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6/10/2021 AnxietyWhat is Anxiety?
‘Anxiety’ is a rather common term used today. Anxiety involves a general feeling of apprehension about possible future danger. This is not to be confused with fear - an alarm reaction that occurs in response to immediate actual danger. Anxiety disorders are characterised by unrealistic, irrational fears or anxieties that cause significant distress and/or impairments in functioning. According to Barlow, the anxiety response pattern is a complex blend of unpleasant emotions and cognitions that is both more oriented to the future and much more diffuse than fear. What are Anxiety Disorders? Though anxiety disorders may seem the least harmful, anxiety disorders have the earliest age of onset out of all mental disorders, making them a serious cause for concern. Anxiety Disorders often result in frequent intense, excessive and persistent worry as well as fear about everyday situations. A wide variety of neutral stimuli may thus accidentally trigger or serve as cues that something threatening and unpleasant is about to happen. Often, they tend to include repeated episodes of sudden feelings of intense anxiety. What are the different Anxiety Disorders? The DSM-5 currently recognises five anxiety disorders. Namely:
General Anxiety Disorder (GAD): Specific Phobia A phobia is present if a person shows strong and persistent fear that is triggered by the presence of a specific object or situation and leads to significant distress and/or impairment in a person’s ability to function. When encountering a phonic stimulus, those with specific phobia would often react immediately with a fear response that resembles a panic attack. The anticipation of encountering a phobic object/situation would also result in them going to great lengths to avoid such encounters with their phobic stimulus. The occurrence of this anxiety disorder is rather common, occurring in around 12% of people at some point in their lifetime. According to the DSM-5, there are five sub-types of specific phobias:
Social Anxiety Disorder (SAD) SAD, also known as Social Phobia, occurs when a person experiences disabling fears of one or more specific social situations (such as public speaking, urinating in a public bathroom, or eating or writing in public.) This fear usually occurs when a person believes that he or she is a social object exposed to the scrutiny and potential negative evaluation of others or that they might act in an embarrassing or humiliating manner. Such fears thus cause people with SAD to avoid such situations or endure them with great distress. The DSM-5 recognises 2 sub-types of SAD:
Unfortunately, approximately 12% of the population meets the diagnostic criteria for SAD at some point in their lives. This disorder occurs more commonly amongst women and typically begins during adolescence or early adulthood. Panic Disorder Panic Disorder can be described as the occurrence of panic attacks that often seem to come “out of the blue.” A DSM-5 criteria for panic disorder is the requirment for the person to have experienced recurrent, unexpected attacks and must have been persistently concerned about having another attack for at least a month. For an event to qualify as a full blown panic attack, there must be abrupt onset of at least 4 of the 13 symptoms listed below as stated by the DSM-5:
Panic attacks are often unexpected and appear even when unprovoked by any identifiable aspects of the immediate situation. In some other cases, panic attacks may however be situationally predisposed, occurring only sometimes while the person is in a particular situation such as driving or being in a crowd. Agoraphobia: Agoraphobia simply put is the fear and avoidance of public and crowded places such as shopping malls, movie theatres and stores. It is often a frequent complication of panic disorderPeople with agoraphobia are usually concerned that they may have a panic attack or get sick in public places. This results in anxiety about being in places or situations from which escape would be difficult or embarrassing, or in which immediate help would be unavailable if something happened (DSM-5 criteria). In most cases, people with this disorder are typically anxious when venturing outside their homes alone. In extremely severe cases, agoraphobia is extremely dysfunctional and disabling in which the person is unable to even venture beyond the narrow confines of their home. When should your anxiety be classified as a disorder? Experiencing occasional anxiety is a normal part of life. A person might feel anxious when placed under pressure, in high-stakes situations such as taking a test, going for a job interview, or making crucial decisions. However, some indicators of anxiety disorder that warrant diagnosis include the following.
How can I cope with anxiety disorder?
If you need somebody to talk to and you are not sure who to turn to, drop us a call at +65 6970 5611 to schedule a session, or sign up using the form on our website. How do we help someone suffering from an anxiety attack? (Mental First Aid) According to the Mental Health First Aid, appropriate first aid response can decrease hypervigilance about physical symptoms or fear future panic attacks. The steps recommended by the MHFA can be summarised into the simple acronym of ALGEE: The Action Plan. ASSESS:
GIVE:
ENCOURAGE:
While anxiety disorders may seem rather common and harmless, they are in fact extremely detrimental to clients. Those who border on the severe side for such disorders often find themselves unable to live a fully functional life. It is thus of the utmost importance that we educate ourselves on the different aspects of anxiety disorders. References used: Sandoiu, A. (2019, November 6). Deep sleep may help treat anxiety. Medical News Today. https://www.medicalnewstoday.com/articles/326926 6/10/2021 Depression One of the most common mental health disorders, with one of the highest prevalence rates is Depression. According to the World Health Organization (WHO), more than 264 million people globally suffer from this disorder (World Health Organization, 2020). Despite its high prevalence, most of society still remains ignorant and oblivious to its symptoms and detrimental effects on the human body. It is therefore imperative for us to further educate ourselves on the array of symptoms as well as consequences of depression.
Depression to many is a singular term referring to the main type of depression called Major Depressive Disorder (MDD). It is, however, an umbrella term that references several other conditions related to depression. They are:
The two main types of depression are Major Depressive Disorder (MDD) and Persistent Depressive Disorder (PDD). While normal depressions are common and expected in people who have experienced painful but common life events and losses. MDD is however characterized by the client being in a major depressive disorder and have never had a manic, hypomanic, or mixed episode. PDD on the other hand, is characterized by a persistently depressed mood most of the day, for more days than not, for at least 2 years (1 year for children and adolescents). While periods of normal moods may occur briefly, they are usually intermittent and last for only a few days to a maximum of 2 months. However, the chronicity of this disorder has proven to be far more damaging than MDD (Hooley et al., 2017). Symptoms of Depression: According to the American Psychiatric Association (APA), common symptoms include (American Psychiatric Association, 2020):
Misconceptions on Depression: As humans, we experience adverse and tragic life events such as the death of a loved one, loss of a job or the ending of a relationship. These common familial and economic losses are painful and difficult experiences we all have to endure. During such events, it is normal for feelings of sadness, grief or bereavement to occur. These “depressive” feelings however differ from having depression. While grief and painful feelings come in waves, often intermixed with positive memories of the loved ones we’ve lost. In MDD, mood or pleasure are decreased for most of two weeks. While self-esteem is usually maintained during periods of grief, in depression, feelings of worthlessness and self-loathing are common. Furthermore, in grief, thoughts of death stem from the fantasizing of “joining” the deceased loved one. Whereas, in depression thoughts of suicide are due to the inability to cope with the pain of depression and feelings of worthlessness. It is however important to note that grief and depression can co-occur. Grief may also serve as a trigger for some, which may lead to depression (American Psychiatric Association, 2020). Depression in Youths: What many of us fail to realise is that our youths are extremely vulnerable to depression. With adolescence being a unique and formative time, youths are extremely susceptible to emotional, physical and social changes. According to the World Health Organization, exposure to poverty, abuse or violence, can make youths vulnerable to mental health problems One of the most common disorders to emerge during adolescence are emotional disorders such as depression. Globally, depression is one of the leading causes of illness and disability among adolescents, with suicide being the third leading cause of death in 15 to 19-year-olds. Sadly, in 2016, an estimated 62,000 youths died as a result of self-harm (World Health Organization, 2020). Our youths are the pillars of our future, it is therefore essential that we double our efforts in securing their mental health. What are some things I can do to cope with depression? (Adapted from article by Bushman, 2017) Even if you’re on antidepressant medications, positive coping skills are frequently recommended by scientific research and medication prescribers, such as psychiatrists, as crucial parts of treatment. It is recommended that you follow most, if not all, of the subsequent coping techniques once a day when experiencing depression. You likely won’t feel motivated to do any of them at first, since depression often drains your motivation. This is normal, and it’s alright to feel unmotivated until you are halfway through these activities. These can be summarised with the acronym: MY PEERS.
If something goes wrong with your goal, reflect on what you can learn from the experience (a growth mindset). Don’t judge yourself harshly (fixed mindset).
No matter what medication you’re taking, doing several of these activities every day - especially when you don’t feel like doing them - is crucial to treating depression. These skills may take time and practice, but they’re well worth it in the long run. What can Family Members and Friends Do? As family members and friends of those suffering from depression, we are often confronted with the thought of “how can I make this better?” and “I wish there was something I could do.” Understanding and support for our loved ones are thus what we as family members and friends can provide (Mayo Clinic, 2018). According to the Mayo Clinic, family and friends can: Learn the symptoms of depression: More often than not, those suffering from depression fail to recognise their need for treatment. It is thus up to family members and friends to recognise the tell tale signs of depression. It is important to note that symptoms vary from person to person. However, common symptoms include prolonged feelings of sadness, tearfulness, emptiness or hopelessness. As well as a loss of interest or pleasure in most or all normal activities. Encourage treatment: Most people with depression might feel a sense of shame with regards to their disorder. They often believe that depression can be overcomed with their willpower alone. It is therefore imperative that we as family and friends show our support and suggest professional help. By expressing our willingness to help, patients might be more open to treatment, greatly reducing treatment gaps. Identify warning signs of worsening depression: As everyone’s experience with depression differs, we need to consider these issues
Understand suicde risk: Given that people with depression are often at an increased risk of suicide, we should always remain alert for warning signs of suicide. If signs of suicidal behaviour do occur, we should take it seriously and act immediately.
Provide support and be willing to listen Recovery is not always an easy road. As family and friends, we should always try to provide positive reinforcement and offer assistance. Being patient and helping to create a low-stress environment is crucial. Lastly, other than learning more about depression, we should also be mindful of our own mental well-being. Depression is thus a real and pressing problem society has to acknowledge. It is vital that we continue to shed light on the realities and dangers of depression. Bibliography American Psychiatric Association. (2020, October). Depression. American Psychiatric Association. https://www.psychiatry.org/patients-families/depression/what-is-depression Bushman, B. (2017, May 15). 7 ways to overcome depression without medication. Intermountain Healthcare. https://intermountainhealthcare.org/blogs/topics/live-well/2017/05/7-ways-to-overcome-depression-without-medication/ Hooley, J. M., Butcher, J. N., Nock, M. K., & Mineka, S. (2017). Abnormal Psychology. Pearson. Mayo Clinic. (2018, November 28). Depression: Supporting a family member or friend. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20045943 World Health Organization. (2020, January 30). Depression. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/depression World Health Organization. (2020, September 28). Adolescent Mental Health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health |
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