Turning Points Blog

Anxiety For The Man's Man

I just got of the phone with a new client who is a man dealing with generalized anxiety. This past year he walked away from his marriage, his home and his business and decided to start over and go back to school.

For months he was feeling like everything was under control. He was clear about the decisions he'd made and was very focused on moving forward. It wasn't until he was driving away from the house he built with his own hands,  his truck all packed to the hilt when it hit him. As he puts it, his thoughts started "looping"  and he began "freaking out".  Now his number one goal in life is to get rid of this freaking anxiety.

Preliminarily,  it sounds like he's got a classic case. To make matters worse, he's complicating the situation because he's bought into social prescriptions of gender that dictate he should be taking all of this like a "man" and not a "weakling".  For those of you who can relate to him, I want you to pay close attention to what I'm going to say: anxiety is gender blind. Testosterone is not the antidote.

"Gender" refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. May I suggest, for the sake of your overall well being, that you begin to think about anxiety not as a liability but as an opportunity to come more into power and alignment with your inner resources.

Sounds esoteric but it isn't.  Open up your mind a bit here. I want you to put a new frame around the picture you have of what you think anxiety is. You can think of it as a disorder, or an affliction, or an illness. Or, you can put a more adaptive frame around your picture of what anxiety is and think of it in terms of a warning system, or a flashing yellow light. Anxiety is an indicator  that  unconscious material is surfacing in your mind, body and spirit. Unconscious material. That's all.

The big bugaboo about unconscious material is simply that we don't know what it is yet.  We can't yet name it so we can't yet tame it. All we know, based on our freaking out, or our symptomology is that it is there. Something is there and it is something that's out of whack - out of alignment.

Ultimately, my client will overcome his anxiety once he begins therapy.  He will learn to identify the unconscious material and integrate it into his conscious thinking. There is a story inside him that makes sense but which he has yet to tell. A story of which the details can be changed, designed, modified and  controlled in a conscious and intentional way if he is willing to take a serious look at himself and everything that comes with him.

Psychotherapists facilitate this process with power tools like EMDR and CBT.  These methods and protocols help you to construct the story.  Once you have a cohesive story, your ego achieves an important sense of mastery which ultimately quells the anxiety.  

But a word of warning: the story will undoubtedly have emotional material in it. This is usually the scariest part for men because they seem to be less inclined than women (in an admittedly overgeneralized and stereotypical way) to explore and be with their emotions. This is unfortunate because emotions are uniquely human, not uniquely feminine so, men have to have them too, even though they often don't feel very comfortable with that fact and even more often are unaware of the discomfort they have with respect to these mysterious and dangerous things called emotions. 

I will let you in on a secret with respect to emotions: we are not that which we feel. In other words, we are not our emotions. They are simply things that we have on occasion. They do not define who we are.

Grief, sadness, fear, loneliness, insecurity; these are all normal emotional responses to loss. Loss of relationship, loss of identity, loss of meaning in life. If you experience loss and or separation out from what you previously were attached to, identified with, committed to, and you have no emotional response to the shift or change in your life, something is seriously wrong, more so than a generalized anxiety, you're probably using very low levels of defense mechanisms like denial, repression, avoidance or maybe your drinking a lot, doing drugs, gambling, using sex - anything to keep a safe distance between you and a healthy emotional response to your loss.

So what's wrong with denial, repression, avoidance, addictive behaviors etc.? Well, they are actually less adaptive  than anxiety because they create what I call "blind vulnerability".  Anxiety is like a tug on your coattails or a finger tapping on your shoulder, asking you to pay closer attention to something you are missing.

Denial, avoidance, repression, addiction, they only serve to alienate you further, and leave you out of the loop of important information; they weaken the structural integrity of your mind, body, and spirit over time so that when life tosses up a more serious stressor like, lets say a death in the family, or loss of income, or an accident of some sort, you actually have even less on board to deal with the challenge; you have less inner resources because you did nothing constructive to fortify your ability to think in ways that can handle the emotions that inevitably will occur.

So to sum it up, if you're having anxiety, and you're a man's man, do the world a favor and give yourself a break. Some people may judge you for being weak - that's their problem. It's actually a "projection" which means it's a quality inside of himself he cant tolerate so he tosses it out onto you - as if to say,  "Here you hold the weakling because I can't stand him". Obviously you're dealing with someone who needs some help accepting his own vulnerabilities.  Don't let his problem become your problem.

Take care of yourself. Your anxiety plays an important function in getting you back into your true power and balance. Listen to it and work with. Don't try to ignore it or shut it off and DON"T project your own intolerance onto other men. That won't make the world a better a place and it won't help you get any stronger.  

I invite you and encourage you to pull the car over and ask for directions. How would it be for you to get where you want to go safely and in a timely fashion? You don't have to do it on your own. Sometimes you couldn't even if you wanted to.  Here's to your health and happiness. May you learn all of your lessons in safety and prosperity and may you make good use of all the resources at your disposal.

Turning Points

I’m thinking of writing a book titled: Calmness for Savants. I want it to help people learn to live anxiety-free.

Why for Savants?

I can't imagine thinking of any of my readers as idiots. Nor, can I expect you to think of yourself as one. Savant means wise person or sage. Lastly, a book title can be a post-hypnotic suggestion - an idea you take in while you're not thinking about it and it ends up changing your entire reality.

For example, if you are reading "Managing Axiety for Dummies", you are identifiying as a Dummie and that is very unfortunate. You also identify with the thing you are trying to get rid of: the anxiety! You may not truly believe you are a Dummie but let’s face it, the title is a bit suggestive.

I have a few of those books in my bookcase like, "401k's for Dummies". For example, I wanted to empower myself around my retirement planning and since that was the only book on the shelf in the entire store, I was forced to suggest to myself for even a brief moment that I am dumb. There's no way around it. If you want the book badly enough, you have to wear the dunce cap.

These are two inescapable facts: 1.) tons of us have associations with low self-esteem on some level or other, 2.) the only book on the shelf that has a the answers to your questions is often the one that says " Dummies” or “Idiots” on it. Brilliant marketing: it makes you feel dependent, doesn't it? If there's even a remote or better yet, post-hypnotic chance that you're not smart enough to think for yourself then, those Dummies and Idiots books are no-brainers.

Good thing you’ve got options, like knowing you’re smart enough to read this blog. The rest is simple and I promise to keep it that way. Yes, I will occasionally throw out a multi-syllabic word or two but, you can handle it. It's just a new word in your vocabulary - not a four year degree.

Take “post –hypnotic” for example. You might say to me, “Christine, post-hypnotic isn't a simple term”. But, If I were to encourage you to take a nice deep breath, in through your nose and out through your mouth while paying attention to your breath for 6 seconds, you would discover that you were focused on your breath, wouldn't you? Of course you would!

That is the simplicity of a post-hypnotic suggestion. Easy, isn't it? Of course it is. Now, do you want to focus on being calm, or do you want to focus on having anxiety? Take 6 seconds and explore what it means to be calm.

Deep breath, inhale for three-nose...exhale for three-mouth.

Simply put, "hypnotic" means inducing or tending to induce sleep, kind of like a valium but non-addictive and better for your liver. Even more simply put, "post" means "after the fact".

Post-hypnotic refers to the state of having sleepwalked into a subconscious moment of recognition: you are an intelligent person and you will be successful in overcoming anxiety simply and effectively because you can. Isn't that healing? It feels better than having to be an idiot in order to qualify as the appropriate market or audience for a book, doesn't it? That alone would be enough to cause me some anxiety.

Here’s how a post-hypnotic suggestion changes reality. If I tell you not to think about an elephant, what’s the first thing that comes to mind? By reading my imaginary book, ” Calmness for Savants” you chose to identify with the word savant for one reason or another, even if only for a second; even if only to explore what a savant is – you can’t deny something you haven’t yet identified.

If you think about a wise person, then for a brief moment in time, you have the wisdom of a sage in mind rather than the intellectual qualities of an idiot or, dummy. What you do next is a reflection of your own self-acceptance and esteem. You can affirm that thought and say yes, I do have wisdom in mind at the moment or, you can behave symptomatically and say, I’m a Dummie.

While reading Calmness for Savants, you will discover what calmness feels like and how to have more of it in your life and on demand. I invite you to let your place of residence be the next village without an idiot.

Claim your ability to think for yourself and start by taking another nice deep breath in for three through the nose and out for three through the mouth. The breath is not the answer but it is a critical component to staying centered, relaxed and grounded; I encourage you to make it as conscious an act as often as possible.

Until next time, peace.

Depression Hurts

Living with depression hurts everyone around us: spouses, partners, children, parents, co-workers and friends.

There are many types of depression the effects of which reach deep into family, work and social life.

Childhood depression and depression in teens are manifestly on the rise. Depression effects both men and women.

Depression creates isolating behaviors, steals our energy and prevents us from being emotionally available to those around us.

Depression hurts so much sometimes that a person may want to harm himself or herself. The emotional pain of depression can become unbearable.

It can be difficult for loved ones to understand how intolerable living with depression can be. When that happens, family members or friends may become critical or judgmental.

They may give advice about what to do get out of a depression. They may become impatient with the person who is depressed.

They may not believe the extent of the depressed person's suffering and begin to feel manipulated or resentful. They may expect a person with depression to just snap out of it.

Sometimes therapy is a good idea for someone who's having difficulty coping with the fact that his or her loved one is depressed.

According to the World Health Organization, facts tell us that mental depression is something 16% of the population will be coping with at some point in their lives. Depression hurts about 6 million men in America who are diagnosed with severe depression every year.

Depression in women is more widely recognized than in men because about twice as many women than men are likely to seek help.

Treatment for Depression

Depression treatment is widely varied, and there is alternative medicine to consider. But research indicates that certain forms of treatment for depression are more effective than others.

For example therapy called Cognitive Behavioral Therapy Cognitive Behavioral Therapy is documented as the best treatment alone, or with medication. My intention is to support you in coping with depression and providing you with the information you need to transform it.

If you would like to try Cognitive Behavioral Therapy for treating depression, it's easy to contact me by using the form below. I'll get back to you right away.

Clinical Depression Symptoms

Clinical Depression symptoms are officially defined by the Diagnostic and Statistical Manual for Mental Disorders IV or DSM IV as symptoms that meet the criteria for a depressive disorder.

I will list the symptoms that apply to several types of clinical depressive disorders.

Clinical depression usually refer to a mood that is depressive but, not a temporary, normal response to difficult life events or grieving.

This page lists many clinical depression symptoms and several types of depressive disorders.

Major Depression

In order to have a diagnosis of Major Depression, a person must have five or more of the following symptoms for more than 2 weeks:

• a feeling sadness for no apparent reason
• a lack of energy, feeling unable to do the simplest task
• an inability to enjoy the things that used to bring pleasure
• a lack of desire to be with friends or family members
• irritability, anger, or anxiety
• an inability to concentrate
• a marked weight gain or loss (or failure to gain weight as expected), and little or too much interest in eating
• a significant change in sleep habits, such as trouble falling asleep or getting up
• feelings of guilt or worthlessness
• aches and pains even though nothing is physically wrong
• indifference about the future
• frequent thoughts about death or suicide

Although major depression can be treated effectively, individuals who suffer from it feel as though they are falling into an ever widening black hole with no way out. In an agitated depression, both mania and depression happen at the same time. This is also called a mixed state.

Fact: 15% of the population of most developed countries demonstrate clinical depression symptoms. [1]

Dysthymia

For a diagnosis of dysthymia, a person must have at least two of the following symptoms almost all the time for at least 1 year:

• feelings of hopelessness
• low self-esteem
• sleeping too much or being unable to sleep - extreme fatigue
• difficulty concentrating
• lack of appetite or overeating

Clinical depression symptoms can indicate Mild, Severe or Chronic forms of depression.

Mild Depression

The first stage of depressive illness where only a few symptoms are noticed. This stage may be overcome with self-help tips.

Severe Depression

Severe depression happens when a depressed mood is intense enough to impair functioning in relationships, performance at work, school or with daily tasks at home, or even leisure.

Chronic Depression

Chronic Depression is longstanding depression. The longer it goes untreated, the more difficult it may be to resolve.

Manic Depression also known as Bipolar Depression

• A diagnosis of bipolar I disorder requires at least one manic episode.
• Bipolar II disorder is defined as hypomania plus at least one episode of major depression.
  
  

Bipolar II depression is more common. The spectrum of bi polar disorder appears to be consistently expanding so I've included in this list not only signs to be aware of, but also other types of depression or mental disorders that may be co-occurring.[2]

Clinical depression symptoms of bipolar depression:

• Three or more failed treatment attempts with anti-depressants.
• Symptoms start after treating depression with antidepressants.
• Panic disorder and generalized anxiety disorder are resistant to antidepressants
• A person is restless, irritable, has difficulty sleeping, and experiences worsening panic attacks while gradually increasing depression medication doses.
• Behavioral problems: difficult interpersonal, legal, or occupational histories
• Attention-deficit/hyperactivity disorder
• Borderline Personality Disorder
• A first-degree relative (father, mother, sibling) with an established diagnosis of bipolar[3]
• Bipolar depressions may be periodic or seasonal
• Bipolar disorders typically appear prior to age 25.

Although major depression can be treated effectively, individuals who suffer from it feel as though they are falling into an ever widening black hole with no way out. In an agitated depression, both mania and depression happen at the same time. This is also called a mixed state.

Clinical depression symptoms can also involve coming to tears while manic, or racing thoughts while in a depressed mood are examples of agitated depression. Of all the types of depression, a mixed state can be the most dangerous because it so often involves substance abuse, panic disorder, and suicidal thoughts or gestures.

Seasonal Depression

Seasonal depression or winter depression may be mild types of depression. If clinical depression symptoms that are seasonal are severe enough to cause problems in relationships, or performance at work, home or school, or in recreational activities, Seasonal Affective Disorder (SAD) may be an appropriate diagnosis.

The lack of sunlight during winter months can contribute to feelings of depression. Exposure to bright light - phototherapy - and cognitive therapy can help in these cases.

December is designated as Seasonal Depression Awareness Month. The Substance Abuse and Mental Health Services Administration is offering information and resources about SAD among the special monthly features on the National Mental Health Information Center web site.

Psychotic Depression

One of the most severe forms of mental illness, psychotic depression is a chronic condition. A person may have general depressive periods with nothing major happening and then periods when severe psychotic features break out.

Psychotic Depression

People who demonstrate clinical depression symptoms with psychosis are the most likely of anyone with a depressive disorder to be suicidal. A psychotic episode can be triggered by stress and substance abuse and can present very much like other types of depression including Bipolar Disorder.

Common symptoms of Psychotic Depression

• agitation
• psychomotor Problems
• unreasonable feelings of guilt
• suicidal gestures and thinking
• audio and or visual hallucination
• a feeling of general malaise
• aggressiveness
• frustration
• hopelessness
  
  

Atypical Depression happens when mood improves mood improves in response to a positive event but they are still in a major depression.

Clinical symptoms of depression that are atypical are overeating and excessive sleeping.

Even though it's called "atypical" it's actually the most common subtype of depression[4][5] — up to 40% of the depressed population may be classified as having atypical depression.

Exogenous depression means "from the environment", and is also known as situational depression or reactive depression.

Causes of situational or reactive depression

• loss such as the loss of a loved one,
• moving from one house to another (especially with children)
• disillusionment about one's career prospects
• Domestic disputes
• Financial difficulties
• living in an uncaring environment
• holiday depression

Endogenous depression happens when there are no apparent environmental causes but instead come from a person's biochemistry.

**The types of clinical depression symptoms headlined on this page are essentially endogenous forms of depression.

It's important to know the difference so that we can treat the cause of the depression rather than the symptom.

Depression Facts

#1 About 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year will be affected by a depression disorder. This includes major depressive disorder, and bipolar disorder. [6]

#2 Everyone, will at some time in their life be affected by some type or level of depression -- their own or someone else's, according to Australian Government statistics. (Depression statistics in Australia are comparable to those of the US and UK.) [7]

 

References

[1] NIMH. “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series.

[2] Bipolar disorder in primary care: the bipolar spectrum is larger than was once believed, and mis-diagnosis can lead to an unfavorable treatment response - Foundational treatment Journal of Family Practice, March, 2003 by J. Sloan Manning

[3] Lapalme M, Hodgins S, LaRouch C. Children of parents with bipolar disorder; a meta-analysis of risk for mental disorders. Can J Psychiatry 1997;42:623-31.

[4] http://www.biopsychiatry.com/atypical.htm Course and treatment of atypical depression

[5] http://www.mcmanweb.com/article-200.htm Atypical Depression

[6] Australian Institute of Health and Welfare, 1998. “National Health Priority Areas Mental Health: A Report Focusing on Depression.” Depression statistics in Australia are comparable to those of the US and UK.

[7] NIMH. “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series.

Serotonin Levels

Low serotonin levels can have serious effects on your mental and physical health. Serotonin deficiency symptoms can be fairly obvious. Depression, anxiety, insomnia, overeating, PMS, migraine, OCD, aggressive or violent tendencies, fibromyalgia, alcoholism, and bulimia are all associated with relatively low serotonin levels.

Is Your Serotonin System In Balance?

If the answer to the following questions is “yes”, circle the number underneath.

When you eat processed carbohydrates or foods with high sugar content, do you feel more relaxed or experience relief from anxiety, or both?

4

Have you ever taken pharmaceuticals, such as Paxil, Prozac or Zoloft?

7

Do you often have symptoms of abdominal discomfort such as gas, bloating, loose stools or constipation?

5

If you have ever used cognitive behavioral therapy with a licensed psychotherapist, did you feel better as a result?

7

If you‘ve ever used marijuana, did you find that it caused you to relax?

4

Does depression run in your family?

4

Do you find that when you feel down or when you have the blues, that you are also irritable and anxious at the same time?

4

Do you have a regular pattern of explosive anger or easily triggered rage?

5

Do you have a history of sleep problems, especially difficulty sleeping soundly throughout the night?

4

Do you often have the sense that you are “out of step” or not focused?

4

Do you prefer alcohol over other drugs?

5

Add up the points you have circled.

________________

18 to 24 points means you are probably serotonin-deficient. 25 or more points means you are very probably serotonin-deficient.

You can click here to learn about cognitive behavioral therapy for serotonin deficiency.

Now let’s look at the other end of the spectrum. Is it possible to have too much serotonin?

Serotonin syndrome is the name for a condition when the body has too much serotonin. Serotonin syndrome typically occurs when you’ve taken one or more medications cause too much serotonin to be released or inhibit the re-uptake (make less available). If you have excessive serotonin in your system, you may be having a “serotonin storm” which could occur only minutes to a few hours after taking these could be indicated by symptoms including:

• Overactive reflexes
• Restlessness
• Hallucinations
• Loss of coordination
• Excessively fast heart beat
• Rapid changes in blood pressure
• Increased body temperature
• Nausea
• Vomiting
• Diarrhea

The symptoms can occur within a few minutes to a few hours after taking the medication or combination of medications. You are more at risk when you begin or increase the dose of a new medication, specifically triptans together with antidepressants called selective serotonin reuptake inhibitors (SSRIs) and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs)

You may also be at risk for serotonin syndrome if you take SSRIs with St. John’s wort, monoamine oxidase inhibitors (MAOIs), meperidine (a painkiller) or dextromethorphan (cough medicine).

If you are having a serotonin storm and you stop taking these combinations of medications your symptoms may subside. If you let them go untreated, they could be fatal. Always talk to your doctor before discontinuing any medication. If you think you may have Serotonin Syndrome, call your doctors office right away.

So far, I’ve only addressed serotonin levels that go from one extreme to the other. Of course, it is possible to achieve balanced serotonin levels through medication, diet, proper sleep hygiene, exercise, natural serotonin supplements and psychotherapy specifically, cognitive behavioral therapy.

What Causes Depression

What causes depression to manifest? Biology and sociological factors are the primary things to look at when trying to determine why you or someone you know may have a depression.

For the past generation psychiatry has what causes depression is an imbalance in the neurotransmitter serotonin.

Neurotransmitters are biochemical molecules in our brain involved in regulating mood. Serotonin is a well known neurotransmitter.

But, research is finding that serotonin, while still a player, isn‘t as important as we thought it was. [1]

Our behaviors and social stressors are also at play. What causes depression in one person may have no effect on another person.

For example, one person may have the social stressor of a job loss and manage to remain active and optimistic in a new job search while demonstrating no symptoms of depression, whatsoever.

Then, a second person experiences the same job loss but handles it very differently and gets depressed. The second person may have additional social stressors like a bigger family to support, or lower self-esteem.

Or, he or she may have a biological factor called a "genetic predisposition" which means his or her biology cannot withstand the stress of the job loss.

Therefore, the biochemistry falls out of balance negatively affecting important neurotransmitters that regulate mood.

If depression happens very early on in life, it is more likely to leave a lasting impact on later years, or even become chronic and worsen over time [2].

Further down you can read about what causes depression in teens.

Biological Causes of Depression

• genetics
• serotonin imbalance
• long-term presence of the stress hormone cortisol
• surplus of noradrenaline
• illness
• medications such as steroids and narcotics
• adrenal problems
• thyroid problems
• improper calcium levels
• anemia
• arthritis
• heart disease
• cancer
• viral infections
• liver infections
• brain infections
• Chronic premenstrual syndrome (PMS)
• Chronic pain

Social Causes of Depression

• social stressors
• the death of a loved one
• moving from one place to another
• financial problems
• relationship conflict
• career problems
• poverty
• living with someone who has serious medical problems
• drinking alcohol
• using illegal drugs
• having a substance abuse problem
• Recent childbirth (Postpartum Depression)
• fatigue
• learned beliefs of powerlessness
• racism
• homophobia

Causes of Childhood Depression

• Childhood trauma - emotional, physical or sexual abuse
• yelling or threats of abuse
• neglect (includes two parents working)
• criticism
• inappropriate or unclear expectations
• maternal separation
• family conflict
• divorce
• violence in the family, neighborhood or TV
• racism
• poverty [2]

Causes of Teen Depression

• normal maturation process
• sex hormones
• independence conflicts with parents
• disturbing events such as the loss of a loved one
• a breakup with a boyfriend or girlfriend
• failure at school
• low self esteem
• highly critical self-talk
• little sense of control over stressful events*homophobia

 

References

[1] Prof Steven Dubovsky, Mind Body Deceptions (New York, Norton & Co, 1997)

[2] Danya Glaser, “Child Abuse and Neglect and the Brain,” J Child Psychol. & Psychiat. 2000, 41:1:97-116; L Rowell Huesmann, et al., University of Michigan, “Longitudinal Relations Between Children's Exposure to TV Violence and Their Aggressive and Violent Behavior in Young Adulthood: 1977 - 1992,” Developmental Psychology, 39:2.