Turning on the Light: Anxiety in All Forms

Last week the focus was on depression this week we focus on anxiety. Though all of us deal with stress at particularly stressful times, some people deal with anxiety that is present on regular basis and can make it difficult to live a normal life. Over 18% of the adult population in the United States struggle with some form of Anxiety Disorder. So what is anxiety? Well, it can vary from a mild uneasiness in certain situations to a full panic attack. It can also vary in how long they last from a short few minute burst to a constant struggle for many years.

Anxiety can present in many ways. Physically it can include heart racing, feeling flush, shortness of breath, headaches, sweating, numbness, aches, restlessness, and even tremors. Psychologically it will potentially involve excessive fear and worry, racing thoughts, nervousness, irritability, indecision, inability to sleep, unable to sleep, and unable to focus. These symptoms can cause you to avoid potentially stressful situations, phobic behaviors, and distress in social settings. And this is not an exhaustive list. Anxiety can take on many forms and cause varying results.

While people often say they are dealing with anxiety there are a number of anxiety disorders. The most common are Generalized Anxiety Disorder, Panic Disorder, Phobic Disorders, and Post-Traumatic Stress Disorder.

• GAD's main symptoms are uncontrolled worry accompanied by a number of the physical and psychological symptoms. GAD makes it difficult to particpate in life. 
• Panic Disorder is characterized by reoccurring panic attacks for a month period. A panic attack is a sudden onset of intense fear or panic often coupled with a racing heart, sweating, chest pain, hyperventilating, dizziness, and a feeling of detachment from reality. With a Panic Disorder people with often avoid places, people, and situations that are similar to the one that caused the panic attack. 
• Phobic disorders are when a person changes their activities due to a strong and persistent fear. Phobias can be anything from spiders (arachnophobia) to fear of panic attacks, embarrassment, or helplessness (agoraphobia). One of the most common phobias is Social Anxiety Disorder. 
• Social Anxiety Disorder is the fear of public scrutiny. It is often accompanied by the fear of embarrassment and worries about not being accepted as they are. The most commonly feared situations are public speaking, social gathering, eating in public, and dates in public areas. 
• PTSD is the stress that is caused as a result of a traumatic event that the person has witnessed, responded to, or been close to someone who has witnessed it. This can be anything from a car accident to a natural disaster to exposure to war. The most common symptom is reexperiencing the event in flashbacks and dreams. 

These are some of the things that people with anxiety deal with on a daily basis. The biggest way that someone can help is to be accepting and understanding. Don't make someone feel worse about their anxiety than they already do. Be understanding of situations that people cannot handle. Social Anxiety Disorder is the most common anxiety disorder. To those who have it many of life's situations cause increased anxiety. To those who do not have it, it sounds like an excuse. It's not an excuse. I encourage you if you have more questions to reach out to someone with social anxiety or one of the other anxiety disorders. If you do think you know anyone affected by anxiety, you do, but I would suggest Googling stories of anxiety it could be quite enlightening. 

Next week I will be featuring the first interview with a friend struggling with depression and the art that has resulted from it. As always of you need someone to talk to I am here and willing to listen. It is in silence that problems go untreated. If you are in need of immediate help please call one of the numbers below. The suicide hotline is answered 24/7. If it is not an emergency, but you need more resources for anxiety or depression check out the Anxiety and Depression Association of America. 

Resources:

Information used from the Mental Health First Aid USA (First Edition (Revised)) copyrighted by National Council for Behavioral Health and the Missouri Department of Mantla Health (2015).

Turning on the Light: What is depression?

So I have decided to start off by actually explaining what depression is and I will talk about what anxiety is next week. Depression is a word that gets tossed around a lot. Some people use it correctly while others use it as a replacement for sad or bummed. I believe this is where a good deal of the confusion about depression and other mental illnesses come from. Before you can understand something you need to have a working idea of the definition. When most people think of depression they are thinking of the Major Depressive Disorder.
DSM-IV defines MDD as having a depressed mood or loss of interest or pleasure in daily activities and this must occur for more than two weeks. This is subjective, but the easiest way to gauge this is by having a baseline and noticing a departure from it. MDD will cause impaired social, occupational, and educational function. There are nine major symptoms to look for and if five or more of these is present nearly every day the person may be dealing with MDD and a psychologist or psychiatrist should be contacted. The nine symptoms are listed below taken directly from the DSM-IV (American Psychiatric Association, 2013).
1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite 
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy 
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan

While no one symptom is able to definitively diagnosis MDD, if you start to notice any of these in yourself or others it is a good indication to start watching for the other symptoms so that the problem doesn't escalate to a dangerous level before it is noticed. Personally, when I was in the worst of my depression I was dealing with depressed mood, decreased interest, change in sleep, fatigue, guilt/worthlessness, and difficulty concentrating. While mine was part of MDD, others can go through a depressive episode as an isolated episode.

A depressive episode can come in differing levels of severity and display differing symptoms. I have listed below the guide to identify a depressive episode. I have not placed this here for you to start diagnosing yourself or others, but rather to give you an idea of what someone with MDD or going through a depressive episode is experiencing. If you do notice these symptoms regularly I highly recommend seeking out mental health resources (American Psychiatric Association, 2013).

Category A:
Depressed Mood
Loss of interest and enjoyment in usual activities
Reduced energy and

Category B:
Reduced self-esteem and confidence
Ideas of guilt and unworthiness
Pessimistic thoughts
Disturbed sleep
Diminished appetite
Ideas of self-harm

Severity of Depressive Episode: 
Mild: More than 1 from category A plus 1-2 from category B. Or 5-6 symptoms but mild in severity and functional impairment.
Moderate: More than 1 from category A plus 2-3 from category B. Or 7-8 symptoms but moderate functional impairment.
Severe: All 3 from category A plus more than 3 from category B. Or fewer symptoms but any of these: severe functional impairment, psychotic symptoms, recent suicide attempt, or has specific suicide plan or clear intent (American Psychiatric Association, 2013).

Depression can look many different ways from totally withdrawing from society to being hidden behind the smiling face of those closest to you. While a number things can lead to depression (we will look at causes in a later blog) it can effect anyone. I am not advocating interrogating your family and friends to see if they struggle with depression. I am advocating making it know that your door is always open and that you care about them so much that you would be happy to listen if they ever want to talk. If you are out there needing someone to listen I am more than happy to listen. If you need more immediate help this I have listed below the number for the National Suicide Prevention Hotline.  If you have a mental health question please submit it for Sunday's post!

Resources:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Image borrowed from https://tvlvmcjg4f-flywheel.netdna-ssl.com/wp-content/uploads/2016/08/NSPL_Logo.jpg

Announcement!

I have been semi-consistently been writing my blog for a while now and even though I am sure I will continue to think of wonderfully eloquent and clever things to write I have decided that I will be doing blog segments each week. From my experience with mental health issues and my studies in becoming a counselor, I have decided to have two mental health themed blogs each week.
In addition to the things that I already write I will be writing a blog each Thursday on Anxiety and Depression to help people get inside the mind of someone struggling with it and to help people understand what it actually entails. This will include facts about the diagnosis, the treatment options, and tips and tricks. It will also include interviews, reflections, and poems from people living with depression and anxiety.
The other will be a post in response to a mental health related question on Sundays. This can be really a question about anything. I do not claim to be a mental health professional yet, but I will do research and answer your question to the best of my abilities. It will be anonymous so don't worry about what you ask only I will know. If you are interested in asking a question you can use the form that is now on the right side of my blog below my profile. If for some reason this does not function correctly for you, I can be emailed at ludwig4408@gmail.com.
Final Note: This is the most dismal time of the year and depression rates are at their highest. That being said I want to let everyone know that I am available to listen to any problems you might have. I will be more than happy to put on a pot of coffee or tea and listen. I don't have the all the answers, I don't even have most the answers, but I am more than willing to be present with you. If you need more than just someone to listen I can recommend some options or talk through the experiences I have had in the mental health field. Remember you are not alone.

The Year of Joy

So I have been asked a number of times "What is your New Years Resolution?" and I resolved last year that I would never have one again. I think that it is infeasible to try and commit to something for that long, we are far too fickle creatures. So last year I decided that I would resolve to one new thing each month and then if at the end of the month I wanted to quit I could guilt free. It was a great success.
While I do not want to resolve to change something for an entire year, I have decided that I want a theme for all the month resolutions that I make. The theme for this year is Joy. I want to do only things that bring me joy or things that lead me to things that bring me joy. Last year was a year of dealing with really hard things and starting the healing process. I believe that they next step in the healing process is embracing joy. Joy is not dependent on my circumstances but on my savior and the things he has enabled me to do.
This year I ask for your help as well friends. If you see me doing something or living in such a way that joy is not present pull me aside and ask me about it. There will be circumstances that make me unhappy, but through that joy should still be present. So my prayer and resolution this year are that joy will permeate my life and that I will remain fixed on Him through all trials and tribulations.

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.

~ Romans 15:13

Image borrowed from http://www.lilblueboo.com/2014/01/the-year-of-joy.html

Grace is Easy, Accepting its Hard

Why do most Christians struggle to accept the grace we have been freely given?

For by grace, you have been saved through faith. 

And this is not your own doing;

 it is the gift of God, not a result of works, 

so that no one may boast. 

Ephesians 2:8-9

This question is a difficult one to answer. Though I believe that people around the world struggle with it, we in the United States have a particularly hard time with this concept. I know that I do. And these three topics I address are the reason that I struggle to accept grace in my own life and the reason I believe that we struggle with it as a country. 

The first part of what stands in our way is ourselves. In the US we have the idea of the America Dream, which at its core is the belief that we can do and become whatever we want if we work hard enough. We believe that we will receive whatever we work for and that we deserve whatever we get. The idea of reaping what we sow has been instilled in us from our earliest days. Some may say, that as a society we love getting things for free, but even in this I believe that we subconsciously think that getting something for free is really a way of the cosmos paying us back for being a good person. Think about it, we accept gifts, no problem, unless they are too big. Once it reaches this threshold we feel guilty. I think this is because it is so generous that we cannot justify why we deserve it. With grace, it is the most generous gift we can ever receive with the highest cost that has ever been paid. There is no way that anyone can justify in their mind that they deserve to have the God of the universe die for them. So to accept grace is to accept our own unworthiness. 

Psalm 31 does an excellent job at explaining the position we must adopt to accept grace:

O Lord, my heart is not lifted up;

my eyes are not raised too high;

I do not occupy myself with things

too great and too marvelous for me.

But I have calmed and quieted my soul,

like a weaned child with its mother;

like a weaned child is my soul within me.

O Israel, hope in the Lord

from this time forth and forevermore.

Psalm 31

So we are the first thing that stands in the way of us accepting grace easily. The second is the loss of control. This also stems heavily from the American Dream. We like the idea that we are in control of our own lives, it is not until things start falling apart that we start to look outside of ourselves for a cause. In an average conversation overheard in any public place, you can hear people explain how they brought about their good fortune and blame others for any woe they have suffered. Accepting the fact that someone else helped us or provided our good fortune is contrary to our nature. It reveals the biggest lie we believe that no one else actually believes about us. We have no more control over bringing about our salvation that we do about the orbit of the earth or the flow of the tides. Accepting grace leads to the destruction of the illusion of self-sufficiency. God did for us what we could not do for ourselves, we had no control or say in this. It is this fact that makes grace hard for us to accept. 

Then Job answered the Lord and said:

“I know that you can do all things,

and that no purpose of yours can be thwarted.

‘Who is this that hides counsel without knowledge?’

Therefore I have uttered what I did not understand,

things too wonderful for me, which I did not know.

‘Hear, and I will speak;

I will question you, and you make it known to me.’

I had heard of you by the hearing of the ear,

but now my eye sees you;

therefore I despise myself,

and repent in dust and ashes.”

Job 42:1-6

The third thing that stands in our way is fear. This is wrapped up in the other two. Another aspect of the American Dream, though it is never spoken of, is the idea that we are supposed to be fearless in all that we do. Nothing is supposed to unsettle us. Nothing is supposed to give us pause. It's the belief that we are the greatest nation on earth, we can conquer anything without batting an eye, and as a citizen, we should be as fearless as our nation. This is the lie we most easily see through, because even though we would never say it out loud we are terrified. And what are we terrified of the most?Easy, the things that happen outside of our control. The things we could not stop if we tried. The things that no amount of preparation can prevent or hasten. We are scared to trust God because it forces bravery we are not used to. With Him, we have to face our fears, because the more we know him the more we know we are not in control of anything. God can be trusted and He will destroy our fear.

Fear not, for I am with you; be not dismayed, for I am your God;

 I will strengthen you, I will help you,

 I will uphold you with my righteous right hand.

Isaiah 41:10

Grace is hard to accept because to accept it we have to accept so much more. We have to accept that we are undeserving. We have to accept that we are not in control of anything. We have to accept that we are afraid. Grace brings us to our knees, but it is right where we need to be.  

Resources:
Why Is Grace So Hard To Accept? (2012, July 3). Retrieved December 22, 2016, from http://www.truthandway.org/blog/why-is-grace-so-hard-to-accept

McNulty, K. L. (n.d.). IMPACT- The Problem With Grace. Retrieved December 22, 2016, from http://www.madradioshow.net/impact/impactgrace.html

Mayer, M. (2014, September 15). Grace is Hard to Receive. Retrieved December 22, 2016, from http://everysquareinch.net/grace-is-hard-to-receive/

Picture borrowed from http://www.flowingfaith.com/wp-content/uploads/2012/04/11776.jpg

Advent

The days start to shorten

     and the darkness creeps in

Our hearts long for saving

     and the waiting begins

We enter this season

     with priorities all wrong

Beat down by the year

     so painful and long

So often it is said

     that hope spring eternal

But often it's forgotten

     in pursuing the external

But assured is this hope

     though we cannot yet see

It is certain and ensured

     by His death on the tree

Frequently this season

     is nothing more than a blur

But presence is a gift

     like frankincense and myrrh

Preparing our hearts

     should not be by chance

So that the manger

     receive more than a glance

Often passing delight

     is mistaken for joy

Craving the next thing

     it's all just a ploy

Though often it's missed

     joy itself is a gift

Through a future secure

     we are no longer adrift

If everyone were honest

     one would top the list

Most valuable is love

     giving a meaning to exist

It can sometimes be found

     in family and friend

But the true source

     no other can transcend

Christ is the focus

     the waiting is finished

Our souls are revived

     we can strive undiminished

Dispelled is the darkness

     and hope born anew

Our lives are ransomed

     God broke through

Picture borrowed from http://www.thevillagechurch.net/the-village-blog/the-season-of-advent/

Waiting For Christmas

For as long as I can remember I have waited with bated breath on the happiness that December brings. I would make my list and dream of the chocolate dipped pretzel my mom makes every year. Throughout the months of waiting there were times that I would despair feeling that it would never arrive and that I couldn't wait another second. Every year to date, however, I have made it to Christmas. I have gotten to over indulge on sugary sweets. I have gotten too ripe open my presents. I have gotten to experience the magic of Christmas.
Though not intentionally, I believe that this has been training me to experience the Advent season on a deeper level. Advent is about the waiting and I have been waiting for Christmas for many years now. Now I understand that the despair I felt was the world without the gift that Christmas brought. And we still have that despair at times waiting for the Savior to come again. To free this broken world from the darkness that still exists.
Going through the Advent season this year has really helped me appreciate this time of year better. Not only this time of year but my life as well. The waiting and despair have a purpose and that purpose is to prepare our hearts for the receiving. The receiving is put into perspective when we know what we currently have. We live in a broken world that will never truly satisfy our soul deep desires.
Christmas is the culmination of our desire to see a restored world and revived souls. Though this season has been corrupted like everything else in the world it does serve as a glimpse into what is to come. Our souls have life breathed into them. We are able to gather to those who mean the most to us. We are able to take the time to reflect on the birth and death of our Savior. And we are able to share the love of Jesus through gifts and the gospel.
Though the clouds have not yet been rolled back and the Jesus has not yet called us home, we can share His love and experience our own relationship with him on a deep level this Christmas Season.