#Generalized Anxiety

[amyintherapy]

Things I've Learned in 18 months of therapy

When people repeat the same patterns of behavior that are more negative than positive, it's usually trauma related. Examples: Your sister who has dated 15 different men who all are emotionally unavailable, short-fused guys who don't respect her. Or your aunt who has gotten into severe debt several times in her life, always buying items she doesn't need. Or your friend who has always befriended people who are not disabled but don't work and chronically need 'favors' so they end up allowing people to mooch off them to the point of it harming their own financial security. Basically anytime you find yourself frustrated and wondering 'why do they always DO that?" or "why don't they just do X instead? They always do Y which just makes things worse..." the answer likely is, they have trauma related to this issue, and/or their behavior is related to their trauma response that they are stuck in. Of course, this is true for you also! If you keep reacting to certain situations in a way you dislike, or going back to a coping method that you see as harmful and can't figure out why you can't stop...it's probably trauma related in some way.

Part of being traumatized involves your brain trying to hide the trauma from you..at least most of it, if not all of it. My therapist has used the example of a piece of paper that is standing upright. You might see the fine edge of the paper, so you sometimes know a piece of paper is in front of you, but you can only see the edge, so when that paper finally gets turned so that it's facing you and you can read everything written on it, it kinda knocks you over and you feel like you should have known all of that all along...after all, the paper was right there. But you couldn't read it before, and you didn't even know there was all that writing on it anyway so you didn't realize such a big piece of your puzzle was missing. In other cases, the paper may be more like...trapped in a book, so it was always there, but you had no idea it was as you thought it was just part of the book, not this hand-written note hidden inside. So anyway, it's very normal to feel shocked at how lacking in awareness you were about the full impact or detail of your trauma once you get on a roll with therapy. I always knew I had trauma, and I've always been a self-reflective person...so I thought I was self aware of my trauma. But I've been surprised at how much I was failing to see fully.

ADHD is stupidly named. Having ADHD doesn't mean you have a deficit of attention. It means you can't control (aka regulate) your attention the way most people can. Tons of people with ADHD would tell you that they feel like they have too much attention. They are interested in ALL the things which is why they struggle to keep their focus on one thing while blocking out everything else going on around them. The things you do that cause you problems, were things you originally did to protect yourself. For example, maybe your addiction started because you were reaching for emotional relief and had no other (healthier) way to make yourself feel better. Or maybe you shut down and isolate when you're hurt, because when you tried reaching out for support as a child it just made things worse because your caregiver was reactive instead of supportive. Endless examples, but people do things for a reason. Your coping methods have a logical cause of some kind or another, even if they do more harm than good now, that wasn't always the case. At one time, they helped you cope with or avoid some bigger pain or problem. Depression and anxiety are both forms of avoiding other feelings. Much of general society knows the concept that "anger is a secondary emotion" (which is only sometimes true, it's also a core emotion) but I didn't know this was true of anxiety and depression. They're always secondary emotions. However, it's important to differentiate between sadness and depression, and fear and depression. Fear and sadness/grief are core emotions, but anxiety and depression are secondary. The fact that I am detail-focused and couldn't be concise if my life depended on it, are both ADHD related for me. Social anxiety is usually attachment trauma aka an insecure attachment. Anxiety and depression are often caused by trauma. I wish I knew this earlier. I spent a lot of time thinking of my anxiety was simply genetic or sort of temperament based and therefore unlikely to be healed or fixed. I don't mean to suggest that genetics or temperment isn't some element but...I can't help but wonder how many people are like me and don't realize they could heal a lot of their anxiety or depression by doing trauma work. I'm definitely still an anxious person, but I've seen a really big improvement in my anxiety. More than I thought was possible two years ago. Most kids and teenagers are avoidant in therapy, so they don't usually see as much progress from the experience, at least compared to adults. It's often a rather slow process to see improvement. However, it's still really helpful in the longrun if they have a positive experience with therapy as a teen, they're likely to try again as an adult when they're really ready to face their issues. Online, I've seen child therapists outright say that their #1 goal with kids in therapy is to make them think of therapy positively so they'll come back to therapy when they're older! I saw some progress in therapy as a teen for sure, but the 4+ years of it resulted in roughly as much (if not less?) progress than I've seen in 18 months of therapy as an adult. Apparently that's quite common. Talking about trauma feels awful, and it often makes me leave trauma-related therapy appointments wondering if there is any point or if i'm just making myself sad. A "okay, I understand this issue I have now was caused by XYZ experience from my past...but wtf do I DO about it? I understand it now, but I still have no clue how to fix it?" type of feeling. This is the result of being too close to the current day to see the full picture. Over the course of time, the benefits and healing always become apparent to me.

People who get angry often are sort of the opposite of me. I default to feeling anxious when I "should" feel angry (like when someone is rude to me), and sometimes also when I 'should' be sad. Most people who experience chronic anger are simply people who are converting their fear and/or sadness into anger. It's sometimes the difference between being an internalize and an externalize. Anger is an external emotion, fear/anxiety is an internal one. So if you struggle to externalize, you'll convert anger to sadness or fear, and if you struggle to internalize you'll convert sadness and fear to anger.

My "small t" traumas - like emotional neglect, are at least as impactful as my "big T" trauma (sexual abuse) was.

Sensory issues are common in ADHD, not just autism even though the content online often makes it seem exclusive to ASD.

I am probably forgetting a lot, but if I don't publish this now I never will. So if I think of more later, I'll just add on. :)

[lousydrawingsforgoodpeople]

i’m rebranding my generalized anxiety.

[mogai-hotel-boss]

[ID: A set of two images. The first is of Lucifer from Hazbin Hotel with a white outline and a translucent black drop shadow in front of a flag splice of his listed identities. The second is a blank flag splice. ID end]

Lucifer Morningstar is an autistic canonically depressed trans bi mspec fallen angel with anxiety!

For an anonymous friend!

[boyczar]

[basilsbestpainting]

Having severe anxiety is buying both the yeast infection and the uti screening kit then immediately having an anxiety attack as you approach the check out counter

At the pharmacy :/

[moonlit-positivity]

Mmm telling a trauma survivor to "feel the fear and do it anyway," is about as productive as telling an ostrich not to be a fucking ostrich. We are in perpetual fight/flight/freeze/fawn, we can't even find some sense of shelter from the fear we are already experiencing. Why isn't there more emphasis on safety & how to shift our nervous systems out of panic and survival first? Having a comfort zone is actually kinda essential when you're escaping abusive situations!!! Some of us have never even had a comfort zone to begin with!!!

[copingmecha]

I made a successful phone call the other day

It only lasted 2 minutes but it was crazy to talk to another human being on the other line

[modernwizard]

Why I love the Spymaster #84: Portrayal of anxiety disorder!

Find my full series under the HELP I WUVS HIM tag.

#84: Portrayal of anxiety disorder!

I've said here and there in my list of reasons I love the Spymaster that he runs on anxiety, but I haven't really dug into that. However, the Spymaster displays quite a few symptoms of generalized anxiety disorder.

According to the DSM-V, generalized anxiety disorder is marked by the presence of excessive anxiety in one's life for a period greater than six months, an inability to manage one's worry, distress/disruption in functioning, symptoms not due to substance addiction, use of drugs, or other medical conditions, and symptoms not being attributable to another mental disorder like panic disorder.

Let's compare the Spymaster's symptoms to the list.

Excessive anxiety? Check.

For >6 months? Check.

An inability to manage worry? Check. Have you seen the Spymaster's coping skills? They all fail spectacularly.

Distress/Disruption in functioning? Check.

Symptoms not due to substance addiction, use of drugs, or other medical conditions? Almost certainly a check. Obviously we can't rule out his symptoms being caused by incorporation of the Matrix and/or the Cyberium. However, we have no evidence that he's dealing with addiction, using any medications, or experiencing another medical condition that would cause these symptoms.

Symptoms not attributable to another mental disorder like panic disorder? Almost certainly a check. Figuring this out is complicated by the fact that the Spymaster has no explicit in-universe mental health diagnoses and also by the fact that different mental health problems can share symptoms. However, the Spymaster does not seem to have something like panic disorder, which features panic attacks, which are episodes of intense physical and mental symptoms of fear.

Besides the signs above, a person must also have three or more of the following: restlessness, fatigue, problems concentrating, irritability, muscle tension, difficulty with sleep.

The Spymaster definitely experiences fatigue [see permanent eyebags of doom in #32: His eye makeup in The Timeless Children!], and irritability [#27: His headbanging!]. He arguably also evinces restlessness in his constant insecure questioning of others [#18: His self-consciousness! and #54: He's still excruciatingly self-conscious!].

Interestingly, generalized anxiety disorder is often comorbid with major depressive disorder. In other words, people with major depressive disorder are highly likely to have generalized anxiety disorder. As far as I'm concerned, the Spymaster clearly has major depression [#83], so the probability is high that he had generalized anxiety disorder as well.

Conclusion: The Spymaster is mentally ill. He has at least one mental illness. One of those is definitely major depression. He may also have generalized anxiety disorder. I feel less confident about this diagnosis because there are symptoms like difficulty with sleep and muscle tension that we don't really have enough information about for the Spymaster. However, he definitely has some severe problems with anxiety, if not a full-blown anxiety disorder.

@natalunasans @sclfmastery @rowanthestrange @timeladyjamie @whovianuncle

[leebird-simmer]

Anxiety Disorders

Anxiety = feeling of concern or worry, with responses such as increased muscle tension, restlessness, impaired concentration, sleep disturbances, and irritability.

- Can be a necessary stimulus for optimum performance in everyday situations (e.g. it encourages more study before an exam).

- However, when anxiety increases beyond a certain level, performance deteriorates noticeably.

{note: see my Educational Psychology posts for more information about stress being a motivator at a certain level and a hindrance at a higher level}

- Strong link exists between anxiety and depression

DSM-5: Anxiety Disorders

Generalized Anxiety Disorder

Panic Disorder

Specific Phobia

Social Anxiety Disorder (Social Phobia)

Agoraphobia

Included previously in DSM-4 (until 2013):

Post-Traumatic Stress Disorder

Obsessive-Compulsive Disorder

Etiology of Anxiety Disorders

Genetics

Stressful experiences

Medical conditions

Drugs (alcohol, caffeine, benzodiazepine dependence)

Generalized Anxiety Disorder (GAD)

- Individuals show signs of constant worry and continuously predict, anticipate, or imagine dreadful events.

- Life is generally stressful, and even minor events provoke worry.

- The chronic anxiety reduces the individual’s performance on many tasks and decreases pleasure.

Panic Disorder

Panic attacks = individual experiences all the effects of a fear reaction without a threatening stimulus, accompanied by strong arousal of the sympathetic ANS (autonomic nervous system).

Symptoms: elevated heart rate and/or chest pain, sweating, shortness of breath, fainting, choking, fear of losing control or dying

- These symptoms can last anywhere from minutes to hours.

- The word “panic” comes from Pan, the Greek god of pastures and shepherds.

Specific Phobias

Phobia = a persistent and excessive fear of an object or situation.

- Focus on specific objects or situations such as high places or enclosed spaces, snakes or other animals, etc.

Cynophobia (extreme fear of dogs)

- Phobias can usually be treated with behavioral desensitization: presenting the fear-inducing stimulus in gradual increments, allowing the individual to maintain a relaxed state while confronting the source of the fear.

- A more contemporary version utilizes exposure therapy in a virtual reality setting.

Social Anxiety Disorder (SAD)

- Extreme fear of being evaluated or criticized by others

- Sufferers tend to avoid most interpersonal situations. When these situations are unavoidable, they suffer extreme anxiety.

- Onset is typically at a young age, with half of affected individuals developing symptoms by age 11.

Post-Traumatic Stress Disorder (PTSD)

- Listed in DSM-5 under section 1.2.7 (Trauma- and stressor-related disorders)

- Appears after a person survives or witnesses a traumatic event

- Symptoms can persist for months or years after the event. Symptoms include...

Nightmares & flashbacks about the event

Sleep disturbances

Increased physiological reactivity to reminders of the trauma

Avoidance of stimuli associated with the trauma

- Genetic component: children whose parents have PTSD are at an increased risk of developing PTSD themselves

Obsessive Compulsive Disorder (OCD)

- Listed in DSM-5 under section 1.2.6 (Obsessive-compulsive and related disorders)

- OCD is characterized by...

Obsessions = unreasonable thoughts and fears

Compulsions = repetitive behaviors in an effort to ease stress

- Obsessions lead to compulsions.

Ex. If a person fears contamination by germs, they may compulsively wash their hands over and over until they’re sore and chapped.

Neurobiology of Anxiety

- The amygdala is a major component of several emotion processing circuits.

- The amygdala aids in formation of emotional memories --> conditioned fear or conditioned emotional response.

- It receives highly processed sensory and cognitive information from the sensory thalamus, sensory and association cortices, and hippocampus.

- The amygdala orchestrates the components of fear: autonomic nervous system activation, enhanced reflex, increased vigilance, stress response, etc.

- Activation of the sympathetic autonomic nervous system produces increased heart rate, sweating, and other signs of “fight-or-flight” response.

- Patients with generalized anxiety disorder (GAD) have increased volume of the amygdala.

- PET scans show greater amygdala activity with exposure to negative stimuli in GAD and phobia patients than in healthy individuals.

- The amygdala also contributes to memory consolidation through its connections with the hippocampus.

- The hippocampus may have a role in some anxiety disorders because reciprocal connections with the amygdala modulate emotional responses.

- Smaller hippocampus can predict PTSD.

- The prefrontal cortex (PFC) exerts inhibitory control over the emotional subcortical regions.

- Anxiety disorders are often considered to arise from an imbalance between emotion generating centers and higher cortical control.

Neurochemistry of Anxiety Disorders

Multiple neurotransmitters and hormones are implicated in the pathophysiology of anxiety disorders.

- Monoamines

Serotonin

Dopamine

Noradrenaline

- GABA; anti-anxiety drugs are GABA agonists.

- Stress hormones (cortisol)

Treatments for Anxiety Disorders

(A) Pharmacological Treatments

Benzodiazepines

Anti-depressants

(B) Deep-Brain Stimulation (for OCD)

(C) Cognitive Behavioral Therapy (CBT)

as effective as medication in treating chronic anxiety disorders

(D) Other Treatments

Electroconvulsive therapy (damages memory)

Transcranial magnetic stimulation

GABA Receptor Agonists

- Drugs that relieve anxiety are called anti-anxiety agents or anxiolytics.

Benzodiazepines (minor tranquilizers) are often given to people who are undergoing some major life stress.

- Sedative-hypnotic drugs include barbiturates and alcohol.

Barbiturates are sometimes prescribed as sleep aids, but most often used to induce anesthesia before surgery.

- Both sedatives and anxiolytics are CNS depressants; all of these drugs reduce brain activity.

The GABA (a) receptor has two sites:

Sedative-Hypnotic site = targeted by alcohol and barbiturates, directly influences Cl- influx

Anti-Anxiety site = targeted by benzodiazepines, enhances binding effects of GABA. Effect is dependent upon amount of GABA present.

- Combining sedative-hypnotics (alcohol, barbiturates) with benzodiazepines (ex. Valium) is extremely dangerous and can result in coma or death, due to:

the double inhibitory effect

enzyme competition (for cytochrome P450)

Barbiturates

- clinically introduced in 1904 and become popular sleep aids

- Between the 1920s and the mid-1950s, barbiturates were practically the only drugs used as sedatives and hypnotics.

- Today they have been largely replaced by benzodiazepines for medicinal uses, such as...

General anesthetic

Sleep aids

Anti-anxiety drugs

Anti-convulsant (to suppress seizures)

- Examples include...

Pentrobarbital (Nembutal)

Secobarbital (Seconal)

- Side effects include...

altered sleep

loss of judgment, mental “cloudiness”

slowed reflexes

- High doses lead to severe intoxication. Coma and death result from respiratory depression. Barbiturates are extremely dangerous when combined with alcohol.

- Barbiturates produce significant physical dependence and potential for abuse.

- Terminating drug use after extended treatment produces a potentially fatal withdrawal syndrome similar to that for alcohol.

- For these reasons, they are no longer prescribed as anxiolytics or hypnotics.

Benzodiazepines

- relieve physical symptoms of anxiety, along with sense of worry and fear

- first choice for short-term treatment of anxiety, or for acute anxiety

- The introduction of benzodiazepines in 1955 led to a decrease in the prescription of barbiturates, and by the 1970s they had largely replaced the older drugs for sedative-hypnotic and anxiolytic uses.

- They target anxiety without producing excessive sedation, loss of judgment, loss of motor coordination, and produce less mental cloudiness (compared to sedative-hypnotics).

- Examples include:

Alprazolam (Xanax)

Diazepam (Valium)

- Longer-acting BDZs are useful hypnotics to aid sleep.

- Some BDZs are useful muscle relaxants and others are anti-convulsants for the management of epilepsy.

- They can also prevent acute alcohol or barbiturate withdrawal symptoms.

- BDZs do not induce liver enzymes, resulting in less tolerance.

- There is a lower risk of dependence and abuse, but it does happen.

- Reinforcement is much lower than with barbiturates, but BDZs with rapid onset can be self-administered by animals.

- Recreational use of BDZs is often combined with alcohol, opioids, or other CNS depressants, which can be highly toxic.

Anti-Depressants for Anxiety

- Antidepressants including tricyclic antidepressants, MAOIs, and SSRIs can treat both anxiety and depression, which often occur together.

- SSRIs are the first choice for chronic anxiety because they have fewer troubling side effects, a high therapeutic index, and low abuse potential.

MDMA for PTSD

- also known as “ecstasy,” “molly,” or “mandy” (in the UK)

- currently illegal, no approved medicinal use

- increases sociability, empathy, emotional awareness {note: it was developed for use in family & couples therapy.}

- August 2017: FDA designates MDMA as “breakthrough therapy” for PTSD.

- MDMA is currently in Phase 3 trials, the final stage before FDA approval. Learn more about that here: https://maps.org/mdma/ptsd/phase3/

[cautiousgoose]

I think one of the worst things about having an anxiety disorder is that knowing that stressing about the thing won't fix the thing does not stop the stressing.

So like, then you get to have two downward spirals: one about whatever the original issue was, and a second spiral about how all the first spiral is doing is negatively effecting your physical and mental health.

[topcon1992014819911-blog]

I'll discuss things like !

What topics do you like to discuss? Discuss Depression, anxiety, PTSD, addiction, my health,today’s news, my new books , life, daily post, blogs , Lawsuit, bullying, criminal offenses, sexually assault, relationships,dating , I talk about many different aspects of things because in today’s life people don’t want to address things or to be honest not only that they don’t want to talk about…

[equilibriumhealthllc]

We all feel anxious sometimes, but when feelings of anxiety start to negatively affect your life, you may be dealing with an anxiety disorder that may require therapy.

[familydocblog]

Worrier to Warrior: 7 Small Steps for a Brighter Mind

Worrying is a typical behavior that frequently coexists with anxiety and stress. It can be difficult to escape its hold, but with a little work, you can reduce anxiety and improve your general wellbeing. This blog post will delve into helpful recommendations designed especially for the vivacious 20–50 age group. Learn how empowering yourself with modest efforts can help you overcome worry and…

[graybeams]

Dear Diary,

Lately I have been envious to those who can make friends through anything they do. It just comes so naturally to them. Some people can just ease their way into conversations and walk right out of them with someone who wants to talk to them each time they see them. I find it hard to make friends through my passions too, mainly irl, because on the internet it's just so much easier to like someone's post and comment underneath it without mumbling or stuttering. I don't have to dwell on an awkward moment for much longer than neccessary and I can just breathe. But when someone does try to talk to me in person, I just freeze or avert my eyes away.. sometimes I even tense up from the sound of their voice.

That one may be from past trauma but I just hate it so much! I hate that I'm like this. Why can't I just be normal?! I'm told all the time that I'm not normal. That everybody else my age does this or that... That I'll never thrive if I don't rid this anxiety... It almost feels like a curse. And I'm aware that a lot of people suffer with anxiety but so many people in my life don't and that's why I get so emotionally frustrated. Because they don't understand. They don't understand how I'm feeling. If I could make it all go away... if I could make the mocking voices stop... I'd be okay. I'd feel okay. I could finally breathe without holding my breath every damn time sometimes approaches me. My palms wouldn't be damp. My shoulders could rest. My heart would slow down.

My whole mind would be at peace. No more overthinking. But instead, it's always going. I'm consumed with constant worry and stress. I wish my anxiety didn't kill my social skills. I wish I wasn't born like this. I wish I was normal. I wish it would end. I wish I could stop asking myself, "What's wrong with me?" and just disappear instead sometimes. Then I'd no longer have to feel this way anymore. Living with anxiety is exhausting. Existing is exhausting.

[madpunks]

poor memory is a huge deal and i wish people wouldn't diminish it by saying "oh yeah i can't remember what i had for breakfast lol."

i can't remember the first 10 years of my life. i can't remember entire days, weeks, months at a time. i can't remember entire people, i can't remember names or faces. i can't remember when things are scheduled for, my calendar app on my phone is booked to the max with reminders and task checklists. i can't remember when i moved into what home when, i can't remember important milestone dates like when i got or lost certain jobs, or when i started a new hobby.

that's what i mean when i say i have poor memory. poor memory is so scary for the person who has it. it's not a quirky thing, everyone forgets small details. memory problems are scary because you can go through entire events or days with no memory, or plan for things in the future that you can't recall ever even looking into or scheduling. it's not a funny haha kind of thing, it's serious, and it affects a lot of people in very unavoidable ways.

not being able to plan for appointments or work schedules, not being able to remember people's names or faces, not being able to recall whether or not you were present for something or whether or not you met someone, not being able to keep track of what's happening on what dates and losing track of items because you can't remember where you put them are all very real problems, and anyone dealing with them deserves to be taken seriously, and not diminished when they choose to speak up about it.

[brainrotcharacters]

the man trained by the shimotsuki since childhood, the mind behind the three sword style, the demon pirate hunter, vice captain of the Strawhat Pirates,

easily stopped with a hand on his shoulder by his captain (currently in a silly hungry vibe)