Tuesday, 13 May 2014

Dealing with panic attacks, anxiety and depression.

"I am more than my mental health."
This is not something I have ever really talked about before, and it is not something I feel 100% comfortable writing about, but I think it is an important subject which needs to be addressed. Not only to help people understand what panic attacks, anxiety and depression actually are but also how you can help yourself or if you are a friend, partner or relative of anyone suffering from this.

Panic attacks, anxiety and depression affect one out of four of us, myself being one. Mental illness affects one in four of us and something which I believe people need to really try to understand before judging someone. It isn't someone being 'over the top', 'attention seeking' or 'difficult', it is something you can't control. Imagine it like this; if you feel tired, your automatic instinct is shut your eyes and to go to sleep. Now imagine it like this, you are completely exhausted and need to go to sleep: your eyelids shutting are the panic attacks, anxiety and depression taking control and your ability to keep them open and to stay awake is your fight against them. This is basically impossible; they are inevitability going to close at one point or another. 

September 2012 was probably the lowest part of my life mentally and physically; It started when I didn't want to leave my flat, I lost my appetite, had no motivation whatsoever, I didn't see the point in anything any more and if I did go out, it would be so that I could get so drunk that I would forget everything. It became a vicious circle and it then developed into me not really leaving my bed, sometimes waking up when it was dark due to insomnia and never seeing light for a few days and wanting little or no contact with anyone; I felt like life really wasn't worth living any more.
I had left university due to this but only told one person there, I think, that that was the real reason why, other than that I didn't tell anyone else. I was terrified to even go down the road to the shops let alone to the University campus with hundreds of people there. If friends asked me why I wasn't there or why I didn't bother to go, I would make up any amount of excuses just to stop them asking. I don't really know what exactly triggered this to happen all at once, but I certainly know that I wasn't in control of it. Mental illness is not something you choose to have and I wouldn't wish it on my worst enemy. I continually struggle everyday to lead a normal life and although I am a million miles away from how I used to be, I still have a lot of work to do.
I hope that this post will hopefully reaffirm things for you and help you in some way if this is something which happens to you, or if you suffer from these symptoms and don't know what they are. Everyone is different, so my experiences and the types of things I panic about daily are subjective, so not everyone will be affected in the same way.
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What is a panic attack?

A panic attack is a rush of physical and psychological symptoms, which can happen at any time, sometimes for no reason and usually last between five to twenty minutes. The physical symptoms are basically your body going into'fight or flight' mode because it perceives something as a threat and begins to shut down. The psychological symptoms are that you experience an overwhelming sense of fear and have a detached sense of reality of the world around you. I found that they basically make you feel as if your having a heart attack and are going to die.

The Physical symptoms include:
  • Lack or shortness of breath
  • Dizziness
  • Nausea
  • Chest pain
  • Trembling
  • Sweating
  • Believing you are having irregular heartbeats (palpitations)
The body releases a sudden rush of adrenaline, your heart begins to beat faster and your muscles tense up.

The Psychological symptoms include:
  • Experiencing an overwhelming sense of intense fear and panic
  • Having an irrational view of reality

My experience:
Thankfully, I don't suffer from panic attacks as much as I used to but when I do I tend to not like people around me, my senses go into overdrive; sounds seem overwhelmingly louder, smells seem increasingly heightened and I usually can't stop crying. I feel sick throughout the whole attack, this is because your digestive system begins to shuts down. My heart beats so fast that I feel as if I am having a heart attack and I feel like can't breathe or catch my breath. These symptoms continuously build up and up making me feel as if I can't cope draining me mentally and physically.
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What is anxiety?

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Anxiety is something which will most likely affect all of us at some point in our lives, for example, if you sit an exam or have a job interview. However, some people find it more difficult to control their worries and therefore, their anxiety often affects their everyday life.
Anxiety is the main symptom of a number of conditions, including phobias, post-traumatic stress disorder, social anxiety disorder and panic disorders. Generalised anxiety disorder or GAD can affect you both physically and mentally and the severity of symptoms varies from person to person.

GAD can cause a change in your behaviour and the way you think and feel about things, resulting in symptoms such as:

  • Restlessness
  • A sense of dread
  • Feeling constantly "on edge"
  • Difficulty concentrating
  • Irritability

These symptoms may cause you to withdraw from social contact, such as seeing your family and friends so that you avoid the overwhelming feelings of worry and dread. In addition you may find other activities, such as going to work extremely stressful and may have to take time off sick. Anxiety can also make you worry about irrational fears which therefore, decreases your own self-esteem.

GAD can also have a number of physical symptoms, including:

  • Dizziness
  • Tiredness
  • A noticeably strong, fast or irregular heartbeat (palpitations)
  • Muscle aches and tension
  • Trembling or shaking
  • Dry mouth
  • Excessive sweating
  • Shortness of breath
  • Stomach ache
  • Feeling sick
  • Headache
  • Pins and needles
  • Difficulty falling or staying asleep (insomnia)

Certain situations may trigger your anxiety. For example, if you suffer from claustrophobia which is a fear of enclosed spaces, you recognise that being confined in a small space will set off your anxiety. However, if you have GAD, the exact cause of your anxiety may not always be clear. Not recognising or knowing what actually causes your anxiety may make you feel like there is no solution to overcoming your mental illness and you could begin to worry more.

My experience:
I think I suffer from anxiety most of all, as it is still something I struggle with daily. I worry constantly, about things which have happened, about things which could happen and about things that, I believe will happen, even though they probably won't. This happens to me on the bus to work, at work, out with friends, going out for food, at my flat, saying bye to my boyfriend when he leaves for work, travelling anywhere I don't know, being alone in public; basically anywhere and everywhere, it is a build up of anxiety which overwhelms my day to day life.
A lot of questions I always get asked are: "But why are you worrying about that, it's nothing to worry about!","Your just being over the top", "Stop being silly", "Pull yourself together your 22" and "How can you be so anxious about that? It's nothing!". I'll try and explain it this way; A regular house that is built from bricks represents those who don't suffer from mental illness. A straw house that is built from, you guessed it, straw, represents sufferers of anxiety. The wind represents your average day to day circumstances/events (e.g. walking across a road, getting on a bus, leaving your house). When the wind blows, the brick house doesn't fall down, in fact it doesn't really affect it at all. However, the straw house is much more affected and the whole house is destroyed. In short; anxiety and mental illness sufferers cannot always cope with everyday life which doesn't seem important, relevant or disastrous to others who don't have it. They are more affected by day to day actions as they have an increased sensitivity to them e.g walking or being anywhere alone, personally this is one which has affected me for years and still does. I have to either be texting, on the phone to someone or with someone to feel some sort of calmness or normality. If I don't, my heart begins to beat increasingly fast, I experience shortness of breath and I have to walk fast to get to where I need to be e.g the bus stop. I feel as if everyone is staring at me, I worry in case they do something, say something, shout something, literally anything. I worry when I cross the road, in case a car comes speeding round the corner and crashes, in case I don't get across in time, in case someone pulls out too fast and hits me, you name it I'll probably be thinking it. I know it may sound 'over the top' to someone who doesn't suffer from anxiety, but until you have it, you really have no idea what it's like to suffer from and I don't mean to come across patronising, but if your ignorant enough to think that it's stupid or attention seeking then you are extremely narrow minded.
The best thing you can do for someone is to try to be there for them if they want you to and to try to understand them. You could also research their illness or symptoms and encourage them to seek medical help but don't force them, do it at their pace no matter if it takes two weeks, six months or a year or more. This can be extremely challenging, however to be the best mother, father, friend, partner or relative you can be, being patient and being there for them as much as you can will really make a difference to their lives. The biggest mistake anyone can do is to make the person feel as if they are 'abnormal'; We understand that this is not how most people feel or function, we don't need to be reminded or segregated, especially not from people we love and care about. Also, don't retaliate with comments like 'crazy', 'nutter' or'psycho' even if you want to say it just to get a reaction in an argument as I will guarantee you that you will have set the person back multiple steps and their progress will be stalled; No one wants to be called these harmful remarks never mind people who suffer with mental illness. It will also make the person feel as if they cannot place their trust in you, as if telling you about their illness would have been for nothing which would put them back to square one (on the trusting side of things). This can lead them to reject trusting others and a reluctance to seek help in the future.
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What is depression?

Depression is much more than simply feeling down or unhappy for a couple of days. Everybody experiences the feeling of sadness at some point in their lives, however, if you suffer from depression this will make you feel persistently sad for weeks or months, rather than just a few days. Certain individuals who do not recognise that having depression is a genuine health condition are completely wrong; It is a real mental illness with real symptoms and sometimes harmful consequences. It is not something that you can snap out of, or wake up in the morning for it to be gone completely and it is most definitely not a sign of weakness. However, like many mental illnesses, depression can affect individuals in a variety of ways, which in turn can cause a wide array of symptoms.
They range from continuing feelings of sadness and hopelessness, to losing interest in the things you previously enjoyed and you may feel very tearful and upset a lot of the time. Many people who suffer from depression also have symptoms of anxiety.

The physical symptoms may include:

  • Feeling constantly tired or fatigued
  • Developing an inconsistent or unhealthy sleeping pattern which may lead to insomnia
  • Having little or no appetite
  • Having little or no sex drive
  • Suffering from aches and pains

The severity of the symptoms can vary from person to person. At its mildest, you may simply feel persistently low in spirit, while at its most severe depression can make you feel suicidal and that life is no longer worth living.
Most people experience stress, anxiety and sadness during challenging times in their lives, but their low mood may improve after a short period of time, rather than it being a sign of depression.
Sometimes there may be a trigger for your depression such as losing a loved one, losing your job or even having a baby. In addition, those whose families have a history of depression, are more likely to experience it themselves. However, you can also become depressed for no specific reason and that's okay too, you are not considered any less important than those who have a clear reason for their depression.
It also may interest you to know that depression is rather common and affects about one in ten of us at some point in our lifetime and affects men and woman, regardless of their age. It may also affect children as certain studies have shown that around 4% of children ages five to sixteen in the UK are affected by depression.

My experience: I realised that I needed help in September 2012; I had lost my appetite and replaced food with cigarettes, my sleep pattern was all over the place, I didn't leave my flat, I deliberately made up excuses to not attend places/events with family or friends as I was too anxious and had no motivation at all, I hardly washed or left my bed and I constantly felt like my life was no longer worth living. I also began to notice that I was having problems during my first year at university; I ended up not turning up as much and didn't know why I had no motivation and felt as if I couldn't leave my flat; by the time I had entered into Year two, I knew this problem was not going to go away. Furthermore, I had recently come out of a mentally abusive 'relationship', but it wasn't really a relationship as such it was more like spending time with someone who messed with my head for over a year. When I built up the strength to no longer reply or take part in the individuals mind games, I changed my phone number so he could no longer contact me and also blocked him from all the social networking sites I am a part of. If anyone else is in the same situation as I was, I wouldurge you to do the same; At first it may seem like it causes you more stress and anxiety, however, in the long run it is really beneficial as eventually you may end up not worrying as much over the situation as they are cut out of your life and are no longer relevant any more.
A few weeks later I visited my Doctor and I found out that I was suffering from depression and anxiety, which is something I did not discuss with a lot of people, including those who attended University with me. It was one of the most difficult times in my life and although I do suffer daily with anxiety, I am a million miles away from what I used to be, as I was a former shell of myself. 
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Seeking help, breaking the cycle and learning to cope with your mental health:

Make an appointment with your GP/ Doctor.
It is difficult for anyone to admit that they have a problem and need help, but I believe that it is vitally important that you do not suffer alone, as it may make your mental health worse. Initially, I found it rather hard to explain what exactly I needed help with, as mental health covers a whole range varying of thoughts and feelings; Don't be afraid to tell your Doctor exactly what you are going through and what you think day to day.
My GP referred me on to a 'Supported Self-Help' group which is ran by the North Tyneside Psychological Therapies Service. The first few times she referred me I did not turn up as I either couldn't leave my flat, I wasn't ready or I thought I could handle it on my own. A year and a half later, I eventually I plucked up the courage to attend the presentation; This may seem like a long time, but I needed to ensure that I was fully committed to getting myself well again and accepting that I had a problem.
After attending the 90 minute presentation, we were all asked to choose a therapy that we would want to go to and then hand the sheet back to the nurse who was speaking about the presentation. I must admit that I did feel slightly uncomfortable, however, I asked if my mum could come along for support which they said was absolutely fine; Having her there to support me meant a great deal and make it easier for me relax.

Here are a few of the options which were presented to us:
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CBT (Cognitive Behavioural Therapy).

Cognitive behavioural therapy is a talking therapy that can help you manage your problems by changing the way you think and behave. It does not abolish your problems, but it teaches you various ways to manage them in a positive way. It encourages you to reflect on how your actions may affect the way you think and feel. CBT also encourages you to talk and change your behaviour, which can change the way that you think and what you do which can make you view life in a more positive way.
Cognitive behavioural therapy has been proven to be particularly beneficial at tackling mental illness, such as anxiety, depression, post-traumatic stress disorder (PTSD), eating disorders and drug misuse. It deals with your current problems and looks for practical ways to improve your state of mind on a daily basis and help the individual to cope.
CBT helps you to make sense of your overwhelming problems by breaking them down into smaller sections. Many people who suffer with mental illness are trapped within a negative cycle, cognitive behavioural therapy aims to break down certain scenarios that are making you feel negative, anxious or frightened so that they are more manageable. It helps you to change these negative thought patterns to improve they way that you think  and feel.
If you choose this form of therapy, you will probably have a session with a CBT coach or therapist once a week or one every fortnight. However, certain problems may require a more intensive intervention, therefore, a therapist could potentially spend several hours at your home to encourage you to face your fears. The number of sessions you partake in depends on your individual issues and what you wish to achieve whilst receiving CBT, but the treatment usually lasts between sex weeks to six months.
Cognitive behavioural therapy has been shown to be effective in treating mental health, however, a vital element included within the therapy is a high sense of commitment. A therapist can advises you but they can't make your problems disappear without full co-operation.
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Counselling.

Counselling is a talking therapy which encourages the individual to speak about their problems and feelings in a confidential and supportive environment. A councillor is professionally trained to listening to your issues with empathy and can help you to deal with negative thoughts and feelings. This treatment is used to treat a variety of mental health conditions such as depression, anxiety, borderline personality disorder, post-traumatic stress disorder, obsessive compulsive disorder, long-term illness, eating disorders, drug misuse. Counselling can help you to face up and deal with your issues that are causing you distress, leading you to potentially overcome these problems. They do not usually offer advise, but will encourage you to find your own insight and understanding of your issues. Counselling is a talking therapy and it usually involves speaking about painful feelings and as you begin to face up to them, you may initially feel worse, however, with the support of your counsellor you should gradually start to feel a lot better. It normally takes at least a few sessions before the counselling begins to make a difference and commitment is key element required to make the best use of the therapy.
During counselling you will be encouraged to speak about your thoughts and feelings to allow your counsellor to gain a more in depth understanding of your feelings and thought processes, as well as identifying ways of finding your own resolutions to your issues. They will be able to help you highlight the effects of other people and their actions, and explore alternative ways of coping with them. Once you share your anxieties and fears with your councillor, this may provide you great relief as they acknowledge your feelings and are able to encourage you to reach a positive solution.
For this form of therapy to be effective, you need to build a trusting and safe relationship with your counsellor. However, if you do not feel like you are not getting on with your councillor or feel as if you are not getting the most out of your sessions, you should discuss this with your councillor or you may also look for another therapist with whom you feel more comfortable.
Counselling is provided in a variety of ways such as face-to-face, individually or in a group, over the phone, by email or using a specialised computer program. Evidence-based psychological therapies can be accessed through your GP, the workplace, universities, schools or colleges or some voluntary and charitable organisations.
If you are referred for council-ling or another psychological therapy though the NHS, it will be free of charge, however, you may also deicide to see a private therapist. You should enquire about charges and agree a price before you begin your course of counselling.
Some charities or voluntary organisations also offer a form of counselling. These organisations usually specialise in a certain aspect of therapy such as couples counselling or bereavement counselling. Charities that may offer counselling include Cruse Bereavement Care, Relate, Rape Crisis and Victim Support.
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North Tyneside Health and Wellbeing Courses:

I am only able to provide information in this section for the North East of England, if you do not live in the North East then please see your GP and once you have attended the 90 minute introductory session, you should then be given particular information for certain courses in your area.

Stress Control (six sessions)
This course is provided in a "lecture-style" format (no group discussions or activity) and considers how people may effectively manage the symptoms of stress and anxiety. Learn how to control anxious thoughts, how to relax, and how to change anxiety related behaviours.

Confidence Building (five sessions)
This course focuses on the practice of a range of skills and approaches, in a supportive and friendly atmosphere. It aims to help people who wish to become more confident, and topics include identifying our own strengths, standing up for ourselves, developing the way we communicate with others, and improving self-acceptance.

Assert Yourself (three sessions)
Build on strengths, stand up for yourself, and feel okay to say no!
This course focuses on identifying positive communication styles, standing up for your own rights and respecting the rights of others, dealing with criticism, and developing practical assertiveness skills for use in day-to-day-life.

Relaxation Skills (three sessions)This course focuses on the practice of a range of relaxation skills, in a supportive and friendly atmosphere. Areas considered on the course include body scanning (noticing how your body feels), practising relaxation )through tensing and relaxing muscle groups), diaphragmatic breathing, and a consideration of the benefits of exercise and activity.

Feeling Good and Developing Activities to Improve Mood (four sessions)
This course aims to help people who wish to learn more about the links between activity and mood, and who are willing to make some (even small) changes to lifestyle to bring about a more positive mood.

All courses are free of charge and are available to adults who are registered with a North Tyneside GP. The courses are provided by staff from North Tyneside Psychological Therapies Service, Northumbria Healthcare NHS Trust.

Please phone North Tyneside Council Adult Learning Alliance (0191) 643 2288 to reserve your place.
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Self-Help books.

These books provide helpful information and step-by-step self-help techniques for managing common conditions, including depression and anxiety. You can buy the books or alternatively, they may be available for you to borrow in your local library.

Here are a few self-help books you may wish to read:

Panic:

  • 'Overcoming Panic and Acrophobia', by Derrick Silove and Vijaya Manicavasgar.
  • 'Panic Attacks: What They Are, Why They Happen and What You Can Do About Them', by Christine Ingham.

Phobias:

  • 'An Introductions to Coping with Phobias', by Brenda Hogan.

Relationship Problems:

  • 'Overcoming Relationship Problems', Michael Crowe.

Self-Esteem:

  • 'Overcoming Low self-esteem', Melanie Fennell.
  • 'The Feeling Good Handbook', David Burns.

Sleep Problems:

  • 'Overcoming Insomnia and Sleep Problems', Colin A. Espie.

Social phobia:

  • 'Overcoming Social Anxiety and Shyness', Gillian Butler.

Stress:

  • 'The Relaxation and Stress Reduction Workbook', Martha Davis.
  • 'Manage Your Stress for a Happier Life', Terry Looker and Olga Gregson.

Worry:

  • 'The Worry Cure: Stop Worrying and Start Living', Robert L. Leahy.
  • 'How to Stop Worrying', Frank Tallis.

Anger:

  • 'Overcoming Anger and Irritability', William Davies.

Anxiety:

  • 'Overcoming Anxiety', Helen Kennerley.
  • 'Overcoming Anxiety, Stress and Panic: A Five Areas Approach', Chris Williams.
  • 'Feel the Fear and Do it Anyway', Susan Jeffers.

Binge eating/ Bulimia Nervosa:

  • 'Overcoming Binge Eating', Christopher G. Fairburn.
  • 'Getting Better Bit(e) by Bit(e): A Survival Kit for Sufferers of Bulimia Nervosa and Binge Eating Disorders', Ulrike Schmidt and Janet Treasure.
  • 'Overcoming Bulimia Nervosa and Binge Eating', Peter J. Cooper.

Chronic Fatigue:

  • 'Chronic Fatigue Syndrome (second edition)', Frankie Campling and Michael Sharpe.
  • 'Overcoming Chronic Fatigue', Mary Burgess with Trudie Chalder.

Chronic Pain:

  • 'Overcoming Chronic Pain', Frances Cole, Catherine Carus, Hazel Howden-Leach and Helen McDonald.

Depression:

  • 'Overcoming Depression and Low Mood: A Five Areas Approach (third edition)', Chris Williams.
  • 'Mind Over Mood: Change How You Feel by Changing the Way You Think', Dennis Greenberger and Christine Padesky.
  • 'Overcoming Depression', Paul Gilbert.

Health anxiety:


  • 'Overcoming Health Anxiety', David Veale and Rob Wilson.
  • 'An Introduction to Coping with Health Anxiety', Brenda Hogan and Charles Young.

Obsessions and compulsions:

  • 'Overcoming Obsessive Complusive Disorder', David Veale and Rob Wilson.
  • 'Understanding Obsessions and Compulsions', Frank Tallis.
  • 'Break Free from OCD: Overcoming Obsessive Compulsive Disorder with CBT', Fiona Challacombe, Victoria Bream Oldfield and Paul M. Salkovskis.

Contact.

If you found this blog post useful and would like to ask me any questions regarding panic attacks, anxiety and depression, please do not hesitate to contact me. Although I am in no way a medical professional, I may be able to offer an insight into my own mental illness as I experience these issues daily.

My email address is: Lauraaamckennablog@gmail.com

Useful links:

Time to change:
 http://www.time-to-change.org.uk/?gclid=COeq0cKwl70CFSsKwwodfYkAsA
"Led by Mind and Rethink Mental Illness we're England's biggest programme to challenge mental health stigma and discrimination."

NHS websites on panic attacks, anxiety, depression and mental health:
I gathered most of my information from the following websites listed below.

http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/understanding-panic-attacks.aspx

http://www.nhs.uk/conditions/anxiety/pages/introduction.aspx

http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx?url=Pages/What-is-it.aspx

http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/low-mood-stress-anxiety.aspx

http://www.moodjuice.scot.nhs.uk/anxiety.asp

http://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/#.U1V6_vldWSo

http://www.mentalhealth.org.uk/help-information/mental-health-a-z/F/fear-anxiety/

http://www.nhs.uk/Conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/Counselling/Pages/Introduction.aspx

http://www.nhs.uk/NHSEngland/AboutNHSservices/mentalhealthservices/Pages/Overview.aspx

http://www.nhs.uk/Conditions/Psychiatry/Pages/Definition.aspx?url=Pages/What-is-it.aspx

http://www.nhs.uk/Conditions/Suicide/Pages/Introduction.aspx?url=Pages/What-is-it.aspx

http://www.nhs.uk/conditions/hypochondria/Pages/Introduction.aspx

http://www.nhs.uk/conditions/medically-unexplained-symptoms/pages/somatisation.aspx

http://www.nhs.uk/conditions/Antidepressant-drugs/Pages/Introduction.aspx

http://www.time-to-change.org.uk/your-organisation/support-workplace
http://www.nhs.uk/Service-Search/Information-and-support-for-mental-health/LocationSearch/330

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