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What are
depression, anxiety and panic? by Chris Williams, MD Introduction We wish to start this section
with a clear definition of what we mean by the terms depression,
anxiety and the very high levels of sudden-onset anxiety known as
panic. Together, these affect more than
one in five people at some time in their lives. What
is depression? Feeling fed up and low in mood
is a normal part of life. When difficulties or upsetting events occur
it is not unusual to feel down, stop enjoying things and to feel
understandably low for a time as a reaction to these events. Likewise when good things
happen, a person may experience happiness, pleasure and a sense of
achievement. The reasons for low mood are usually clear - a stressful
situation, a relationship difficulty, feeling let down by someone,
financial difficulties, unforeseen events or some other practical
problem. Most of the time the drop in
mood only lasts for a short period of time and then we "bounce back". Occasionally, however, a
person's mood may seem to fall for little or no obvious reason and it
may be difficult to begin with to know quite why. In some cases this
"depressed" feeling can worsen and completely dominate the person's
life. When someone feels very low for more than two weeks and feels
like this day after day, week after week, this is called a depressive
illness. It is important to say that
there should no stigma attached to the diagnosis of "depression". In
reality the term is simply a convenient way of describing a broad range
of symptoms that vary from person to person but are having an unhelpful
impact on their lives. b).
What is anxiety? Anxiety, worry, tension and
stress are all terms that are used to describe what is a widespread
experience for many people. Anxiety is a common emotion, which at times
can be helpful even though it can feel very unpleasant. For example, in situations of
danger we begin to feel anxious and this prompts us to try to deal with
it by getting away as rapidly as possible. If you walk along a badly
maintained path next to a large drop, anxiety can be life saving,
appropriate and helpful. However, sometimes anxiety can
occur inappropriately and then it becomes unhelpful. The person may
feel anxious in situations that are not really dangerous at all, or
notice excessive anxiety well beyond what is actually helpful or
appropriate in the circumstances. Worrying thoughts are common in
anxiety. In worry, the person goes over things again and again in their
mind in a way that is unhelpful because it does not actually help to
resolve the difficulty that is being worried about. Instead, problems
are turned over and thought about again and again. Sometimes the worry may be out
of all proportion; something that may originally have happened in a few
moments, perhaps something that someone has said to you, can dominate
your thinking for much of the following days or weeks, adding up in
total to many days or even weeks of worry over the following months. In anxiety, the person often
overestimates the threat or danger they are facing, and at the same
time usually underestimates their own capacity to cope with the
problem. Normally, when there is no
stress, the person feels able to cope with the problems they face. In
other situations, they may begin to feel stressed. Either they see the
problem as too large or overwhelming, or they think they cannot cope. In both situations, the anxiety
balance is upset, and the person begins to feel increasingly stressed
and upset. At times of emotional distress, it is sometimes easy to
forget that we are not alone when we face life's difficulties - we do
not only have our own capacity to cope, but also upon the support of
others around us including friends, relatives, voluntary sector groups
and health care practitioners such as your GP as well as those working
within the mental health services.. c).
What are panic attacks? Sometimes anxiety can come on
very rapidly (usually within 10 minutes) to such a high level that the
person feels so mentally and physically tense and unwell that they stop
what they are doing and try to leave or escape from the situation.
Failing that they may become paralysed into inactivity like rabbits
caught in the headlamps of a car and just wait, expecting disaster to
strike at any moment. They do this because they fear
that something terrible or catastrophic will happen. This feeling of
acute fear, dread or terror is called a panic attack. Panic attacks typically have a
rapid onset and are short-lived, usually lasting no longer than 20-30
minutes. During panic, the person can experience catastrophic fears
that a sudden and threatening physical illness or terrible event will
occur right now. "I'm going to faint", "I'm going
to suffocate" "I'm going to collapse", "I'm going to have a stroke", or
"I'm going to have a heart attack", are the sorts of thoughts that will
go through their minds. Sometimes the fear is that a
catastrophic mental event will occur such as going mad and losing
control. These fears may take the form of a mental image (for example,
a picture of losing control or of being admitted to hospital with a
heart attack). Sometimes fears may be focused
upon the reaction of others (e.g. a fear that others will look and
laugh or mock you if you were to collapse). The key point is that the fear
is immediately threatening, scary and catastrophic. Sometimes the
person becomes so fearful that even just thinking about the situations
and places where panics have previously occurred may result in them
feeling anxious. They may find themselves
worrying that a further panic attack will occur and this anticipation
itself can add to the person's anxiety. The person commonly reacts by
avoiding anything to do with that situation or place. The result is often an
increasingly restricted lifestyle, reduced confidence and additional
long-term distress. When this happens, the person is described as
having a phobia as well as panic attacks. A phobia is anxiety that
regularly occurs in a specific situation. You may have heard of people
who have panic attacks on buses or in shops or crowded situations - the
most common form of phobia and is sometimes called agoraphobia. Panic attacks also commonly
occur in other specific situations (in open spaces, and in phobias of
certain animals such as spiders and snakes, and even such apparently
harmless creatures as butterflies). In some cases the person may not
have a specific fear or anxiety but experience panic attacks when other
upsets or fears build up and up in their minds. It is important to
realise that problems of anxiety, depression and panic may occur
together, or quite separately. However they are affecting you,
this chapter will help you to find out more about the causes of these,
and help you to begin to plan ways of changing this. How common are
depression, anxiety and panic? Depression and anxiety are far
more common experiences than most people think. Anxiety and depression
can affect anyone. Some well known people have
experienced them. You may have seen television programmes or read books
about their experience of tackling these problems. Around 1 in 5 people
experience depression and at least 1 in 10 people experience a panic
attack at some time in their lives. It is extremely likely that you
will know one or two friends, family members or people you come across
on a daily basis who regularly experience these problems. There will probably be many more
people around who are suffering from depression, anxiety and panic than
you are aware of because of the unwillingness of many people to admit
having such experiences. ------- Source: Living Life to The Full livinglifetothefull.com References:
Overcoming
Depression: A Five Areas Approach. Williams C. Overcoming
Anxiety: A Five Areas Approach. Williams C. I'm
not supposed to feel like this: A Christian self-help approach to
depression and anxiety. Williams, C., Richards, P and Whitton, I. ~ ~ ~ |
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