When anxiety is killing you from inside…

“It was dark and I was watching the murder in horror. I was cold and sweaty, both at the same time but seemed to be frozen and welded to my seat. The darkness was killing and though I was sipping my coke I could not ignore my heart beating wildly against my chest. I was drenched n a cold sweat and was shaking. It was so dark everywhere. I wanted to run”. 

It happened to her every time they went to watch a movie or a play; the darkness, the sea of faces and the enclosed spaces seemed to scare the daylight out of her; so much so that she stopped thinking rationally. When her husband asked her “What are you scared of?”, she could not think of an answer. But scared she was, to the point of passing out in sheer terror. She had GAD (General Anxiety Disorder).

So what is GAD?

There are different types of anxiety disorders people suffer from. In GAD, people typically complain about a heart- attack-like feeling or report an attack.

We end up taking anxiety lightly, at least the rest of the family or friends do and the sufferer ends up suffering in silence not able to voice her thoughts, just like the lady above. Most people do not understand what anxiety is, they do not accept that is a form of a mental illness and that the sufferer needs help.

Today, I am going to try to dispel the clouds of misunderstanding that ‘Anxiety’ is shrouded in. I am going to try to answer some questions that people ask me about ‘Anxiety’. Here you go:

FAQs

Q # 1: What is anxiety? I feel anxious even before a presentation. Is something wrong with me? 

Anxiety before presentation or a performance is perfectly normal. Anxiety becomes a disorder when it starts occurring regularly.

Anxiety has three characteristics:

a)      It has to be intrinsic (within you)

b)      It is vague – does not have a shape – you really cannot pinpoint its reason

c)      It is conflict producing – it puts you in a dilemma

Anxiety is not fear and there is a difference between the two. Fear is external, has a definite shape (you know what is it that is making you fearful) and fear never produces conflict. Example: There is a snake under your chair and you are terrified of it – that is fear.

But anxiety is – you are scared ‘something untoward’ is going to happen and you don’t know what that ‘something’ is, why it could happen or when it could happen. 

You become a patient of anxiety when it starts becoming a frequent phenomenon.

Q # 2: How do I know that I /my near and dear one may be suffering from anxiety? What are its signs?

Questions to ask yourself :

1)      Are you constantly worried?

2)      Are you gripped by fears that you know are irrational, but can’t shake off?

3)      Do you believe that something bad will happen, always?

4)      Do you avoid everyday situations or activities because they cause you anxiety?

5)      Do you experience sudden, unexpected attacks of heart-pounding panic?

6)      Do you feel that there is danger lurking around every corner?

7)      Is your normal life disrupted due to excessive worrying? 

Q # 3 Is anxiety of one type, people worry about so many different things…?

There are different types of anxiety disorders people suffer from, as is given below. In all these, people typically complain about a heart- attack-like feeling or report an attack.

1)   Generalized Anxiety Disorder:  Symptoms will be among those mentioned above.

2)   Panic Disorder: The person has a heart-attack-like feeling, palpitation (heart beating wildly), profuse sweating and a feeling of ‘I am going to die’.

3)    Obsessive Compulsive Disorder (OCD): Obsession about something to the extent that the person feels that it will be the end of the world if he/she does not perform a particular task. Example: A person may have an obsession about cleanliness so much that he/she may even try to keep toilets outside his home clean, unknowingly).

4)    Post-Traumatic Stress Disorder: This anxiety is the result of some trauma the person has or is suffering from like bereavement, death of a near one, shock due to accident, close shave with fate, etc.

5)     Specific Phobias: A phobia is an intense, irrational fear about a particular thing such as Hydrophobia (Fear of water/ocean/swimming), fear of closed spaces like Claustrophobia (a person may be terrified about getting stuck in a lift) or Vertigo - fear of heights.

Q # 4 How does anxiety affect my body?

1)      Anxiety may cause disturbances in your Blood Pressure

2)      May affect normal functioning of your thyroid and cholesterol

3)      Anxiety has a direct correlation with many illnesses – diabetes, BP

4)      Anxiety before a pre-surgery blood test or MRI is even known to affect the prognosis (readings).

Q # 5 Can Anxiety be cured? How?

There are various ways to address ‘Anxiety’. Anxiety disorders respond very well to treatment and more often than not in a relatively short period of time. So stop worrying! The specific treatment approach depends on the type and severity of the anxiety and the individual.  Most anxieties are treated with behavioral therapy, medication, or some combination of the two.

Behavioral therapy for anxiety disorders: Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Behavioral therapy for anxiety usually takes between 5 and 20 weekly sessions.

Medication for anxiety disorders: This is most effective when combined with behavioral therapy and anxiety self-help methods. 

 

Q # 6 Do I have to take medicines for life? Will I get addicted to these medicines?

The duration for which you may need to take medicines depends on the type of illness. In an acute illness, it is good for you to begin with medicines and later switch to therapy. 

Q # 7 Will medicines make me drowsy or stop me from work?

These days medication has no sedation, which means you will have no difficulty in concentrating on tasks and day-to-day functioning will be normal.

So just relax. Anxiety can be cured.

Twisted minds, or plain ill minds? 

What goes on in the minds of the sexual offenders?

While the whole country was out on the roads protesting against Nirbhaya’s brutal rape, more victims were being raped in broad daylight. Were the rapists not scared that the angry crowd was not going to let them off easily, or did they simply not care!!?? 

Every day, rapes and murders, child abuse, unbelievable sexual crimes hog the headlines. 

Who are behind these? Perverted minds? Ill minds? Or cruel minds? 

Let’s take a look at some of the commonly researched traits of sexual offenders, although there is no such thing as a ‘typical’ sex offender. But the most common traits point out to the fact that the offender is calculative, deceptive, egotistic, chauvinistic, and secretive with feelings of entitlement. Sex offenders come from all socioeconomic backgrounds, ages and communities.  The bitter truth is that a majority of offenses are committed by someone the victim knows. This however does not mean that every person with such a trait is likely to be a sexual offender. 

Common traits of sexual offenders

• Although most sexual offenders know that sexual assault like rape and child abuse are illegal and harmful, they still commit it. They do so because of what is called as ‘cognitive distortions’, where they tell themselves that this behavior is not really harmful. They may claim that the victim enjoyed and wanted it or initiated the sexual contact, or look at women as mere sex objects who deserve this kind of treatment. 
• In most cases, the potential victim is identified well in advance by the offender and is selected on the basis of vulnerability and accessibility, where the offender sees the maximum opportunity of not getting caught. 
• Sexual gratification is not always the prime motivator for rape; power, control and anger are. 
• Offenders lack empathy and take pleasure in controlling their victims. 
• Research shows there is a lack of healthy coping skills in the offenders. Many have trouble managing their emotions. Some are highly impulsive and do not think about the consequences before they act. Others plan in advance. 
• Sex offenders often display uncommon sexual behavior, which begins in mid to late adolescence. Many offenders have themselves been victims of sexual abuse. 
• Most sex offenders are male, but females are in it too.
• Most rape offenders are married or in consenting relationships. Many sexual assaults of adult women are considered ‘confidence rapes’, in that the offender knows the victim and has used that familiarity to gain access to her. 
• 90% percent of child victims know their offender, with about half of the offenders being a family member.

Because sexual predators are getting smarter by the day, it is becoming increasingly difficult to identify and single them out in society.  

You ought to take mental illness seriously

Acting in time may save your family from serious trouble

Ninad’s parents were very happy that Ninad was an independent child. The only son of working parents, Ninad used to be on his own during the day with an old grandmother at home. He was in the 11^th Std and in college – the best college for science. He was a good boy, polite, obedient, a good student and a confident young lad. He was friendly and had an excellent relationship with his parents.

 However, lately, Ninad used to be quiet at home and not his usual self. He used to spend a lot of time in his room with his door shut according to his grandmother. His parents thought it was natural for a teenager, given the weird ways of this age. So the issue became a non-issue as soon as it had cropped up.Six months later, Ninad had to be admitted for de-addiction – he had become a drug addict.

This story is shocking, yet quite common. With working parents and the freedom and exposure children get, one never knows when even the so-called good kids give in to temptations and then succumb to them.

Could Ninad’s parents have stopped this? Can Ninad be helped?

The answer to both these question is a YES. Ninad’s parents could have stopped this much before, had they paid more attention to the change in his behavior – of locking himself in his room even when he was alone in the house, with only an old grandmother for company. Drug addicts or newcomers to the drug world usually hide behind closed doors to take a shot. After repeated indulgence, their behavior starts changing – they start becoming irritable, lost in their own world and start hiding – something. Like Ninad, there are many people, who are victims of substance abuse – drugs, alcohol and smoking. Like Ninad, there are many others, from our families, our near and dear ones who may be suffering from some other mental disorders. It could be anything - like depression, schizophrenia and anxiety and stress disorders. Initially though, most of these may sound harmless, but if not noticed and reported may balloon into disasters beyond our help.

Unfortunately, even if you may have noticed a change in behavior, you may choose to do nothing about it, just wishing it to go away. The bitter truth is that most people cannot accept mental illness amongst their kith and kin. They fear social stigma, after they have sought the help of a psychiatrist.  It is true that even in the modern age, the mentally ill are looked down upon by society as a nuisance and a disgrace to the family, community and therefore the larger society.

But what is more important to you, needs to be decided.

Is ‘what your neighbors say’ more important or ‘is your close one’s mental health’ more important to you?

If you don’t try and arrest the mental illness at an early stage, it can develop into something that may cause serious trouble to the one suffering from it and to his close ones.

We agree that you may not be able to ‘diagnose’ like a doctor and sometimes recognizing symptoms may be difficult or may result in a false alarm. If it is the latter, we will be only too happy, but if it is a positive diagnosis and the person is indeed suffering, you should be taking the first step to treat him and turn him around into a normal, fine person that he is.

What is crucial is to be alert so you can pinpoint a noticeable change in behavior. The next thing is to accept it and report it immediately to a psychiatrist. The mentally ill, just like the physically ill are in dire need of the right treatment at the right time and care from their family.

With the right help, the mentally ill can be turned into the mentally well.

We regularly have seminars on various mental illnesses to make you aware of things, of illnesses, their symptoms and how the mentally ill can be helped. The first one in the series will be on Anxiety and Depression. If you are interested in attending this seminar, do write to us at drjahagirdarrohan@gmail.com with the subject line as ‘Seminar on Anxiety and Depression’.

Beating burnout

Beating burnout
 www.expresshealthcare.in/sections/life/829-beating-burnout

Aversion Therapy

Aversion Therapy
Aversion Therapy is a behavioral therapy. It is one of the group therapies that attempt to change undesirable/destructive behavior. These undesirable behaviors come about because we associate them with pleasure, the brain learns that, let's say substance abuse makes the person feel relaxed and lowers our stress levels.
Aversion therapy is a form of treatment that utilizes behavioral principles to eliminate unwanted behavior. In this unwanted method, the unwanted stimulus is repeatedly paired with discomfort. The goal of the conditioning process is to make the individual associate the stimulus with unpleasant or uncomfortable sensation.
During aversion therapy, the client may be asked to think of or engage in the behavior they enjoy while at the same time being exposed to something unpleasant feelings. Once the unpleasant feelings become associated with the behavior, the hope is that the unwanted behavior or action will begin to decrease in frequency or stop entirely.

Meaning of Aversion Therapy
Aversion Therapy is a form of psychiatric treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensation, and to then stop certain behavior.

Purpose
As with other therapies, aversion therapy is a treatment grounded in learning theory-one of its basic principles being that all behavior is learned and that undesirable behavior can be unlearned under the right circumstances the goal of aversion therapy is to reduce or eliminate undesirable behavior. Treatment focuses on changing a specific behavior itself. The behaviors that have been treated include such addictions as alcohol abuse, drug abuse, smoking and pathological gambling, sexual deviations, etc.


Different Methods 

• Chemical and Pharmacological stimulants
• Electric Shock Method
• Insight-oriented approaches( Verbal Aversion Therapy)

ART THERAPY

Art therapy is a powerful tool that helps one to get in touch with feelings through the creative process. By providing a visual explanation as to what is going on inside the mind. Art therapy makes the unconscious conscious. The art process taps into the rich inner resources of material where the experienced art therapist can help, guide and assist in understanding and healing.

Art therapy is used to help patients overcome emotional conflicts and become more self-aware. To do this, the art therapist will guide patients in the use of certain art materials, such as pastels or crayons, to express himself/herself. Clay, paper or finger painting can also be used, depending on the issue being addressed. These specifically selected materials can be used to express what is in the patient's mind before they are able to put it into words.(Sometimes art is an easier form of expression for patients than verbalizing their pain.)

Art therapy can provide a positive feeling of expression within patients as well as allow a physical release of creative energy as work is being created. Creative expressions improve self-esteem, self-awareness, and personal growth, and also provide a sense of mastery. It can also be less threatening than traditional forms of therapy, which go deep through the layers of consciousness to find new meanings, that would not ordinarily surface.

If a specific topic is not immediately apparent, the therapist might suggest a topic for expression, such as one's family or a vivid childhood memory. There is a misconception that one needs to be artistic to do art therapy. You absolutely do not need to be an artist. The emphasis is on the process, not on the product. 

THERPEAUTIC INTERVENTIONS in Rehabilitation

GROUP ORIENTED INTERVENTIONS

Small groups facilitated with all types of reinforcement and support from professionals to create rhythm in the day-to-day activities of clients. The professionals interact with all the clients and establish an empathetic relationship with them. Professionals facilitate variety of group-oriented activities with an intention to improve the social skills of the group members. The main focus is to enhance self confidence, self esteem, cooperation, adjustment, pattern of communication and helping the group members to accept criticism, to give criticism, to promote a healthy lifestyle among the members, to build capacity to share their views in the group, leadership quality and to become aware of one's own problems. The social workers act as a catalyst to improve or restructure the maladaptive pattern of the clients during the group sessions. The group interventions can be broadly classified as follows-

• ART THERAPY
• AVERSION THERAPY
• RELAXATION THERAPY
• YOGA THERAPY
• REMINISCENCE THERAPY
• FAMILY THERAPY