Panic Takes Your Breath Away: Remember to Breathe

June 19, 2017 / Amy Krolak  / 
deep breath whale

Worry versus Anxiety

Everyday life presents stress, fear, and worry for everyone, but when you experience anxiety your brain experiences stress in a different way. Although it can be overwhelming, it can be managed and does not have to control your life. In previous articles, I have addressed other mental health issues. This article, written in collaboration with my adult daughter, Kelsey, addresses anxiety.

I will always remember my paternal grandmother as a worrier and there was not much you could say or do to convince her it was okay to let some things go. In her day, resources were limited and she would not have asked her family doctor about her worrying. Now, so much more is known about symptoms and how to treat anxiousness. There is a difference, however, between ordinary worrying and clinical anxiety.

10 Crucial Differences Between Worry and Anxiety

  1. We tend to experience worry in our heads and anxiety in our bodies.
  2. Worry tends to be specific while anxiety is more diffuse.
  3. Worry is verbally focused while anxiety includes verbal thoughts and mental imagery.
  4. Worry often triggers problem-solving but anxiety does not.
  5. Worry creates mild emotional distress, anxiety can create severe emotional distress.
  6. Worry is caused by more realistic concerns than anxiety.
  7. Worry tends to be controllable, anxiety much less so.
  8. Worry tends to be a temporary state but anxiety can linger.
  9. Worry doesn’t impact our professional and personal functioning; anxiety does.
  10.  Worry is considered a normative psychological state while anxiety is not.

ANXIETY DISORDERS

I am not alone in my experiences with an anxiety disorder. “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18% of the population.” (Source: National Institute of Mental Health) While Generalized Anxiety Disorder (GAD) is the most common diagnosis of anxiety, many also suffer from Panic Attacks. Panic attacks fall under the umbrella of anxiety disorders. In an article written by Alex Hanna, Founder of Challenge The Storm, Panic Attack: Do’s and Don’ts, more specific details on panic attacks and how they differ from episodes of anxiety are discussed. “Panic disorder affects about 2.4 million adult Americans(~4%.) Panic disorder most often begins during late adolescence and early adulthood. It is twice as common in women as in men.” (Source: Web MD)

mother, daughterKelsey and I have both dealt with the symptoms of anxiety over our lifetimes. However, just because we both experience symptoms of anxiety, doesn’t mean we experience it in the same way. We can’t diagnose or provide treatment but we can say: if you are experiencing anxiety, you are not alone, there is help, and there is hope. We provide insight into the different ways anxiety and panic manifest in our lives so that you might recognize similarities and reach out for yourselves.


What does anxiety mean to you and when did it become a part of your life?

Amy:
Anxiety entered my life as a young child. I don’t think my parents were aware of a problem or if they did, lay people were ill-informed about mental illnesses. Some of my most visual memories of childhood involve being anxious, of loud men’s voices and of being left alone. I found comfort sleeping in my bedroom closet.

I continued to experience anxiety through adolescence and in my teens, I started having panic attacks. I was unaware that’s what they were and would have benefited from professional help. As an adult, I have been fearful of feeling out of control, unable to rationalize the things in my life frightening me. I also experience anxiety stemming from a fear of rejection. When someone says something that makes me feel bad or I feel uncomfortable, I think irrationally and become either withdrawn or I strike out, classic fight or flight behavior. Dealing with a mental illness is difficult enough, trying to do so while raising a family can be overwhelming.

Kelsey:
To me, anxiety feels like having two brains that are perpetually at odds. My regular brain feels normal amounts of stress and worry, but my anxiety brain asks a thousand questions, ruminates, and does not let things go. I can rationally see a situation as being stressful or experience fear or worry, but it is my anxiety brain that keeps those thoughts moving, buzzing, and poking around. I remember having anxiety as a small child. As a kid, I wanted to enjoy activities that seemed “normal” to me, like sleepovers, staying with extended family, and staying up late for special events. However, I always struggled with bedtime. I endlessly worried about falling asleep and what would happen if I did not fall asleep. My mind would often ruminate for hours on the possible repercussions of not being able to control all of the circumstances around my sleep routine, and sometimes it prevented me from social situations or fully enjoying time with family. Sometimes I would call to get picked up from sleepovers, other times I would lie awake with insomnia hoping for some shut-eye.

I remember having my first clear episodes of anxiety during middle school. Once, I received a low grade on an assignment and when I confronted my teacher about it, I started to panic. I remember visual symptoms like objects suddenly looking neon, flashing lights, shortness of breath, and I instantly started to cry. It took the wind out of me. I had a similar instance a few years later, triggered by a stressful situation that seemed to paralyze me emotionally. In college, I experienced mostly manageable levels of stress and worry about exams, studying, and my future. However, I would sometimes get panic attacks after finals week was over. I remember talking to my dad on the phone walking down Bascom Hill, at UW-Madison, after having completed a week of finals. When I graduated, I became a teacher, which presented new stress and new triggers for anxiety. I once had a panic attack during my prep period, and I felt like I could not face my students or go pick them up without crying. The interference my anxiety had on my daily life and job led me to seek help. As a young adult and professional, now having taught for five years, I understand that I experience cognitive distortions and irrational patterned ways of thinking, at times.

How would you describe a panic attack?

Amy:
My problem is with breathing. I forget to do it sometimes.  Depending on the severity of the panic attacks, they come on differently and have intensity levels. When they are at the worst, I feel so out of control. I am not sure that I feel like I am going to die but I  know that sometimes, I will have feelings of suicidal ideation, being better off dead. Or that the pain was going to kill me. When I was not properly treating my anxiety, the episodes were quite severe, but now under treatment, much less.

Kelsey:
I experience both physical and mental symptoms during a panic attack. As I mentioned before, sometimes I experience neon, blurry, or spotty vision, increased heartbeat, shortness of breath, crying, dizziness, and a need to sit down. Mentally, my thoughts spiral pretty quickly. Before seeking help, they would be fixated on what if the episode did not end and it feeling like it would last forever. It felt like paralysis….like an inability to process. After seeking help, and experiencing racing and irrational thoughts, I try to use positive self-talk. I remind myself to breathe, find a private space, and to wait it out or ride the wave until the panic and symptoms subside.

How would you describe an episode of anxiety?

Amy:
I treat my mental health issues as being just important as my physical health issues. I do not need to suffer in silence. I want to lessen the stigma.The constant I experience with anxiety is difficulty breathing.  Ever since I was a little girl, I would unconsciously hold my breath when I was afraid, sad or nervous.  When I go to the dentist, I am reminded to breathe many times during procedures.  When I am having anxious thoughts, I have to tell myself to breathe to control myself and calm myself down.  I think of my generalized anxiety as being related to triggers, claustrophobia, large crowds and having to go outside of my comfort zone.

Kelsey:
When strategies to lessen anxiety fail, at times, I experience similar symptoms of a panic attack but it is triggered by something specifically (confrontations, important events, large crowds.) As these episodes are triggered by a specific situation, I can try to withdraw from what is triggering me, such as walking out of a crowded grocery store or taking a break during an event with a large crowd.

How do you manage your anxiety?

Amy: 
I have had therapy and learned about irrational thinking v rational thinking, I have come to avoid some situations which I know trigger me. I also realize that there are different levels of anxiety and I try to determine at which level I am experiencing. It was not until adulthood, I received therapy and medications to combat these symptoms.  One thin, in particular, that was beneficial was a book given to me by my therapist called  The Worry Trap by Dr. Chad LeJeune. “ LeJeune says that it’s important to learn how worry works. Imagine you’re hiking along a cliff, he says. Your brain tells you “I might fall,” and you picture yourself falling. This thought helps you realize that you need to be extra careful about where you’re walking. This is “a helpful thought to have,” he says. However, “when your anxiety is high, you’ll experience that image not as ‘I might fall,’ [but as] ‘I will fall.’” With heightened anxiety, “we are less able to discriminate [between] the thought that might happen” and the reality. This is called “cognitive fusion,” when “a thought becomes fused with what it refers to.” We experience a thought “as a reality, an almost inevitability.”

Kelsey:
I pulled my hamstring in high school, and anxiety also reminds me of caring for that injury. At its worst, I sought medical help and treatment (both with my hamstring and my anxiety). After learning to manage it on a daily basis, it sometimes flares up, but I know that I need to take extra care in certain situations. To compare, for my hamstring that looks like stretching before a dance class or after a strength training session. For my anxiety, it means I practice self-care before and after a particularly stressful event. My management of anxiety (and also my pulled muscle) has created an awareness that currently is mostly preventative. I know that if my anxiety worsens or interferes more with my daily life, I can and will seek more help. I currently practice deep breathing and relaxation, as well as engage in activities that I enjoy, such as working out, playing guitar, or spending quality time with friends and family. I also reflect on my own thinking. A therapist taught me about cognitive distortions and how at times, my brain is reinforcing my negative thinking and anxiety by distorting what I am experiencing. ( https://psychcentral.com/lib/15-common-cognitive-distortions/ )

I self-evaluated which cognitive distortions my brain was often doing, reflected deeply on what aspects of my life trigger my anxiety. To combat the cognitive distortions I experience, I use positive self-talk to help evaluate how I’m doing in terms of experiencing stress and life as it is, without letting my “anxiety brain” take over. For example, a colleague at work once made a comment about my age, and assumed that I had less experience than I did. My anxiety brain and distorted thought pattern experiences this comment as: This person thinks I am young. They do not value my experience. If this one person thinks this, many people at work probably think this. Perhaps everyone thinks that I am young and inexperienced, and I am not valued. I’m working on flipping comments from disempowering to empowering. It can be difficult, but in this situation I could think it was possible that I do look young, objectively, and that perhaps I seem eager to learn and try new strategies, a quality that some might attribute to being young. It’s a work in progress.

ON A FINAL NOTE

Amy and Kelsey have both worked with qualified professionals to help determine and reflect on the root of their anxiety. We would encourage others to seek help from a therapist or psychologist to provide insight into your particular situation. It is helpful when those around you have an understanding of what I experience as an anxiety sufferer.

7 things an anxiety sufferer wants friends and family to know:

  1. Just because you don’t understand it doesn’t mean it doesn’t exist.
  2. I am embarrassed and ashamed that I cannot do the things you can do.
  3. I don’t like feeling this way.
  4. I don’t use anxiety as an excuse.
  5. Stress can make my anxiety much worse.
  6. I know many of my fears are irrational.
  7. It’s okay if you don’t know what to do.

Other sources used:

Our Beloved Robin Williams

June 9, 2017 / Danei Edelen  / 
robin williams

A hilarious genius, Robin Williams would verbally shower us with his brilliance as we laughed until our bellies ached. We marveled at his boundless energy and his ability to be extemporaneously funny. Robin Williams’ mind improvised stand-up comedy routines which he delivered flawlessly. He was a comedic tour de force. The USC film school has established a Robin Williams Comedy Chair. “Robin was a comedy genius with a boundless talent,” Lucas said. “He was singular in every way, yet had great respect for the genre and for the dedication it took to succeed. His talent was only matched by his work ethic. That’s why he made it to the pinnacle of comedy success, and why his legacy will be to motivate and inspire young storytellers.” [1]

Lewy Bodies

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Will my new baby inherit my bipolar condition?

June 3, 2017 / Amy Krolak  / 
DNA Generational Mental Illness

One more thing to worry about

As a mother of three and now grandmother of one, I worry what has passed on genetically to my offspring. We don’t have a family history of bipolar disease and as far as I know, no particular gene is identified for the condition in any case. However, I did grow up knowing that my maternal grandmother was clinically depressed. Losing a child to Leukemia took its toll on her. I was quite young and obviously have no memories of Grandma from that time. I do know she additionally suffered the loss of her father during her teen years along with living through wars the Great Depression. I have often wondered whether I received hereditary mental health predispositions.  How much of her bout(s) with depression were passed on to her children, grandchildren, great and now great, great grandchildren is unknown. I am unsettled by this lack of information.  What does all this mean for my family? What does your family history of mental illness look like?

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Calling All Jedi: A Star Wars Analogy in the War against Suicide And Stigma

May 27, 2017 / Danei Edelen  / 
star wars

star warsAs any true geek would admit, seeing Luke Skywalker (Mark Hamil) gaze across the horizon on the planet Tatooine, in the American epic space opera film Star Wars IV: A New Hope, was one of the most profound moments in movies for me. Luke’s soul cry to Destiny echoed in my own soul in that movie theater that day. Yet like Luke, I was naive. I had no idea as to the nature of the struggle going all around me but also within myself.

The Force

Somewhat controversial by Star Wars fans, but in the movie, Episode 1: The Phantom Menace. Qui-gon took a blood sample of young Anakin to determine whether or not he was “strong in the force”. Obi-Wan says, “Even Master Yoda doesn’t have a midi-chlorian count that high!” Researchers have found that the neurotransmitter dopamine plays an important role in Schizophrenia and Parkinson’s disease a decrease in Dopamine in the brain has been implicated as the cause of Parkinson’s disease. An excess of Dopamine or oversensitivity of certain dopamine receptors is one of the causal factors in schizophrenia (https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml).

In a study of women with a history of mental health conditions, they found an abnormality on the dormant X chromosome caused by unusually high levels of the XIST gene. Researchers are optimistic this may lead to a blood test, better interventions, therapy and treatment options. Source- University of California, San Diego Health Sciences. (http://www.bphope.com/new-biomarker-identified-in-women-with-mental-illness/)
Where cancer research was 75 years ago, we are today I believe. By the time my future grandchildren are grown their mental illnesses will probably be as treated like diabetes. Today, however, we are in a struggle for lives. One in five individuals wrestles with a mental illness. Every 16 minutes someone is killed by suicide. Just like Leia and other in the “Rebel Alliance” we are fighting for hope for a better future.

Dark Side

Charles (names have been changed to protect anonymity) wasn’t the first person to speak up when entering a room, but often times he was the last to leave ensuring everyone had a listening ear. When Charles and I presented together, I learned he had struggled with suicidal thoughts since his teens. It wasn’t until he was married with two children that his mental illness first brought him to his knees. For even a warrior like Charles, it took homelessness to get him to admit he needed help. Over the last few years, however, Charles had made a remarkable recovery. When I met Charles, he was a presenter, working part-time as a Peer Support Specialist, teaching regularly at the NAMI Peer-to-Peer class, and voluntarily leading a group on the psyche ward at a local hospital. Soon after, he got engaged.

While teaching the Peer-to-Peer class, Charles was battling symptoms related to a medication transition. He told us before class one night, he felt like climbing the walls. He had experienced more severe symptoms during previous days at home, too. “Charles, go to the Emergency Room or at least call in sick from work tomorrow,” I said vehemently, knowing that bold action was needed. Charles responded quietly but in his equally steely, resolved voice, “There are people depending on me.” Charles was killed by his mental illness the following week. This does not negate the fact that Charles was a valiant warrior, a soldier in the war against mental illness and stigma. Charles’ story is a tragic lesson in authenticity and self-care.

My Yoda

Recently, I changed psychiatrists and the first thing she said to me was “You are hypomanic.” I said, “What? Just because I talk fast? I always like to talk fast. I would agree if this was the fifth time you met me, but this is just my personality.” She said, “Hold out your hands.” I did. She put a piece of paper on my hands and I couldn’t hold it. Some of my friends had noticed my hand tremors, but I hadn’t. “She asked me, “Are you agitated?” Of course, I was at her! At that point, I realized I am not good at self-diagnosis. As we continued to work together, she continued to reduce my medication, but because I am “not acute” I will always be hypomanic. Hypomania is a mild form of mania, marked by elation and hyperactivity.

Tigger

I love to talk fast. It feels natural! Everyone probably thought, “That’s just Danei.” In other words, to use a character from Winnie the Pooh, I am a recovering Tigger. I remember a locker mate in high school asking me why I was always happy. I remember thinking “Isn’t everyone?” At a CIT police officer training recently, I was trying to explain what hypomania was and they were not getting it. So, I had to reveal my inner Superpower, “Tigger”. Granted, it’s not as “exciting” as a lightsaber to go with the Star Wars analogy but that’s my point. Charles’ tragic story taught me the valuable lesson to focus on authenticity and self-care. “Learning to use the force” for me means taking my medications, diet, exercise, but also not talking at 60 miles an hour or I will verbally shock people all the time. A Tigger can be “a bit much”.

The “Rebel Alliance” Needs All of Us

One thing I love in every Star Wars movie is that all kinds of under-estimated races come together to work to defeat the unstoppable Empire. What Destiny has asked of me is not what I expected. I need to authentically share about my mental illness. Why? The silence is killing us. We are in a war. Every 16 minutes someone is killed by suicide. 22 veterans a day are killed by suicide. The suicide rate has increased 24% from 1999 to 2014. One in five individuals in this country wrestles with a mental illness. I will be silent no more. The Rebel Alliance needs you.

Image of Luke Skywalker sourced from here.

Now That I Have Your Attention…What Mindfulness Has To Offer

May 2, 2017 / Amy Krolak  / 
mindfulness

chocolateCan you hold an object in your mind for three minutes? Does it even make sense to you why someone would want to? Only a few hours into my inpatient hospitalization for depression and anxiety, among other ailments, I reluctantly found myself in a group session and the facilitator was telling me to focus on this piece of chocolate. I can tell you, in that moment, I wondered who the crazy one was…Of course because professionals in mental health know what they are doing, there were several reasons why this was part of my treatment plan. I came to realize that the ability to focus on an object was an exercise in mindfulness. I have learned many things about mindfulness over the last decade in therapy and it has become an integral component of the management of my mental health.

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Musings of the Mind at 3AM

April 27, 2017 / Alex Hanna  / 
sleep

Raise your hand if you’ve been here: it’s 3AM, you’re wide awake, and you can’t seem to settle on any single topic to think about. Your mind has ricocheted from work to Easter dinner, to that poem you wrote over a year ago which had a cool line, to building a cabinet for extra paint cans. At this point, I’ve basically solved world hunger, yet I can’t solve the pesky issue of getting to sleep. We’ve written articles related to sleep before (here and here), but why not another one from the point of view of the wise night owl?

The rationalization game

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