It's All In Your Head

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Everyone experiences symptoms of anxiety, but they are generally occasional and short-lived, and do not cause problems. But when the cognitive, physical and behavioural symptoms of anxiety are persistent and severe, and anxiety causes distress in a person’s life to the point that it negatively affects his or her ability to work or study, socialize and manage daily tasks, it may be beyond the normal range.
The following examples of anxiety symptoms may indicate an anxiety disorder:

1. Cognitive: anxious thoughts (e.g., “I’m losing control”), anxious predictions (e.g., “I’m going to fumble my words and humiliate myself”) and anxious beliefs (e.g., “Only weak people get anxious”).


2. Physical: excessive physical reactions relative to the context (e.g., heart racing and feeling short of breath in response to being at the mall). The physical symptoms of anxiety may be mistaken for symptoms of a physical illness, such as a heart attack.


3. Behavioural: avoidance of feared situations (e.g., driving), avoidance of activities that elicit sensations similar to those experienced when anxious (e.g., exercise), subtle avoidances (behaviours that aim to distract the person, e.g., talking more during periods of anxiety) and safety behaviours (habits to minimize anxiety and feel “safer,” e.g., always having a cell phone on hand to call for help).

Several factors determine whether the anxiety warrants the attention of mental health professionals, including:

• the degree of distress caused by the anxiety symptoms

• the level of effect the anxiety symptoms have on a person’s ability to work or study, socialize and manage daily tasks

• the context in which the anxiety occurs.

An anxiety disorder may make people feel anxious most of the time or for brief intense episodes, which may occur for no apparent reason. People with anxiety disorders may have anxious feelings that are so uncomfortable that they avoid daily routines and activities that might cause these feelings. Some people have occasional anxiety attacks so intense that they are terrified or immobilized. People with anxiety disorders are usually aware of the irrational and excessive nature of their fears. When they come for treatment, many say, “I know my fears are unreasonable, but I just can’t seem to stop them.”   

Source: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/anxiety_disorders/Pages/anxiety_disorders.aspx

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Depression is much more than simple unhappiness. Clinical depression, sometimes called major depression, is a “mood disorder” that is a significant mental health problem.

Symptoms

The main symptom of depression is a sad, despairing mood that:

·         is present most days and lasts most of the day

·         lasts for more than two weeks

·         impairs the person’s performance at work, at school or in social relationships.

Other symptoms of depression may include:

·         changes in appetite and weight

·         sleep problems

·         loss of interest in work, hobbies, people or sex

·         withdrawal from family members and friends

·         feeling useless, hopeless, excessively guilty, pessimistic or low self-esteem

·         agitation or feeling slowed down

·         irritability

·         fatigue

·         trouble concentrating, remembering and making decisions

·         crying easily, or feeling like crying but being not able to

·         thoughts of suicide (which should always be taken seriously)

·         a loss of touch with reality, hearing voices (hallucinations) or having strange ideas (delusions).

Depression in women

Major depression can occur in 10 to 25 per cent of women — almost twice as many as men. Many hormonal factors may contribute to the increased rate of depression in women — particularly during times such as menstrual cycle changes, pregnancy and postpartum, miscarriage, pre-menopause, and menopause.

Depression in men

Men with depression typically have a higher rate of feeling irritable, angry and discouraged. This can make it harder to recognize depression in men. The rate of completed suicide in men is four times that of women, though more women attempt it.

Depression in children

A child who is depressed may pretend to be sick, refuse to go to school, cling to a parent or worry that the parent may die. Older children may sulk, get into trouble at school, be negative or grouchy, and feel misunderstood. Because normal behaviours vary from one childhood stage to another, it can be difficult to tell whether a child is just going through a temporary “phase” or has depression.

Misconceptions

·         “People should just get over the blues and get on with their lives.”  Clinical depression is not just unhappiness — it is a complex mood disorder caused by a variety of factors, including genetic predisposition, personality, stress and brain chemistry. While it can suddenly go into remission, depression is not something that people can “get over” by their own effort.

·         “My life will never be normal again.” Most people can and do return to function at the level they did before they became depressed.

Source: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/depression/Pages/depression_mhfs.aspx

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·         Depression is a serious condition. Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will.

·         The symptoms of depression aren’t personal. Depression makes it difficult for a person to connect on a deep emotional level with anyone, even the people he or she loves most. In addition, depressed people often say hurtful things and lash out in anger. Remember that this is the depression talking, not your loved one, so try not to take it personally.

·         Hiding the problem won’t make it go away. Don’t be an enabler. It doesn’t help anyone involved if you are making excuses, covering up the problem, or lying for a friend or family member who is depressed. In fact, this may keep the depressed person from seeking treatment.

·         You can’t “fix” someone else’s depression. Don’t try to rescue your loved one from depression. It’s not up to you to fix the problem, nor can you. You’re not to blame for your loved one’s depression or responsible for his or her happiness (or lack thereof). Ultimately, recovery is in the hands of the depressed person.

Signs that your friend or family member may be depressed

·         He or she doesn’t seem to care about anything anymore.

·         He or she is uncharacteristically sad, irritable, short-tempered, critical, or moody.

·         He or she has lost interest in work, sex, hobbies, and other pleasurable activities.

·         He or she talks about feeling “helpless” or “hopeless.”

·         He or she expresses a bleak or negative outlook on life.

·         He or she frequently complains of aches and pains such as headaches, stomach problems, and back pain.

·         He or she complains of feeling tired and drained all the time.

·         He or she has withdrawn from friends, family, and other social activities.

·         He or she is either sleeping less than usual or oversleeping.

·         He or she is eating either more or less than usual, and has recently gained or lost weight.

·         He or she has become indecisive, forgetful, disorganized, and “out of it.”

·         He or she is drinking more or abusing drugs, including prescription sleeping pills and painkillers.

How to talk to a loved one about depression

Sometimes it is hard to know what to say when speaking to a loved one about depression. You might fear that if you bring up your worries he or she will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.

If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. Encourage the depressed person to talk about his or her feelings, and be willing to listen without judgment. And don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.

Ways to start the conversation:

·         I have been feeling concerned about you lately.

·         Recently, I have noticed some differences in you and wondered how you are doing.

·         I wanted to check in with you because you have seemed pretty down lately.

Questions you can ask:

·         When did you begin feeling like this?

·         Did something happen that made you start feeling this way?

·         How can I best support you right now?

·         Do you ever feel so bad that you don’t want to be anymore?

·         Have you thought about getting help?

Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that he or she will understand and respond to while in a depressed mind frame.

What you can say that helps:

·         You are not alone in this. I’m here for you.

·         You may not believe it now, but the way you’re feeling will change.

·         I may not be able to understand exactly how you feel, but I care about you and want to help.

·         When you want to give up, tell yourself you will hold of for just one more day, hour, minute — whatever you can manage.

·         You are important to me. Your life is important to me.

·         Tell me what I can do now to help you.

Avoid saying:

·         It’s all in your head.

·         We all go through times like this.

·         Look on the bright side.

·         You have so much to live for why do you want to die?

·         I can’t do anything about your situation.

·         Just snap out of it.

·         What’s wrong with you?

·         Shouldn’t you be better by now.

Source: http://www.helpguide.org/mental/living_depressed_person.htm (abridged)