Tag Archives: anxiety

Facing a trigger

There is a world of difference between causing anxiety, and triggering. Anxiety is unpleasant, no two ways about it, but a trigger will give a person a flashback to a situation of trauma. It is possible to tackle anxiety by facing up to the sources of fear – and of course the less well founded the fear is, the more effective this is. Sometimes we end up scared of things for no good reason and we have to retrain ourselves to deal with stuff. I’ve done some of this along the way, I’ve found CBT approaches really useful.

The worst thing to do to someone who suffers PTSD is to make them revisit the trauma. Untreated trauma, and trauma revisited can build up layers of additional triggers and problems. Been there too. I don’t have a PTSD diagnosis because the doctor I was seeing when that would have been most useful didn’t want to send me for tests – not because he thought there was no issue, he just didn’t want to send me for tests, and I didn’t have the energy to fight him. Every single professional person I encountered over a period of years – doctors, police, solicitors, social workers and the like, every last one of them required me to retell what had happened. That’s a lot of deep retriggering, often in situations where being distressed put me at a significant disadvantage. I have no idea if being able to name a diagnosis would have helped.

Triggering happens because something is too associated with the original trauma, and brings it all back. This is why trigger warnings matter – on obvious things like child abuse, torture, extreme cruelty and rape it is worth warning people because anyone who has experienced that will suffer enormously if they come upon it unprepared. This isn’t like pushing past fear of going outside to go outside – because in that example, you go outside and you probably don’t face a terrible thing. Being triggered means facing a terrible thing. So on the whole, facing down a trigger is not the ideal way to deal with it.

The further removed the trigger is from the trauma, the more chance you have of taking it out. You need to stack up a lot of time feeling safe and secure first. There is no real scope for dealing with triggers while you’re still in a dangerous situation. I’ve written before about how I have overcome being panicked by post. I’ve got that down to just a bit anxious, now. The reason I had become so panicked by post, was that terrifying things came in envelopes for some years. Many of those terrifying things came from my solicitors, and every envelope represented a bill that would cripple me financially for good measure. Between this and the deliberate retriggering described above, I’ve been totally unable to deal with most people in a professional capacity for some years now.

Yesterday I went to see a solicitor about making a will. The same family solicitors company responsible for all that letter sending. I let a professional person ask questions about my life. But, because it was a will, we didn’t get into the stuff I never want to have to talk about again. And I knew upfront what it would cost. The appointment letter, when it came in the post, made me feel bodily sick, but I weathered it. I’ve kept reminding myself that I’m in charge of this process. Perhaps next year I will find the means to go and talk to a doctor – and it will be a different doctor – about things that are wrong with me.

It has taken me years to get to the point where I feel like I can do this. Years of kindness and support on the domestic front. Years of rebuilding my sense of self. It is possible to challenge a trigger, but it is not something to rush towards. Only the person dealing with the trigger can say when it might be worth having a go.

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In the aftermath of anxiety

A panic attack can be a rather self announcing thing. It has inherent drama, so it can be possible for people not experiencing the panic to tell that something is going on. However, the aftermath of a panic attack is also a difficult time, and it is far harder to see what’s going on then, so I thought it might be a useful thing for me to talk about.

The physical symptoms can persist. Raised heart rate, tight chest, difficulty breathing – these things can go on for hours, even days after a big panic attack. It feels awful and can lead to the fear that something has gone wrong at a bodily level. I’ve never been clear how you’re supposed to tell between panic and heart attack warning signs. Those of us who suffer panic are told to ignore what others are told to take seriously.

There can be a huge emotional backlash. It invariably leaves me feeling like I’m stupid, irrational and I’m embarrassed by my loss of control. I hate not being able to control what I’m doing. I get anxious that people will not take me seriously, or will think it’s a stunt, a bid for attention, an attempt at emotional blackmail. Often as a consequence I will become withdrawn afterwards, especially when I don’t know how people are responding to me.

Once panic has been triggered, it is easier to re-panic me. This can lead to incredibly vicious cycles where it gets ever harder to stop panicking. Without calm and respite, panic can get seriously out of control.

Exhaustion is a common part of the backlash. Emotional and bodily exhaustion can be severe and can last for days. The desire to just down tools and go to bed is huge. When things are really bad, a massive panic attack can result in the no energy, not coping outcome of a big round of depression.

If you are dealing with a person who suffers from panic, then the best way to find out how to help them is to ask. On the whole, taking people seriously and treating them kindly makes a lot of odds. However, as panic is often related to abuse experiences, make sure that what you do to help doesn’t seem controlling, doesn’t give the sufferer the feeling that they are so useless they can’t take care of themselves, doesn’t patronise or demean them. Those of us who are ok with being touched can be significantly soothed through long hugs, but never hug without asking. Unsolicited body contact can be a panic trigger. Bring drinks, reduce noise, remove threats, talk calmly, give space and time.

Triggers are tricky things. Someone else’s triggers may make no sense to you, and you may feel that the time it takes them to recover is unreasonable. This is because it isn’t your trigger, or your history, or your body, and it is important to bear that in mind when dealing with someone in distress.


Making space for the feels

For much of my life, I’ve had external pressures making me feel emotionally unacceptable. Along the way I’ve been mocked, shamed, humiliated and punished for expressing my feelings. I’ve loved people dearly only to find them horrified by any expression of my loving them dearly. I’ve been told my expressed emotions are so extreme as to seem fake. Ridiculous, over the top, drama queen, attention seeking… you get the idea.

And so I learned to mute myself. To not say a good 90% of whatever I feel. To understate, make tame and easy and comfortable everything that goes on inside me. I’ve crushed myself to avoid having to deal with others crushing me. I’ve known for a long time that this process, whether it comes from within or without, has a ghastly effect on my mental health. But I’ve also learned how to put a poker face on and hide that as well. It seems fair to assume that the people who habitually dismissed me would also dismiss mental breakdowns as further attention seeking and fuss making.

In recent years I have benefited from safer and more supportive space and it has allowed me to stretch and experiment a little. I find that if I make some space for me in which I can be totally honest about how I feel, that I don’t take damage. Often this means getting some time alone (bathrooms are excellent for this) and holding a few minutes of space where I can feel the unacceptable thing. Anger, frustration, resentment, envy, bitterness – these are often the most trouble to express. However, I can have a fair amount of trouble with joy, pain, sorrow… I’m still not easy about crying over films in company.

If I make some space for me, and properly acknowledge what I’m feeling and treat it with respect, then hiding it feels very different. I am not made smaller. I am not crushing myself.

There are a lot of things I cope with by bullshitting. Physical pain is a constant in my life. Depression and anxiety are often present in my head. I’m often short of energy. I don’t find that dwelling on these helps me, and I prefer, for my own dignity and comfort, to put a good face on it. But this also means that most people are dealing with my fakery, and have no idea what’s really going on. Recently I’ve been experimenting with saying how things are but acting as I normally act. I’m working out who responds well to that information, who shares honestly in return, and who says ‘how are you?’ as a social gesture expecting ‘fine thank you how are you’ as the only possible reply. Because it’s not about genuine care, it’s about presenting socially in the right way.

I also find that where I make space deliberately for other people to be honest with me, and they take me up on that, I feel more confident about expressing myself. It gets easier to do the good stuff, too. To be exuberant, wholehearted, affectionate, to laugh wildly, and all those things, in the company of people who have room for it. Once again I find myself obliged to point out that mental health problems require community solutions. I did not get into that mess alone, I have not got out of it alone.


Meditation for mental health

Meditation can seem like an excellent tool for tackling mental health problems. So much so that if you go to a GP, you may find that mindfulness is suggested as the answer to your problems. Here are some of the things meditation helps with, and things it doesn’t.

Using meditation to calm panic attacks. You have to be an experienced meditator to be able to make your brain switch gear in face of panic. If you are learning to meditate to control panic, do not expect rapid results.

Using meditation to reduce anxiety. It can work if the panic is all inside your head. However, the odds are good that there are external stressors involved. You can learn to be calmer through meditation and thus cope better with stressors, if the stress isn’t too much. If you are under constant pressure, it is only by dealing with the external problem that you can sort out the anxiety. It isn’t all about what goes on in your head – not if you are bullied, forced to work in inhuman conditions, not getting enough rest or sleep and so forth. Trying to meditate your way out of it can make you feel more responsible for a problem not of your making.

Working alone and meditating in a way that makes you more aware of what your brain is doing (ie mindfulness style approaches) can work if your faulty thinking is most of the problem. For most people, anxiety has been caused by something. Sitting mindfully with your traumatic memories will do you more harm than good. Resolving trauma without the support of a counsellor is a long, hard, painful road. It can be walked, but I feel no one should have to do this alone.

When a person is depressed, the world appears in certain ways. I’ve never found meditation helpful for changing my outlook, not if all the meditation does is send me inwards into my own personal hell. Distraction is much better – pathworkings and other guided meditations, meditating on something simple and uplifting – a plant, a cloud, a nice oracle card… Getting out of your own head in this way can bring considerable relief. Sometimes, just getting the headspace is enough to help move things forward. Sometimes it isn’t.

There’s every reason to use meditation techniques for immediate relief and for coping with problems. If you find you can use it to tackle larger problems – all power to you. However, if you find meditating makes things worse, it is not a personal failing. If you find no respite, and that it sends you further down your own rabbit holes, don’t do it. If your problems are out there in the world and caused by other people, don’t make yourself solely responsible for fixing things.

Meditation is not a magic bullet, it is not a salve for every ill. Anyone who tells you otherwise is either trying to let themselves off the hook, or save themselves money, or wants to diminish your problems for their own comfort. It may be that they’ve only experienced very mild depression and anxiety – the sort meditation can definitely help with – but they don’t know what a minor brush they’ve had.


Intuition, ill health and uncertainty

As a much younger human, I trusted my intuition, but through my twenties I became ever less able to do so. For a long time I’ve had incidents that make it difficult to tell what I’m dealing with.

Anxiety will tell you that something is terribly wrong. Depression will tell you that there’s no point even trying, it’s all hopeless. Stress will tell you that you have to keep going, flat out no matter what. Problems with bodily health can feel like psychic attacks, premonitions or signs. If you start buying into these as intuitions of the truth, what you do is reinforce whatever is wrong with you. But at the same time, none of these conditions turn your intuition off, so that can also mean missing important insights.

I don’t think intuition is a ‘woo-woo’ issue, at least not all the time. We take in vast amounts of information – far more than we are consciously aware of. We do most of our processing unconsciously. Thus often what we experience as a magic thing happening, is really our brains having worked through what we’d got. Those ping moments of inspiration, eureka, and intuition aren’t at odds with reasoned thinking, they’re just one mechanism amongst many. At the same time, if your take on reality has room for truly magical things to happen, well, sometimes what we intuit can be so far removed from what we had information about, that this seems plausible.

The question remains, how to tell one from another? Just because you’re feeling anxious, doesn’t mean you’re paranoid. Just because you’re depressed doesn’t mean nothing is crushing you down.  In the last few years I’ve let go of the idea that my intuition is totally broken, unreliable and best ignored, and started making space for it. I’ve started trying to tease out those threads of mental health, hormonal activity, body feelings and so forth to get a better picture of what’s going on in my life.

I’ve come up with a couple of things I think are useful. Firstly, checking in with someone else. Most mental health issues make it difficult to trust your own judgement or perceptions. If there’s a person you really trust, being able to run things past them can be helpful. Am I being paranoid? What’s the most likely source of this experience? What’s your perception? It is worth being wary because two people intent on out-wooing each other can build layer upon layer of imagined things and end up convinced that they’re at the centre of a magical war or some such (I do not jest, I’ve seen it happen). If you can help each other think critically, all well and good. If not, it may do more harm than good.

My other solution is to give my intuition defined outlets – divination tools to play with where the interpretations do not depend so much on my own mental state. Oracle cards are great for this. It gives me a cross reference for the body feeling. Do the cards reinforce what I’m experiencing, or are they at odds with it, or do they cast the whole thing in a different light? It’s also a way of honouring and making space for my intuition rather than wholly distrusting it, and I feel better for being able to do that.


Gnawing away at the roots

Trigger warnings – exploring the mechanics of abuse.

It’s all too common to imagine abuse in terms of obvious physical violence. In practice, when people are subjected to physical abuse it’s often late in a process that has already ground them down so badly that they don’t resist or complain and instead feel it’s what they deserved. The long term consequences of emotional and psychological abuse tend to be far more damaging than any physical abuse that is survived (but not everyone survives). Our criminal systems focus on bodily wounding.

Psychological and emotional abuse is not always deliberate. There is often no way to tell if it is meant to harm the recipient or not. People may be repeating their own family patterns and experiences, affected by their cultural background, religion, belief and so forth. They may think what they’re doing is fine, they may be projecting all kinds of crap onto their victim. This doesn’t lessen the effect, but it means if challenged they will be very clear that they aren’t doing anything wrong, and this makes them difficult to challenge. If you tell your significant other that they are hurting you and they respond by saying it is your problem not theirs, they are fine, it only serves to entrench the damage.

This kind of abuse is often a slow process of attrition and erosion. No single act will be enough to make you realise it isn’t ok. It’s just little nit picking criticism and complaints, it’s living without praise or kindness, it’s being told off and told you look lousy and that your cooking isn’t up to much. You make too much noise, you don’t smile enough, your taste in clothes, films, books, friends is piss poor… and slowly, day by day, more is shaved off your identity until you wake up one morning and you don’t know who you are any more, you just know you aren’t any good at anything and its all your fault.

You don’t know what happened. And maybe the person who did this to you tells you that they still love you, even though you look terrible and aren’t doing anything interesting. They still love you, even now you’re fat and boring. And you’re grateful to them. They’re heroes. No one else would want you in this mess and you are so desperately glad they are willing to put up with you that you’d do anything to try and make them happier. You wish you were a better person so that you could do more good things for them.

If you’ve grown up with this coming towards you from a parent, you may never notice that it isn’t normal or ok, and that your crushed self esteem and the anxiety that comes from it is not something that you deserve. If you take it from a spouse, you may keep taking it for years, all the while internalising your own alleged shortcomings. How do you tell that you’re ok when the key people in your life constantly undermine you?

There are no easy answers to this. It is very hard for a person in that situation to wake up and get out on their own.  However, most people who are being ground down in this way will defend the person crushing them if faced with a direct challenge (because you’re dissing the one person who can put up with them). A well meaning attempt to get someone out of this trap can instead push them further into it. The only thing I’ve seen work is to get in there and gently, persistently build someone up. Affirm them, praise them, encourage them, ignore whatever they do to deflect it. And keep doing it, for months, or years or as long as it takes for them to start questioning how rubbish they think they are.


Working when ill

It’s something I’ve done a lot of over many years. One of the advantages of being self employed is that you have some flexibility when sick. You also have no scope whatsoever for sick pay, often there’s no one who can cover for you, and being ill can be expensive in that it can cost you future work. Increasingly, conventional workplaces seem to be pressuring people to work when ill as well.

I know from experience that I’m considerably less efficient when ill. It plays havoc with my concentration. I move slowly, making more mistakes, my judgements are never as good, I don’t have good ideas. There isn’t an ailment out there that won’t be easier and quicker to deal with if you’re able to rest, and won’t be exacerbated by additional stress. And some illnesses are contagious, and taking those to visit other people isn’t nice. The idea of keeping a human working when they’re sick clearly isn’t informed by anything real about the implications of illness.

Over time, there’s a bigger and more insidious impact to working when ill. It dehumanises you. It takes away the sense of being a proper person with the same rights as other people. You’re just a thing to keep slogging along to get the work done. This is one of the ways in which a physical health problem can easily develop into mental health problems as well. Exhausted, demoralised people who are obliged to keep suffering are likely to end up with low self esteem, anxiety and depression at the very least.

I will do the things I absolutely have to do, and then I’m heading back to bed with a book – because I can, and it’s a far better idea. There will be many other people obliged to work a full day today, despite being sick. Some of those people will be doing unpaid domestic work, but that doesn’t guarantee you respite, either. Given that the amount of work available is decreasing as people are replaced by machines, we could collectively square up to this and bring in a citizen’s income, so that no one has to work full time, and no one has to work when they’re ill. Failing that, better worker’s rights and a better social safety net would be a great help.


Anxiety, Depression and Self Esteem

On the whole, anxiety and depression are best tackled with self care. Rest, moving away from the sources of distress, not being outside your comfort zone too much, good food, sleep, exercise… All the obvious things that contribute to good health are needed to bring a person back from mental difficulty. Some (many?) of us who suffer from anxiety and depression have terrible trouble taking proper care of ourselves.

The person with poor self esteem struggles to believe that they deserve basic, essential things. Getting the job done thus seems more important than being well. Being useful is more important than being well even if being useful in the short term may compromise your longer term viability. For me, for a long time, the idea of self-care was itself a panic trigger and if people suggested it, I’d get even more distressed. I think I’m not alone in this.

When poor self esteem underpins poor mental health, the odds are a person has internalised a lot of crap from other people. We do not come alone to the idea of being worthless, useless, and that we deserve to suffer. We may believe we’re lazy, making a fuss, a nuisance – because we’ve had prolonged exposure to people telling us these things. We believe that we aren’t really ill, that the problem is that we aren’t trying hard enough. If only we made more effort to be more positive, we’d be better people. Getting a person to believe the bullshit of positivity logic can be one of the cruellest ways of keeping a mentally distressed person trapped in cycles of ill health.

Getting out of this is not a solo project. I know this because I can look back on my own journey and see when things started to change. Wind the clock back seven or eight years and I did not see myself as a real person. I was a thing made of straw and only my usefulness mattered. If I struggled, I’d push harder, beating myself up – physically and emotionally – to keep moving. I’d name call and shame and ridicule to make myself keep going, keep working, keep doing all the things. Running on internalised hate, I’d use the energy of that to keep my broken self moving.

There have always been people happy to add to the inner hate pile, and then to humiliate me as someone who ‘just plays the victim’ on top of that. I have taken those words into every burnout with me. I’ve listened to well meaning people online telling me I needed to take better care of myself, and I’ve been afraid to do so. As though being kind to me would turn me into something even more horrible and unworthy than I’d already been told I was.

I’ve been able to change because my environment has changed. It has taken time. Support and kindness at home, for years, has had consequences. Good friends who treat me with warmth provide an antidote to the poison others have poured into my ears. Support from fellow travellers has helped create a context for looking differently at these things. I could not have done this alone.

It’s a thing about mental health that needs saying and saying again. Most of us do not fall apart on our own. We fall apart for reasons that are outside our heads. Trying to find a personal solution to this is often futile. If environments are sick, the people in them will become and remain sick. Where people exploit each other, treat each other as worthless, expendable, or mock visible suffering, things only get worse. Collective solutions are the only workable ones, and in treating each other better, and being kinder to each other we can overcome so much more. Individual positivity can’t heal much of what’s wrong. Collective determination to change things really can make a difference.


The politics of madness

Political choices are causing mental health problems. This isn’t going to be a properly referenced article, but everything I’m talking about is out there in the public domain and easy to find if you want to poke about.

A great deal of psychological distress is caused not by something going on inside the sufferer, but by external things. We tend to place the blame on the sufferer, and most interventions focus on what the sufferer can do to sort themselves out, not what needs changing to make their lives bearable.

Twenty years ago when I studied psychology at college it was known that stress causes mental health problems. It was also known that your ability to resolve the problem is the major factor in how much stress you feel. Powerful people with great responsibilities do not feel anything like as much stress as poor people with no control over their lives.

Political choices are increasing poverty and insecurity. Zero hour contracts, precarious renting arrangements, threats to the NHS, to families and business and local environments all piles stress onto people who can do nothing to resolve the problems. The actions of our politicians are increasing mental health problems.

At the same time, funding for mental health care is abysmal, and the system that should take care of anyone too sick to work is such a nightmare that getting into it is likely to cause a person significant mental distress and lead them into anxiety and depression.

To be well, people need to feel reasonably secure and passably in control of their lives.

Poor diet has a negative impact on mental health. You can look at prison research into increasing vitamins in the diet and how that changed things for people. You can look at anything at all about brain chemistry. A person needs protein to build serotonin, and this chemical is key to feeling ok. Anyone on an impoverished diet will have impoverished body chemistry, with consequences for their mental health. That would be everyone depending on foodbanks.

Exhaustion, sleep deprivation, lack of rest and lack of fresh air and exercise all impact on mental health. Everyone I know is tired. We know we collectively have a sleep shortage problem. Noise pollution deprives us of quiet and traffic deprives us of clean air to breathe. Traffic deprives us of safe places to walk. Anything making our bodies ill will also impair our mental health because it’s all one system.

The trouble is, most of us are just statistics. There are more people than our government feels it needs, and so we are a disposable commodity, easily replaced. Why waste money taking care of people when you can throw them away and get new ones? It is, quite simply, the politics of madness, devoid of kindness and humanity. We are being normalised to it, and told any other way of being is naive and unrealistic. We are told all the things hurting us are in our interests – because it all comes down to money and growth.

All the while, the people pedalling this, who have to recast failure as success, the well meaning as traitors, the good as the enemy, the vulnerable as villains, are slowly driving themselves round the bend with cognitive dissonance.


A bit worried or suffering anxiety?

A bit back I wrote about the differences between depression and sadness and the problems that arise when people think that their brushes with melancholy mean they know what depression is. You can read that here – https://druidlife.wordpress.com/2017/05/15/depressed-or-melancholy/

The issues for anxiety are similar in that an experience of fear is not the same as anxiety as a condition. Humans have fight and flight reflexes, but in the anxious person, the urge to flight can be overwhelming and irresistible. A panic attack is a really physical experience. How it impacts may depend on the severity of the situation for the person experiencing it. It may cause numbness and temporary inability to move or react. It may accelerate the heart rate in ways that are also alarming. Breathing can be affected – loss of control of breath as the body hyperventilates is also distressing. Chest pains as though you were having a heart attack. Gut pains leading to voiding of the bowels. A panic attack is a body issue, and all the person experiencing it can do is try to get it under control. It can also impact on a person’s ability to go out, deal with other people, hold down a job – any aspect of life may be made more difficult by it.

You can help someone who is experiencing a panic attack by helping them to feel safe, asking what they need. Little things – a glass of water, a seat, help to move away from the trigger… these are good. Telling the panicking person to get over it, pull themselves together, stop making a fuss it really isn’t that big a deal… will make it worse. If you have an option on doing those things, don’t assume everyone else does.

This brings me round to triggering – a word too often used to indicate mild discomfort. Specifically a word used to indicate mild discomfort by people who don’t have issues and wish to ridicule and denigrate those who do. Triggers do not mean you are some kind of pathetic. Triggers are a consequence of trauma and the experience of the trigger – typically something that in the sufferer’s mind connects to the trauma – take the sufferer back to the experience of their trauma in an immediate, uncontrollable way. The shell shocked soldier will have flashbacks in response to sudden loud noises. Victims of rape and other physical abuse, victims of torture and anyone coming out of a war zone, and people coming out of long term domestic abuse are the kinds of people who have triggers. You can’t see by looking and many of us are not self announcing because one of the worst things to do with trauma is revisit the memories of it.

This is why trigger warnings are so useful, because they allow a person chance to brace themselves, and a reminder you were prepared for is much easier to handle than one that comes unexpectedly, and you get the choice of whether you’re feeling up to it right now. Trigger warnings are not about protecting wimps from reality as is so often claimed. Trigger warnings are about protecting victims of child abuse, torture, rape and violence from reminders that may send their minds back into living those experiences again. It tends to require details – which is why I’ve not put trigger warnings on this blog, for example. If I was talking in detail about specific experience, I would start with a trigger warning.

Untreated anxiety has the habit of infecting other aspects of your life – the process is called conditioning, we’ve known about it for more than a hundred years. If a bell rings when you feed a dog, the sound of the bell ringing will eventually be enough to make the dog salivate. If there was a soundtrack to your abuse, or certain key phrases were signs of danger, if there was a behaviour pattern that went ahead of violence in your home, then things that look like it will start to feel dangerous too. It won’t make sense to anyone else, it’s not the sort of thing anyone expects to get trigger warnings about, but it still needs taking seriously.

If someone tells you that what you do is triggering them, they are in an awful place and trust you enough to ask you to do differently. That’s a lot of trust. They could have just run away. The gift of helping someone feel that bit safer is a huge one, and helps with recovering from the trauma. Failure to take seriously the apparently irrational triggers can contribute to making things worse. Triggers are so easy to dismiss if you aren’t the one experiencing them.