Every single hour of every day, we have choices. We have choices about how we view what we are experiencing. Every choice we make is creating a habit, or a neural pathway, in our brain, that stays connected. The more we think a certain way, it becomes easier to travel down that path, because our neural synaptic connections are created and sustained by how we think. In other words, If we persistently think negatively, then we will have trouble seeing the positive, even if there is positive to be seen.
Acceptance and Commitment Therapy is defined by a commitment to change while also choosing to accept things the way they are. The idea follows the line of thinking that, “psychological suffering” is caused by our inner language or cognition. When we are inflexible psychologically we lose a healthy connection with the present moment.
In today's world we have a lot to be worried about; job loss, bill payments, rising grocery costs, keeping our children safe, and keeping up with everything on our plates all while maintaining a smile in public. Some of us are chronic worriers and some not. Generalized Anxiety Disorder is a condition of chronic worry. It occurs when our worries never seem to subside. An ongoing wave of anxious thoughts and behaviors invade our lives daily and we may struggle to let go of them. My counseling intern, Jill Oulman, Unlicensed Psychotherapist, who will be completing her counseling degree in the next few months, wrote a few thoughts on Generalized Anxiety. I thought that I would share them with you.
Generalized Anxiety Disorder
By Jill Oulman
It can be easy to confuse Anxiety for Depression. Both affect one’s ability to concentrate, both affect mood, often both anxiety and depression affect sleep, and with both disorders one can appear agitated or restless. Because anxiety is a part of natural human existence, it can be something many individuals brush off as normal. When it begins to affect their daily lives, they assume it must be something more severe than anxiety. Many people assume they are depressed and seek help because they cannot deal with their feelings of hopelessness.
By properly assessing the condition as Generalized Anxiety Disorder, the therapist can work to teach the client tools to reduce anxiety and feel in control again. Human beings are programmed with a fight-or-flight mechanism. In an individual with Generalized Anxiety Disorder, that mechanism can be faulty and the body is not able to restore itself to a decreased state of adrenaline once that mechanism has been activated. Often the feelings of anxiety are automatic and not controlled by the client. Using relaxation techniques can be an effective management tool for the client to restore order to their day.
When patients can be taught techniques to help themselves, it brings the focus of control from external to internal. That may be the most important skill as often patients feel as though the source of their anxiety is beyond their control. This lack of control is what worries them the most. Enabling clients to have control over their treatment can be a first step in healing. The therapist can allow the client to focus on controlling their environment instead of the other way around.
Many individuals live with anxiety but it can be
Worry is a constant struggle for many of us. Sometimes our mind will latch onto a concern and not let go. It's as if worrying will somehow solve the problem. If we obsess, we reason, we will figure out a way to solve the problem eventually.
Worry is often linked to feeling out of control of something. It is a fear that something "horrible" will happen and we will have no control to stop it. I often call it living in "what if land." We ponder; "What if I lose my job," "what if my son gets in a car accident," "What if the dog throws up on the carpet," "What if I don't like my new job."
Many worriers have trouble falling asleep. It can take an experienced worrier hours to fall asleep sometimes. Often, a worrier will be awakened at 3 am stare at the clock helplessly while the redundant list of worries cycle through; 3:00 am, 3:15 am, 3:45 am, 4:30 am. Sometimes even though we know worry doesn't help anything we still do it. It just is a hard habit to stop.
A well known sleep specialist described the worry box as a method to combat nighttime obsessions. I have been pleasantly surprised by
Since fear and dread and worry
Cannot help in any way,
It’s much healthier and happier
To be cheerful every day—
And if we’ll only try it
We will find, without a doubt,
A cheerful attitude’s something
No one should be without—
For when the heart is cheerful
It cannot be filled with fear,
And without fear the way ahead
Seems more distinct and clear—
And we realize there’s nothing
We need to face alone,
For our heavenly Father loves us
And our problems are His own.
Helen Steiner Rice
Once you have anxiety or trauma has triggered panic attacks, it can be very distressing and difficult to overcome. Once anxiety starts it is hard to squelch it. It has a life of it’s own. Trauma and abuse can change the chemistry in the brain and set into motion automatic responses to triggers and reminders of the trauma. Once you have had panic attacks, pathways have been set in the brain that leave you vulnerable to more panic attacks.
Friends and family may be puzzled or tell you it is all in your head. But you know it’s more than that; it’s in your brain, it’s in your body, and you can’t seem to run away from it because wherever you go-there you are. Once the response starts a surreal experience occurs and you feel unable to calm down.
God seemed to know we would struggle with anxiety because scripture often addresses it. He reminds us of his loving care and assures us not to feel anxious or to worry, “And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:7-8). Still, we worry about our kids, our future, our job, making the mortgage payment, our parents, to name only a few.
Worry and Panic are separate entities, but the treatment for each can be related.
1. Learn to manage your self-talk or inner dialogue.
Name Calling: I am aware that many of us spend a lot of time abusing ourselves verbally in our thought life. We may call ourselves names or put pressure on ourselves to do things “just so”. When we fall short of our (excessive) expectations we may call ourselves a “loser”, “stupid” or any other variety of names. If you call yourself names then it is important to catch yourself and then tell yourself, “I am not a loser!” This will help you change your habits. Take labeling yourself out and focus on the situation, “I am not stupid, I just made a mistake.”
Catastrophizing: Assuming that a negative outcome will occur and that it will be catastrophic. This is usually where we live in “What if” land. What if______________ happens? It would be horrible! If you use the words horrible, awful, terrible or other extreme word to describe everyday occurrences then you need to stop! Without realizing the magnitude of words and our thought life we set ourselves up for anxiety.
Change your thoughts to reflect minor disappointments rather then “end of the world” scenarios. If you are late to practice it is not the end of the world…it is just a disappointment, for example.
Underestimating your ability to cope: While you may overestimate the gravity of the situation, you may also underestimate your inner strength. You might feel that you will die of embarrassment, people will think less of you, or you don’t have what it takes. It is important to recognize your own resilience. Remind yourself of past successes, or tell yourself “I can do this”, instead of “I can’t do this.” Or, “If it isn’t perfect then it is okay.” Work hard to reassure yourself instead of assuming your own failure.
2. Meditate on Scripture
Christians don’t panic! Meditation has long been a Christian practice. As long as the meditative time is focused on the Lord, Scripture, and His presence meditation can be fulfilling and life changing.
“The Bible is full of reflective or meditative passages and calls us to open our private worlds to them. Among the most popular are those passages out of the Psalms where the writer fixes his mind upon certain aspects of God’s being and consistent care for His children” (P. 214, Ordering your Private World, Gordon MacDonald).
If you struggle from anxiety do a search on http://www.biblegateway.com to find some verses that speak to you. You can search by word or phrase. Type in anxiety or worry and see what comes up. Write those verses down and meditate on them. Ask God to reveal to you what He wants you to know about His character. Sit in a quiet place and let the verses sink into your soul. Let your soul be like a sponge and the verses a drink. As they sink in you will feel your perspective changing.
Verses that stand out to you can be written on note cards or paper and taped on your bathroom mirror, or your kitchen cabinets. This way you can read them daily as you allow God’s spirit and love to minister to your soul.
Another quote from Gordon MacDonald clarifies; “The act of meditation is like tuning the spirit to heavenly frequencies. One takes a portion of scripture and simply allows it to enter into the deepest recesses of self. There are often several different results: cleansing, reassurance, the desire to praise and give thanksgiving” (p. 214, Ordering Your Private World).
Life is harried, busy and we normally have too much on our plates to stop and do this. I find that when I do, I gain perspective on what I need to be focused on and somehow the capacity to do it comes along with it. We think we are wasting precious time to slow down enough to find a quiet place to mediate on scripture, but it helps us more than frantically chasing our own schedule. I challenge you to make this a habit and see what happens.
3. Visualize a peaceful scene
Sometimes during those quiet times the Holy Spirit can give you an image of something to bring fresh perspective. I shared before how I pictured a bungee cord holding me up on top of a skyscraper when I had panic attacks 12 years ago when I was held up at gunpoint in my office. That helped but as I continued to pray the cord was replaced with an image of the Lord or and angel holding me up and carrying me to safety. My sense of security improved and my anxiety started to subside.
For those of you who can’t sleep due to excessive worry you can pray and ask God to give you an image of a peaceful scene. You can select a favorite place to visualize to take your mind off of your worries. I personally choose the beach and overlooking the water. Some of my early quiet times were done at the beach and I grew up near the lake. Others of you may choose a mountain scene or something else. Whatever it is, use it to deter your thoughts off of your anxiety.
4. Deep Breathing
This is a very simple exercise. It involves changing your breathing habits. It is not meditation. When you are stressed or anxious most of us will start to breath short shallow breaths from our chest. We usually don’t realize we are doing this. Most of us live high paced lives and rapid shallow breathing becomes habitual. When we are relaxed we should be breathing deep slow breath’s from our gut.
The way to test your breathing is place one hand on your shoulder and one on your stomach and breath in. Either your hand on your shoulder will go up or the one on your stomach will go out. If your shoulder goes up then you are breathing improperly. You will get less oxygen to your brain and muscles, which will increase your stress level.
Practice until the hand on your shoulder stays down and your stomach pushes your hand on your stomach out. Once you get it (it’s okay to chuckle while you are learning) then do several slow breaths in and out counting slowly to 4 or 5.
In…2…3…4… Out…2…3…4… In…2…3…4… Out…2…3…4… In…2…3…4… and so on.
I practice in the car, grocery isle and any time I remember to switch my breathing back to a calmer state. If you are a singer this breathing will give you more breath support and for the rest of us it will help us be less anxious. Keep practicing until it becomes habit.
5. Stay away from stimulants
Too much caffeine, ginseng, or decongestants can trigger panic or create anxiety attacks. If you have anxiety it is probably not a good idea to drink Starbucks double shots, Red Bull, or other energy drinks. They will jazz you up only to perpetuate the cycle and dependence on them to keep you going.
Some people shy away from anti-depressants because it implies you don’t have enough faith or you are not strong enough to handle it on your own. Would a diabetic not take insulin to treat an imbalance in the body? Would that mean a diabetic didn’t have faith? What about someone with a thyroid condition? Thyroid medications are among those most prescribed in the nation. So why then would we say to someone who has a deficiency of Serotonin in the brain to not take medication to treat it?
Severe Depression and Anxiety can be debilitating and very real. If you or someone you know is suffering the ill effects of debilitating anxiety you may want to consult with your doctor. I know of few people who would take medication just to take medication. If you are considering it then I assume you may need it. Try other things in addition to the medication. Exercise is a natural way to improve Serotonin imbalances in the brain (although, It may not be enough for severe depression). Don’t feel ashamed, but be responsible for your own well-being.
I hope that is enough to get you started. Hang in there because sometimes these things work and other times they don’t. Do not get discouraged and do not give up. It is a life long process and sometimes life throws a bunch of stressors at us at once. Just keep going forward and remember that you are not alone. God is nearby for you to call out to for help. Here are some good verses to start with:
“Who of you by worrying can add a single hour to his life? Since you cannot do this very little thing why do you worry about the rest?” (Luke 12:25-26)
“Therefore, do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” (Matthew 6:34)
“Whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things” (Philippians 4:8)
“Who of you by worrying can add a single hour to his life?” (Matthew 6:27b)
Best wishes to you and keep the faith!--Gretchen
Anxiety comes in several different forms. If you suffer from anxiety you may know that you are anxious, but lack the discernment to know what type of anxiety you have. Treatment of anxiety involves first diagnosing your anxiety type, and then treating it specifically.
Here is a list of various clinical anxiety disorders:
- Panic Disorder- A Panic Disorder sufferer will have intense episodes of panic that come on suddenly often without apparent cause or warning. The individual may experience a racing heartbeat, sweating, shaking, chest pain, shortness of breath, and a variety of other panic symptoms.
- Agoraphobia- Primarily understood as a fear of open spaces, it is often more related to a fear of having a panic attack in a location that would be difficult escape from for relief. Commonly the fears are brought on by crowded places such as grocery stores, subways, airplanes, or other similar locations.
- Social Phobia- This anxiety disorder involves an intense fear of social situations. It can involve any situation in which embarrassment or humiliation is feared.
- Specific Phobia- This phobia typically brings about avoidance of specific things or situations. The thing or situation is stagnant in that it doesn’t tend to change. For example, someone may have an intense fear of dogs but not fear other small animals.
- Generalized Anxiety Disorder- This type of anxiety is much less specific than other types of anxiety. Often the individual feels a chronic sense of anxiety over life circumstances that are stressful, such as finances. The symptoms are ongoing and last for 6 months or longer.
- Obsessive-Compulsive Disorder- While tidiness is often an admirable trait; individuals with Obsessive Compulsive Disorder take it to an extreme. They will become preoccupied by obsessive thoughts that lead to obsessive actions. An example would be someone who cleans the kitchen sink 5 – 10 times during each day. If the person were prevented from following through on their task, obsessive thoughts about the ritual of sink washing would then cause debilitating anxiety.
- Post-Traumatic Stress Disorder- Disabling symptoms often develop for a person who experiences a traumatic event. A variety of acute anxiety symptoms surface surrounding memories of the event. Veterans of war, rape victims, and victims of severe catastrophic events can suffer from this disorder.
- Acute Stress Disorder- This disorder is similar to Post Traumatic Stress although the symptoms subside within a month of the event.
- Anxiety Disorder due to a General Medical Condition- There are a large number of medical disorders that can cause anxiety symptoms. Some examples are hyper- and hypothyroidism, a vitamin B-12 deficiency, or encephalitis. It is good medical practice to test for thyroid conditions when addressing anxiety symptoms.
- Substance–Induced Anxiety Disorder- A number of ingestible substances can trigger anxiety. Some common stimulants such as caffeine, ginseng, decongestants, or diet pills can trigger symptoms of anxiety. On of the first questions that should be asked when addressing anxiety is what substances are being used and when did the symptoms begin?
In order to treat your anxiety with impact and efficacy you must first define which type you are affected by. Once you are aware of your specific set of symptoms you can begin to treat the anxiety disorder. Any of the above listed anxiety disorders can range in severity from mild to severe.
In upcoming blog posts I will discuss individual anxiety disorders under a closer lens and discuss methods for combating and treating the anxiety. Stay tuned for more.
I remember a story one of my pastors told me that when they had invited guests over during the winter, they had prepared a casserole beforehand for their guests and set it out on the back porch to cool. When their guests arrived, and it was time to eat, they went out to get the casserole. Much to their dismay, the dish was empty, and apparently cleaned as if there never had been a casserole. Wondering what had happened, they looked around and noticed their sweet Labrador had also been outside, and was now contentedly licking her lips and looking for a nice spot to take a nap. They had forgotten she was outside.
If you were in this situation, I ask, would you be able to laugh about it with your guests, or would you panic and believe it to be a catastrophe? Would you worry about what your guests thought about you? Would you convince yourself that it was horrible that you failed to provide them with a home-cooked meal, or would you accept your disappointment and figure out from where you might order in?
I admit there was a time in my life that I would have seen this as a total catastrophe. I would have been horrified and ashamed. I would have needed lots of reassurance. Thankfully, I think I would cope with it better now. I have worked hard at shifting my inner thoughts and have reserved the words horrible or awful for things that really deserve it. It doesn’t always come easily, but if I work at it, I can do it.
We all worry about things from time to time. It is natural to have concerns, and it is important to be realistic about life’s challenges. However, if we allow our fears to invade our daily thought life, we are robbed of enjoyment and freedom from fear. It is the enemy’s goal to rob us of things that God has given us. One of the things he wants to rob us of is peace of mind. Worry and peace really are incompatible. God comforts us and assures us that peace comes from Him and that we can possess it even in the midst of awful circumstances. “Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Phil. 4:7). His peace guards us and surrounds us, even in the darkest of times.
There are times in our lives when anyone would be confounded by our peace, but God gives it to us in an eternal perspective, and it is wrapped in His love for us. We know that even when things on earth go wrong, we will be with Him one day, free from the pain we endure on Earth. “Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal” (2 Cor. 4:16–18).
The most important thing to do when wrestling with the problem of worry in our lives is to explore what Scripture says about worry:
Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more important than food, and the body more important than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they?
We are of great value to God, and He promises to take care of us. Recognizing our value to Him soothes the worry wart inside of us. When we worry we need to remember how much God cares about us.
*Excerpt taken from The Journey Out, Chapter 3, The Weed of Worry vs. The Fruit of Peace
Blessings to you, Gretchen