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CONCISE ANXIETY, DEPRESSION: HELP, and INFO SHEET
Concise Help and Vital Info on Depression and Anxiety from Dr. Parks' Blog Posts and Book: COVID-19/Mental Health Crises
WARNING SYMPTOMS OF ANXIETY
Being frequently nervous
Moody, or on edge
Feeling a sense of impending danger or doom
Increased or rapid pulse/heart rate, palpitations, and dizziness
Fast or troubled breathing and sweating
Increase tiredness, weakness, and sleeping more
Muscle tension, fatigue, and trembling
Difficulty concentrating and getting things done
Having trouble sleeping, with more frequent nightmares
Experiencing digestive problems and changes in appetite
Panic attacks, which appear suddenly and increase in intensity over several minutes, peak, usually going away rapidly. If any of these symptoms persist, please consider seeking appropriate support1
More about Panic Attacks
Panic attacks can occur because of growing anxiety. Panic differs from fear and other types of anxiety. They include severe anxiety, muscle tightness, trembling, fast heartbeat, fast or troubled breathing, dizziness, impaired concentration, palpitations, sweating, and sleep disturbances. Also, panic attacks are often unprovoked, appearing suddenly and increasing in intensity over several minutes, peaking, and then rapidly subsiding over 20 to 30 minutes.
An episode can occur as a one-time event or repeatedly happen, triggered by something remembered, or it can appear without warning and occasionally when awakening from sleep. These episodes can be very disruptive, disturbing, and disabling. One explanation for the cause of the panic attacks is that the body’s typical alarm system of mental and physical responses to an actual threat, the “fight-or-flight response,” gets triggered and activated even when there is no real threat present. Panic attacks possibly occur in 20% of the US population, at least once in their lifetimes, or 3% of the population at any given time.
If the panic episode occurs in a specific setting, as in a store or car, irrational fears or phobias about these situations may arise. If people avoid these situations, they can become increasingly housebound, unable to drive, and develop agoraphobia (fear of public places). If the person doesn’t receive effective early treatment, increasing incapacitation in life activities can result, and panic disorder can become recurrent and disabling.
Factors Contributing to Panic Attacks
An actual or transient medical problem such as a middle ear infection, allergies, mitral valve prolapse (often a mild dysfunction of this heart valve closure), hyperthyroidism, or low blood sugar
Earlier life history of significant trauma or post-traumatic stress disorder, with embedded memories of prior trauma, increase susceptibility for panic episodes in an already highly anxious and hypervigilant person
Medication use or withdrawal, stimulant or substance use, or abuse (caffeine, alcohol, opiates, etc.) can lead to greater vulnerability to panic attacks
Overuse of stimulants like caffeine or non-prescribed or unnecessary stimulant drugs, or drugs of abuse such as methamphetamine or cocaine
Life events involving significant stress, losses, threats of damage, or the feelings of increased vulnerability may precede panic attacks, such as the fears over the coronavirus
WARNING SYMPTOMS OF DEPRESSION
Loss of one’s usual interests or pleasure in doing things—anhedonia
Feeling down, guilt, hopeless, helpless, sad, or irritable, “pushing people away,” or not getting along with others
Changes in sleep patterns, such as trouble falling asleep, not getting restful sleep, sleeping too much, not wanting to get up, or staying in bed much of the day, feeling tired, a loss of vitality, or having little energy
Poor appetite, overeating, weight loss, or gain
Frequently feeling bad about oneself, such as feeling worthless or like a failure
Trouble concentrating or remembering things
Slowing down of speech or movements and having a frequent sad face
Being fidgety or restless more than usual
Difficulty functioning at home or work
Withdrawal and isolating self from others
Spending more time on TV, computers, tablets, or cell phones
Being preoccupied with watching movies or the news
Thoughts of dying, self-harm (suicidal thoughts), or harming others (homicidal thoughts)
Early Recognition of Depression
Be aware of the signs and presentation of depression. Early recognition is essential, as there is always the potential for progression to a significant debilitating mood-related condition. When a new mother is vulnerable to postpartum depression, recognizing the early signs of depression is critical for early intervention.
Reach out for help or support for yourself or someone else in need when difficulties first become apparent. Learn as much as possible about depression, mood, and anxiety-related conditions from information sources, such as reading, attending educational programs, and support groups.
Unfortunately, many healthcare providers do not offer the broader holistic approach to the care and treatment of depression or anxiety-related conditions. Management of anxiety or depression is often done with a tranquilizer, an antidepressant, or reassurance. Beyond merely taking a prescribed pill or relying on a natural remedy selected by yourself, realize that social support, psychotherapy, and other complementary approaches can be an essential part of a successful healing and recovery program.
A thorough evaluation by a qualified medical or mental health practitioner, with experience in recognizing anxiety, panic, and mood difficulties, is an initial and essential step when professional help is needed. A comprehensive and holistic care and treatment program can then be established as needed.
Children with Depression
Signs and symptoms of difficulties in children are often different from adults. Unexpected changes may be a warning sign to seek help for the younger at-risk. Early recognition and support can be critical for reducing the risk of chronic emotional and mental impairments and related physical illnesses. Behavioral or emotional changes in children might include:
Temper tantrums, acting-out behaviors like being destructive, getting into fights, or arguments
Sleep difficulties and nightmares
Showing decreased interest in things they usually enjoyed
Being more sullen or apathetic or becoming more hyperactive
Not wanting to take part in playful or recreational activities with themselves or with others
Not eating well, gaining or losing weight
Loss of concentration, attention, and becoming more distractible
KEY CONTRIBUTORS TO ANXIETY, DEPRESSION, & OTHER MOOD CONDITIONS
Medical issues such as difficulties with nutritional deficiencies, hormone deficiencies, hypothyroidism, diabetes, heart disease, or obesity
Family (genetic history) of depression, bipolar illness, or other mood conditions
Adverse lifestyles such as inadequate nutrition, sedentary habits, chaotic, stressful living, or working in adverse conditions
Traumatic brain injury, chronic pain, impairment or loss of function after accidents, surgeries, injuries, or severe illness
Environmental exposure, disease, or sensitivity because of toxic metals, mold, or chemicals such as lead and mercury
Presence of disabilities or poor social and adaptive skills that make one vulnerable to discrimination, rejection, bullying, and trauma
Substance use problems with drugs of abuse such as opioids, alcohol, stimulants, sedatives, or hallucinogenic substances
Social factors such as dysfunctional families, friends, or marriages; adverse, toxic, or abusive relationships; divorces; failures in school or work; loss of social support, a significant other, a job or career, a home, or financial security; or a recent move
Personality issues or chronic adverse personality disorders such as narcissistic, antisocial, dependent, or paranoid personality disorder—which are damaging and disruptive to success and functioning in everyday life activities—lead to the inability to form significant supportive relations
Identifying and treating contributing factors is essential, along with getting help from a therapist, taking medication, or other beneficial treatments when needed. Consultation to uncover risk factors or predisposition to significant emotional or depressive illness is a place to start with qualified mental health or medical healthcare provider.
Traumatic experiences are often unrecognized as critical contributors to mood disturbances.
These past occurrences are often critical areas to be addressed in any successful intervention or treatment program. Types of traumas to identify in the context of a therapeutic program would include:
Feeling helpless during trauma, as in childhood sexual abuse, rape, physical assault, auto accidents with the threat of injury, violence, or death
Occurrences of overwhelming, adverse, life-threatening events (early life or in adulthood) or compounded traumas (i.e., series of traumatic events: as a job loss, divorce, death of a significant other, financial loss, subjugation to violence, and imprisonment)
Being a healthcare worker, such as an EMT, nurse, or doctor in medical care work, or a soldier in combat overwhelmed by the witnessing of death and devastation
Surviving a climatic or natural disaster, a war, a holocaust, a mass casualty event such as a terrorist attack, a pandemic, a mass shooting, or a bombing
Witnessing domestic violence, death, or injury to others (health care providers, law enforcement, and emergency workers experience much traumatic exposure regularly)
The effects of trauma and its aftermath can occur at any life stage, in childhood or adulthood. The trauma experience can result from various situations and predispose to mood disorders like depression and trauma-related illness such as post-traumatic stress disorder (PTSD).
The Time for Action and Getting Help
All the listed symptoms or behaviors of anxiety, depression, or panic attacks may be only slightly present, noticed at times, or be very pervasive in a severely affected person’s daily life and activity. If a person feels that life has lost its meaning and is not worth living and has suicidal thoughts or feelings about hurting oneself or others, it is time to act. Seek outside help from a qualified mental healthcare professional or resource.
For immediate or crisis help, call your local suicide hotline (1-800-273- 8255, 1-800-273-TALK, 1-800-273-8255), or 1-800-SUICIDE (1-800-784- 2433) for the National Suicide Prevention Lifeline.
A Comprehensive or Holistic Program May Include:
Psychotherapy, somatic, or spiritual support work
Lifestyle modifications and life skill enhancements
Mind, body, and spiritual practices such as yoga; chi gong; mindfulness; meditation; exercise with mindfulness as running, swimming, biking, or dance
Stress management and relaxation techniques
Targeted nutritional therapies and education about dietary choices
Medication may also be of value in resistant or severe emotional or mental health conditions, such as significant mood disturbance if natural, non-medication treatments have not worked
Antidepressants or tranquilizers used by conventional medical practitioners can sometimes bring more immediate relief. However, the long-term use of certain medications is controversial because of the possibility of long-term contribution to other medical issues. Once in use, trying to stop medication can lead to relapse or, with some tranquilizing drugs or alcohol, can cause withdrawal seizures. Medicines may not have the same lasting effect and benefits as useful therapy programs and natural alternatives.
TIPS: TWENTY-ONE INTENTIONAL WAYS TO REDUCE ANXIETY DURING STRESSFUL TIMES
1. Reduce the time watching shows, checking social media, or listening to news stories on your TV, computer, or smartphone when at home or in the workplace. Check only once or twice per day to keep informed. Pick unbiased and truthful news outlets that do not have partisan political ties. Avoid misinformation or politically motivated reporting about the virus, pandemics, or politics. Hearing about the problems repeatedly during the day can lead to increased worry, anxiety, tension, poor sleep, or worse.
2. Instead of too much inactivity, such as passive watching, listening, or obsessing about current worries or events, take frequent time-outs with regular exercise. Active movement includes stretching and eating healthy meals (avoiding sweet binging and over-snacking on high sugar and high-caloric food or drinks). Enjoy periodic relaxation times with deep breathing, meditation, or yoga. Sleep to get adequate restorative rest.
3. Cut down or stop smoking or vaping, putting you at higher risk of COVID-19 infection. Use a nicotine patch if necessary.
4. Avoid alcohol and non-prescription drugs.
5. If working from home or in the workplace, take more frequent breaks, stand more, or take outside walks.
6. Keep to a regular exercise schedule such as 15 to 30 minutes one to two times per day. Beneficial exercise can take many forms. Examples are walking, biking, walking stairs, housework, or an exercise routine. Other choices include taking part in an online group exercise program or a circuit exercise routine, including push-ups, lunges, jumping jacks, and running in place. Do relax, enjoy, and allow any worries and fears to move to the background of your awareness as you fully embrace the physical movement, breathing, and letting go of tension.
7. After doing an exercise routine, you can treat yourself to a nice hot bath with two or three cups of Epsom salt and a few drops of essential oils as lavender oil to melt away any remaining tension.
8. Get outside and into natural settings. Being in and closer to nature is very calming and healing. Move, breathe, take in the beauty and harmony that abounds around us.
9. Get involved with enjoyable recreational or artistic activities like art, writing, and craftwork. It is the time for creative homeschooling if you have children.
10. Read an enjoyable and inspiring book.
11. Complete home construction projects or prepare new recipes and meals.
12. Enjoy listening to music, dancing, or watching a good movie.
13. Complete a crossword or jigsaw puzzle.
14. Watch a comedy show for some humor and laughs.
15. Stay socially connected with friends, family, and community. Share your concerns if feeling isolated—value what has been positive for you amidst any times of turmoil and stress.
16. Learn or do yoga, mindfulness practices, meditation, or beneficial exercise routines to help with stress reduction and relaxation. Look for some interesting instructional videos that you can watch online on your computer or smartphone.
17. If the time and resources are available, participate in an in-person or online virtual certification, continuing education, or a university degree program.
18. When any crisis presents itself as significant disruption and travails occur, let it be a time to review what is essential and meaningful. Meditate and reflect on what is beyond your fears and self-preoccupations. Be aware of our small but significant connection with everything outside of ourselves. Find inspirational readings or online materials and teachings from the spiritual, mystical, or faith traditions.
19. Find meaning and purpose when difficulties, turmoil, or tragedy feel overwhelming. Being more centered and grounded will bring better preparedness for what may unfold, which may call for the strength and the spirit to do the best for yourself and others while not giving in to fear or over-focusing on personal issues and losses. Allow any current crisis or stresses to inspire you towards living a simpler, more meaningful life, to serve better the greater good, the community, and the environment. Be encouraged to be socially active to bring about positive change.
20. Do absolutely nothing, be in the moment, breathe, take it all in, including trouble and worry, and what is comforting, beautiful, and inspiring for you—all of that for which you can be thankful. Taking a respite, a time-out to refill your reserves, will help you regain your resilience and strength—so that you can move on with purpose, gratitude, and hope.
Finding the best path for yourself to move through fear and anxiety is of central importance during any stressful time. Be constantly aware and get the help you need at the first signs of distress. Be prepared to offer service and support to others with emotional difficulties. The time is now for acceptance and compassion towards oneself and others as ever-changing feelings, emotionality, insecurities, and vulnerabilities constantly challenge us.
I appreciate your interest. Be well and mind wise on your journey of discovery and learning,
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Ronald R. Parks, MD’s CONCISE ANXIETY, DEPRESSION: HELP and INFO SHEET is prepared and modified from Dr. Parks blog posts and book COVID-19/Mental Health Crises – Holistic Understanding and Solution, ParksPress 2021, available from Amazon and other book distributors.