Common Mental Health Issues and Struggles
By Wendy J Poole
Curious to know if your struggles are treatable or, in fact, need to be treated. Are they common? I've broken down some of the most common scenarios I deal with in my office to help you understand where you may be, and to help you decide what the next steps are.
Anxiety Disorder is a dreaded ordeal for some human beings. It sounds like the end of the world for some of us ... that maybe I don't really have all my stuff together if I indeed have anxiety. Nobody wants to be an anxious person. So it is not surprising that few people want to admit to the fact that they are struggling with anxiety. And it is even less surprising that people who know they are struggling with it, desperately don’t want others to know about it. This cycle of hiding our lives from others though, only leaves us more anxious and debilitated in our lives.
The question that really needs to be asked is … Why do we have such poor perceptions of anxiety, and why do we even need to call it a mental illness if it is so pervasive in our society? After all, anxiety disorders are the most common mental disorders in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year. And this statistic is only measuring ones seeking treatment...so I am sure the number is quite higher. So really, the odds are that as you read this article in that coffee shop you love, on that college campus where you’re going to school, or in that church you attend, someone else is likely experiencing exactly what you are.
Anxiety disorders are highly treatable, but due to the unfortunate negativity surrounding the word anxiety only 36.9% of those suffering receive consistent treatment. This means most are left in an isolated struggle that only exacerbates their inability to feel like they can have a moment of peace.
Perhaps at this point you’re wondering if you have ANXIETY. Well, that’s a great question that anyone who feels like she is just not quite her usual self or constantly in her head about EVERY. LITTLE. THING. should consider. The signs of anxiety are fairly easy to identify if you know what you’re looking for. Among the symptoms of anxiety, some common symptoms are:
Compulsive thinking in the past or future (I call this the gerbil wheel of thought...hard to jump off. Seemingly impossible to stop thinking and worrying. “I should have done, said, behaved or I need to say, do, behave like this.)
Stomach aches/digestive troubles (Sometimes IBS or chronic digestive issues.)
Nervous habits and cravings (i.e., cigarettes, alcohol, binge eating, picking your fingers, scabs, etc.)
Pain or lump in your throat and/or trouble breathing in moments of stress
Sleep loss due to excessive worry
Tightness/pressure or pain in your heart or chest area
Paralyzing fear of some person, thing, or scenario in your life
I have personally struggled with anxiety starting at a very young age. Many nights I have lain awake desiring to just fall asleep and stop caring so much, but I found myself unable to do so because of the compulsive thinking patterns (excessive worry). Some of these issues stem from the fact that my own family members suffered from anxiety, and the proverbial apple fell very close to the tree. Many in my family took up the unhealthy habit of smoking to “soothe the nerves.” Others drank alcohol regularly for the same soothing effect, and others pursued different negative numbing strategies: alcohol, busying themselves, habitually over cleaning, over exercising, relationship seeking, binge eating, binge television watching, etc. In all of these things, the overarching desire was for control and peace, even if just for a brief moment. These habits, even as unhealthy as they are, could offer them relief from extra stressful situations. My family members and I were not facing our fears or other dark feelings that inevitably come. We were merely coping (with negative habits) or numbing.
I see the same stories every day in my work as a counselor. Many clients struggle with things like substance abuse, pursuing unhealthy relationships or inappropriate sex partners, habitually gambling, binge eating or binge watching TV, or compulsively scrolling on their phones... all in the hopes of "numbing" their constant emotional pain or fear/anxiety or even everyday stress.
Does this sound like you? Then I have good news and bad news for you.
The bad news is this is pretty normal and certainly not atypical... you most likely have some level of anxiety in your life. It means you’re probably not dealing with the real issue or dark feeling, but are merely circumventing the issue by using negative coping mechanisms. You are currently in a stage of life where you’re experiencing what I like to call the “gerbil wheel of thought" or the “rabbit hole of hell.” If you continue down this rabbit hole, I do have a caution for you. It will lead to awful and complicated life experiences. That eating habit will only make you feel worse about yourself later. That relationship you know isn’t healthy will only leave you more broken. I cannot stress the importance that these things only help you cope in the short term.
“I feel like I am going to die” is something I have heard from my clients a heartbreaking amount of times. And I believe them when they say it. I’ve even had family, friends, and clients show up at emergency rooms when these things escalate into actual Panic Disorder.
But despite all the above, there is hope and that is the the good news. It’s simple. Your story isn’t that odd. It’s actually fairly normal as I stated at the beginning of this article. This means that if you can overcome your initial fear and learn to talk about your anxiety, whether with a counselor like myself or even just a friend you trust, that the ability to heal and move past it is possible. You don’t have to continue being plagued by worrisome thoughts that require you to do things to numb the feelings that flutter around inside your chest. While it does take time and disciplined energy to change thought patterns, I can excitedly tell you from my own own experience and the experience of hundreds I have counseled that change is possible and these desperate and debilitating behavior patterns don’t have to last a lifetime.
If you have a hard time thinking about talking to a friend or family member, then I really do encourage you to pick up a phone and meet a therapist. For one, therapy actually works. I even meet with a therapist myself. Imagine that, a therapist getting therapy! But more than that, therapists have confidentiality agreements and cannot disclose sensitive or private information. So if you’re worried about gossip, this is a great way to experience empathy and privacy in your conversations to begin healing. So, please pick up a phone and call a counselor who has expertise in Anxiety. If you want to call me, my number is (479.381.1652)
If you feel confident talking to a friend, and she has earned the right to hear your story, allow yourself to be present with your anxiety and give yourself space and time to actually feel your feelings. This will be overwhelming at first, but is a necessary step towards healing. Over time, that feeling that seems like it will crush you will naturally begin to dissipate. I have learned many coping strategies in my own counseling sessions or during my study of it, they have really changed my life, and this is only one of them. Visualize it as a wave, it comes…it is painful, but then it recedes and you are stronger for it.
Generalized anxiety disorder (GAD) is characterized by chronic anxiety that persists for at least 6 months and is complimented by phobia, panic attacks, or obsession. To be given a diagnosis of generalized anxiety disorder, your worry must focus on two or more stressful life circumstances (finances, relationships, health, work problems or school performance) for a majority of days during a six month period. It is common if you are dealing with generalized anxiety disorder, to have a large number of worries and to spend a lot of your time worrying. Yet you find it difficult to exercise much control over it. The intensity and frequency of the worry are out of proportion to the actual likelihood of the feared events happening.
Current treatment for anxiety disorders falls into these following categories. I will work with you in any and all categories to find the best solution.
Cognitive Therapy. Fearful and perfectionistic self-talk underlying specific worry themes is identified, gently challenged, and hopefully replaced with more realistic thinking. When you worry, you overestimate the odds of something negative happening and underestimate your ability to cope if something bad does, in fact, happen. Cognitive therapy aims to correct both types of distorted thinking. You would also work on changing negative beliefs about worry itself. These include both beliefs that worry will help you avoid something negative, such as “if I worry about it, it won’t happen,” and fearful beliefs about worry itself such as “My worries are uncomfortable” or “I’ll go crazy from worrying.” Realistic self-statements are consistently practiced and internalized over time.
Worry Exposure. In worry exposure, you do repeated and prolonged exposure to fearful images (your worst-case scenarios) of what you’re worried about. In these images you include strategies you would use to reduce anxiety and cope with situation.
Reducing Worry Behaviors. You identify overly cautious “safety behaviors” that tend to reinforce worrying. For example, if you tend to call your spouse or child several times a day to check on them, you reduce the frequency of this behavior.
Problem Solving. This means taking systematic action to solve the problem you are worried about. You and I focus on solutions to the problem that worries you instead of the worry itself. If there is no practical solution, you work on changing your attitude toward the situation; that is, learning to accept what you cannot change.
Distraction. A variety of distraction techniques can be helpful for worries that do not lend themselves easily to cognitive therapy or problem solving. Common healthy diversionary activities include talking to a friend, journaling, listening to music, gardening, exercise, arts and crafts, and cooking.
Mindfulness Practice. Mindfulness is an attitude of simply witnessing the ongoing stream of your thoughts and feelings without self-judgment. It originated in Buddhist meditation practices but is now being used as common treatment for stress, depression, and generalized anxiety.
Lifestyle and Personality Changes. Such changes: stress management, increased downtime, regular exercise, eliminating stimulants and sweets from diet, resolving interpersonal conflicts, and changing attitudes toward perfectionism, and excessive need to please others, or the excessive need to control.
DEPRESSION or FEELING STUCK
Everybody feels blue now and then, this is just part of life (Life is Struggle), but most of the time it lasts just a few days and goes away on its own. Depression is different. It gets in the way of your daily life and makes it harder to do the things you love. You'll need treatment to get better.
Some people find themselves stuck in a mindset, whether it is in a relationship (with partner/parent/sibling/child); a job; a social setting; or a church. After a few sessions, it is usually revealed that this IS a pattern. We look at the childhood patterns. This is not a blaming experience. We don’t pick our parents apart to lie blame on them for how our life has turned out; although we do analyze it thoroughly so that we can understand what we originally learned in our childhood. Typically we adult with these same behaviors UNTIL we find something that works better for us. And sometimes we find that something subconsciously through numbing ourselves, and typically numbing is NOT a good coping strategy.
There are a lot of signs of depression, but you may not have them all. How intense they are, and how long they last, are different from person to person. Some of the ways you might feel are: sad, empty, helpless, worthless, hopeless, irritable, less interest in activities or hobbies, less energetic, need for more sleep, less ability to concentrate, more apathy.
The cause of depression can be due to a combination of things. For one person, depression is caused by inherited inefficient brain structure. A prominent theory is altered brain structure and chemical function. Brain circuits that regulate mood may work less efficiently during depression.
Depression might also be caused by tragic or traumatic life events or unresolved childhood problems and patterns. The ability to discuss your feelings (which you probably have covered up for some time) with an empathetic partner like a therapist is a great tool to begin to understand any and all possible causes of depression. I can offer you a sounding board, empathetic ear, and some possible changes in the way you think to help as coping strategies for your depression.
If you cannot muster the energy to get out of bed or bathe regularly, I believe that you could be suffering from some type of severe depression. If you have suicidal or homicidal thoughts, it IS an emergency situation, so get to the ER. A moderate level of depression feels like a weight around the legs or just lack of “giving a flip”. LETHARGY regularly haunts you. Thoughts like “It wouldn’t be a big deal if I weren’t here.” “If a car hit me, then it wouldn’t be such a loss.” Some folks with a moderate level of depression, can muster the energy to go to work, but isolates most of the other time. Isolation is a coping strategy you have employed subconsciously; however, it isn’t the healthiest one. My job is to help you discover better and healthy coping strategies.
Pharmacology for both Anxiety and Depression is available and sometimes very appropriate; however, I think the medications for these mental health issues have been way over prescribed without getting a real look at what the origin of it is and how to solve for it otherwise. I suffer from both periodically, yes, my inherited predisposition, to Anxiety and Depression, and I have been medicated sometimes in my life. I believe that it is a good option SOME OF THE TIME for SOME PEOPLE. However, if a person is up for the challenge of locating where the issues stem, there are ways in which someone can move through sessions of effective psychotherapy (with or without pharmacology) to deal with the origin and consequential behaviors and yes CHANGE your behavior.
Drugs For Depression
Called antidepressants, these help lift your mood and ease the sadness and hopelessness you might feel. If this is an option for you, I will work with you so that you can work with your doctor to find the one that works best for you with the fewest side effects. It’s all about the brain circuitry that helps manage your mood. The three key chemicals are norepinephrine, serotonin, and dopamine. Research shows that in depression, brain circuits that use these chemicals don't work efficiently. Antidepressants tweak the chemicals so that the circuits work better. That can help improve your mood, although researchers don’t understand exactly how. I am NO expert in medications, and I do not pretend to be, nor do I prescribe them to my clients; however, I can be someone to help you get the right expert on your side.
LACK OF SELF-ACCEPTANCE
This is the third category of difficulty for which folks land in my office. I believe that this category can catapult you into the other two categories (one or both): Anxiety or/and Depression. If we can solve this problem by looking mindfully at our thoughts and actions in depth and habitually, you can CHANGE YOUR LIFE dramatically over time by breaking your self-deprecating and self-punishing patterns. I believe, particularly in the Southern Culture, we experience a lot of our lives AT THE EXPENSE of ourselves FOR others, whether it is your spouse, friends, child, children, parents, siblings, or job or church.
As a professional, I have been trained in Dr. Brene Brown and Dr. Kristen Neff’s academics: Daring Greatly, Rising Strong, Braving the Wilderness along with the Self-Compassion curricula. I have helped and can help someone reach inward and develop kindness toward herself and help her make herself a priority (not pridefully) and set proper boundaries so that she can live a more authentic and happy life.