Some ramblings about anxiety

[Tay]

I've been dealing with anxiety for a long time, and early this morning I had an inexplicable drive to write about some useful tools and concepts which have helped me manage and cope. I don't really have a purpose beyond putting these concepts to paper, but if anyone finds them useful, I'll be doubly glad. (Some parts of this post were taken from an earlier post I made sometime last year) Lastly, if you experience anxiety or depression, I can't recommend enough talking to a doctor. There are quick (~4 mins), effective screenings available to help you better gauge what tools are available to help you in case you need/want them.

 

 

Cartesian Dualism vs. Neuroscience

There's this thing called "Cartesian Dualism", which is better known as the mind/body separation hypothesis, which Western cultures have believed for a long time. The short version: your mind and body are separate from each other. It leads to a lot of misunderstandings and incorrect armchair psychology, and in recent years we've learned that it just isn't true at all. The recent research has shown that the mind and body are very much connected in a single system, and they can influence one another.

 

There are two divisions of your autonomic nervous system (the part of your nervous system which doesn't control voluntary muscle): the sympathetic nervous system ("fight or flight"), and the parasympathetic nervous steam ("rest"). When the body is stressed (whether that be an impending exam, or a tiger chasing you), your sympathetic nervous system overpowers the parasympathetic, and you go into "fight or flight" mode. Your parasympathetic nervous system is what kicks in when you’re relaxing, or just finished a meal, or giggling on the couch as you read Fate/tay Night. It shunts blood to the gut and body core, dramatically lowers the levels of stress hormones/chemicals in circulation, and it makes you feel at rest. Think of these two systems as a teeter-totter: if one is engaged, the other is dampened.

 

 

Anxiety and the Sympathetic Nervous System

Have you ever been totally stressed out and somebody tells you, “Just calm down!”? I'm pretty sure it's never, ever worked. Why? Well, largely because you've got a sympathetic overload going on: you've activated responses which are near-identical to what you'd feel being chased by a tiger. That's one of the ways we understand anxiety today: a big sympathetic response.

 

 

Why Cartesian Dualism can go to hell

When you've got a sympathetic overload going on -- aka, you're feeling extremely anxious -- it's extremely difficult to mentally will your way out of it. There's a reason for that: your brain has labeled your exam, or your job, or [enter your stressor] as a metaphorical "tiger", and just like if a tiger was actually chasing you, you better believe your brain's more interested in you being freaked out and highly anxious so you'll escape the tiger and survive, than it is about your emotional well-being. That's why Cartesian Dualism sucks: it says that since the anxiety is mental, you need to deal with it with mental willpower/fortitude. 

 

Here are the two good pieces of news:

1. Your sympathetic and parasympathetic nervous systems work like a teeter-totter: if one is engaged, the other is dampened
2. You can use your body to activate either one (and in so doing, dampen the other)

If you start to breathe fast and clench your fists or exercise, your body's reaction will be to activate your sympathetic NS. But, useful to us, you can also do the opposite: even when your brain is super anxious, you can use your body to activate that parasympathetic NS and force the whole system -- mind and body -- to calm down.

 

 

Stuff that has helped me build "Parasympathetic Tone" (also known as "Vagal Tone")

The more you consciously use your parasympathetic NS to overcome sympathetic (anxious) responses, the better you'll get at it. That's sometimes called "parasympathetic" or "Vagus" tone -- it's a play on words referring to how your muscle tone (strength) gets bigger and stronger with practice. Here are a few resources which have helped me:

• The most effective thing I've been using lately are these free, guided meditation exercises from UCLA (link). The 5 minute one is my favorite (it's quick and really good). The 20-minute complete meditation is pretty strong potion, so to speak, and I'll use it if things get really bad
• Herbert Bensen M.D. and many teams in universities across the US and UK have studied/been studying meditation and they've been able to distill the reproducible core of transcendental meditation. If you'd like to try "real meditation" without any of the spiritual or doctrinal overtones from gurus or religions, I'll post the results down below (it's actually pretty wild that thousands of years of meditation practice can be analyzed and reproduced on a single piece of paper)
• There's a really common stress reversal technique I'll post below. It's not my favorite, but a lot of the people and patients I work with swear by it

 

---

 

UCLA Meditations: Link

 

"The Relaxation Response" (reproducible, distilled practices of meditation)

The relaxation response is a meditative technique that quiets the body and mind.  There are several things you should do to receive the maximum benefit from practicing the relaxation response.

 

1. Choose a good time and place to practice:

      (a) You need a time when it is unlikely that you will be interrupted for at least 15 minutes;

      (b) Use either a comfortable, upholstered chair or a recliner or a bed; it is  important that you be able to become relaxed in the chair or bed;

      © Select a place where there are few distracting lights or sounds to interrupt you.  Keep your eyes closed throughout the practice.

 

2. Try to adopt a quiet attitude of letting yourself become relaxed;  do not force the relaxation;  furthermore, do not worry about the exact timing or length of practice; instead concentrate on how you feel.

 

 

The specific instructions for eliciting the “Relaxation Response” are as follows:

 

1. Close your eyes.

2. Deeply relax all your muscles, beginning at your feet and progressing up to your face.  Keep them relaxed.

3. Breathe through your nose.  Become aware of your breathing.  As you breathe out, say the work “ONE”, silently to yourself.  For example  the sequence should go, breathe in…out, “ONE,” in…out, “ONE,” etc.  Breathe easily and naturally.

4. Expect distracting thoughts.  When these distracting thoughts occur gently bring yourself back to repeating the word “ONE.”

5. Continue for 10 to 20 minutes.  You may open your eyes to check the time, but do not use an alarm clock.  When you finish, sit quietly for  several moments, at first with your eyes closed and later with your eyes opened.  Do not stand up for a few minutes.

6. Do not worry about whether you are successful in achieving a deep level of relaxation.  Maintain a quiet attitude and permit relaxation to occur, at its own pace.  When distracting thoughts enter your mind, try to ignore them by not dwelling upon them and return to repeating ONE.  With practice, the response would come with little effort.  Practice the technique once or twice daily, but not within 2 hours after any meal since the digestive processes seem to interfere with the elicitation of relaxation response.

 

~ adapted from “The Relaxation Response” by H. Benson, M.D. & M. Klipper  

 

 

Stress Reversal Technique

• Take a few deep breaths with your eyes closed
• Visualize the face of a clock. Notice that the hands are still in this moment.
• Imagine the hands of the clock slowly circling backwards, erasing all the built up tension of the day as the clock unwinds.
• Many people find it easiest to see the hand sweeping back as they exhale out all of the tension they have picked up throughout the day or week or month.
• As the clock continues to unwind and passes 12, allow yourself to release more and more mental or physical tension

 

(all of this is stuff I've been learning in med school, but it's definitely not medical advice! There are lots of resources out there if you're dealing with anxiety. Don't let asinine cultural shaming stop you from talking to a doctor and learning more about yourself)

[reyaes]

Wow thanks for the post Tay. A friend of mine is schizophrenic and he's been finding many ways to relax himself to combat his condition, as medication does not wok. I've learnt much from him in regards to stress management. In my opinion, these are things that should be taught to children in elementary school. The world would probably be a much beter place for it.

Speaking to someone, from what I've seen, is one of the easiest and most beneficial things one can do. My friend seeing a counelor has been paramount to him.

I've put some time into meditation larely and that alone has had benefits.

[Stray Cat]

Why Cartesian Dualism can go to hell

 

I always love hearing these statements.  It's unfortunate how much this theory is rooted in pretty much every aspect of biomedicine, not to mention how many other cultures realize it makes zero sense. 

[orochinagi]

Interesting post and regarding something i've been experiencing over the last few years.

 

Everything was essencially the same but work overload was taking it's toll on me (wasn't effectively able to shut down and disconnect from work) and I find it interesting that you mentioned the relation between mind and body. I was mainly feeling without much hunger and would often end up feeling sick and for a long time I thought it could be due to previous abuses I had done (lots of alcohol and such).

I ended up going to have my stomach checked and everything was fine, he (the doctor) suggested that it could be stress related and I then decided to take a leave without pay at work.

 

Truth is, that after that I've been feeling much better and ever since I realized it was my stress and work related issues that was making me feel "bad" I did everything on my reach to disconnect from work.

 

Even if everything is "fine" or "the usual" in your life, it doesn't mean you're not having anxiety attacks (so to speak) and/or stress related issues. It's NOT easy for one to realize the stress you're feeling mainly when it starts building up slowly.

 

Edit:

I see what you did there

as you read Fate/tay Night.

[Zakamutt]

(all of this is stuff I've been learning in med school, but it's definitely not medical advice! There are lots of resources out there if you're dealing with anxiety. Don't let asinine cultural shaming stop you from talking to a doctor and learning more about yourself)

[Darklord Rooke]

 

• The most effective thing I've been using lately are these free, guided meditation exercises from UCLA (link). The 5 minute one is my favorite (it's quick and really good). The 20-minute complete meditation is pretty strong potion, so to speak, and I'll use it if things get really bad

 

Hey Tay, have you looked into mindfulness meditation (vipassana), in addition to transcendental meditation? Vipassana also has no religious overtones (you CAN but you don't HAVE to,) the difference is it seeks to develop awareness in all things, especially your own thoughts. It's much harder to learn (the idea is you can analyze your suffering, trace your feelings down to its core/roots, then abandon it) but it's the type of meditation Buddhists use. It's also the type used by the man dubbed "The happiest guy alive" (Matthieu Ricard, who went from Molecular Biologist to ... Monk ) So it might have some benefit.

 

[1]But when researchers from Johns Hopkins University in Baltimore, MD sifted through nearly 19,000 meditation studies, they found 47 trials that addressed those issues and met their criteria for well-designed studies. Their findings, published in this week’s JAMA Internal Medicine, suggest that mindfulness meditation can help ease psychological stresses like anxiety, depression, and pain.

 

Dr. Elizabeth Hoge, a psychiatrist at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard Medical School, says that mindfulness meditation makes perfect sense for treating anxiety. “People with anxiety have a problem dealing with distracting thoughts that have too much power,” she explains. “They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit.”

 

“If you have unproductive worries,” says Dr. Hoge, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,'” says Dr. Hoge.

 

If it sounds interesting, here's an introductory book on it: http://www.amazon.com/Happiness-Guide-Developing-Lifes-Important/dp/0316167258

 

 

[1] - http://www.health.harvard.edu/blog/mindfulness-meditation-may-ease-anxiety-mental-stress-201401086967

[Zalor]

Your parasympathetic nervous system is what kicks in when you’re relaxing, or just finished a meal, or giggling on the couch as you read Fate/tay Night.

 

I see what you did there with your typo.

 

More on to topic though, thanks a lot for this. 

[ExtraMana]

Anime always calms me down helps get between that sometimes awkward time of dinner and sleep

[Suzu Fanatic]

Thanks Tay, it doesn't happen often, but I do have some sleepless nights due to life problems, never found a way to expel the anxiety (except maybe venting my thoughts into writing on notepad).  at the very least, this might help abit in those cases.

[LinovaA]

As someone who deals with almost crippling anxiety at times, it brings me ease to read articles like these. I have probably said this a few times around here, but I am a major hypochondriac. I can get into some pretty nasty anxiety loops that don't ever really resolve themselves.

 

Thanks for this. I'll probably try some of these techniques next time another bout of it comes at me.

[suikashoujo]

This is really useful. I actually recently went back onto some anti-anxiety medication after about 6 months of being off of it (with my doctor's permission), because I was just so on-edge most of the time that I felt sick pretty much every morning. Even though that helps a little bit, it's nice to have some resources that could help me out when I start stressing out needlessly.

[rainsismyfav]

I think my anxiety symptoms are more of paralysis than a nervous breakdown... It sucks either way :|

[zoom909]

I've got anxiety and obsessive compulsive disorder and in general it's true that "willpower" doesn't do very much with this sort of thing.

 

I'm avoiding SSRI's for the time being.  I'll tell you a little of what I do.  Deep breathing/relaxation helps me.  So does physical exercise, as long as it's enough to make me feel a little tired.  Mental exercise (programming, translation) or attempting a real-time activity that leaves no room for hesitation (play an instrument or play high-speed video games).  I also do meditation.  Speaking of which...

 

Of course I am aware that the problem is with my physical "brain" rather than my logical "mind".  So I agree that one should not try to separate "mind" from "brain" in treating anxiety problems.

But. there is another dualism that is rather more important: the material and the spiritual.  In other words, not body and mind, but body and soul.  If you are one of the people who can acknowledge this, then there is another source from which you can draw strength--something not dependent on your own mental willpower.  (But that is another story...)

[Silverbullet312]

Thanks for this. I have anxiety at times and this could be pretty useful. I'll try the techniques sometime.

[Cyrillej1]

I have some anxiety I've been dealing with for a long time. The way I've dealt with it was doing exposure in the past and still a bit now.. like small steps in putting myself into situations I feared, and then increasing them into more difficult steps (that way I gradually got used to situations, and not go into full-blown flight mode). It still happens at times.. so I take deep breaths and try to remind myself that nothing is out to hurt me and I'm overthinking xD.  Another way is deep breaths and trying to clear my mind completely of thoughts..zoning everything out but focusing on one task/person at a time so I don't get overwhelmed into anxiety attacks.  Sometimes, I do write down my thoughts into a journal to cope as well (it's almost like letting off steam, or getting worried thoughts, etc. out if there's no one else to actually talk to)... also stuff like positive self-talk if I remember to, lol.

 

My anxiety/depression can get so bad sometimes, I would sometimes wish to go on some medication to numb it..but I prefer to find a more natural way for my body&mind to build and strengthen my coping mechanisms I guess?

 

At home, in times of stress or depression, video-gaming helps me relax too since I can just focus on what I'm playing and not think about anything else and just have fun.

 

When I had worse anxiety in the past, I used to look up lots of tips and ways to improve or manage it.  Things like this and what Tay said^^  soo thanks for sharing~  I've definitely gotten better than how I used to be (I used to be a mute, scared of everyone and everything, and hardly ever smiled...tried to be invisible).  I still have problems, but at least I know there are ways to manage it now instead of being totally confused with myself like I used to be.

[Kosakyun]

So I read through this.

It was a nice read.

 

The problem is that I can calm down when somebody tells me to.

Or rather, I can already make myself calm down if I want to.

I guess it's something that differs from each and every person?

 

Of course, my heart differs a little from how I can make my body respond. I can make myself not anxious, but my heart refuses to not be anxious. You can say that I'm still anxious because of the heartbeat and stuff, but there are a lot of stuff that you can still do when you're not anxious even if your heart is beating like crazy.

 

You might take that as bullshit or something. Sorry if it comes to that.

 

The best ways I have to reduce stress is to sleep. Yeah, sleep. You might call it something lazy but it works. It reaaaaally works. Especially before an exam. I also generally perform better in exams when I sleep before taking it. Also, if that doesn't work, laughing also gets me out of the ditch. Just laugh. Loosen up. It's ironic that I laugh most of the time because I'm that unfortunate to be put in a specific situation. Nonetheless, it helps me calm down.

 

At the end of the day, it comes down to the person himself, I guess.

 

I'm also planning to take medical school with a pre-med course of Health Science, so these things are quite interesting.

 

Also, pls /tay night me.

[Snowtsuku]

I'd say I just love reading information like this. As for anxiety, I don't really think I have problems about it.

[arakura]

pls /tay night me.

[madvanced]

Thanks for sharing this Tay. I, personally, will not use this information, even though I do suffer from some crippling anxiety.

 

That is because I can somehow control it nowadays(at least normally, but there are times that I'm wrecked bu it). But it's always interesting to see what others think and know about this subject.

[FinalChaos]

It was a good read.

 

With me though, it's generally the opposites. Either I'm in anxiety/stressed or am just a bit too relaxed(yep I'm really lazy).

So generally if I take the example of my exams what happens is that first of all I'm lazy, procrastinate and wait till the last moment. Then I realize that 'oh shit the exam is in 2 days', get stressed. Then after a bit I realize I've got stressed and try to relax myself(which works). But due to that I'm a bit more relaxed then I should be and again become lazy and waste a lot of time.

You could say that it's a vicious cycle of getting stressed and a bit too relaxed.