6 Signs It’s Time to Seek Help for Your Anxiety

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Like all emotions, anxiety is healthy, and we’re all prone to feeling it sometimes. Anxiety can become a debilitating problem, though, when the stress you feel is no longer in proportion to the situation. An upcoming test, jobinterview, or first date may make you feel anxious, and that’s healthy. But, if you feel symptoms of anxiety absent any apparent reason, or everyday things make you anxious—leaving your home, for example—it may be time to see a mental health professional. To know if your anxiety is unmanageable, you have to know the symptoms.

1. Physical Symptoms

The physical symptoms of anxiety may include an upset stomach, excessive sweating, headache, rapid heartbeat, and trouble breathing. If you get a stomach ache every time someone invites you to a social function; if you sweat through your shirt whenever you leave the house, even in the middle of winter; or if you feel like your heart is beating so fast it might burst when talking to a stranger on the phone, you may be unhealthily anxious. If your body regularly reacts to everyday stressors the way a caveman would if a lion chased him, your anxiety is no longer healthy.

2. Cognitive Symptoms

Memory issues, trouble concentrating, and insomnia are also symptoms of an anxiety problem. If you can’t fall asleep or wake up repeatedly during the night because you can’t stop thinking about things that stress you out, anxiousness is ruling over you. The same goes for if you can’t focus on work, or sit through a movie, or read a book, or if you seem to be continually forgetting things that happened even recently. When you’re severely anxious about something, even if the thing is “irrational,” it can be hard to function normally.

3. Procrastination and Avoidance

Whether it’s procrastinating about doing the thing that triggers your anxiety—like putting off an errand or not reading an important email until you’re “ready to deal with it”—or avoiding doing just about everything, excessive procrastination and avoidance are both signs of an anxiety issue. We all put off starting unpleasant or difficult tasks sometimes, but when you spend more time avoiding than doing, it may be time to seek outside help.

4. Overthinking and Constant Worrying

If worrying keeps you from functioning or you’re overthinking so much that you can’t focus on important work or sleep at night, you may have an anxiety problem. Your mind races, you lose track of your surroundings, and you’re so caught up in a storm of stressful thoughts that you miss your freeway exit. Anxiety tips over from healthy to unhealthy when it disrupts your life. If a recent health diagnosis has you worried, that’s totally normal. If you’re afraid that you’re dying every time you sneeze, that’s not.

5. Feeling Agitated and Restless

If you feel on edge, you can’t stop moving, and you’re quick to anger, you may be anxious. I’ve written before about how anger can disguise itself as anxiety, but did you know that anxiety can also disguise itself as anger? Anger can be a way to shield you from stressful thoughts. By raging at someone else, you can blame your anxious feelings on an outside force. And if you’re always moving, you don’t have time to ruminate on anxious thoughts. But neither response is healthy or helpful in the long term. When you feel agitated and restless more often than not, when you can’t stop moving and get easily annoyed or are prone to snap at people, you may have a serious problem with anxiety.

6. Panic Attacks

Often people mistake a panic attack for a heart attack. Tightness in your chest, rapid heartbeat, sweating and shaking, shortness of breath, and an upset stomach can easily be mistaken for a heart attack. It’s important to know the symptoms of a heart attack so that you don’t dismiss one by thinking it’s a panic attack or do the opposite and call 911 when you should call a psychologist. Frequent panic attacks are a sign you may have a panic disorder.

To differentiate between healthy and unhealthy anxiety, ask yourself: Is this manageable? If your anxiety keeps you from sleeping, working, social interactions, or errands, you may want to reach out to a therapist. If you feel anxious more than half the week for six months or longer, it’s probably time to seek help.

How To Let Go Of Resentment – Without Giving Anyone A “Pass”

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You’ve probably heard the adage that holding onto resentment is like drinking poison and expecting other person to die—it’s one of the most meme-able quotes in recent memory and has been attributed to everyone from Buddha and Nelson Mandela to Carrie Fisher. (Thanks, internet.)One thing is clear, though, says New York City-based therapist Jennifer Silvershein: Whoever said it was right.

But once you’re in the throes of remembering and rehashing all the sins of the person who done you wrong—and getting re-pissed off about all of it—it’s hard to stop that mental loop. Even if you know it’s poisonous, remembering why you’re so mad feels good because at least it explains the feelings. And you may even get cheered on by others—hey, every hip-hop beef is fueled as much by applause as anger.

But, as difficult as it is to let go of resentment, it can be done, Silvershein says. And you’ll be the happier for it, as soon as you pull focus from the object of your ire (who, in many cases, is blithely unaware of the whole thing, anyway).

“So often we’re holding onto a negative feeling about someone and they have absolutely no idea. So when we’re spending our time reflecting on whatever bothered us the other person is living their life absolutely unaware,” Silvershein says.

So, how do you actually put the poison down, and stop drinking from it? Here are her 3 pieces of advice.

How to let go of resentmentPIN IT
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Talk it out—or just let it go

“I recommend to my clients that they should attempt to find resolution when holding onto resentment. So whether that is having a conversation with the individual who hurt or bothered them oradjusting their behaviors [in terms of expectations], either way, at least we are discussing or changing how we’re going about things,” Silvershein says. If you do reach out to the person you feel resentment toward, she suggests talking about what happened, how you’re feeling, and what you’re having difficulty getting over.

Adjust your expectations

“So often we realize that a person doesn’t live up to our expectations and every time they repeat the behavior that disappoints us we use it as evidence that the person is bad or rude,” Silvershein says. “Rather than waiting around for them to do the same behavior that bothers you, instead begin expecting what the individual has historically done and hopefully this will allow the annoyance to dissipate.”

Reflect on your own

This doesn’t have to mean you do it in solitude—but find a friendly ear or another outlet for your thoughts, besides the person who’s triggering your anger and resentment.

“I encourage clients to speak about, journal, and meditate on resentments as well,” Silvershein says. “So often when we can talk through the feelings, reflect through journaling, or begin doing three-minute meditations (my favorite is Headspace), we’re also able to give ourselves the time to heal and process rather than silently suffering.”

 

 

If You’re Often Angry Or Irritable, You May Be Depressed

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Registered nurse Ebony Monroe of Houston recently went through a period of being quick to anger about every little thing. She didn’t realize then what it might mean for her health.

“If you had told me in the beginning that my irritability was related to depression, I would probably be livid,” Monroe says with a laugh. “I did not think irritability aligned with depression.”

She’s not alone. Many people — including physicians — associate depression with feelings of hopelessness, sadness and a lack of motivation or concentration, but not anger. Some researchers say that’s a problem, given that there appears to be a strong link between irritability and depression.

If you pick up what is often called the “bible of psychiatry,” the Diagnostic and Statistical Manual of Mental Disorders, you’ll find that the list of core symptoms for major depression doesn’t include anger.

“It’s not included at all in the adult classification of depression,” says Dr. Maurizio Fava, a psychiatrist at Massachusetts General Hospital and a professor at Harvard Medical School.

But he points out that irritability — a reduced control over one’s temper that results in angry outbursts — is listed as a core symptom of depression for children and adolescents. It has never made sense to him that it’s not included for adults. “Why would someone who happens to be irritable and angry when depressed as an adolescent suddenly stop being angry at age 18?” he asks.

Anger is an emotional and physical feeling that makes people want to warn, intimidate or attack a person who is perceived as threatening. Fava says a depressed adult with lots of anger is often assumed to have bipolar disorder or a personality disorder.

“We see in our clinics patients who are labeled as having other diagnoses because people think, ‘Well, you shouldn’t be so angry if you are depressed,’ ” says Fava. The diagnosis matters because it affects the kind of treatment people get.

Back when he was trained decades ago, Fava says, he was taught that in depression, anger is projected inward — that depressed people would be angry at themselves but not at others. That didn’t match what he was seeing in a lot of his patients with depression.

“I would say 1 in 3 patients would report to me that they would lose their temper, they would get angry, they would throw things or yell and scream or slam the door,” says Fava. Afterward, these people would be filled with remorse.

Fava thinks these “anger attacks” may be a phenomenon that is similar to panic attacks. His research found that this kind of anger subsided in the majority of patients treated with antidepressants.

Psychiatry has carefully studied how anxiety and depressed mood are experienced by patients, notes Fava, but anger has been relatively neglected. “I don’t think that we have really examined all the variables and all the levels of anger dysregulation that people experience,” he says.

That view is shared by Dr. Mark Zimmerman, a professor of psychiatry at Brown University. “The field has not sufficiently attended to problems with anger,” says Zimmerman.

“The most frequently used scales to evaluate whether or not medications work for treating depression don’t have any anger-specific items,” he notes.

Yet Zimmerman says clinicians frequently see increased anger in people who come to doctors seeking help. “Irritability is not that much less frequent than sadness and anxiety in patients who are presenting for psychiatric treatment,” he says.

Zimmerman and some colleagues recently surveyed thousands of patients who were making their first visit to the Rhode Island Hospital’s outpatient psychiatric practice. All were asked about the level of anger they had felt or expressed in the preceding week.

“Two-thirds of individuals reported notable irritability and anger,” he says, “and approximately half reported it at a moderate or severe level.”

Another large study by a different research group looked at more than 500 people who had been diagnosed with major depression. It found that more than half showed “overt irritability/anger,” and that this anger and irritability appeared to be associated with more severe, chronic depression.

Monroe, the nurse, was lucky enough to have a concerned friend who gently suggested that maybe she should talk to someone. “The way that she approached me decreased that wall of anger and anxiety,” says Monroe, “and that’s when I decided to seek the help.”

Monroe came to realize that traumatic events from her childhood had left her depressed and full of unresolved anger. With nowhere for that anger to go, she was lashing out at loved ones like her sister and husband. “So they caught the back end of my irritability when, in fact, they had nothing to do with the source of it,” she says.

After about a year of counseling, her life has improved a lot, Monroe says. She now works with a group called Families for Depression Awareness to help others recognize the signs of depression. Its list of symptoms that families should watch for includes “picking fights, being irritable, critical, or mean.”

Still, people with depression can have a hard time recognizing this in their own lives.

When I called up the Depression and Bipolar Support Alliance to ask about anger, I reached its communications person, Kevin Einbinder. He initially thought to himself, “I’m sure somebody else certainly deals with anger, but I don’t have anger issues associated with depression.”

Then he started reflecting on his life with depression over the past three decades. “I thought of all the people in my life who have interacted with me — my family, the counselors, psychiatrists, even employers, significant others,” he says, “and I realized that anger was an underlying factor in all those relationships.”

For example, he used to use caustic, sarcastic humor to put people down. “This really drove people away,” says Einbinder. He also recalls sending angry emails late at night after lying awake and ruminating about things that had happened during the day. A counselor helped him see why this wasn’t such a good way to handle problems.

Overall, though, he and his caregivers never focused on anger.

In hindsight, he says, he really wishes they had.

“I think that would have provided a tremendous amount of context for what’s adding to my depression and in helping me, early on in my life, with more effective coping mechanisms,” Einbinder says.

With medication and therapy, he is doing much better now. Einbinder hopes that sharing his experiences will help people understand that if they’re dealing with depression and anger, “they’re not alone and there’s loads of resources out there.”