Tuesday, October 11, 2011

Our Guest Blogger Writes About Anxiety

Again we harold our friend, follower, and guest blogger, Kerry Stott. (@kerrystott)

As we just came off of a day where the irrationally paranoid (but maybe not) one of us had to deal with some recent tenant issues, we were stricken with some severe anxiety, above what is normally felt, as we sat and waited for the unexpected mediation, the lesser violent tenant to arrive.

Sweaty palms, shallow/heavy breathing, fear, tears...are among the things we experienced this morning while trying to take care of some of the issues, with the help of city tenant professionals, that we have been having.

So anxious were we that when of one of the two men (the violent schizophrenic one) had to meet with the professional mediator, we chose to sit in another room, where he could not see us. We heard him storm into the office and ask "where is the landlord"...we sat in a room off of the waiting room and waited for him to leave...the professional came in later to let us know that "the crazy one is gone"...he understanding our fear at that point, and then we wrapped up matters.

Say what you will about us, we are not all badasses...and sadly Catherine was in charge, and had to deal everything with today...we just chock it up to a growing experience for her...but those of us around could feel her hear racing, her short breath, her tears, hear her scared words...and after the unpredictable tenant left, she asked the professional in charge of the situation if there was a back way out, because she felt unsafe leaving the front of the building. (She figured they may be parked there, waiting for us)

He shower her, and The Boyfriend, the way out the fire exit, down the back stairs...they took the alley and sidewalks toward home where she they would be/feel safer, anxiously looking behind her at every chance before we got to the place where we, & James, were to have lunch and drink with Fuck Face. (yes, yes, we know....we were supposed to have said goodbye to him a month ago...life isn't always black & white)

So. Was she irrational in her anxiety? It's possible not. Say what we will about her being paranoid, and irrational...aside from a couple of extreme cases, she is usually right...aside from the social anxiety/paranoia she feels every time she steps out of the time. But it's just her survival tactic, no? She doesn't feel the world at large is a safe place for her.

We though today's post from Kerry was fitting...for Catherine's sake.

Again, thank you Kerry, for being able to 

Anxiety – the good, the bad and the down right ugly!

We all get anxious at some time.  I am due to start a research job soon and I am a bit anxious about that.  I wonder if I will do ok, or if people will like me, or if I will cope with the extra travelling?  All of these worries are flitting through my head, sometimes they linger, sometimes I chase them away, like naughty puppies who have wee-d on the floor, with more logical thoughts – I was asked to do the job, they approached me not the other way round so they must want me, right?

Anxiety is part of the fight or flight syndrome that evolved with us to survive in caveman times.  Should we run at the bear and kill it for food or do we run away?  Part of the anxiety...dry mouth, heart racing, butterflies in the stomach or that sinking feeling, sweaty palms and armpits (niiiice)...focuses our attention to possible threats. The physiological response is this: all the blood rushes away from our mouths as we don’t need to swallow or chew food.  No need to digest any food so blood all rushes away from our intestines and stomach which creates that butterfly or sinking feeling.  Blood vessels constrict increasing our blood pressure so that it can be squirted around the body faster.  The heart beats faster so that blood can be pumped round the body more quickly.  Breathing becomes more rapid and shallow to increase our oxygen intake.  Blood gets forced from our none essential areas to our arms and our legs so that we have the strength to run and/or fight.  The adrenaline makes our senses more acute so we can hear better see more clearly, our brain is alert so it takes in and processes more information.  Pretty cool huh!

In a modern world it means that we have the potential to perform better.  Athletes use this energy to focus themselves and give themselves the edge they need.  Some people thrive on this nervous anxious high and so do it as part of their job.  I like to challenge myself in my job because the stakes are high and someone could die if I get it wrong *breathes into a paper bag* no pressure there then!  Some people are addicted to it, adrenalin junkies, once upon a time I did a bungee jump and I wanted more after it – wooohooo what a rush.  In relation to my new job, I am in this camp currently, on a high for being singled out and ready to take on the world – confidence is high!

That’s one of the key things, confidence.  Confidence allows you to put into perspective negative thoughts.  It allows you to put a positive spin on problems so that you can use them to your advantage or not get bogged down by them.  However, when our confidence is lacking those negative thoughts can take over, they can bog you down, they can stop you doing things that you want to. Strangely all of this is normal; a little reticence prevents us from doing stupid or dangerous things.  It will stop me on my first day from walking into the room and saying ‘Hi guys!’ and waving manically at my colleagues.   Anxiety makes people stop, think and reflect upon the potential outcome of their actions.  It can be annoying, uncomfortable and unpleasant feeling but part and parcel of life and something to deal with.

Clinical anxiety is a whole different kettle of fish!  Clinical anxiety really stops you doing things.  It wraps its cold fingers round your heart and suffuses it with blackness that is sticky and hard to rid yourself of and it seems to touch every aspect of your life.  Clinical anxiety and depression are like best buddies, they hang out together, they drink together, hell they probably even live together and if you have one you are more than likely to have the other.  Having just glanced at the International Classification of Diseases (ICD 10) and the DSM IV (the American version of the ICD 10) there are lots of different types of anxiety (I needed to be clear in my mind before I wrote anything, I wouldn’t want to feed you a line of bullshit, I use twitter for that).  If you want to read them please feel free http://apps.who.int/classifications/apps/icd/icd10online/  there are just too many to write down here and I wouldn’t want to give you ideas, a little bit of knowledge can be a bad thing.  Needless to say this level and type of anxiety makes you think and behave in strange ways.  Panic can make you feel like you are having a heart attack or that you will die; pretty strong motivation to do anything that will stop you feeling like you are going to die.  Obsessive compulsive disorder (OCD) can make you think odd things (obsession) which makes you do odd things (compulsion) to alleviate the hellishly uncomfortable feelings of anxiety.

I have seen patients with an inability to leave their own home because of anxiety for a variety of reasons.  There are dangers ‘out there’, they can’t decide if they should throw away the junk mail they have received, they can’t decide if they want tea or coffee.  Real crippling, debilitating, disabling anxiety.  For people who feel like this, if it’s you, get some help...tell someone, life does not need to be like this, it does not need to feel this bad.  Living a ‘normal’ life is possible and attainable.

Medication is only one of the tools in the tool box.  For those that have read my previous blog posts, you will know that I do not believe in the ‘medical model’ of health care, there is a time and a place for medication but it is not the be all and end all of every problem.  I would be disappointed if, as humans, we were that simple; complexity is what makes us fascinating to others.  Anyway, back to medication.  Benzodiazapines such as vallium have their place but I am not a great fan as they are so very highly addictive and National Institute of Clinical Excellence (NICE – I kid you not that’s what they are really called, honestly who thought that up!) guidelines state that they should only be used for the short term, no more than 2 weeks.  There are other medications, some anti depressants have anti anxiety properties and can be used to help people experiencing anxiety.  Some anti psychotic medication can be used for the more intrusive thoughts, the ones that won’t go away and everything you do just doesn’t get rid of those thoughts.  I can hear people recoil in horror at the thought of anti psychotic medication for anxiety but it is for the more extreme end of anxiety and patients who we (the multi disciplinary team I work with) feel may need it will often take it as they feel so ill. 

There are things that you can use in conjunction with medication or in some cases instead of medication and they are talking therapies. I feel like a bit of a plank because I will not go into depth about the different therapies.  The reason being is that first it needs to be decided what type of anxiety you have, what your circumstances are and your cognitive style.  Therefore, it would be stupid and naive of me to suggest that you need cognitive behavioural therapy when you could benefit from dialectical behavioural therapy or cognitive analytical therapy or you should have person centred counselling instead of psychodynamic therapy.  You see what I mean, there are loads of things out there and to take one particular therapy on the advice of some random dude from a blog would be idiotic of you and foolish of me. Don’t stress I wouldn’t do that to either you or me.  So what should you do?  If you have this level of disabling clinical anxiety get some help.  If you had hurt your ankle so badly that you could only limp or you couldn’t get out of the house you would get yourself checked over.  Common sense, if fact the older I get I realise that there is nothing common about common sense.

Reoccurring themes in my blogs are about getting help, being aware, talking to someone or each other.  I do this because it helps, full stop [period for my North American readers].  One of the biggest mistakes we make is thinking that mental health will go away if we ignore it. Cancer, HIV, diabetes, heart disease don’t so why should mental health?  This level of anxiety requires outside help, just like the poorly ankle.  If you could fix it yourself, you would have done so by now, and I would be out of a job.

I am aware that in the UK all you need to do is go to your GP, and there is a system in place to help you.  It is never the case of going to your GP and everything will be taken care of but they will be able to point you in the right direction and refer you onto the appropriate team.  After all it is their job.  I am uncertain as to what system there is in other countries but your primary health care provider is a good place to start.  However, if you feel that you would like to go to a private practitioner, there are many out there.  There are a few simple guidelines you should follow:
1) Word of mouth is the best recommendation; go with people whom your friends have recommended.
2) Ask to see qualifications. There are many charlatans out there who are more than willing to take advantage of someone who is vulnerable (they should all be burnt at the stake!).  Practitioners are used to talking about their qualifications, I do on a regular basis and will often direct patients towards the Nursing and Midwifery Council (NMC) of which I am a member, so they can check out my credentials.  Do not think of it as being rude; think of it more as being safe.
3) Don’t hand over a lump sum of money.  Private practitioners will either have a set fee or it can be negotiated if you are on a low income. I have NEVER known any people who have a private practice to ask for money upfront or a lump sum.
4) If you don’t like it leave.  It’s your money and your life; you can walk away and never see that therapist again.

To conclude, anxiety for most of us is normal. We like to whine about it and bitch but that too is normal.  Clinical anxiety sounds odd to people who have never experienced it but I view it any a crippling silent illness and people who have it should be treated with respect. It can be a slippery illness that is hard to pin down but it can be dealt with and got rid of; recovery is not just possible but do-able and attainable.

Good luck my worried warriors.
Kerry x

 - Other entries written here by Kerry-

No comments:

Post a Comment