Module 5 – Understanding Your Headspace & EMDR

Module 5 – Understanding Your Headspace & EMDR

Dr. Paul Miller, MD, DMH, MRCPsych

Everything You Need to Know About Anxiety

Overview

Anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.

But if your feelings of anxiety are extreme, last for longer than six months, and are interfering with your life, you may have an anxiety disorder.

What are Anxiety Disorders?

It’s normal to feel anxious about moving to a new place, starting a new job, or taking a test. This type of anxiety is unpleasant, but it may motivate you to work harder and to do a better job. Ordinary anxiety is a feeling that comes and goes but does not interfere with your everyday life.

In the case of an anxiety disorder, the feeling of fear may be with you all the time. It is intense and sometimes debilitating.

This type of anxiety may cause you to stop doing things you enjoy. In extreme cases, it may prevent you from entering an elevator, crossing the street, or even leaving your home. If left untreated, the anxiety will keep getting worse.

Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age. According to the American Psychiatric Association, women are more likely than men to be diagnosed with an anxiety disorder.

What are the Types of Anxiety Disorders?

Anxiety is a key part of several different disorders. These include:

  • Panic disorder: experiencing recurring panic attacks at unexpected times. A person with panic disorder may live in fear of the next panic attack.
  • Phobia: excessive fear of a specific object, situation, or activity.
  • Social anxiety disorder: extreme fear of being judged by others in social situations.
  • Obsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific, repeated behaviours.
  • Separation anxiety disorder: fear of being away from home or loved ones.
  • Illness anxiety disorder: anxiety about your health (formerly called hypochondria).
  • Post-traumatic stress disorder (PTSD): anxiety following a traumatic event.

What is Social Anxiety Disorder?

Social anxiety disorder, sometimes referred to as social phobia, is a type of anxiety disorder that causes extreme fear in social settings. People with this disorder have trouble talking to people, meeting new people, and attending social gatherings. They fear being judged or scrutinised by others. They may understand that their fears are irrational or unreasonable but feel powerless to overcome them.

Social anxiety is different from shyness. Shyness is usually short-term and doesn’t disrupt one’s life. Social anxiety is persistent and debilitating. It can affect one’s ability to:

  • Work
  • Attend School
  • Develop close relationships with people outside of their family

According to the Anxiety and Depression Association of America (ADAA) approximately 15 million American adults have social anxiety disorder. Symptoms of this disorder may start around the age of 13.

Symptoms of Social Anxiety Disorder

Social interaction may cause the following physical symptoms:

  • Blushing
  • Nausea
  • Excessive sweating
  • Trembling or shaking
  • Difficulty speaking
  • Dizziness or light-headedness
  • Rapid heart rate

Psychological symptoms may include:

  • Worrying intensely about social situations
  • Worrying for days or weeks before an event
  • Avoiding social situations or trying to blend into the background if you must attend
  • Worrying about embarrassing yourself in a social situation
  • Worrying that other people will notice you are stressed or nervous
  • Needing alcohol to face a social situation
  • Missing school or work because of anxiety

It is normal to sometimes feel anxious. However, when you have social phobia, you have a constant fear of being judged by others or humiliated in front of them. You may avoid all social situations, including:

  • Asking a question
  • Job interviews
  • Shopping
  • Using public restrooms
  • Talking on the phone
  • Eating in public

Symptoms of social anxiety may not occur in all situations. You can have limited or selective anxiety. For example, symptoms may only occur when you’re eating in front of people or talking to strangers. Symptoms can occur in all social settings if you have an extreme case.

What Causes Social Anxiety Disorder?

The exact cause of social phobia is unknown. However, current research supports the idea that it is caused by a combination of environmental factors and genetics. Negative experiences also may contribute to this disorder, including:

  • Bulling
  • Family conflict
  • Sexual abuse

Physical abnormalities such as a serotonin imbalance may contribute to this condition. Serotonin is a chemical in the brain that helps regulate mood. An overactive amygdala (a structure in the brain that controls fear response and feelings or thoughts of anxiety) may also cause these disorders.

Anxiety disorders can run in families. However, researchers aren’t sure if they’re linked to genetic factors. For example, a child might develop an anxiety disorder by learning the behaviour of one of their parents who has an anxiety disorder. Children can also develop anxiety disorders as a result of being raised in controlling or overprotective environments.

What is Separation Anxiety Disorder?

Separation anxiety is a normal part of childhood development. It commonly occurs in babies between 8 and 12 months old, and usually disappears around age 2. However, it can also occur in adults.

Some children have symptoms of separation anxiety during their grade school and teenage years. This condition is called separation anxiety disorder or SAD. Three to four percent of children have SAD.

SAD tends to indicate general mood and mental health issues. Around one-third of children with SAD will be diagnosed with mental illness as an adult.

Symptoms of Separation Anxiety Disorder

Fear of separation can also cause anxiety-related behaviours. Some of the most common behaviours include:

  • Physical illness, such as headaches or vomiting
  • Violent, emotional temper tantrums
  • Refusal to go to school or work
  • Poor school or work performance
  • Not wanting to sleep alone

SAD can also occur after a stressful life event such as:

  • Moving to a new home
  • The death of a close family member
  • Global pandemic

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health disorder that begins after a traumatic event. That event may involve a real or perceived threat of injury or death.

This can include:

  • A natural disaster like an earthquake or tornado
  • Military combat
  • Physical or sexual assault or abuse
  • An accident
  • A global pandemic

People with PTSD feel a heightened sense of danger. Their natural fight-or-flight response is altered, causing them to feel stressed or fearful, even when they’re safe.

PTSD used to be called “shell shock” or “battle fatigue” because it often affects war veterans. According to the National Centre for PTSD, it’s estimated that about 15 percent of Vietnam War veterans and 12 percent of Gulf War veterans have PTSD.

But PTSD can happen to anyone at any age. It occurs as a response to chemical and neuronal changes in the brain after exposure to threatening events. Having PTSD doesn’t mean you’re flawed or weak.

PTSD Symptoms

PTSD can disrupt your normal activities and your ability to function. Words, sounds, or situations that remind you of trauma can trigger your symptoms.

Symptoms of PTSD fall into four groups:

 

Intrusion

  • Flashbacks where you feel like you relive the event over and over
  • Vivid, unpleasant memories of the event
  • Frequent nightmares about the event
  • Intense mental or physical distress when you think about the event

Avoidance

Avoidance, as the name implies, means avoiding people, places, or situations that remind you of the traumatic event.

Arousal & Reactivity

  • Trouble concentrating
  • Startling easily and having an exaggerated response when you’re startled
  • A constant feeling of being on edge
  • Irritability
  • Bouts of anger

Cognition & Mood

  • Negative thoughts about yourself
  • Distorted feelings of guilt, worry, or blame
  • Trouble remembering important parts of the event
  • Reduced interest in activities you once loved

In addition, people with PTSD may experience depression and panic attacks.

Panic attacks can cause symptoms like:

  • Agitation
  • Excitability
  • Dizziness
  • Light-headedness
  • Fainting
  • A racing or pounding heart
  • Headaches

PTSD Symptoms in Women

According to the American Psychiatric Association (APA), women are twice as likely as men to get PTSD, and the symptoms manifest slightly differently.

Women may feel more:

  • Anxious and depressed
  • Numb, with no emotions
  • Easily startled
  • Sensitive to reminders of the trauma

Women’s symptoms last longer than those of men. On average, women wait 4 years to see a doctor, while men usually ask for help within 1 year after their symptoms start, according to the U.S. Department of Health and Human Services, Office of Women’s Health.

PTSD Symptoms in Men

Men usually have the typical PTSD symptoms of re-experiencing, avoidance, cognitive and mood issues, and arousal concerns. These symptoms often start within the first month after the traumatic event, but it can take months or years for signs to appear.

Everyone with PTSD is different. The specific symptoms are unique to each man based on his biology and the trauma he experienced.

Tips For Employers Returning to the Workplace

Tips For Employees Returning to the Workplace

What is EMDR Therapy?

Eye Movement Desensitisation and Reprocessing (EMDR) therapy is an interactive psychotherapy technique used to relieve psychological stress. It is an effective treatment for trauma and post-traumatic stress disorder (PTSD).

During EMDR therapy sessions, you relive traumatic or triggering experiences in brief doses while the therapist directs your eye movements.

EMDR is thought to be effective because recalling distressing events is often less emotionally upsetting when your attention is diverted. This allows you to be exposed to the memories or thoughts without having a strong psychological response.

Over time, this technique is believed to lessen the impact that the memories or thoughts have on you.

What are the Benefits of EMDR Therapy?

People who are dealing with traumatic memories and those who have PTSD are thought to benefit the most from EMDR therapy.

It’s thought to be particularly effective for those who struggle to talk about their past experiences.

Although there is not sufficient research to prove its effectiveness in these areas, EMDR therapy is also being used to treat:

  • Depression
  • Anxitety
  • Panic attacks
  • Eating disorders
  • Addiction

The Butterfly Technique

The Butterfly Hug is accomplished by an individual wrapping their arms around themselves, so that each hand touches the opposite upper arm or shoulder. They then move their hands like the wings of a butterfly, to tap their arms/shoulders in an alternating rhythm. (As an alternative, the person might just tap their knees.)