Anxiety, Generalized Anxiety, Panic Attacks, Phobias, Obsessions and Compulsions

Depression

The word "depression" is often used in our everyday life in order to describe feelings of sadness or even to emphasize how much we have been hurt by a situation or by another person. Usually we do not differentiate between depression and some milder conditions such as dysthymia and melancholy. So we cannot say for everyone who states that he/she “is depressed” that they necessarily suffer from acute depression that may require psychotherapy and in some cases medication. It is natural to feel sad on many occasions; sadness is a feeling, one the rich range of emotions experienced by an individual and it is healthy to be expressed. What more natural than one who is sad when he/she loses a loved one? Any kind of intervention is helpful when the feelings of sadness, helplessness and anhedonia (inability to experience pleasure and joy) are not resolved, they persist and do not gradually give their place to a more optimistic and hopeful attitude towards life.
Then we could be trapped in a vicious cycle of emotional and physical symptoms such as:
  • Persistent sadness, anxiety or sense of inner void
  • Difficulty sleeping • Lack of appetite or overeating
  • Lack of libido • Irritability
  • Lack of energy, fatigue
  • Difficulties in memory, concentration and decision making
  • Feelings of guilt, hopelessness and despair • Suicidal thoughts
  • Various persistent physical symptoms such as headaches, gastrointestinal disturbances etc.
All these symptoms do not only end up deteriorating our mood but also affect all of our bodily functions – including brain functions – making it even harder to get out of this cycle. As a result the symptoms could become more intense and chronic. There may be several causes for the emergence of depression; there may be biological factors, psychological and environmental (social) factors so its treatment may not be onesided. The administration of medication could be useful to restore the chemical balance of the brain and bring a first relief of the symptoms, but they do not provide a definite solution. Body and soul are interrelated and psychotherapy is there to restore the emotional balance, to maintain this balance over time and to provide the client with "tools" that will help them effectively manage the difficulties of life. It is advisable to visit a mental health professional as soon as we notice symptoms that complicate our lives and before they overwhelm us, as we would do for any other health issue

Eating Disorders

  • Anorexia
  • Bulimia
  • Binge-Eating
  • Obesity

Self-confidence - Self-esteem

How we see ourselves is formed over the years through the interaction with important individuals in our lives. We have gained strong beliefs about how we are and according to them we lead our lives. Somewhere along the line we may find ourselves stuck with a "label"
such as that of the angry, the spoiled, the insecure, or the hypersensitive. So we either try to live up to these roles or spend our energy trying to get rid of the "bad name". This effort can be exhausting and it may ultimately have no effect at all since our attention is distracted from what we want and we end up putting our energy in what others want from/for us. But if some of these beliefs are false or distorted then they will regularly appear as difficulties in communication with others, as well as obstacles in our personal development.
But we can avoid this self-sabotage by exploring our real abilities and needs and thus allowing our authentic self to emerge.

Life Transitions: Loss - Grief, Divorce, Menopause, Unemployment

Under this category fall those issues that represent a significant - and emotionally painful - situation in our lives. The loss of a loved one or of our job, dealing with a serious illness, the so-called "midlife crisis", a divorce and anything that can disrupt our life as we know it, can cause us increased anxiety and feelings of depression and so we may feel we are losing the balance we once had, until the traumatic event. Considering that even changes that are usually seen as positive (e.g. the birth of a child, starting a new job, moving to a new home etc.) could be experienced as traumatic events which may be accompanied by high levels of stress, then one can imagine that an undesirable change may have a significant impact on our everyday life. Often, these events become the motive to visit a mental health professional. In these cases the role of counselling and psychotherapy is not only to provide psychological support but to also help the client to effectively manage the new facts of their life. Personal exploration within a therapeutic environment can provide the client with a clearer picture of their needs and the changes they want to make in order to regain their lost balance. Ultimately the client will be helped to change the things they are able to change and to accept the things that cannot be changed.

Emotional Intelligence I

The development of emotional intelligence is equally, if not more, important than the cultivation of intellectual intelligence. It focuses on our interactions with others, from the simple contact with the grocer of our neighbourhood to the complex communication with our child, our spouse, our colleagues. It enables us to coexist in harmony with others and this includes minimising the unnecessary stress that is so often caused by the everyday friction with individuals either from the family or the business environment. By developing our emotional intelligence we increase self-awareness and we move steadily towards a more harmonious and whole existence since we can enjoy the pleasures of work, family and social life.

Emotional Intelligence II

Social Anxiety - Embarrassment - Fear
Social anxiety, or otherwise known as social phobia, is considered to be the most common of all anxiety disorders. Stress may manifest itself in specific social conditions (e.g. speech before an audience) or be generalized to all forms of social circumstance, such as:
  • When eating and drinking in front of others
  • When working around others
  • When we are the centre of attention
  • When we associate with others in a team
  • When we go shopping
  • When driving

Symptoms of Anxiety
  • Intense and persistent stress and anxiety in social situations remains stable or increases
  • over time
  • Persistent thoughts about what others think about us and about the ways a social occasion
  • can be embarrassing, even before we get into it
  • Physical symptoms such as dry mouth, rapid heartbeat, sweating, tremor, confusion,
  • diarrhoea, tightness in the stomach
  • Complete avoidance of stressful social situation
What is emotional intelligence?
Goleman (1995)

"The ability to recognize our own and others’ emotions, to motivate ourselves, to properly
manage emotions both in ourselves and in our relationships"
The main factors that seem to make up emotional intelligence are:
1. Emotional Self-awareness
the ability to recognize what you feel at any time and use this knowledge to make effective decisions with the best possible outcome for yourself and others.
2. Emotional Self
Regulation - the ability to manage your emotional state and verify theinterpretations we give to external events. The ability to choose how we feel and shape our stress levels.
3. Emotional Self 
Mobilisation
the ability to use your emotions and transform them into action. The ability to move forward despite any resistance, to engage and persist with optimism and confidence.
4. Empathy
the ability to listen to others quite actively and effectively so we can get the position of another person. You may not always agree but you can understand the position of others in order to maximize communication and trust.
5. Relationship Management
the ability to work in a group and show concern for others, respect individual differences and create conditions of mutual profit. D. Caruso (1990): “it is very important to understand that emotional intelligence is not the opposite of intelligence is not the triumph of heart over logic – it is the unique combination of the two”.

In what ways can we develop Emotional Intelligence?
Consciousness - Self Awareness
  • Acknowledging your feelings at any time you can make the appropriate choices for
  • yourself so that you are satisfied with them.
  • If you pay attention to your emotions it help you to recognize when you are under
  • pressure and will therefore highlight the need to take action to alleviate this pressure.
  • The greater the contact with your own emotions, the greater the understanding for the feelings of others.
Active listening
  • Be present - when someone speaks our mind often 'travels'. It takes practice to manage to bring attention back to the speaker.
  • Mirroring - briefly repeat in your own words what has been said by the speaker to confirm that you understand them and to let the other know that you are actively listening. E.g.
What you're saying is that .... You mean that ...
Effective Speech
  • Use ‘open’ questions - open-ended questions promote discussion because they require more than a simple 'yes' or 'no' answer.
  • Use 'I' statements – in that way you can avoid absolute views and the possibility to offend others, while leaving room for disagreement and debate to develop. E.g. I believe that...
​​​​​​​Beware of 'blockages' in communication!
  • When you compare yourself with the speaker or the speaker with others.
  • When thinking about what to say afterwards.
  • When you make fast conclusions.
  • When you think you already know what he wants to say.
  • When you say 'something similar had happened to me'
  • When, instead of listening, you are thinking what advice you will give.
Anyone can become angry - that is easy.
But for one to be angry with the right
person, to the right degree and at the
right time for the right reasons and in the
right way - this is not easy.
Aristotle, Nicomachean Ethics

Nutrition & Mood

Three Types of Anxiety:
1) real anxiety
experienced under real threat eg natural disasters, illness, loss, etc. Physiological reactions panic and anger / aggression or escape / avoidance (Fight or Flight).
2) neurotic anxiety
produced from experiencing unresolved psychological conflicts, especially if there are insufficient defense mechanisms.
3) existential anxiety
a general human experience as a living creature. The separation from nature (the mother), may have offered us more freedom but it has also removed the security that derives from the contact with her. For Kierkegaard, existential anxiety is the "dizziness of freedom."

Generalized anxiety
Generalized anxiety is characterized by a high level of stress that
a) is not justified by the facts and
b) does not refer to anything specific. The stress is prolonged, indefinite and is able to disturb significantly the life of the individual. Sometimes it is concealed behind a facade of security and confidence.

Phobias
In phobias anxiety is associated with specific objects and/or situations. Eg:
Agoraphobia: fear of crossing a street, an empty square, or an empty room. Fear of staying in small or confined spaces e.g. elevator (claustrophobia).
Social phobia: obvious intense anxiety before or during public appearances, examinations etc. The individual is afraid of failureand/or of blushing (erythrophobia) and avoids being exposed to such situations.
Specific Phobias: Any of the stimuli in the environment may become the subject of specific phobias eg anxiety about height, depth, extreme weather, the visit to the doctor. There is also stress associated with transport (eg ship, aircraft), with various objects (eg knives) or harmless animals.

Panic Attacks/Cardiophobia
Without the existence of any basic organic disease, acute anxiety is manifested in the form of an episode/fit and the person is overwhelmed with a fear of imminent heart attack and death. It usually occurs in young adults. In a state of hyper-stimulation the person is panicked and asks for help. The duration of the episode is between 15'-2 hours. When help arrives or expected, the stimulation and anxiety subsides.

Manifestations during an episode
  • In some cases it is preceded by nausea, vertigo, inner restlessness, slight feeling of anxiety in the heart.
  • The episode begins suddenly
  • Intense palpitations
  • Slight rise in blood pressure
  • Intense and choking heaviness in the heart
  • Respiratory distress (feeling of lack of air)
  • Sweating
  • Dizziness and feeling of complete weakness (but not loss of consciousness) In between episodes
  • Continuous monitoring of cardiac function, the person is convinced that he/she suffers from a serious heart disease • Hypersensitivity to minor physical symptoms and functions
  • Excessive caution and self-care
  • Avoidance – the person avoids situations of anxiety and arousal that can lead to an episode
  • Difficulty sleeping because of fear that the panic will attack during sleep
  • Avoids being in places with lots of people (the panic attacks can coexist with agoraphobia and claustrophobia)
  • Tries not to be left alone (Tolle & Windgassen, 2005. Psychiatry)
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