Sleep – we need it to beat anxiety

Sleep, something we need but for the most part do not get enough of! While we sleep our minds resent and hopefully we wake feeling reasonably replenished.

But actually we don’t. Many people feel tired all the time, and this effects our lives. If we don’t sleep enough we lack motivation, humour and enthusiasm. We don’t perform as well as we could and our relationships at home and work become more strained.

So, what can we do about it? It depends. Some people suffer from insomnia, that is to say that they can’t sleep at all, sleep very little, or can’t maintain a normal sleep pattern. For people who have been suffering from insomnia for any length of time a visit to the doctor is a must. CBT and medication can both be used to treat insomnia, although people should be extremely cautious about the long term use of benzodiazepines such as Valium. Any good doctor will think long and hard before prescribing this type of drug for insomnia.

If your sleep disturbance isn’t severe enough to merit the label insomnia then you can probably improve the quality of your sleep with a few self-help techniques.

Why not try some of the following:

  • Play relaxing music
  • Have a long bath
  • Avoid Caffeine
  • Avoid sugary foods and drinks
  • Avoid alcohol
  • Learn a meditation technique
  • Write down your worried and angers before you turn-in
  • Do some gentle yoga
  • Experiment with herbal teas, such as Chamomile
  • Keep to a regular rhythm of getting up every day

In fact, the last one is said to be the most important. Make yourself get up a bit earlier however tired you feel, and often, it is claimed, you will achieve a much healthier sleeping pattern in just a matter of days.

A recent article by the BBC said that repeating the word "the" over and over managed to stop a racing mind! I don’t know if that is true, but I will certainly try it!

I think power naps and siestas are also good, as is regular exercise and a healthy diet! Tags: , , , ,

CBT – The Great Con

In my last post I said I thought that CBT (Cognitive Behaviour Therapy for those of you who don’t know) was good and worthwhile for anyone with anxiety. I stand by that but today I want to give a different opinion about CBT, I want to argue that it is being missold to us.

First we had psychoanalysis, then we had CBT. Psychoanalysis went out of fashion because it took too long and that made it expensive. It also made it hard to prove worthwhile in terms of efficacy. These days scientists, medical practitioners, psychologists and bureaucrats alike need to be able to prove their brainchildren to a skeptical public. That means they need quantitative data. People like percentages. They like to know that 80% of people found CBT helpful, or that of those people who go through a programme of CBT less than 30% relapse into depression (these statistics are just examples, please don’t take them seriously). That is all well and good but it doesn’t tell the whole story.

There is a time and a place for quantitative data, but the time isn’t always and the place isn’t everywhere. Let’s take anxiety as an example (although we could take and illness or many other things). Experiencing anxiety can have many different facets. There is the possibility of panic attacks, feelings of disassociation or feeling detached, there’s insomnia, stress, irritability, agoraphobia, co-morbid depression…the list goes on and on. These things, as any anxiety sufferer will testify, are often very hard to put into words. Often the first struggle is to make people understand what you are feeling. What I am arguing is this: anxiety is not a quantitative thing. You can’t count it or represent it on a graph. Anxiety is a qualitative thing – you know how you are feeling. It is more of an instinct. So when I see statistics that tell me how good CBT is I become suspicious. How do you put people’s anxiety recovery into a graph. In all honesty I trust one detailed testimonial from an impartial source more than a ten thousand patient data-set.

This matters because governments and health insurance companies don’t take anxiety and depression seriously and never have. Drugs and CBT are relatively cheap, can be justified through statistics, and keep people quiet as they think they are getting the best treatment available. Oftentimes they are not. All too often a more analytical approach would be more suitable and more successful. I know because I have been there. If I had been surveyed about CBT I would have answered quiet positively. It did help, and I did feel better. But, and it is a bug but, I did not feel as good as I did after proper Jungian style therapy that helped me understand myself.

Have CBT! It’s good, But unless you have a simple phobia, I would recommend you only see CBT as part of your treatment.

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Anxiety, Panic and Phobias

I suffered from Anxiety and Phobias for a long time, and I tried almost everything to get rid of them. Some of what I tried was rubbish, and some of it was actually very useful.
People often write and ask me what I think is best, what works, what is painless and above all what is quick.
Here, I will try and expand on the things that helped me and give ideas regarding what might help you.

1. CBT. For lucky people Cognitive Behaviour Therapy is made available to them by their doctor when they first present with symptoms of anxiety or panic attacks which have lead to phobias. CBT is good for anxiety and panic related problems because with CBT you learn how to challenge your negative thoughts. This can relatively quickly and painlessly relieve some of the nastiest parts of the condition: fear of going mad, being convinced that you were about to die, being convinced that you are going to pass out etc. Although it is not by any means always always a cure for anxiety it generally is very helpful, and the skills you learn with CBT can be applied to life in general, not just anxiety.

2. Medication. Medication does work for a lot of people. Whether you take short term tranquilizers like Valium or Xanax for anxiety and panic attacks or a full blown course of antidepressants like Citalopram effects can be had. Sometimes (and always under the supervision of a doctor) you need to try various different drugs before you find the right one. I personally found that some tranquilizers didn’t particularly agree with me, while others were highly effective. Likewise with SSRI types of anti-depressant. In the end though both classes of drug served me well. Drugs are considered controversial and I advise you not to be propogandized by either the drug companies or the alternative therapy brigade. Just speak to your doctor, do some research online, and go with what feels right.

3. Meditation. When I was at my most anxious I had so much trouble with hyperventilation. The only time I was truly calm was when I was so engrossed in something that I took my mind of my breathing. But more often than not my breathing felt continually laboured – sometimes it was annoying, sometimes it was scary. Every time I noticed my breathing it would go out of control, I would hyperventilate, and I would pray for it to slow down or normalize. Through mindfulness mediation I quickly realized that actually my breathing was not going to kill me, that it was under my control, and that it could be normal.

4. Choosing to be free of it. This is a strange one to try and put into words. Sometimes when you are feeling anxious, panicky, or phobic there is just a voice which comes to my head that says “Come on, I am in control of this”. You do chose whether or not to be anxious, and you can chose to feel well. It is a hard choice to make and I will talk more about this at a future date. I have a feeling that this is the best way to beat anxiety once and for all.

NaSSAs – Noradrenergic and specific serotonergic antidepressant

Noradrenergic and specific serotonergic antidepressant, or NaSSA’s as they are known, are a modern type of anti-depressant that is being used in some cases instead of the more traditional anti depressants such as Selective Serotonin Re-uptake Inhibitors (SSRI’s) and Serotonin-norepinephrine reuptake inhibitor (SNRI’s).

To the end user, the patient, there may not appear to be much difference between the three classes of drug. They are all anti-depressants, they are all taken daily over a long period of time, they have all had a bad press at some time or other and can all cause unpleasant side-effects. In fact the drugs work on different receptors, effecting the balance of different neurotransmitters in the brain. NaSSA’s work on adrenergic receptors which can help to increase levels of both Serotonin and norepinephrine, which is also known as noradrenaline.

So could this newer type of anti-depressant be for you? Well, it might be but it is hard to tell. Anti-depressants effect different people in different ways. Some people react very well to the older kinds, and others have to stop the same drug due to horrendous side effects. There are many many anti-depressants on the market and each individual patient will have their preferences. Clinical trials have shown, however, that the newer NaSSA’s seem to have a better side effect profile in terms of sexual dysfunction, which is something SSRI’s are almost synonymous with. So if you need an anti-depressant and medication induced sexual dysfunction has been a problem in the past then it might well be worth asking your doctor about NaSSA’s. I would add however that many people who experience side effects, including sexual dysfunction, when first embarking on a course of anti-depressants would do well to persevere while of course keeping in contact with their doctor. In my experience the worst side effects pass in the first few weeks. It’s not true for everyone though.

Other things to be aware of include the fact that newer drugs tend to be more expensive. This may effect you if you have medical insurance or if your country has a national health service that hesitates to provide expensive medication.

For details of how other drugs are used to treat anxiety, panic attacks and depression please go to the drugs page.

Related articles:

Alternatives to anti-depressants

The media is increasingly taking the issue of the over-prescription of anti-depressants seriously. Article after article is being written about how the figures of anti-depressant prescription have doubled, tripled and even increased five-fold, depending on which statistics you believe, which time frame you examine, and how you interpret the data.

7 Steps for a Depression Free Life – Click Here! 

The bare most important fact is that anti-depressant prescription has soared, no matter which way you look at it. This is not necessarily bad as this kind of medication (typically Selective Serotonin Re-uptake Inhibitors or SSRI’s or Serotonin-norepinephrine re-uptake inhibitors -SNRIs) can really save lives. The upturn in prescription could show one of two things: either over-prescription by poorly trained or under-resources medics, or an increase in the numbers of people suffering from anxiety, depression, bipolar and the other maladies which are often treated by anti-depressants. In truth, the true reason for the increase is probably a combination of the above.

There are of course alternatives. St John’s Wort is one popular herbal remedy that is used more than anti-depressants in Germany, according to some reports. Herbal remedy advocates shouldn’t coo too much about the widespread use of this product as it is available without prescription and therefore it is very difficult to study how it is used. Many people may be taking in when it is not really necessary, many more may not be using a therapeutic dose.

Interestingly, when I was researching this post I came across an article on the health section of BBC Online. A lady from Perth in Scotland is talking about how art therapy helped her get over depression. This interested me because I have seen an art therapist and believe that this kind of therapy can have a very profound effect. Whether it slows you down and helps you come into the present (where you are necessarily ok – see this section on mindfulness if you don’t believe me), or helps your unconscious express itself, increasingly people are starting to notice it. Just doing art can be therapeutic, but combining it with therapy with a trained an experienced art therapist is worth every penny if you suffer from anxiety or depression, or any other complex mental health problem that you don’t fully understand.

The key is to do something other than just take drugs! But remember, for some of us drugs are an important short to medium term strategy which can help us climb out of a rut and get ourselves back on our feet.

For more information on art therapy why not visit BAAT – the British Association of Art Therapists and see if there is a therapist in your area that you could meet for an introductory chat.

Self-discovery – Anxiety, depression and mental disorders

Anxiety sufferers often look for the deeper meaning and causes behind their anxiety. In recent decades there has been a fad for self-discovery. Not just involving people suffering from anxiety, depression and other mental health disorders, but from almost every quarter. Mostly self-discovery is sought by those who feel some kind of unhappiness, inertia or unknown, un-quantifiable dread.

Sadly there has been a lot of rubbish written about self-discovery, and most people never really scratch the surface. The kind of questionnaire’s that one comes across in glossy magazines are not much good to anyone, and likewise most of the psychologically derived analytical questionnaire’s are aimed at the business market, helping them test employees’ aptitude and reliability.

Of course many people with mental issues such as anxiety and depression have sought out eastern methods of self-discovery which generally rely on meditation. These may be more or less effective depending on the persistence of the person practicing. I am a big fan of Inner Guide Meditation, which I have blogged about previously. Certainly any kind of meditation is probably preferable to none for those who are seeking to take a step back and become able to see the world and themselves for what they really are.

Mindfulness meditation can also be useful for self-discovery.

But meditation is not for everyone. Although I recommend it to everyone, not everyone takes to it and not everyone perseveres with it and many people seem to be scared of it or convinced that they can’t possibly meditate due to poor concentration.

I have come across a technique called Watchword (no longer exists?), which has been designed to aid self-discovery and is based largely on Jung’s ideas of self-realization. I won’t describe the process here in detail because I am not a professional psychologist and the website where Watchword is based describes it more than sufficiently. I will say, however, that it involves using a word matrix to identify certain aspects of your being to help you understand more about yourself.

I should just add that Watchword is not sold as a quick-fix cure to anxiety or depression, and if it was I would not be discussing it here because almost all quick or instant cures for anxiety are gimmicks run as money making schemes. Instead there is no mention of anxiety per se, just the idea that through a greater self-understanding you might be able to learn some more about yourself, your problems, your motivations and beliefs. I think it is through this kind of understanding that a greater sense of how to control or remove excess anxiety is found.