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Mental Health Awareness Week – Anxiety
and depression have been the number one reason for visiting a doctor in Scotland since 2004. Currently, at least 1 in 8 people in Scotland suffer from either condition and it is estimated that 1 in 4 people will suffer one or both of these conditions in their lifetime. Until recently, people have wrongly concluded that depression and anxiety were restricted to people who are weak willed, had a bad attitude or a challenging life. The truth is, anxiety and depression are medical conditions that are widespread, rapidly increasing and can affect absolutely anyone.
Anxiety is a normal response to threat or danger and part of the usual human experience, but it can become a mental health problem if the response is exaggerated, lasts more than three weeks and interferes with daily life. Anxiety is characterised by worry and agitation, often accompanied by physical symptoms such as rapid breathing and a fast heartbeat or hot and cold sweats. ‘Stress’ is not considered a mental health problem in its own right, but long-term stress may be associated with anxiety or depression. Generalised anxiety disorder (GAD) is diagnosed after a person has on most days for at least six months experienced extreme tension (increased fatigue, trembling, restlessness, muscle tension), worry, and feelings of apprehension about everyday problems. The person is anxious in most situations, and there is no particular trigger for anxiety. People who experience anxiety usually have symptoms that fit into more than one category of anxiety disorder, and are usually diagnosed with at least one other mental disorder, most commonly depression.
Obsessive compulsive disorder
is a common form of anxiety characterised by obsessive thinking and compulsive behaviour. Obsessions are distressing, repetitive thoughts which may be seen as irrational, but cannot be ignored. Compulsions are ritual actions which people feel compelled to repeat in order to relieve anxiety or to stop obsessive thoughts. For example, someone may believe that their hands are constantly dirty so wash them over and over again. 2-3% of people will experience Obsessive Compulsive Disorder during their lifetime. It often takes between 10 and 15 years for people to seek professional help.
Phobias (including panic attacks)
describe a group of disorders in which anxiety is experienced only, or predominantly, in certain well-defined situations that are not dangerous. As a result, these situations are avoided or endured with dread. The person’s concern may be focused on individual symptoms like palpitations or feeling faint and these are often associated with secondary fears of dying, losing control, or ‘going mad’. Phobias are much more common in women than men, affecting about 22 in 1,000 women compared with 13 in 1,000 men in Britain. Agoraphobia is the term for a cluster of phobias that include fears of leaving home, entering shops, crowds and public places, or travelling alone in trains, buses or planes. Social phobias are characterised by a fear of scrutiny by other people. Symptoms may include blushing, shaking hands, nausea or the urgent need to go to the toilet. There are numerous phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, using public toilets, eating certain foods, dentistry, or the sight of blood or injury. Panic disorder occurs when there are recurrent, unpredictable panic attacks followed by at least one month of persistent concern about having another attack. Panic attacks are usually contained episodes characterised by a sudden and intense sensation of fear and accompanied by physical symptoms, and the person may feel that they are dying.
Post-traumatic stress disorder (PTSD)
develops following a stressful event or a situation of an exceptionally threatening or catastrophic nature. Intentional acts of violence are more likely than natural events or accidents to result in PTSD. Common symptoms may include re-experiencing the event in nightmares or flashbacks, avoiding things or places associated with the event, panic attacks, sleep disturbance and poor concentration. Depression, emotional numbing, drug or alcohol misuse and anger are also common. In children, re-experiencing symptoms may take the form of re-enacting the experience, repetitive play or frightening dreams without recognisable content. The risk of developing PTSD after a traumatic event is 8.1% for men and 20.4% for women. Symptoms of PTSD usually develop immediately after the traumatic event but for less than 15% of people affected, the onset of symptoms will be delayed. PTSD sufferers may not seek treatment for months or years after the onset of symptoms.So, how do you overcome anxiety? The latest statistics from Yale University show that, for people who have a mental health issue such as depression or anxiety and treat this issue with medication only, approximately 20% of people in this category will be free of the issue one year later. If Cognitive Behaviour Therapy is added to the treatment, then 70% of people in this category will be free of the issue one year later. Statistics also show that people who have undertaken CBT are less likely to have a relapse later in life than those who have taken medication alone.
Power. It’s that intangible thing that so many people strive for. For some people, feeling a sense of control — over themselves, others, situations or all of the above — is a natural thing. For others, it doesn’t come as easy. In her TED Talk (http://www.thinkingbetter.org.uk/cbt-therapy.html), social psychologist Amy Cuddy shares an easy way that anyone can change not only others’ perceptions ofthem, but the way they feel about themselves — spending two minutes “power posing” with their arms or elbows out, their chin lifted and their posture expansive. Cuddy’s research, done in collaboration with Dana Carney, has shown that adopting the body language associated with dominance for just 120 seconds is enough to create a 20 percent increase in testosterone and a 25 percent decrease in the stress hormone cortisol. In other words, adopting these postures makes a person feel more powerful.
Over the past decade, psychology researchers have not only identified the great social, psychological, and physical health benefits that come from giving thanks; they’ve zeroed in on some concrete practices that help us reap those benefits. And perhaps the most popular practice is to keep a “gratitude journal.” Studies have traced a range of impressive benefits from the simple act of writing down the things for which we’re grateful — benefits including better sleep, fewer symptoms of illness, and more happiness among adults and kids alike.
The basic practice is straightforward. In many of the studies, people are simply instructed to record five things they experienced in the past week for which they’re grateful. The entries are supposed to be brief — just a single sentence — and they range from the mundane (“waking up this morning”) to the sublime (“the generosity of friends”) to the timeless (“the Rolling Stones”).
Robert Emmons, a professor at the University of California, arguably the world’s leading expert on the science of gratitude and an author of some of the seminal studies of gratitude journals, shared these research-based tips for reaping the greatest psychological rewards from your gratitude journal.
Don’t just go through the motions. Research by psychologist Sonja Lyubomirsky and others suggests that journaling is more effective if you first make the conscious decision to become happier and more grateful. “Motivation to become happier plays a role in the efficacy of journaling,” says Emmons.
Go for depth over breadth. Elaborating in detail about a particular thing for which you’re grateful carries more benefits than a superficial list of many things.
Get personal. Focusing on people to whom you are grateful has more of an impact than focusing on things for which you are grateful.
Try subtraction, not just addition. One effective way of stimulating gratitude is to reflect on what your life would be like without certain blessings, rather than just tallying up all those good things.
Savour surprises. Try to record events that were unexpected or surprising, as these tend to elicit stronger levels of gratitude.
Emmons says that when people start keeping a gratitude journal, he recommends that they see each item they list in their journal as a gift — in fact, he suggests that they “make the conscious effort to associate it with the word ‘gift.’” Here are the exact instructions he gives participants in his studies: Be aware of your feelings and how you “relish” and “savour” this gift in your imagination. Take the time to be especially aware of the depth of your gratitude.
“In other words,” he says, “we tell them not to hurry through this exercise as if it were just another item on your to-do list. This way, gratitude journaling is really different from merely listing a bunch of pleasant things in one’s life.”
So why might this particular practice do such good for our minds and bodies? Emmons points to research showing that translating thoughts into concrete language — whether oral or written — has advantages over just thinking the thoughts: It makes us more aware of them, deepening their emotional impact.
“Writing helps to organise thoughts, facilitate integration, and helps you accept your own experiences and put them in context,” he says. “In essence, it allows you to see the meaning of events going on around you and create meaning in your own life.”
Though he does have suggestions for how to keep a gratitude journal, Emmons also stresses that “there is no one right way to do it.” There’s no evidence that journaling at the start of the day is any more effective than journaling before you go to bed, for instance.