woman covered in a blanket sits by the ocean in the morning.

A tidal wave- the perfect metaphor for depression. My life seemed like a simple and joyful day at the beach, with no worries. Suddenly, I’m overtaken by this wave of depression, sweeping over me, tossing my feelings around as I clutch to some vague sense of security. Security in what? I try to grab for what I know will calm me in such tempestuous times- spirituality. Yes, at least now when the tidal wave sweeps over me, I can grasp for spirituality.

ben-white-692414-unsplash

I turn my radio stations in between 3 different Christian channels. A renown pastor was preaching on Moody Broadcasting. Air1, the alternative Christian music network, resonated with me as a listener spoke about her personal struggles. On WFHM, I listened to MercyMe and cried as I finished my drive home from Walmart on my day off work. The boss finally gave me a day off after working so many weekends. It was supposed to be so joyful. I went shopping at 7:00 am, right after I dropped my kids off at school. The store was quiet and I was able to shop with relative ease and peace. I spent way more money than I had budgeted!

Signs of Depression

I should’ve seen my depression developing. I was irritable and short with my family last night. After being cooped up every day, listening to my kids chew LOUDLY- the cracking and popping sounds emanating from the bowels of their braces and jaws, I just howled, “Stop!”

For the past week, I’ve felt as though life could never be dismal. My thoughts and ideas swirled around my head- I have felt inspired. Now, I feel devoid of anything.

If only I had been attuned to my emotions better, I could’ve taken better care. Maybe I wouldn’t have spent so much money at Walmart today.

  • Feelings of hopelessness, as though, no matter what you do, nothing will change or improve.
  • Loss of interest in activities or hobbies that once brought joy.
  • Weight/appetite changes. An increase or decrease of 5% of your body weight in a month is significant.
  • Sleeping too little or too much, or waking up too early, or oversleeping.
  • Irritable and Angry. Your fuse is much shorter, people tend to get on your nerves easily.
  • Self-hate- feeling guilty, worthless, overly-critical of self.
  • Loss of energy. Feeling sluggish, or slow. Tasks take longer to complete.
  • Recklessness- Engaging in risky or dangerous activities or behaviors or abusing drugs or alcohol.
  • Unable to concentrate.
  • Frequent physical pains in the muscles, stomach, or headaches.

Risks For Depression

Unfortunately, many people who suffer from depression or bipolar disorder, have fewer emotional, social and financial reserves. Many people who suffer from mental illness have fragmented social and family ties. As a result of their mental illness, they may be alienated from friends and family. Many of these people may come from an abusive family or have been affected by alcoholism. Certain factors increase your risk of depression.

  • No social support (family and friends, or other support systems)
  • Isolation, lack of mobility.
  • Unemployment or underemployment (not living up to full potential, not being recognized at work).
  • Relationship problems/marital issues.
  • Poverty, crushing debt, not enough money to live comfortably, unable to meet needs.
  • Early experiences with trauma, childhood abuse.
  • Health problems.

Interestingly, this week I’ve experienced several episodes of anxiety. From nearly passing out at work, to the agony of managing my workload, I also recall feeling diminished and invisible at work. It seems everything else is expected to take a backseat to my job. The moments I get to spend with my family seem fleeting, and at times, my aspirations to be a successful writer/illustrator and entrepreneur, seem hopeless. Last week, however, my dreams were soaring. I tried to imagine being successful and getting another job.

Road Rage

Today, I felt an uncomfortable surge of anger when I was driving to Walmart. The car tailgating me rushed over into the next lane when the road changes to two lanes. It had been raining out, my tire treads are choppy (only $500-$600 to get all new tires). When the light turned green, I floored it to prevent the other driver from getting in front of me. The “slippery conditions” icon was activated on my dashboard, yet I persisted. I could see the other driver turned right just after passing through the intersection.

Feelings of apathy, flatness, are dominant when I’m depressed. My body feels aching, my mind is becoming drained. It will soon become that time when I can do nothing more than “reflect”.

On a positive note, my supervisor informed me that he understood my issues because he experiences anxiety too. When I asked him how he manages, he told me he takes Lexapro. He had to stop using Paxil because it made him feel like a zombie.

I think I tried Lexapro when I was in my thirties. I had to stop taking it because I couldn’t afford it. The doctors offered me the generic alternative, Celexa, which upset my stomach. The Lexapro seemed to work okay back then. I didn’t take it long enough to note anything else.

SSRI’s are not effective in treating bipolar depression. I found this out when I went to my doctor in 2017. She prescribed Lamictal, which is used for both bipolar disorder and seizures. The dosing schedule she gave me seemed unusual. I didn’t want to take any more medications, and I failed to follow-up.

I feel drained at the end of the day. It’s after 5:00 pm by the time I remember to call to make appointments. I hate talking to receptionists. So many times, I’ve been talked to in a condescending manner.

I don’t always know when my depression is going to manifest. Who could know, especially when your mind is busy or clouded by other thoughts? Although I feel hopeless, I want to keep fighting. Every battle scar has a story, and every story has an ending. I know I can rewrite it if I make the effort.

References:

  1.  (https://www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm/).
  2. (https://www.cuimc.columbia.edu/news/bipolar-disorder-anxiety-often-follows-mania).

Understanding Anxiety’s Psychological Effects and Syncope

Speeding light corridor.

Every once in a while, something triggers my anxiety so intensely that I become physically and emotionally ill. Yesterday was one such day where I felt like I was going to faint. My skin was clammy, my stomach was churning- I initially thought the fruit I ate at lunch was causing the mild cramps in my stomach. I felt so weak and sick that I had to retreat to the bathroom and rest for a few minutes.

What set off the series of unpleasant symptoms was that I got cut on my finger at work. My co-worker was talking to me and I was feeling a little tired and distracted. This proved to be a recipe for disaster, at least, in my mind. As I was talking and working, the cutters slipped and sliced through the middle of my fingernail, drawing blood and stinging like crazy. I quickly wrapped the finger tightly and tried to continue working.

My co-worker suggested the cut may need stitches. When I told her I had cut through the nail and I didn’t think they could “stitch” my nail, she proceeds to offer vivid details about how the doctor might “rip my nail off”. She also mentioned they may apply “New Skin” to the nail, but since she already polluted my anxious mind with details of ripping my fingernail, I grew weak and dizzy. My skin got colder. I told her I had to go for a few minutes to look at the cut and sit down.

Eventually, I found a more helpful co-worker who provided me antibiotic cream. She told me the doctor might stitch under the nail, and apply the liquid bandage to the fragmented nail. I opted to wrap the finger as tight as possible and deal with a more thorough examination at the privacy of my home later that day.

I’ve had a few times in my life where anxiety- and the sight of blood or other bodily fluids, organs and things of that nature, have triggered the same symptoms.

The first time was when I was in elementary school. Our class had to walk down the corridor to look at the science fair entries. One project appeared to be a mason jar with the contents of an animal’s brain. The kids were enthralled by the “brain”. They kept talking about it, and suddenly, everything looked blue and surreal. The next thing I recall is waiting for my mom at the nurse’s station in the school office. The staff doted on me and seemed concerned.

In high school, my mind was occupied about various issues. At this time in my life (age 17), my grandmother had passed away. The funeral and surrounding events- the drinking binges my mom went on after my grandmother’s passing, may have contributed to my episode. It seems like I started getting more depressed as a teenager. I felt I was losing everybody and everything from my life. My friends were all struggling with problems too. Some of them spoke about their experiences with substances. To compound issues, the type of music I listened to at that time was very dark and depressing. This was undoubtedly a confusing and emotional time.

One day, I started to walk to school as usual. I hoped my friend was going to school that day because I could meet up with her and walk together. I remember that there were a Catholic church and school on my path. Every day, I’d pass and gaze at the statues. They seemed eery to me- they didn’t elicit the same emotions I’d feel when admiring art. In fact, they always gave me a morose feeling.

As I continued past the church, I focused my eyes on the Veteran’s Memorial. Suddenly, everything looked unreal and I felt faint. I kept walking and passed a morning jogger who mouthed, “Good morning!” as I dredged on. It dawned on me that I shouldn’t go to school, and I went home.

The final memory of fainting and dizzy spells comes from when I had an appointment at the doctor. I had blood drawn from that visit and I recall the details of blood work seemed vivid and overwhelming.

So what does anxiety have to do with these fainting episodes? I wanted to understand how something that originates in the mind can cause so many repercussions.

Fainting, otherwise known as syncope, is a “sudden loss of consciousness from a lack of blood flow to the brain.” (www.verywellhealth.com). There are a number of factors they can cause an individual to faint-

  • Dehydration
  • Heart Beat
  • Low Blood Pressure
  • Anxiety

Before fainting, these symptoms are present:

  • Dizziness
  • Nausea
  • Confusion
  • Blurred or Tunnel Vision
  • Sweating
  • Shaking
  • Shortness of Breath

Psychological Triggers

Although less common than other triggers, anxiety, stress, and panic disorder can all stimulate the vagus nerve- the nerve which stimulates the parasympathetic nervous system. “The parasympathetic nervous system regulates organ and gland functions during rest and is considered a slowly activated, dampening system.” (www.lumenlearning.com).

Hyperventilation and Hypoventilation

Too much or too little oxygen changes CO2 levels in the blood, which activates the feeling of passing out that often accompanies anxiety, stress, and panic disorder. (www.anxietycentre.com).

Our stress response prompts a release of stress hormones into the bloodstream that is supposed to equip humans to better manage threats and dangers. These hormones cause emotional, physiological, and psychological responses that signal us to respond- fight or flight.

Maybe, in the recesses of my mind, I perceive “blood” as a warning because I am not prepared for such accidents (i.e, I don’t usually carry bandages and first aid equipment). Who will take care of me if I can’t take care of myself? The vivid details of cuts and wounds really disturb my mind. Ultimately, I am reminded that this body of mine will eventually perish.