Mindfulness and Anxiety/Depression

Just a quick look at some mindfulness methods of tackling negative emotional states like anxiety and depression. Remember that mindfulness meditation, and mindfulness based stress reduction is not a quick fix. It is about a technique you persevere with and see benefits from over time.

For a more detailed article on mindfulness and its application for anxiety click here.

The typical mindfulness meditation exercise involves watching the breath. Sitting (or lying) and bringing your concentration to bare on your breathing, and gently bringing it back to your breathing whenever you notice that it has wondered off elsewhere. In the seminal texts on the subject by Jon Kabat-Zinn it is suggested that the breath is notices not just as it enters the mouth but also in other places in the body that it reaches – the pit of the stomach, diaphragm, and even the toes!


Mindfulness meditation techniques are so good for sufferers of anxiety and panic that they are one of the few things I recommend universally. But the techniques are not limited to mindfulness sessions, you can live your life in an increasingly mindful way – and, I believe, reap many benefits. Allowing your attention to come to your breathing at various times of the day is one way to live more mindfully. Also, why not be mindful of other things…

Here is a list of things I like to be mindful of:

  • My favourite colour of all the colours I can see at any given time
  • The sensations of touch when I handle the things around me
  • A savoured taste or smell
  • How my toes feel
  • What my excact mood is at a time, without trying to change it

There are many more potential ones. Try and add a few of your own and see if you can live IN the moment for some of everyday.


Related articles:

Does tap water have an anti-depressant effect?

Well, of course it doesn’t! But tests have confirmed that in the UK tap water does contain levels of the drug Prozac (Fluoxetine) . It appears that sewage and water-treatment systems are not good enough to remove the drug before waste water makes it back into our taps.

Although it is thought that the levels of the drug in the water are harmless (and nowhere near a therapeutic dose) it does make you wonder whatever drugs might make it into the water supply. If nothing more it suggests that the drug is woefully over-prescribed in the UK, where records show prescriptions have risen sharply since the early 1990s.

The full story as reported by the BBC can be found here.

We say that it is time to take the causes of anxiety and depression seriously. Let’s start using therapy and stop just treating the symptoms.

Depression, disease burden and the importance of correct diagnosis

A recent study found that depression is not only an unpleasant mental disorder, but also a potential physical threat as well. Of course it has long been known that people suffering from depression are more at risk of suicide, but what a recent study by the WHO (World Health Organisation) shows is that in terms of impact on life, depression is worse than angina and asthma.

Sufferers of depression should not think that there are inherent physical risks with depression. What is being talked about here seems to be the exacerbation of symptoms which are already present due to a physical condition.

The author of the report, Dr Moussavi, said that more needs to be done to stop medical professionals ignoring or failing to see depression when treating patients for other conditions. This is of course a difficult problem to tackle for several reasons.

Firstly, those people who are being treated for serious conditions may show some signs of depression. In fact, no one that’s in hospital looks particularly happy about it. Also, people greatly fear the stereotype of depression and may not take kindly to being labelled as depressed.

The most important lesson to be learnt is that people with depression don’t respond as well to treatment for physical conditions as well as non-depressed people. Therefore recognizing, treating and preventing depression must be a much bigger priority than it is now.

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Fear Fantasy – tackle negative beliefs

I recently read a book which included this fantastic exercise for dealing with negative thoughts particularly in the area of self esteem, and assertiveness and confidence.

The thing is, we criticize ourselves with much harsher words than we would criticize others. We also tell ourselves far more negative things than we would tell others. Imagine telling a friend "Don’t go to the supermarket, you won’t be able to cope!" we would just never do it!

In order to show ourselves how faulty some of our thinking is, we can have a dialogue, either in our heads, out loud, or on paper, in which we play the role of someone who believe is criticizing us, putting us down, or thinks bad of us.

Now, what we have to do is, as the other person, tell ourselves the worst possible things to see how ridiculous it is. Let’s imagine we are worried about panicking in the supermarket and making a scene in front of lots of people. The dialogue between you and a person that sees you and who you imagine is critical of you might go something like this: (Let’s call the critical person Frank).

 

You: Oh my god, I’m having a panic attack, I think I’m going crazy.

Frank: What?! Are you some kind of freak or something? I’m going to call security.

You: No please, It’s just a panic attack it happens all the time. I need some fresh air and sip of water.

Frank: You need a mental hospital! I’m going to tell everyone to steer clear of you and I’m going to tell your boss your nuts and I’m going to tell the police what a psycho you are. Maybe you should be in an institution. You definitely shouldn’t be allowed out shopping alone.

etc. etc.

Continue this dialogue for as long as you want to. Really give the character that is criticizing you a lot of venom.

There’s a reason for doing this. The idea here is that you take it to the worst level that you can possibly imagine. Then take it to an even worse level, really try and go crazy.

Why am I doing this you ask? Well, this is an example of something called "Paradoxical Intention". Often with anxiety and panic we spend a lot of energy desperately trying to stop feeling a certain way. When we try and force ourselves to feel a certain way or to not feel a certain way tend to actually make ourselves feel worse. Paradoxical Intention can help us see how wrong we are. It can help the negative thoughts clear as we actually see how ridiculous they are. You can try it in many situations. And it’s good to start with something small. If you are a bit afraid of spiders why not try to enhance your fear of a little spider by imagining it bigger and with bigger teeth. Really over do it! You will then see how hard it can be to be scared!

Remember to start of something easy, and always discuss new techniques and ideas with your doctor or therapist.

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Paradoxical Intention and Insomnia

Celexa questions answered

Celexa is known to cause weight gain. I was speaking to a doctor recently who told me that Celexa is actually one of the better SSRI’s for weight gain, although they all effect people in different ways so you can never really tell which one would be bad for certain people.

To some extent the weight gain can be controlled by diet and exercise. The problem is, as I understand it, Celexa seems to lower your metabolic rate and therefore you need to eat less and exercise more to burn the calories that you would normally burn much faster.

If you don’t want to be on anti-depressants forever then you need to ask yourself what other approaches you are taking to anxiety management/treatment. Are you having therapy? Have you had CBT? Are you doing something to deal with the causes of your anxiety?

If you have stopped taking Celexa and now want to start taking it again, did you come off the drugs because you felt better? And if so did you feel better because of the drugs or because of a positive change in your life/attitudes/negative thinking/past trauma?

What I am getting at is this: if you need to be on anti-depressants then you should also be looking for a long term solution. That means trying to identify the causes and dealing with them. Many people would have some kind of therapy for this although you could take a self-help approach. Either way, the drugs should only be used to treat the symptoms, that is after all what they do, despite marketing hype.

One possible solution might be to take the lowest possible dosage you can manage with, this will minimise the weight gain as much as possible, and then seek help with the causes. It is important to discuss dose changes with your doctor, and agree a treatment plan. On the other hand, if your doctor agrees that it is a good idea, you could forget the drugs and move to a solution focussed cure like therapy or counselling. I don’t know your situation so I don’t know what is best for you, but often just taking those first steps can give you a big lift and a lot of hope. With effort, you can get over this.

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Anxiety – accept or fight

Some people are advised to just accept anxiety. This is a behavioural approach adopted by Australian Claire Weekes several decades ago. I believe this is a good approach still and has benefited many people. It is not the only approach and to make it work you need to understand the paradox. The paradox is that you accept the anxiety, even welcome it, even though you want it to go. It doesn’t therefore follow that if you look for a way out you are not accepting properly and thus the anxiety will last longer. Actually, the accepting approach can be combined with other approaches, as long as you try to accept the anxiety while it is being felt.

It is true that when you avoid a situation the phobia or fear grows. But by looking for an end to anxiety being a major player in your life you are not going to do any harm. Acceptance is just one approach based on overcoming anxiety that has been "learnt".
When you look for solutions to problems -although you may have to try several things before you find success- you don’t automatically make them worse. Trying to uncover root causes with therapy might or might not work – it is not a 100% guaranteed cure as nothing is. But it is worth a try if it is available to you. As the old adage goes – if you always do what you’ve always done you’ll always get what you’ve always got! So I think you should let your setback guide you towards new ideas – without necessarily dismissing the old!

Also, when my anxiety changed it moved from being physical (lots of hyperventilation, panicky stuff) to "mental" – negative intrusive thoughts, more constant lower level anxiety, which i didn’t mind so much – but quite low mood and worrying negative thoughts.
Felt bad, but change is good in my book as change allows you to learn, it also seems to take you nearer to the causes.
I should add that the "mental" anxiety I felt was much more disabling than the physical in some ways. So progress actually made me worse before better! Didn’t realise it at the time!

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Anxiety setbacks email follow up

Here is the second part of an email dialogue I had with a reader concerning setbacks.

—–

Hi!

Thanks for your reply. I have indeed been troubled by anxiety in the past, for many years and in many forms. Also often revolving around issues to do with travel. Over the years my anxiety changed a lot before petering out. I put that down to two things: changing life situation (growing up, leaving home etc) and me attacking the anxiety every way I could. I once asked my doctor what he thought was best for anxiety and he replied “I am a fan of whatever works”. I think that’s important, what works for one person doesn’t necessarily work for another.

I think Claire Weekes’ technique of complete acceptance is great in the short term, especially as it is much better and more empowering than doing nothing. However it does seem to me from what you have said that there are legitimate reasons in your life for you to be stressed and unhappy, and that through tackling those I think you might improve. You can tackle these things in two ways. Either by changing them or by changing your response to them. In reality it is likely to be a balance of both, after all you can’t make MIL do something she doesn’t want to. So do look beyond Claire weekes. I mentioned Jungian therapy and now I have to admit I am no psychological expert! I spent a lot of time with a Jungian therapist that used art a lot. It was strange, you do have to put some trust in the therapist, but I did make dramatically positive steps in my life.

I don’t want to speak out of turn and I don’t know your full situation. But it strikes me that you feel somewhat unappreciated by those around you. If that is the case then I think a good therapist could really help you change your opinion of yourself and how you act around and towards others. This might be one angle to investigate anyway.

Apart from that I also tried hypnosis (don’t recommend it much)

Acupuncture (maybe did me some good)

EFT (Think it changed something, not quite sure what)

CBT (similar to Claire weekes, available on the NHS, no deep analysis which I think I needed – I only ever recommend this for simple phobias)

You say you have counselling. What exactly does this involve? If it’s just time and space to get things off your chest then maybe you should see if you can find a therapist. You might get cheap or free sessions through a training centre if money is a problem.
I never know what to say about these “energy therapies” that promise so much. As I say, I have tried EFT and TFT and I think they did do something. I know someone who is about to have some sessions of this and I am really interested to see what will happen.

I do think making positive changes in your life is the way to start. If you can deal with present unhappiness and also think about past causes and root issues then you will make progress.

Hope to hear from you soon!