Anxiety and Trauma

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Anxiety

Every person feels anxiety on occasion; it is a part of life. All of us know what it is like to feel nervous, concerned, fearful or worried. However a significant portion of the population suffers from devastating and constant anxiety that severely affects and restricts their lives.

Some people describe their anxiety as a ceaseless racing of thoughts, others as a physical sickness, like they are going to vomit of have a heart attack. Still more will say that their anxiety is a dominating force that they feel controls their daily activities. Some people become prisoners in their own homes, unable to leave to work, drive or visit the shops. Anxiety is one of the most common psychological illnesses, one that can have significant impact upon people’s lives. Approximately 15% of the population suffer from devastating and constant anxiety that severely affects, and sometimes restricts their lives.

Symptoms of anxiety include:

People diagnosed with clinical anxiety have a combination of the following symptoms:

  • Worry about real issues to the point where it can affect everyday life
  • Feeling edgy/restless
  • Feeling tired
  • Finding it hard to fall/stay asleep
  • Phobias – being fearful about particular objects or situations (e.g. Social phobia)
  • Ongoing unwanted/intrusive thoughts and fears
  • Needing to adhere to certain rituals
  • Dwelling on the “what if’s” of a situation
  • Depression about life and the inability to stop worrying 
  • Muscle tension (sore back, neck or jaw, headache)
  • Headaches
  • Irritability
  • Frustration

There are a number of types of anxiety disorders, and many people have more than one. Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. 

Types of anxiety include:

Anxiety can manifest in a number of ways, such as:

  • Generalised Anxiety Disorder
  • Panic Disorder
  • Obsessive Compulsive Disorder
  • Specific Phobias
  • Post-Traumatic Stress Disorder

Goals:

People who experience anxiety may seek therapy to:

  • Reduce the overall level, frequency, and intensity of the anxiety.
  • Identify the source of the anxiety.
  • Spend less time “in their head” and more time in the present.
  • Develop coping strategies to effectively handle the full variety of life’s anxieties.

Self care

Create a worry chair: Choose a set time and place for worrying (not in the bedroom). It should be the same every day (e.g. in the living room from 5:00 to 5:20 p.m.) and early enough that it won’t make you anxious right before bedtime. During your worry period, you’re allowed to worry about whatever’s on your mind. The rest of the day if you start to worry try to tell yourself that you will worry about that at your specified time.

Ask yourself if the problem is solvable: Is the problem something you’re currently facing, rather than an imaginary what-if? If the problem is an imaginary what-if, how likely is it to happen? Is your concern realistic? Can you do something about the problem or prepare for it, or is it out of your control?

Accept uncertainty: What are the advantages of requiring certainty, versus the disadvantages? Or, how is needing certainty in life helpful and unhelpful? Do you tend to predict bad things will happen just because they are uncertain? Is this a reasonable thing to do? What is the likelihood of positive or neutral outcomes? Is it possible to live with the small chance that something negative may happen, given its likelihood is very low?

Utilise relaxation and mindfulness strategies.

Psychotherapeutic Interventions:

There are many different approaches to treating anxiety. These include::

  • Cognitive Behavioural Therapy
  • Acceptance Commitment Therapy
  • Eye Movement Desensitisation and Reprocessing (EMDR)
  • Exposure Therapies
  • Mindfulness
  • Mindfulness Based Cognitive Therapy
  • Solution Focused Brief Therapy
  • Dialectical Behaviour Therapy
  • Relaxation

Panic Attacks

 

About 5 percent of adults suffer from panic attacks. A panic attack is extremely upsetting and frightening. It typically lasts several minutes, but in some cases, it lasts longer or can strike several times within a short period of time.

A panic attack can occur “out of the blue” or be in response to (or just thinking about) a specific situation. Often, a panic attack is followed by feelings of depression and helplessness. Most people who have experienced a panic attack say that their greatest fear is that it will happen again. Panic attacks are experienced as intensely uncomfortable states, and often involve a sense of losing control. While some people who experience panic attacks continue with their daily lives despite the panic, for other people, the fear of panic leads them to avoid situations which might be linked to, or cause, a panic attack.  

Common Panic Symptoms;

  • Chest pains or a tight feeling in the chest.
  • Feelings of dread e.g. that something bad is going to happen
  • Racing or pounding heart
  • Trembling or shaking
  • Sweaty palms
  • Terror
  • Fear (of losing control, or “going crazy” or of dying)
  • Dizziness
  • Light headedness
  • Nausea
  • Shortness of breath
  • Tingling sensations in the body

Goals:

People who experience Panic Attacks may seek therapy to:

  • Reduce the impact of panic attacks on their lives.
  • Learn coping strategies to manage their experiences of panic.
  • learn to engage more fully in life and in a broader range of situations, despite their panic.

Self care

Remind yourself that the symptoms of a panic attack are uncomfortable, but not life-threatening. Panic is an entirely natural bodily reaction that occurs out of context. It is related to the flight-or-fight reaction, an instinctual response in all mammals to prepare to fight or flee when survival is threatened. A panic attack occurs when the “flight-or-flight” response is triggered but there is no real immediate danger.

Get to know your panic: keep a record of the frequency, intensity and experience of your panic attacks, and take careful note of what was happening both immediately, and for several hours, before each panic attack. By monitoring your experiences like this, you can learn to take control and alter your daily life in a positive direction. This may also help you get to know the early signs of a panic attack if you don’t already.

Learn abdominal or slow breathing techniques, and practice them often. Practice will help you be ready to use these to slow yourself down if you feel a panic attack starting.

Reduce or eliminate stimulants – especially caffeine, alcohol and nicotine – from your diet.

Try this strategy – it’s a bit like first aid for panic – when you feel the first signs of a panic attack: 1. Sit down 2. Breathe OUT, this will help create a space and loosen your chest muscles; 3. Slow your breathing, this will also help your heart rate slow; 4. Take a small sip of water (again, this helps slow things down and increases a sense of control) and 5. Wait for five minutes. Usually within five minutes, the most severe intensity of a panic attack will subside, although the broader feelings related to the panic may last longer.

Exercise: try to increase the amount of exercise you regularly get. Exercise helps dissipate adrenalin and other effects of the stress-response, and increases neurochemicals linked to positive feelings.

Psychotherapeutic Interventions:

There are many different approaches to treating anxiety. These include::

  • Cognitive Behavioural Therapy
  • Acceptance Commitment Therapy
  • Eye Movement Desensitisation and Reprocessing (EMDR)
  • Exposure Therapies
  • Mindfulness
  • Mindfulness Based Cognitive Therapy
  • Solution Focused Brief Therapy
  • Dialectical Behaviour Therapy
  • Relaxation

Trauma

Traumatic events are very frightening or distressing experiences that may be life threatening, or threaten one or another’s physical or psychological wellbeing. They may lead to a difficulty with coping and functioning normally. Everyone’s reactions to traumatic events differ, and most people will recover without long term problems. However, if difficulties do occur, they may begin directly after the event, or even years later.

The same event can affect individuals quite differently, and may have great effect one person, yet have little on another. The reactions subside over a few days or weeks for most people. The impact the event has may be related to the individual’s physical and mental health, available support, coping skills and past experience including repeated traumatic events. Most people will recover with the support of their family and friends and will not need professional help. However, following trauma, some people may also develop other anxiety disorders such as panic, phobias, and general anxiety, depression and difficulties with alcohol or drugs.

Situations that could lead to a traumatic reaction include:

  • Serious accidents, including serious motor vehicle accidents
  • Natural disasters such as floods or bushfires  
  • Child abuse, rape, or the suicide of someone close
  • Armed robbery, assaults, war or terrorism
  • Violence
  • Sexual, physical, emotional or verbal abuse 
  • Being neglected or abandoned
  • Trauma related to chronic illness (e.g. experiencing unpleasant medical procedures).

Post Traumatic Stress Disorder (PTSD):

PTSD is an anxiety disorder that can be brought on by being involved in or witnessing a traumatic event. PTSD symptoms can occur immediately after the event, or have a delayed onset.   Approximately 8 per cent of people in Australia are affected by PTSD at some time in their lives.   PTSD is a normal response to an abnormal situation

PTSD is very upsetting and can lead to dysfunction in normal activities, work and social relationships. PTSD does not tend to resolve by itself and professional assistance is usually required.

The symptoms of PTSD include:

Re-experiencing the traumatic event

  • Intrusive, upsetting memories of the event
  • Flashbacks (acting or feeling like the event is happening again)
  • Feelings of intense distress when reminded of the trauma
  • Nightmares (either of the event or of other things)
  • Intense physical reactions to reminders of the trauma (e.g. heart racing, rapid breathing, muscle tension, nausea, sweating)

Avoidance and emotional numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma
  • Loss of interest in activities
  • Loss of interest in general
  • Feeling detached from others
  • Feeling emotionally numb
  • Sense of foreshortened future (you don’t expect to live a normal life span, get married, have a career)
  • Inability to remember important aspects of the trauma

Increased arousal

  • Difficulty concentrating
  • Difficulty falling or staying asleep
  • Hypervigilance
  • Feeling jumpy or easily startled
  • Irritability or outbursts of anger

Treatment:

If the symptoms resulting from the trauma are too distressing, causing high anxiety, interfering with work, home or relationships or last for more than two weeks, it is important to talk to a qualified health professional, like a Psychologist.

Effective treatments are available. Treatments for trauma include education, stress and anxiety management techniques. Confronting the memory and working through the experience with desensitization methods, such as Eye Movement Desensitization and Reprocessing (EMDR) are the hallmark of treatments for trauma. Medication, particularly some of the new antidepressants, can be useful in conjunction with these psychological therapies.

Goals:

Reduce the negative impact that the traumatic event has had on many aspects of life.
Develop and implement coping skills to carry out normal responsibilities and participate constructively in relationships.
Recall the traumatic event without becoming overwhelmed with negative emotions.
Terminate destructive behaviours that serve to maintain escape and denial while implementing behaviours that promote healing acceptance of past events, and responsible living.

Self-Care:

Educate yourself: Learn about anxiety & PTSD
Anchor yourself: Learn to calm anxiety by slowing down your breathing (Breathing exercise)
Relaxation: Learning how to calm your anxiety by relaxing the muscles in your body (Progressive Muscle Relaxation)

Psychotherapeutic Interventions:

According to the current research, there are two main approaches to treating trauma. These are:

  • Eye Movement Desensitisation and Reprocessing (EMDR)
  • Trauma-focused Cognitive Behavioural Therapy