Psyche & Soul 37: ANXIETY DISORDERS

 Podcast link:

 https://anchor.fm/boscom/episodes/2-37-Psyche--Soul--81-esduqh

Hello, this is Jose Parappully, Salesian priest and clinical psychologist at Sumedha Centre for Psychospiritual Wellbeing at Jeolikote, Uttarakhand, with another edition of Psyche & Soul.

 

In this weekend’s edition, I shall present anxiety disorders from which very many people suffer.

Anxiety is the body’s response to worry and fear. Anxiety operates on many different levels and to different degrees. There is a wide range in how deeply anxiety affects us and to what extent it interferes with our quality of life. Accordingly there are different anxiety disorders.

Causes of Anxiety Disorders

Genetic (inherited) factors contribute in some degree to anxiety, just as they do in other mental illness. Brain chemicals called neurotransmitters, as well as a pair of structures inside the brain called the amygdalae, seem to play a big role. Personality, experiences and environmental situations also contribute.

 

There are a number of medical disorders and the medications used to treat them that can cause anxiety. Some of these include: hyperthyroidism, heart disease, diabetes, respiratory disorders, emphysema, and asthma

At the root of anxiety is fear that works mostly at an unconscious level. According to MacKinnon & Michels, authors of the classic text The Psychiatric Interview in Clinical Practice,  anxiety “is the psychological response to danger, and is often seen when the individual feels that there is an ongoing threat to his [or her] welfare” The source of this threat may often lie at the unconscious level.

Generalized Anxiety Disorder

It is quite natural for us to worry during stressful times. But some of us feel tense and anxious day after day, even with little to worry about, and without any perceived trigger to provoke it. When this lasts for 6 months or longer, it would be diagnosed as Generalized Anxiety Disorder (GAD), which is the most common of anxiety disorders. What sets generalized anxiety disorder apart from ordinary worrying is the feeling that we can't stop worrying. Worry becomes chronic, almost second nature to us. This will begin to affect our social, work, and family life.

Persons of any age, even children, can develop generalized anxiety disorder. It tends to appear gradually, with the first symptoms most likely to happen between childhood and middle age. An estimated 31% of all adults will experience an anxiety disorder at some point in their life. Anxiety disorders are more prevalent in women (23%) than in men (14%) worldwide.

The main symptom GAD is a constant and exaggerated sense of tension and anxiety. We may not be able to pinpoint a reason why we feel tense. Or we may worry excessively and frequently about ordinary things, such as bills to be paid, our relationships, the safety of our children, or our health. This can lead to sleep problems and distortions in thinking. Poor sleep, in turn, can lead to irritability and strain relationships. It can also lead to restlessness, fatigue, feeling on edge, and difficulty in concentrating. Severe cases can hamper work and daily activities.

When we suffer from GAD, we are vulnerable to developing depression, alcoholism, or drug addiction. Anxiety disorders can also cause physical problems. These include: muscle tension or pain, headaches, nausea, stomach upsets and trembling. we can also develop other disorders that involve anxiety such as panic disorder, phobias, obsessive-compulsive disorder, and posttraumatic stress disorder

Panic Disorder

Panic disorder involves sudden attacks of terror triggered by an object or situation that can reach their peak within minutes. Persons who experience panic attacks may try to avoid situations or constantly worry about when the next panic attack might happen.

Symptoms can include a pounding heart, sweating, dizziness, nausea, trembling, shortness of breath, chest pain and a feeling of being out of control. We may think we are having a heart attack, or facing imminent danger or destruction, or even dying.

Phobias

A phobia is an intense fear or apprehensiveness about specific objects or situations that in reality are not likely to cause any harm. Even when some of these objects or situations may have reason to cause fear, the fear felt by the individual is disproportionate to the actual danger posed.

Common phobias include fear of heights, closed-in spaces like elevators, flying, water or creatures like ants and spiders. One woman I know is so afraid of flying that she never takes a plane, and so does not do any international travel, though she would love to visit many places.

During the height of the Covid pandemic, many people would not leave the home even for essential work, for intense fear of catching the contagion.

Social Anxiety Disorder

Social Anxiety Disorder is a common specific form of phobia. Those afflicted with this disorder feel panicky and self-conscious even in ordinary social situations. They are intensely anxious about being judged or rejected in social situations. Even when they realize their worry is unreasonable, they cannot avoid being anxious. Symptoms include a sense of dread before social events, with sweating, blushing, nausea, or trouble speaking during the events.

 

There are two other common disorders that have anxiety as one of the key symptoms but are no longer classified as anxiety disorders in the DSM-5 (The Statistical Manual of Mental Disorder, volume 5). These re Obsessive Compulsive Disorder or OCD, and Post Traumatic Disorder or PTSD.

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder or OCD is a disorder where individuals have recurring, unwanted thoughts, ideas, or sensations (obsessions); or the urge to do something repetitively (compulsions).  Some people have both obsessions and compulsions.

When we suffer from obsessive-compulsive disorder (OCD), we will have troubling thoughts that we feel we cannot control. We may repeat a name, phrase, or behavior because we fear something bad will happen if don’t do that. We feel the need to repeat actions again and again, such as washing hands or checking that the door is locked. We may be obsessed about dressing in a certain order or count objects for no good reason. They may for example lay out items clothing in a particular order, pick them up in the exact order in which they were laid out, believing if the order is changed some mishap will happen to them. They may also feel they have to touch a particular object before they open the door, in order to ward of any danger.

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) arises in the aftermath of some terrifying event, such as physical attacks in which we fear we may killed, severe sexual abuse, involvement in terrifying accident, or terrorist attack such as the one on the World Trade Centre..

Symptoms may happen months or longer after the event. These may include recurrent vivid flashbacks and nightmares about the event, Avoidance of things related to the event: people, places, or situations and a loss of interest in activities that were once enjoyable.

Treatment

The treatment for anxiety disorders follow the same model as described in dealing with depression and schizophrenia.

Antidepressant drugs, especially the newer variety, work well to lower anxiety. However, some of these drugs carry a risk of dependence.

Psychotherapy, especially cognitive behavioral therapy is very effective in treating anxiety. The focus here is on identifying negative thoughts and changing them. Since feelings and behaviour are primarily triggered by our thoughts, when we change our negative thoughts to more positive ones, our mood changes.  Clients are also taught calming techniques, such as meditation, that help them to calm themselves.

A few simple changes in our daily living can help. Caffeine, sugar, and even some medicines, can boost anxiety symptoms. Getting enough rest and eating healthy foods have a positive effect on anxiety. Use of relaxation techniques, such as meditation also help. Exercise can refresh the body and calm the mind.

Anxiety vs. Depression

It is important to note that there is a difference between anxiety and depression. In a very basic sense, anxiety is an excessive feeling of worry and apprehension, while depression is excessive feelings of hopelessness and worthlessness. It is possible for a person to have both anxiety and depression at the same time.

Introspection and Prayer

Have we experienced any type of anxiety disorders described here? If so, what was the experience like?

We often find Jesus in the Gospels exhorting his disciples not to be anxious. A classic case is that of the disciples caught in the storm at sea (Mark 4, 35-49). Jesus asks them “Why are you anxious?”  Elsewhere he asks them not to worry about their life, for their heavenly father provides them with everything (Mathew 6, 25-34).

We could read or contemplate any of these passages, stay with whatever these evoke in us, and spend time in the company of Jesus who is with us here and now, assuring us there is no need to be anxious and bring to him all our worries and anxieties and ask him to calm our fears.

 

Have pleasant weekend. Be safe. Be healthy. Be blessed.

Thank you for listening/reading.

Picture: Courtesy Google Images

Jose Parappully SDB, PHD

sumedhacentre@gmail.com 

 

Psyche & Soul - 7: COPING WITH STRESS AND ANXIETY DURING COVID – Physical, mental and Spiritual strategies

  Podcast link:

https://anchor.fm/boscom/episodes/2-7-Psyche--Soul---COPING-WITH-STRESS-AND-ANXIETY-DURING-COVID--Physical--Mental-and-Spiritual-strategies-21-ei4v6b

 Hello, This is Jose Parappully, Salesian priest and clinical psychologist at Sumedha centre, Jeolikote with another edition of Psyche and Soul.

Last weekend we focused on self-care during Covid 19. This weekend we shall focus specifically on the stress and anxiety related to Covid, and the physical, mental and spiritual strategies that can help us cope with them.

With the growing data emerging on the lasting physical, mental and emotional consequences of Covid, it is likely that our stress and anxiety levels would be rising higher and higher. The prolonged exposure to stress arising from the crisis is likely to have insidious long‐term health effects including increased risk of physical (e.g., respiratory, cardio-vascular, neurological, reproductive) and mental (e.g., depression, anxiety and post‐traumatic stress, impaired cognitive function) disorders. These effects are likely to remain long after the pandemic ends and the lockdown measures lifted.

At the core of all these conditions lies elements of one of the most basic and primal human emotions--fear. In the case of the COVID pandemic, this fear is inextricably tied to feelings of helplessness and the loss of a fundamental sense of safety, security, financial stability, and the ability to envision a brighter future. Fear of infection in the presence of others, of contact with contaminated surfaces, and of passing too close to another human being evokes an increasingly familiar mistrust of others, avoidance, and withdrawal from everyday activities, thereby shrinking and constraining opportunities for essential human contact and social support, vitally necessary for adaptive functioning. All this leads to increasing levels of stress and anxiety.

There are specific physical, mental and spiritual strategies we can use to cope with this rising stress and anxiety.

 Physical Approach

 

Healing Through Breath

From ancient times breath has been used as a powerful tool for calming oneself. Doing some mindful (slow, focused) breathing affects our parasympathetic nervous system and calms us down and makes us feel more in control.

Abdominal, deep breathing is especially helpful. We take in the breath through our nostrils, hold it for a few seconds, and breathe out through our mouth. Make the exhale, that is, out-breath much longer than the inhale, the in-breath. Pay attention to the pause between the exhale and the inhale. Try to empty out the breath completely in the exhalation before inhaling again. Rounding our lips to create very small opening through which to exhale makes the exercise even more beneficial. After a while notice how the breathing is affecting our body and mind. Stay for a while with whatever we are experiencing.

 This form of breathing can be done often particular when we are feeling overwhelmed.

Mental Approach

Cognitive Reframing

Our beliefs about Covid and its effects play an important role on our capacity to cope effectively with stress and mitigate its maladaptive outcomes. Many models of stress suggest that stress appraisals and mindsets are central to determining whether our responses to stressors are adaptive or maladaptive. When we appraise the stress situation as challenging, that is, offering opportunities for growth, as opposed to threatening, we are able to cope more effectively. This approach is particularly effective in contexts where the source of stress cannot be avoided, as in the case of Covid. So, reframing our beliefs and attitudes, seeing opportunities in the Covid pandemic rather than dangers, will reduce our stress levels and help us cope better.

Are you experiencing the Covid situation as threatening or challenging? What opportunities can you find in the Covid lockdown?

 Spiritual Approaches

 

Healing Through Meditation and Prayer

Meditation and contemplative prayer have a calming effect on us and can heal us. The simplest and easiest, and yet a very effective form of meditation, is to simply sit quietly and focus on our breath. We don’t need to do any kind of deep or slow breathing. Simply be aware of our breath and the breath will do what it needs to do. When our mind wanders away from the focus on breath we gently return to it and keep returning. This will calm us down, relax and refresh us. Doing it even for short spells during the day, will reduce our anxieties and depressive feelings.

 

We can also turn this simple meditation into a prayer. Instead of focusing on our breath, we focus on the Divine (whichever way we understand it) dwelling within us. We simply sit in the loving awareness of this Divine presence within us. When our mind wanders away, we gently return to the loving awareness of the Divine within us, and keep doing this over and over again as distractions are inevitable. Thinking  of a simple monosyllabic word that has for us some association to the Divine (like the name we give it, or words like love, joy, peace etc.) can serve as a vehicle that takes us back into the loving awareness of the Divine. The deep relaxation this attention creates combined with the experience of the unconditionally loving divine presence, can activate healing mechanisms within us.

 

Loving Kindness Meditation

Loving Kindness Meditation is a technique used to increase feelings of warmth and caring for self and others. It consists of turning positive emotions (e.g., love, warmth, compassion) towards oneself, loved ones, other humans, and ultimately to all living beings. During Loving Kindness Meditation, we sit quietly with eyes closed, focus on our heart, think about a person who loves us very much being near us and experience that person’s love filling our heart with warmth. We now think of more and more such loving people around us sending us love and warmth. We feel our heart filling and overflowing with this love. We now send this love to people whom we know and love, and gradually to people all over the world and then to all living creatures in the universe, wishing them health, happiness and wellbeing. We remain in this experience of receiving and giving love for a while, and take a few slow breaths before we open our eyes.

Doing the Loving Kindness Meditation, even for short periods, is a useful tool during the COVID pandemic and other stressful times because of its many psychological and spiritual benefits. It relieves self-pity, sooths fear and anxiety, reduces depression, dissolves anger, and negates feelings of isolation and aloneness in coping with adversity. It enhances positive emotions such as love, warmth, empathy, joy, gratitude, hope and positive feelings toward others. Loving Kindness Meditation enables us to remain calm and peaceful not only when we engage in it, but throughout the day. The overall effect is increase in our emotional wellbeing and overall life satisfaction.

These physical, mental and spiritual strategies have been practised by Jesus of Nazareth in his healing ministry. He reached out and touched people, he breathed on them wishing them peace. He invited people to reframe their beliefs and attitudes. He loved people and invited them to abide in his love as he abides in his Father’s love. He exhorted them to reach out in love to others just as he reached out to them in love….

Whether we practise the healing tools presented in this podcast or not, we can focus on the presence of this loving and compassionate Jesus with us, reaching out to us in love, embracing us warmly and filling our heart with love and compassion. We can then visualize ourselves reaching out to others with love and compassion, thus filling the universe with healing energies, which can also positively affect those infected by Covid and bring them healing and peace…..

Have a pleasant and love-filled weekend. Bye for now.

Jose Parappully, PhD