Common Disorders

Common Disorders

At present you will find the following:

Anxiety

Stress

The Effects of Traumatic Events

Anorexia

Anxiety

	What causes anxiety?
	Mild anxiety is vague and unsettling, but severe anxiety can be extremely debilitating. Anxiety is often triggered by stress in our lives. some are more vulnerable to anxiety, but even those who become anxious easily can learn to manage it well. We also make ourselves anxious with 'negative self-talk' - a habit of telling ourselves the worse will happen!
	How can I recognise anxiety?
	As well as feeling apprehensive and worried, you may experience some of the following physical symptoms: tense muscles - trembling - churning stomach - nausea - diarrhoea - headache - backache - halt palpitations - numbness or pins and needles in arms, hands, or legs - sweating/flushing. It is easy to mistake symptoms of anxiety for physical illness and become worried that you might be suffering a heart attack or stroke. This, of course, increases anxiety.
	How can I help my anxiety?

Firstly, avoiding situations which make you anxious might help you in the short time, but the anxiety keeps returning and has a habit of spreading to other situations. This can lead you to avoiding things like shops, crowded places, and so on. Instead of avoiding:

Learn to manage the stress in your life. Keep an eye on pressures and deadlines.

Learn a variety of relaxation techniques. physical relaxation really does help. Ask your counsellor or psychologist to help with techniques.

Look after your physical self. Eat healthily, get regular exercise and try to keep a regular sleep pattern, avoiding alcohol and illegal drugs.

Practice deep abdominal breathing. There are helpful techniques to make this really effective - ask your counsellor, psychologist, or medical practitioner.

Learn to replace "negative self-talk" with "coping self-talk". When you catch yourself thinking something negative like "I can't do this", try to change it to something more positive, like "This is hard, but I can get through it". It can be helpful to think of 'changing the tape' that runs through your mind. You could make a list of the negative thoughts you often have and write a list of positive, believable thoughts to replace them.

If anxiety is causing you undue stress and unhappiness, make an appointment with a counsellor, or psychologist, or medical practitioner. It is often the case that a course of medication, combined with psychotherapy provides the most effective treatment.

Stress

Stress is useful in small doses, and too little can actually be bad for you - leaving you bored and unstimulated. Sometimes the challenges of study, work, relationships, finances, or home life overload us and we feel unable to cope.

Our relationships, home life, work load, financial and time pressures are stressors we often don't notice. then a specific event such as the loss of a loved one, unemployment etc on top of the daily stress can feel unbearable.

Stressors include: lack of sleep - large workloads - extreme physical exercise, or none at all - sickness or injury - moving house - employment changes or uncertainty - living in a different culture - climatic extremes.

How will I know I am stressed out?

The effects of stress vary between individuals and can change with age and personal circumstances. When the demands on your energy become to great, you may experience these symptoms of stress.

problems - lack of concentration - exhaustion - anxiety - sadness or depression - stomach ache, butterflies, or ulcers - digestive upsets - indecision - asthma and skin rashes - high blood pressure - absenteeism - shortness of breath and chest pains - headaches and migraines - social withdrawal - poor work or study performance - hot and cold flushes.

So what can I do?

Take control by considering how balanced your lifestyle is in terms of meeting your physical, emotional, mental, and spiritual needs. Identify the main sources of stress and what adjustments you can make to reduce them. Do NOT ignore the stress.

	Increase your stress tolerance and resilience by maintaining a healthy lifestyle with good nutrition, sleep, rest, and exercise
	Avoid or limit smoking and drinking - abstain from recreational drugs.
	Find out what helps you relax - e.g. sport, meditation, reading, visiting... do that.
	Practice slow, deep breathing.
	Plan regular recreation breaks throughout the day
	Build a supportive network of friends and family
	Organise, prioritise, and manage your time, breaking big goals into small steps, anticipate deadlines and demanding times in your calendar and reduce other commitments accordingly.
	Have realistic and meaningful short and long term goals. Evaluate the stressors you are prepared to tolerate in light of these and your values. Make changes if necessary.
	If you are having problems, DON'T be afraid to ask for help. What advice would you give a friend if they asked for help with stress - can you follow your own advice?

Where to from here?

	If you want help to work through your issues relating to stress, learning strategies for stress reduction, breath control, relaxation, or generally managing stress make an appointment to see your psychologist or counsellor.

	The Effects of Traumatic Events
	A traumatic incident is any event which has a stressful impact sufficient to overwhelm your usual coping strategies. They are usually sudden and shocking incidents outside the rage of ordinary human experience. Examples of traumatic events include accidents, violent assaults, witnessing a violent incident, suicides or suicide attempts by family members, and natural disasters such as earthquakes and floods. There are strong emotional effects associated with traumatic incidents which are often described as 'normal responses to abnormal events'. Learning to recognise the normal emotions and reactions following an abnormal event can help you understand and feel more at ease with these feelings. In turn, this helps you adjust to what has happened.
	Common reactions to trauma

Although each person has a unique response to an experience, there are some common reactions amongst people caught up in a traumatic event.

	Shock - Disbelief at what has happened - Numbness (the event may seem unreal or like a dream) - You may be slow to comprehend what has happened.
	Fears - Of death or damage to yourself - Recurrence of the event - Personal vulnerability (it may be difficult to admit you are vulnerable) - You may have panicky irrational feelings - Other, apparently unrelated, fears may appear.
	Anger - Outrage at what has happened or what who 'caused it or allowed it to happen' - Anger at the injustice and senselessness of it all - Anger at medical personnel or police for not acting properly or quickly enough.
	Helplessness - Traumatic incidents can show up our human powerlessness to prevent some things from happening.
	Sadness - About human destruction and losses of every kind - for the loss of the belief that the world is safe and predicable.
	Shame - For having been exposed as helpless, emotional, and needing other - For perhaps not having reacted as you would have wished.

Effects on behaviour

	Tension - You may be more easily startled and agitated
	Sleep Disturbances - You may be finding it difficult to sleep or having thoughts that prevent sleep, e.g. replay of the incident.
	Dreams and Nightmares - You may be dreaming about the incident or other frightening events.
	Flashback - You may feel you are re-experiencing the event over and over.
	Fearfulness - You may be frightened by reminders of the incident, e.g. the place it happened.
	Intrusive memories and feelings - Your concentration may be affected by memories, flashbacks, and feelings about the event. You might be trying to shut these out which leads to deadening of feelings and thoughts.
	Irritability - Your mood may swing up and down. One minute you may be feeling happy and the next minute sad or angry.
	Depression - You may feel depressed about the event or past events, or guilty about how you behaved.
	Social Withdrawal - You may have a strong desire to be alone, or you may fear being alone.
	Physical Sensations - You may be experiencing a range of physical sensations. These may include: tiredness, palpitations, tremors, breathing difficulties, headaches, tense muscles, aches and pains, loss of appetite, loss of interest in sex, nausea, diarrhoea, constipation.
	Delayed effects - Any of these effects may occur months or even years after satisfactory adjustments if something triggers them.

While these symptoms are normal, they can be very distressing for you and your family. Your psychologist or counsellor will help you work through the issues you have and take control of your life again.

	Anorexia
	What is anorexia?
	Anorexia, short for Anorexia Nervosa, is commonly known as the 'slimmer's disease'. It is an eating disorder in which a person deliberately looses weight. Anorexia often begins with worry about weight as a reaction to the changes in the body during puberty. Excessive dieting causes such dramatic weight loss that the person's health is affected. The person may not feel unwell, and the often compulsive desire to exercise to help the weight loss may be extreme. Even though the anorexia sufferer may be extremely thin, even skeletal, when he/she looks in the mirror they will perceive a fat person.
	What is the outlook?
	Anorexia seldom starts before puberty. About half of all cases start before the age of 19, and almost all before 45. 90% of those with anorexia are female, and about 1 out of every 100 women developing the disorder. A few sufferers, about 1 in a hundred, die each year, mostly from the complications which arise from starvation. Most recover after a period which can be a few years, and many develop other associated problems such as depression, anxiety, and alcohol problems.

Signs of Anorexia

Early signs of Anorexia Nervosa include:

	concern about, and disgust with, body shape
	wearing concealing or baggy clothing
	exercising in an extreme manner
	refusing to eat with other people
	developing rituals around eating, such as counting mouthfuls, having to use a particular plate, nibbling only tiny portions.
	lying about the amount eaten, or when having eaten
	shown anger when asked about dieting

As weight lowers physical changes happen in the body:

	metabolism slows to conserve energy - pulse slows, blood pressure reduces, body temperature drops.
	In females, menstrual periods stop - the risk of osteoporosis rises
	fat, followed by muscles, is burned up, leading to wasting of the body
	blood flow to the extremities reduces, making fingers and toes blue and cold
	fine hair may grow on face, arms, and back.

With dramatic weight loss, vital organs may be affected

	starvation of the brain - causes loss of concentration and ability to think clearly. Depression and irritability increase.
	starvation of the muscle of the heart leads to heart failure or rhythmic changes - sudden death may occur. There may be little warning of the problem.

Recovery

Living with anorexia can be isolating, overwhelming, and terrifying. People with anorexia often lose hope and belief that they can recover. It can bring shame and sensitivity to other people's fear, prejudice, and low opinion of them. Other may try to bully the person into eating - sometimes the discrimination feels worse than the condition.

The process of recovering is about regaining the hope once held for a productive, happy future - most importantly, believing that you deserve it. Most people with anorexia have a very low opinion of themselves. Recovery is about regaining your role as a healthy person, rather than living your life as a sick person. With help, you can create a vision for your life, change the old patterns, and discover symptoms can be managed.

The psychological treatment of Anorexia

	While there is not a specific medication for anorexia, medication is often given for the co-problems of anorexia - depression, anxiety, and so on. A psychologist will often work alongside the medical practitioner to give the maximum care to a person with anorexia.
	Cognitive-behavioural therapy (CBT) - the focus of the therapy is on changing eating patterns, working through the sufferer's unhelpful beliefs about food and, very importantly, raising their self-esteem. The belief that you have to be thin to be considered worthwhile is one such belief which will be addressed.
	Interpersonal therapy - this explores the person's current relationships, identifying problems, and seeking changes in the way the relationships are conducted. This is particularly helpful when depression accompanies anorexia.
	Narrative therapy - the person is encouraged to see anorexia as something outside of her/his 'real' self. the person will be helped to fight the negative messages anorexia gives her. The person learns to re-story, not as a victim of social forces, but as a survivor of them - and a person who makes choices for her/himself.

If you, or anyone you know, show symptoms of a psychological problem and you would like to make an appointment to discuss this with me, email a-lamont@xtra.co.nz, or telephone (03) 354-1969

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