Characteristics of Depression – An article series.

There are several types of depression, each with distinct characteristics. Let’s explore them:

  1. Reactive Depression:
    • Triggered by specific life events, such as divorce, loss, or financial difficulties.
  2. Seasonal Affective Disorder (SAD):
    • SAD occurs during specific seasons, often in winter due to reduced sunlight exposure. Symptoms include fatigue, low energy, and changes in sleep patterns.
  3. Major Depressive Disorder (MDD):
    • Also known as clinical depression, MDD is the most common type. It involves persistent feelings of sadness, hopelessness, and a loss of interest or pleasure in daily activities. Symptoms can be severe and impact daily functioning.
  4. Dysthymia (Persistent Depressive Disorder):
    • chronic form of depression lasting for at least 2 years. It is characterized by milder symptoms but persistent low mood.
  5. Cyclothymia:
    • Involves unstable moods, including periods of depression and elation. Not severe enough to be diagnosed as bipolar disorder.
    • Psychotic Depression:
      • Severe depression accompanied by psychotic symptoms such as hallucinations or delusions.
  6. Prenatal or Antenatal Depression:
    • Occurs during pregnancy and can affect both expectant mothers and fathers.
  7. Postpartum Depression:
    • Occurs after childbirth and affects both mothers and fathers. Symptoms include sadness, anxiety, and difficulty bonding with the baby.
  8. Bipolar Disorder (Manic Depression):
    • People with bipolar disorder experience extreme mood swings. These include depressive episodes (similar to MDD) and manic or hypomanic episodes characterized by elevated mood, increased energy, and impulsive behavior.

Panic Anxiety Disorders and Health Anxiety  PART TWO

Crossover Symptoms of Anxieties.

In part one we looked at the DMS-5 Guidelines for recognising the differences between Panic Anxiety Disorder and Panic Disorder. In Part Two, we look at people’s experiences from panic attacks of both types and question if there is a link to health anxiety disorder, based on patient experiences.

The Guideline Symptoms:

raised heart rate                                                  shortness of breath.

Feeling queasy                                                    stomach tightening

Throat restrictions                                              hands clammy.

Depersonalisation

The Symptoms according to people’s actual experiences of panic attacks:

Heart rate

It felt like a sledgehammer in my chest, and it felt loud. My chest felt like it was being crushed and I thought I was having a heart attack. I felt like my chest is caving in on itself from so much pressure.

Shortness of breath

 For no reason I felt myself struggling to breathe, my breathing was rapid and in explainable I do not recall having problems with breathing before, but this is weird and restricted.

 I found my stomach feeling queasy.

 I felt like it was rolling like a ship in stormy waters not at all like the usual butterflies when I am nervous.

My stomach

It felt very tight and hard, as if it were suddenly clenched and had become restricted, very painful.

Throat restrictions.

 I just could not speak my throat was all closed down, it was like my throat was not capable of an uttering a word and had completely left me.

Clammy / sweaty

 I felt clammy and sweaty all over but particularly my hands, my face, and my body.

 Depersonalization

 It all felt so surreal, one minute I was walking along and the next, I was having a panic attack and everything around me felt surreal. It was like I was not in reality anymore. I felt totally confused and out of it, like I had gone somewhere else entirely but not somewhere I know. I was so scared and I still am. Since my panic attack I am reluctant to leave the house, and this is the crux of the matter. If asked why? No explanation can be found.

The jigsaw pieces have not been found and this is where therapy can be helpful, joining the dots, so as to speak of a trigger, which relates to the past – let’s not forget the older part of the brain has no concept of time, but keeps a record of experiences and sometimes similar modern experience can trigger a past experience as if it were recent. It all stems from the past experience playing out in the present. The problem or block is that the old experience is not recognised and dealt with (processed).

The differences between a shared natural traumatic disastrous event and a personal traumatic event:

Let us just suppose, a natural traumatic event takes place when you least expect it too. Shock, heartache, misery, confusion and bewilderment are the likely feelings we experience. There is here however a difference, in the way that we process trauma. When it is a shared tragic experience amongst many people at the same time, a shared bonding develops to help the processing with multiple support. We are able to come back online to our nervous system and brain again because the processing of the trauma has been completed. This is where the difference lies, a collective bonding between a catastrophic event which effects so many people at the same time versus a singular incident or catastrophe/trauma in which the individual feels shut down and isolated. With no support, understanding or compassion from other people, the sufferer can be feeling a hidden despair and dysregulation of the nervous and brain systems (not fully online together). Carrying the trauma alone with not enough support or any at all.  Many times, I have seen the symptoms of panic disorder and anxiety, amalgamate into health anxiety disorder (HAD). Hence, it is always wise to look at what else in going on currently and from the past. Clients and patients are the first to then tell you as they have all the information.

Panic Anxiety Disorder & Panic Disorder Part 1

DSM-5 Definition of panic attacks or panic anxiety disorder.

The DSM-5 Diagnostics, has simplified the approach to panic anxiety disorder into two very clear differences: expected panic attacks and unexpected panic attacks.

Expected panic attacks are associated with a specific fear like that of flying and any type of phobia which interferes with day-to-day life or planned activities. It’s quite common for expected panic attacks to be linked to phobias, which is one of the most common causes of expected panic attacks.

Panic anxiety disorder is the opposite and is a completely unexpected panic attack. This type of anxiety disorder where panic attacks can suddenly occur without warning and be followed by increased heart rate, shortness of breath, feeling queasy, stomach tightening, throat restriction, hands clammy. They occur suddenly without any warning catching you completely unawares and leaving you in a dreadful and terrified state, feeling quite shocked. Some people can also experience feeling detached from their reality (depersonalisation) or a feeling of internal numbness.

This type of panic attack is very often triggered unknown to us and at any time any place anywhere. What’s happening here is the information that the brain is receiving is being compared to any previous experiences similar. If there is a strong previous experience, then flight or fight kicks in instantly to aid human survival. These kinds of panic attacks are often linked to PTSD, which can involve ongoing repetitive trauma in the past but also a singular traumatic experience from the past as well. Let’s not forget the area of the brain that is triggered into panic/anxiety mode, is the area of the brain has absolutely no concept of what time is and when trigger experience suddenly occurs and creates a panic attack, it can be related to an incident that occurred in the past and yet, as if it was 5 minutes ago.

What other presenting issues can bring on panic attacks?

Certain drugs or substances alcohol combinations. Other underlying medical conditions and mental health disorders. The majority of people with underlying conditions would be aware of these and realise hopefully that panic attacks can be the result of these things.

If, however panic attacks are a complete mystery to you and causing you such misery because you can’t understand why they’re happening, then it’s a question of looking to environmental root causes and for the answers and the best treatment plans are found to be within talking psychologies, such as psychotherapy, hypnotherapy and EMDR. Talking therapies can help to bring about the missing jigsaw pieces which complete the picture that results in panic attacks. The results are good because it gives you a much clearer picture of the underlying causes and can help you to self-manage the condition of anxiety freeing up your life to reach whatever potential you choose.

Agoraphobia can start as a mild form of avoidance and if not treated can escalate into full blown agoraphobia.  It is an anxiety disorder in which a person is distressed by settings in which there is no easily perceived means of escape. An agoraphobic avoids certain social situations, large or open areas and public places where it would be difficult to hide. In some case’s agoraphobia debilitates someone to a point at which he or they cannot leave home. Any situation unfamiliar to the agoraphobic becomes a potential source of fear or anxiety arising from panic attacks, which some believe stems from traumatic early life experiences. Traumatic events can disrupt learning and memories, causing depersonalisation and other methods of blocking out anxiety.  Hypnotherapy combined with psychotherapy has been proven to produce long-acting beneficial results when the root cause is to be found in the yearly developing years.

How does Agoraphobia develop?

The causes of agoraphobia, like most mental disorders, are not definitive. Still, some experts have theorised that besides stressful and traumatic events, sudden shock, other anxiety disorders and substance abuse may also contribute. Along with agoraphobia, many patients have also been diagnosed with obsessive compulsive disorder (OCD), posttraumatic stress disorder and separation anxiety disorder. Women may suffer from this condition more than men because of social-cultural factors that encourage avoidant coping strategies. Other theories have posited that more women may seemingly suffer from the condition simply because more of them are willing to seek help.

Health Anxiety Disorder. Why I’m always unwell, Why?

Venture towards anybody undertaking some sort of activity or job at a desk with a computer and notice the telltale signs of health anxiety disorder (HAD).

For one thing you’ll notice everything on the desk is reasonably tidy and easy to find, there’s a distinct lack of coffee or tea stains from cups on the table and there may be a little bag of wipes for cleaning around the desk area nearby somewhere. If you look on the desktop you see Google is open on the NHS site or similar containing advice on a medical condition of sorts.

People living with health anxiety disorder very often do a body scan to check in with how they’re feeling, tracking in to make sure they’re OK physically and mentally. They’re looking for self-assurance that they are in control and by keeping on top of things all will be well. They just need to find the answers to their questions. Briefly people will health anxiety disorder just don’t feel safe; they need to protect themselves and are indeed in protective mode.

The exact cause of health anxiety is not yet known, but researchers believe that it may be due to a combination of factors. According to medical journals people who experience severe illness during childhood, have parents or siblings with a serious medical condition, or have other outside conditions such as general anxiety disorder and social anxiety are at risk of developing health anxiety.

Health anxiety can be due to a combination of factors including learned coping patterns, genetics, temperaments, personality traits, childhood and family history, chronic stress and traumatic events. People with health anxiety may also tend to misinterpret physical symptoms as a sign of serious illness, which can lead to further anxiety and worry. It’s worth noting that while HAD has been on the increase several years now it has increased even more post COVID-19.

Hypnotherapy is a gentle and relaxing therapy for the treatment of the differing anxiety groups. With the more pronounced types of anxiety, its effectiveness brings excellent results by helping patients into a nice dreamy relaxed altered state of mind or trance state as it was known for years. During hypnotherapy patients are able visit their fears in a variety of different scenarios feeling safe and relaxed in a gently exposed non-threatening way but sensitised manner. This helps them to realise that the fear can be rationally contained, and several solutions can be shown to counteract the fear.  Anchors can be embedded in hypnotherapy to allow the patients to use when their anxiety starts to take hold. Practicing an anchor can invoke clients with feelings of calmness and ease of mind, by using and practicing their anchor. A good follow on from hypnotherapy is the information retrieved and be explored in psychotherapy and exposure therapy. EMDR is also and successful therapy to reduce root causes of anxiety when used in conjunction with psychotherapy and hypnotherapy.

Exposure therapy is a type of behavioural therapy that helps people confront their fears and overcome anxiety. Graded exposure involves gradually exposing the patient to the source of their fear by going up the ladder one step at a time. Systematic desensitisation involves helping the patient relax and get comfortable with each step of the process. It’s important to note that exposure therapy is highly individualised and should only be done under the guidance of a healthcare professional.

Health anxiety disorder and obsessive-compulsive disorder (OCD) are two separate mental health conditions with a distinct symptom. Whilst there are some overlapping symptoms between the two disorders, they are defined as separate disorders. According to OCD-UK health anxiety is a condition that exists over preoccupation with having a serious illness or a fear of developing a serious illness. People with health anxiety may believe they already have an illness or are in imminent danger of developing one despite receiving reassurance from health professionals. People with health anxiety may continue to worry excessively about their health.

OCD, on the other hand, involves having repetitive upsetting intrusive thoughts (obsessions) I’m feeling the need to address those obsessions with rituals (compulsions), 40% of OCD sufferers use this as a coping mechanism. 60% of OCD sufferers on the other hand employ their obsession with Intrusive thinking.  It is mostly unlikely that the majority of people live with just one issue, as usually we have more than one which stems from a knock on effect, hence, it is possible for someone to be diagnosed with both OCD and mental anxiety however, they are defined as separate disorders with one significant difference worth noting. Those with OCD have better insight into their problems compared to those with health anxiety who honestly believe they have a serious illness.

The prison of Social Anxiety Disorder and it’s difficulties in life!!!

Social anxiety disorder (SAD) has a different characteristic, hence its own label above. The difference with this type of anxiety is that we internalise our world and our place in it. When we internalise our anxiety, we view the cause of concern as being us ourselves, that we are in one way or another, different from other people. In other words, we have too much wrong with us to blend or fit in successfully. Hence, this is known as Social Anxiety Disorder. Our internal belief system about ourselves carries false/inaccurate information leaving us full of self-doubt messages about who and what we are.

The distinguishing threats of Social Anxiety Disorder (SAD) and its internal messages of self -criticism

People see me as stupid, not having much to say, not being educated as much as others. Quiet, boring, not a fun person.

Common issues felt by people living with this condition.

“I feel unable to say much in company and I’d rather listen to others. I feel dread if someone asks ne my opinion because I don’t know how to respond, my words get stuck in my throat and I feel embarrassed, I may even turn bright red in my face and neck. I just don’t have the confidence, that others have. I’d like to interview for a job because I know I would be really good at it but I feel I can’t because I just don’t have the confidence to come across in an interview properly and I’m afraid of going blank and not being able to speak, if asked questions and it’s the same when I meet people I’m attracted to, I just feel tongue tide and then I go bright red, I need to find an escape route quickly.  It takes me a while to get to know people before I feel comfortable in their presence but then I’m already worried that they think I’m a bit stupid before they get to know me.”

Social anxiety disorder is not to be confused with panic disorder. It is related to general anxiety disorder. It can sometimes also be known as social phobia. It stems from interaction with other people and the fear of being judged and criticised. For some young people they may have got involved with other childhood gangs of people and been teased consistently by other kids. Perhaps you had bright red hair awesome kind of affliction.  Vulnerable people who are the victims of some kind of abuse are also easy targets of ridicule by others. This anxiety has wide spreading ramifications and I’ve worked with a small hand full of clients, which have developed body dysmorphia, usually relating to how their face looks. This is where people will see their faces looking distorted. One thing is for sure social anxiety disorder needs to be taken a lot more seriously, with compassion and understanding.

Many an adult has come out with the unhelpful comment, regarding a sensitive or shy youngster by stating “don’t worry, they’ll grow out of it.” You have made the youngster feel that they are not normal!!!!

So, what can the root causes be, because that is where the answers to this awful type of anxiety often lies.

Imagine as a child growing up, you were always criticised or compared to other children who performed better than yourself in certain areas, this could be critical parenting, relatives, and teachers, after all the big grown-ups must be right when they make these judgments.

Now your Self- belief evaluation of yourself is being corrupted when having suffered childhood criticism on a regular basis. It could also stem from sibling rivalry, having a very clever sibling can be a very tough act to follow especially where expectations are put upon us. On speaking of expectations very often the adults IE: our parents’ grandparent’s teachers often have higher expectations of us that we can deliver and therefore perhaps we feel slightly failing or lacking in some ways or not up to scratch, not quite as good as others. This is a disorder that can develop during the first 25 to 30 years of someone’s life, however most sufferers develop this at a much younger age.

Recommended Therapies

Psychotherapies, humanistic therapies such as Person-Centred Counselling and Gestalt therapy. Hypnotherapy and hypno-analysis can very often help with uncovering suppressed root causes. EMDR is also an excellent therapy for producing longer term lasting results when teamed with other major therapies.

My final thoughts on this debilitating type of anxiety are that if we were to compare our instinct deep down, to the inner tribal elders or the inner committee, what would the names of the members be called?

Self-belief, trust, compassion, acceptance, choices and courage with the chairperson sitting on the fence of doubt -known as avoidance.

How does healthy anxiety become unhealthy? How does it manifest in the mind and body?

General Anxiety Disorder & The importance of GABA nutrition?

If a person suffers with an inflamed sympathetic symptom (over-active radar) for six months or more, it is diagnosed as General Anxiety Disorder (GAD). This is because healthy anxiety has become unhealthy and requires intervention treatment. Anxiety can be triggered by a difficult situation that has become out of hand. Different symptoms of general anxiety disorder (GAD) can be negative over-thinking, fears or concern of what can go further wrong in our lives from the environment around us and feelings of being unsafe and insecure. When we live with this type of anxiety, we are externalizing (it normally comes from the outside towards us), the potential threats or actual threat that we have encountered. General anxiety disorder is easily treatable with medical hypnosis, counselling, psychotherapy (if the cause is deep rooted) eye movement desensitisation reprogramming (EMDR).

What are GABA levels and how can they calm anxiety?

Gamma-aminobutyric acid (GABA) is a neeurotransmitter that helps the body to relax after stress. Low GABA activity can lead to anxiety, depression, insomnia, and mood disorders. Research shows that people with anxiety and depression are more likely to have low levels of GABA and it is the most common inhibitory neurotransmitter in the human central nervous system. It reduces the ability to receive, create or send chemical messages to other nerve cells. GABA, when at normal levels, produces a calming effect, with a significant role in controlling anxiety, stress, excessive fear, and depression. GABA supplements have shown a very small amount of beneficial promise in treating anxiety and depression. However, it’s important to note that only very minimal amounts of GABA can cross the blood-brain barrier to have any effect on the brain. Research shows that supplements are poor performers. Better success however, is through diet with certain foods can help elevate and improve levels GABA far more effectively. 

So, what does help to maintain GABA at healthy levels

  1. Almonds, walnuts, and other nuts
  2. Whole wheat, barley, rice, and other grains
  3. Beans, peas, and soybeans
  4. Potatoes and sweet potatoes
  5. Cruciferous vegetables, such as broccoli, kale, spinach, and cauliflower
  6. Tomatoes and green tomatoes
  7. Mushrooms, especially shiitake
  8. Fermented foods, such as yogurt, kefir, tempeh, and kimchi
  9. Tea, especially oolong and white tea

What is Anxiety? and what purpose does it serve in our body as well as our minds? How and where does it occur?

3D Illustration Concept of Central Organ of Human Nervous System Brain Anatomy

Anxiety is a protective process. It allows us to experience protection from what is unsafe to our well-being, such as, intense heat or cold. In pitch darkness it warns us to not put one foot in front of the other as we can’t see where we’re going. It gives us a feeling of disorientation; its too risky. It stems from one of two areas, the mid brain area (limbic/sympathetic area and the nervous system – sympathetic area). It’s an early warning system which detects anything that may be of threat to our survival. This can range from something small to something extremely threatening.

The scale of the threat, however, can’t always distinguished by the Brain. It often depends on what we can see, hear, sense, or feel. Sometimes anxiety is triggered by something in the present that is perceived to be a threat from past experience, which is similar. This is due to the fact that the older more primitive area of the brain, does not have any concept of time and play out past memories of potential threat from the past as if it were happening right here and now.

The front of the brain (cortex) can be pictured like the top part of an iceberg. This is responsible for what you’re doing, planning, thinking about, choosing, contemplating. Your everyday thoughts and behaviours. What remains of the iceberg beneath the water’s surface are the different functions for your physical being and automated learnt actions. This includes patterns of behaviour which stem from earlier belief systems, within the older area of the brain.

The brain interprets a potential threat that requires further action. It is sent via the brain stem whose job it is to alert the physical body and prepare the body for defence or action, within the nervous system as depicted in the photo. This occurs via the inflamed sympathetic system / heightened arousal (flight/fight).

A further explanation of fight/flight is the relationship that occurs between the physical body and brain. A dynamic at an unconscious awareness level occurs, and this is known as Neuroception. In other words, we’re unaware that anything is happening until we feel the physical symptoms. Our bodies carry automatic radar (An inflamed Sympathetic system) alerting us with its anxious feelings.

What occurs in the body to alert it to any kind of threat?

When the brain stem becomes involved with a potential threat it alerts the body by triggering the hormone cortisol and boosting the secretion of the adrenaline glands. The impact of this causes a larger flow of blood to the arms and legs in preparation for what we know as fight or flight. This can occur in various stages and fluctuate (Co-regulation). The result of these changes can cause us to start to breathe from higher up in the stomach and limiting the amount of oxygen to the visceral area off the body – our torso. Our heart rate can increase, our throat and mouth feel dry and sometimes our hands and other areas of our bodies feel sweaty.

The term for this is an inflamed Sympathetic system. The good news is that we have a Para-sympathetic system to balance the body again, once the threat has diminished.