Generalized-Anxiety-Disorder During Mid-Life



"Let me assert my belief that the only thing that we have to fear is fear itself – nameless, unreasoning, unjustified terror that paralyses needed efforts to convert retreat into advance."

F. D. Roosevelt, U.S. President

Anxiety and Mid-Life

Mid-life transition brings more than our share of fears and worries. Health, financial insecurity, retirement plans, kids leaving the nest and your concerns for their future, interpersonal relationship, personal concerns are but a few life-situations instigating anxiety.

At this stage of our life we feel vulnerable and insecure; some of us may feel the stress and the solitude as an enormous weight over their shoulders. It’s a reason more for you to learn to appreciate this stage of life as an opportunity for change, for renewal, for meditation and for giving you the necessary therapeutic tools to help you journey out of your concerns – patiently and in all confidence.

Generalized anxiety does not have to be the outcome of your mid-life years. You acknowledge your illness; let it be a turn-around opportunity that could instigate renewal into your life. You can do it; I believe in you!

"People with generalized anxiety disorder (GAD)feel being wound up and unable to relax, they have difficulty sleeping. They feel unable to let something go, they have trouble concentrating, and feel light- headed, their heart pounding, they constantly feel worry, and anxiety.

Persons with GAD often live through days experimenting exaggerated tension and worry, although there is nothing really wrong. They live in anticipation of a disaster; concerns over money, family, health, and work run through their mind."

www.mid-life-renewal.com/mid-life-generalized-anxiety-concern.html

Living like this is hell…your thoughts create negative feelings draining your energy and paralyzing all your efforts of fight and resistance against discouragement, against fear and against defeatism as you anticipate your future to be disastrous. A very ordinary challenge becomes an overwhelming issue of concern you just simply cannot control; this goes on and on for months (minimum six) and you wonder:

"Will I ever see the light at the end of this black tunnel? Will I ever experience inner-peace?"

Education and therapy are obvious approaches for healing. Understanding your illness, their signs and symptoms and the impact on your personality; knowing that you’re not the only person concerned with such an issue is a relief in itself.

One very important element you must always consider seriously - do not identify yourself as the label of your illness. You may have a weakness but you’re not your illness. That illness may be controlled. You’re much more than your weakness. This applies to your job position, your social status... The first therapeutic approach is to practice saying: "I have an illness called …" rather than saying "

I am a…. (referring to your illness). It’s your first item of control over your concern restraining you from identifying yourself negatively.

You know you’re not your illness or concern; you can now journey with ease further understanding the triggers of generalized anxiety disorder(GAD) and working our way towards a therapeutic approach most suitable for you.

All our anxiety concerns are related to unresolved conflicting concerns – whether they would be relationship related, personality related issues, or even hidden anger related. In other words we learn to be afraid.

I already hear your confusion…

"Gisèle…why would I want to learn to fear?

Now, hold on for a second; I did mention: "learn to fear"… but I did not mention intentionally learning to fear... which makes a difference!

There are three different learning approaches according to behaviourists’ specialists:

  • Classical conditioning
  • Operant conditioning
  • modeling
  • Classical conditioning

    You learn this process as early as childhood. When you were a baby, you associated your mother to food. At school, you associated the sound of the bell to recess or end of class activities. You also associate the sound of an alarm to danger or fire. Can you begin to understand how your anxiety is triggered? An incident having happened a long time ago – having had a strong emotional impact can be revived whenever the associated object, person or incident reappears in your life. E.G.: For a long time I associated the image of a man as to be chauvinist, bossy, and unable to express kindness and understanding; men only searched for one thing: being served. This is the male image I have been raised to contemplate throughout my whole youth period. Over protective was my mother and through words and behaviour the message she gave me for the longest time was: Men could not be trusted. You can picture the rest of the story…!

    Operant conditioning

    Through trial and errors we learn to do things that are rewarding to us and stop any behaviour that leads us to painful or negative outcomes. Ex.: When I was out of town for a holiday, one summer, in the big city of Ottawa, I had been a victim of a car accident. Fortunately, my car wasn’t a total wreck and I wasn’t injured, only nervously shaken. The police officer convinced me with insistence, (against my will at first), that I had to take the wheel again or I would never have the courage to drive. He was right. Many of our fears remain in our subconscious mind because we never had the courage to confront them right on the spot!

    We also develop our fears modeling our parents’. Ex.: I never understood why I have this phobic fear of cold blooded animals. Any animal such as snakes, frogs, mice, rats and worms ices my blood to paralysis. I cannot go fishing or hunting for the same reasons. Don’t ask me to climb a latter or drive on a high bridge my heart begins to race! My mother suffered of these phobias and my father had a fear of snakes. I’ve finally reasoned myself to learn to swim, but never was able to dive in deep water! Near drowning experiences was the reason explaining this last described fear.

    Do you begin to understand where your fears can be rooted? Your story is unique therefore your triggers are linked to your personal experiences. The inner journey experience into your inner core could be helpful in helping you pinpoint and confront those fears.

    Take a break…Click the following link, follow the procedure described in the section entitle:

    An experience is worth a thousand words. Do it as often as you can, every day for five or 10 minutes to help you instigate inner peace.

    An Experience is Worth a Thousand Words

    Your fears are also related to your level of self-esteem. Hey, we mentioned this briefly in our encounter called: Low Self-Esteem. Click on the above link for reference.

    Self-esteem is the perception you’ve created about yourself as a person and in regards to your gifts, personal traits, qualities, abilities and past performances. Twisted thoughts are consequential triggers of the generalized anxiety disorder.

    I quote Dr Joni E. Johnston, Psy. D.:

    "Cognitive theories of anxiety focus on the way our thoughts influence us. Here’s an example: picture yourself about to give a big speech at school or at work. Imagine that you’re thinking to yourself, "Okay, I can handle this. I’m well prepared. Everyone here wants me to do well. Even if I make a few mistakes, it won’t matter."

    Now imagine that you’re in the same situation, but instead you’re thinking, "I can’t do this. I’m going to throw up. I’m going to pass out. The speech I prepared is pure garbage. Everyone is just waiting for me to screw up. One mistake and I’ll get an F (or get fired). It’s the same speech! But there’s no question about which situation would make you, me, or anyone else more anxious. It’s not the reality that matters – it’s what we think about what happens or what might happen."

    In her book: Controlling Anxiety – Keep your Fears and Worries at Bay, Dr. Johnston enumerates the following 13 twisted thinking approaches liable for triggering anxiety into your daily life. With an ironic smile on your lips, you may recognize some of those twisted thoughts to be yours under the influence of anxiety:

  • cognitive distortions: unreasonable, irrational or even ridiculous thoughts

  • catastrophizing: we turn a molehill into a mountain. It’s the end of the world.

  • Dichotomous reasoning: seeing everything as black or white. You’re either a success or a failure. In reality the world is all about shades of grey, we all make mistakes.

  • Disqualifying the positive: happens when you ignore the good feedback and believe the opposite.

  • Emotional reasoning: You decide that what you feel reflects reality. You feel like an idiot therefore you are one!

  • Fortune telling: You act as if your worst fears will certainly come true. You’re sure it will happen.

  • Labelling: You give yourself a global label. I’m a failure. Rather than saying: I blew this one, but I’ll do better next time.

  • Mind reading: Assuming that others are reacting negatively to us – even without any evidence.

  • Minimization: You don’t give yourself enough credit for your good qualities or accomplishments. You cannot tell others anything good about yourself.

  • Overgeneralization: You take one event and your base reality on that.

  • Personalization: taking everything personally and ignoring other factors.

  • Selective abstraction: You focus on one part rather than the whole.

  • "Should" and "have to" statements: going overboard with should … and have to…

    To conclude this section on the triggers of generalized anxiety disorder, I quote Dr.Bob Murray Ph.D. from his website article: Healing Depression Safely Without Antidepressants describing the biological triggers that impact a person concerned with anxiety disorders:

    "Anxiety and panic attacks, which are part of the depressive syndrome, can also be reactions to events in adulthood that mimic those of childhood, even subconsciously. Cortisol, a neurotransmitter related to stress, is over-secreted, and other chemical imbalances occur. At the same time, the very structure of the brain is compromised. As a result of extreme stress and childhood trauma, the hippocampus, for example, doesn’t develop as it should – it literally has fewer neurons. The result is difficulty in handling in emotions and often a loss of short term memory. Traumatic memories stored in the amygdala, a walnut sized part of the central brain which stores powerful emotions, flood the underdeveloped hippocampus. This part of the brain is then unable to differentiate properly between a real crisis or a minor glitch in the present, or an experience in the past. The frontal cortex, which is meant to sort out emotional transmissions and decide appropriate actions, is also damaged."

    THERAPEUTIC APPROACHES TO GENERALIZED ANXIETY DISORDER

    To help you understand the feelings of an individual suffering of generalized anxiety disorder picture yourself sitting in a big box the size of your body, and entirely covered with a thick yarn blanket. The box is shut and you're in that box, eyes closed so you don't see any possible ray of light peeking into the box. It's dark; the space is narrow, the box is closed you can't get out. Picture your feelings: the type and the intensity; se your behaviour as these feelings increase; as you pay closer attention to the messages of your imagination, picture your reactions. Picture yourself alone in the room, wanting to get out and no one avaible to help you. Picture yourself in this situation for at least one hour.

    To be thinking about this makes me feel anxious! If you have the courage to do this, I promise you will have some good idea about generalized anxiety. Multiply this feeling day in and day out!

    Mental health professionals for the most part agree that cognitive behavioural therapy and/or medication can bring relief to candidates afflicted with generalized anxiety disorder. As we mentioned in our first encounter, anxiety-related symptoms can also be medically related, a complete medical examination is strongly recommended. Illnesses such as hypoglycaemia, mitral valve prolapse, insomnia, allergies, hyperthyroidism, premenstrual syndromes or caffeine intoxication and even depression will have generalized anxiety-like symptoms.

    Human beings have at least two separate levels of existence:

  • mind (thoughts, feelings and values)
  • body ( tissues, blood, bones, muscles, molecules, atoms…)

    I personally add a third one:

  • spiritual We are not just thoughts and flesh but all also spirit

    Understanding both the medical and psychotherapeutic approaches can help us appreciate their respective positive outcome and help us accept the best therapeutic approach to overcome our illness.

    Medications are valuable but cannot give you insight or heal relationships. On the other hand psychotherapists and psychologists will assist you in your interpersonal needs: Interpersonal Therapy or IPT) or behavioural modification needs (Cognitive Behavioural Therapy or CBT).

    E.G.: The Interpersonal Therapy(IPT)approach will help you to:

    1. Gather information and to clarify the nature of your illness and life situation.

    2. Concentrate on the ways personal relationships may have contributed or affected your anxiety.

    3. Develop communication skills and techniques for dealing with disputes, role transitions and develop ways to cope with one’s own interpersonal weak spots or deficits.

    Cognitive Behavioural Therapy(CBT) will help you to:

    1. Change negative or irrational cognition and its associated behaviours

    2. Help you identify distorted or distressed thoughts and teach you the ways to counter or change them.

    3. Teach you problem solving techniques where behaviour modification is necessary. Do you begin to see the difference between both and how Cognitive Behavioural Therapy can be a suitable therapeutic approach to help you overcome your anxiety?

    In a case where depression is involved both medical and talking therapy can be of help. The prerequisite for this therapeutic approach is the need for talking, energy and attention

    .

    Medical Therapy

    According to mental health specialists, medical therapy is advised only:

  • When anxiety symptoms are serious and interfering with normal daily functioning

  • When psychotherapy and relaxation techniques can’t work out effectively.

  • When the individual is overwhelmed by anxiety to the point he cannot concentrate.
  • N.B.Anti-anxiety medication can create dependency and become an issue or addiction.

    Self-Help Methods for controlling your anxiety

    1. (From Dr. Joni E. Johnston’s book Controlling Anxiety – Keep your Worries and Fears at Bay)

  • Identify your core values (choose your 5 predominant values)
  • Make a list of them and keep it at reach-of-hand.
  • How do you act them out in your every day words and actions?
  • These values can be a guide of measure by which you evaluate your everyday decisions and choices.
  • commitment
  • communication
  • honesty
  • community
  • honour
  • concern for others
  • integrity
  • creativity
  • justice
  • leadership
  • faith
  • love, romance
  • family
  • loyalty
  • friendship
  • money
  • fun
  • openness
  • goodness
  • gratitude
  • positive attitude
  • hard work
  • adventure

    2.

    "One of the first things most of us do when we are overwhelmed wih inner turbulence is: we instinctively try to calm down into a state of ease before starting to sort out solutions. Why do we do this? Because we intuitively sens that the state of ease helps us to get back in our heart which helps to re-stabilize the mind and emotions - this re-connects us with our reasoning capacity and clear view. We adults occasionally remember the wisdom of such practices, but it's often after the fact and after much energy drain. This article suggest a few advantages of accessing our state of inner-ease, not just for bailing out out of emotional turbulence, but to use throughout the day for maintaining connection and coherent alignment between the heart, mind and emotions."

    You may download this free booklet written by Doc Childre, founder of HeartMath and discover the benefits of the state of ease.


    herbal therapy is another approach possible for for relief towards anxiety

    Two important therapeutic tools can be of assistance in our journey of positive recovery from anxiety. I identify them to be:



    Thought management

    To find detailed information on how these therapeutic tools can instigate renewal into your generalized anxiety concern click the following links:


    Stress Management



    The Sources:

    Books:

    Complete Idiots’ Guide Controlling Anxiety

    Power over Stress – 35 Quick Prescriptions for Mastering the Stress in Your Life by Kenford Nedd, M.D, QP Press Canada 2004 Copyright © Kenford Nedd, M.D. p-183, 205.

    Psychologie – science de l’homme, by Robert J. Trotter and James V. McConnells, Editions HRW Ltée Copyright © 1980

    Take Control of Your Life – A Complete Guide to Stress Relief by Sharon Faelton, David Diamond and the Editions of Prevention ® Magazine, Rodale Press Emmaus Pennsylvania Copyright © 1988.

    The Peace of Mind Prescription – An Authoritative Guide to Finding the Most Effective Treatment for Anxiety and Depression, by Charles B. Nemeroff, M.D.,Ph.D., Dennis S. Charney, M.D. with Stephen Braun, Houghton Mifflin Company Boston New York Copyright © 2004.

    Websites:

    Mental Help.Net http://www.mentalhelp.net/poc/view_php

    Uplift Program http://www.upliftprogram.com/article_together.html

    http://psychcentral.com/disorders/5x24t.html

    The State of Ease

    http://www.heartmath.org