TATAKalikasan: Today's Dilemma: Anxiety, Phobia and Depression - they take away the joy of living

                  

Lesson on TATAKalikasan, Ateneo de Manila University

87.9 FM Radyo Katipunan, Every Thursday, 11 to 12 a.m.

March 16, 2023

Today's Dilemma: Anxiety, Phobia and Depression - they take away the joy of living

All of us are invariably victims of anxiety. 

What do we worry or anxious about?

                                                 Dr Abe V Rotor

What are the common signs of Anxiety (in increasing intensity).

1. Uneasiness, lightheadedness, clumsiness
2. Shaky nerves, sweaty and cold palms and feet
3. Palpitation, racing heartbeat
4. Profuse perspiration, shortness of breath or choking
5. Dizziness, blurred vision, chest pain

6. Nausea, panic, fear of losing control or dying

2. Who are victims of anxiety?

All of us are invariably victims of anxiety. What do we worry or anxious about? Our aging parents, retirement benefits, sex life, health – name it, real or imaginary – and you have it, irrespective of sex, age, domicile, profession, work,
race, creed, etc. While we worry for certain things and situations, other people simply don’t - they simply don’t care. All animals for that matter, especially the small, scurrying kind, appear to feel anxiety – an instinctive response necessary for survival. Rats and chicken freeze in place momentarily when subjected to sudden fear stimulus. The opossum feigns dead which is actually an involuntary fear response.

3. Is anxiety necessary then as a survival mechanism?

Yes, anxiety helped in human evolution. Records of anxiety show how humans shared the planet with saber-toothed tigers. Without it few of us would have survive, if at all. But now we live in a particular anxious age brought about by modern civilization, so that anxiety has developed into a more complex kind. For example, we are worried for 1001 reasons as individuals, but we are also affected collectively. Take the case of the effects of the two world wars on mankind. Then came the Cold War which lasted for nearly half a century, creating an uneasy kind of world order imposed by fear of Armageddon, should the US and USSR and their allies engage in final confrontation. Such mass anxiety was revived by terrorism with its baptism in the 9/11 attack on the Twin Towers of New York.

4. When do we say anxiety is good and when it is not?

There is something mysterious about anxiety, its dualism. It is a normal response to physical danger so that it can be a useful tool for focusing the mind where there’s a deadline looming. But anxiety can become a problem when it persists to long beyond the immediate threat, which leads to anxiety disorder. It affects 19 million Americans, 25% not having any medical treatment. It is steadily rising in all countries where Western influence is getting stronger.

5.What are the two major forms of anxiety?

According to Sigmund Freud, One is more biological in nature and the other is more dependent on psychological factors.

6. What are the stages in the development of anxiety – and depression?

1. Stress – any external stimulus from threatening words to a gunshot, that the brain interprets as dangerous.

2. Fear – The short-term physiological response produced by both the brain and the body in response to stress.

3. Anxiety – A sense of apprehension that shares many of the same symptoms as fear but builds more slowly and lingers longer.

4. Depression – Prolonged sadness that results in a blunting of emotions and sense of futility; often more serious when accompanied by an anxiety disorder.

7. Of the 12 anxiety conditions listed in the psychological diagnostic, what are the most common?

1. Panic disorder – This is recurrent, unexpected attacks of acute anxiety, peaking within 10 minutes. One finds himself in a situation such as in a crowded elevator. If extreme anxiety symptoms appear, the person may be suffering of anxiety disorder that needs medical consultation, even if this is occasionally experienced.

2. Specific Phobia – This is characterized by consuming fear of a specific object or situation, often accompanied by mild to extreme anxiety symptoms. It may just be plain hate, or fear, say heights. Behavioral therapy – gradual introduction of the cause, until enough courage is built; and cognitive therapy – re-orientation of perception or behavior, may be needed independently or jointly.

3. Obsessive-Compulsive Disorder - a preoccupation with specific thoughts, images or impulses, accompanied by elaborate and sometimes bizarre rituals. Even if they are irrational thoughts, repetitive ritual (e.g. hand washing, prayer), time consuming – researchers are certain whether of not OCD is genuine anxiety. Whatever it is, it does respond to treatment.

4. Post-Traumatic Stress Disorder – repeated, anxious reliving of a horrifying event over an extended period of time. It is not anxiety if the experience fades away steadily, but if it may persist, and sometimes PTSD will not appear until six months after the event. This is caused by recurrent recollection or dream of the event, feeling the even to be still occurring, experience reminding you of the event, and difficulty in avoiding thought associated with it.

5. Generalized Anxiety Disorder – Excessive anxiety or worry for days or months, but does not affect quality of life. Characterized by restlessness, difficulty concentrating or sleeping, irritability, fatigue, muscle tension. Have three or more of these symptoms confirm a person is suffering of GAD.

8. Is anxiety inherited?

Yes, some people seem to be born worriers. Some anxiety disorders are known to run in the family. If the genes involved are reinforced by environment, the expression become more distinct. (Nature-nurture) But there is a good note to this: heritability is only between 30 to 40 percent, according to researchers at Virginia Commonwealth University. Identical twins more likely show stronger tendency to suffer from generalized anxiety disorder. However, even one with low genetic vulnerability could develop a fear of something that may even be greater than one with high genetic vulnerability.

9. Is it true that children suffering of anxiety are most likely candidates of depression?

Yes. But it is also true that many kids outgrow their anxiety disorder to become well-adjusted adults. Anxiety and depression have similar underlying biology. Anxiety may surface early in life and depression later. But researchers are divided in this observation.

10. Anatomy of Anxiety - how do we explain it to the ordinary citizen?

First, let’s start with the senses picking up a threat – a scary sight, aloud noise, a creepy feeling – the information takes two different routes through the brain.

A. The shortcut – the brains automatically engages an emergency hot line to the fear center – the amygdale, which sends an all out bulletin that alerts the brain structures resulting to classic fear response as cited in symptoms, notably increased blood pressure and burst of adrenaline. All these happen before the brain is conscious of the event – before you know you are afraid. Now the second paths takes place.

B. The high road - After the fear response is activated does the conscious mind acts; the information takes a cu\circuitous route, stops first at the thalamus (processing center) to the cortex (outer brain layer which serves as data analyzer) to the senses, deciding whether there’s need of fear response. If yes, cortex signals amydala and the body stays alert.

11. How does the body respond to anxiety stimuli?

The amygdala triggers a series of changes in brain chemicals and hormones and puts the body in anxiety mode, characterized by the following:

• Stress-hormone boost – the hypothalamus and pituitary glands pump out cortisol, the stress hormone (Too much cortisol short circuits the cells in the hippocampus making it difficult to organize the memory of a trauma or stressful experience.

• Racing heartbeat – The sympathetic nervous system responsible for heartbeat and breathing shifts into overdrive.

• FFF (Fight, Flight, Fright) - Adrenaline shoots into the muscles preparing the body to do the appropriate action.

• Digestion Shutdown – Brains stops thinking about things that bring pleasure, conserve energy otherwise wasted on digestion, hence vomiting, defecation, urination may occur.

12. What are the ways to relieve anxiety?

• Behavioral therapy – Best for phobias, obsessive-compulsive disorder. Panic disorder is to expose patients to a tiny bit of the very thing that causes them anxiety.

• Cognitive therapy – rethinking, behavior modification through proper advice.

• Antidepressants – Prozac, Paxil, Zoloft are best known among the antidepressant drugs.

The newest group is norepinephrine which control emotion and stabilize mood.

• Minor tranquilizers – examples are Xanax, Valium, Klonopin serve temporary relief and therapy under doctor’s supervision.

• Exercise – talk therapy, simple exercise (at least 30 minutes), brisk walk Exercise releases natural opiates called endorphins,

• Lifestyle Changes – cut back or eliminate the use of sugar, caffeine, alcohol, and recreational drugs

• Alternative treatments – yoga, meditation, guided imagery, aromatherapy, massage

Audience Participation

• Cite an anxiety episode you actually experience.

• How did you overcome your anxiety.

References: The Science of Anxiety Time July 8, 2002
Lost Lives Time November 10, 2003
What Scares you? Phobias Time April 2, 2001

Part 2: Stop Before You Reach DEAD END!  

Do you see a face at the center of this painting? If yes, stop with what you are doing and read this article.

The road is fine all right and you are running fast because you want to reach your destination – or your goal. Then all of a sudden a signboard appears. Dead End.

Painting in acrylic by AVRotor acrylic, 1994

Shocking. You are in your prime. You have a happy family, good breeding, good company, and bright future. Good life – oh, the malls, Internet, travel, medals, rubbing elbows with personalities, greetings everywhere you go.

What happened? Were you moving too fast in life because you want more? More money, honor, acquaintances, possessions, or just keeping up ahead? Or you are trying to escape? Escape from criticism, inadequacies? For not being able to cope up with the Joneses? Escape from tradition, because everything today must be modern? Escape from rural life because in the urban lies the golden city?

POM (Peace of Mind) Square

Of course you do not think of these while you are running. Then you start to walk, exhausted, and you look around. You are back to your senses. You realized you have not been a “square”. Your sense of dimension is lost and you did not care what shape you are in. Because you lost the integrated balance of the four pillars of a happy, fulfilled life.

• Intellectual/mental
• Spiritual
• Physical
• Psychological/Emotional

1. Physical – It's your health, body physiology, the machine and prime mover that keeps you going biologically. When was the last time you visited your doctor? Is your food balance? Maybe you are not getting enough exercise. Driving for hours does not constitute an exercise. Are you having difficulty to sleep, even only to rest? Imagine a machine breaking down because of strain.

2. Intellectual or mental – Your thoughts are assigned to two parts – the left for reasoning and the right for creativity. Either you have overtaxed the whole of your brain, or you failed to balance the two hemispheres. That's why it is important to attend to hobbies like painting and music (right brain) to balance the left which you use more often in office and home. As the body is subject to fatigue, so with the brain. A fatigued brain may lead to psychiatric condition that can not be relieved as easy as that of the body. Quite often extreme conditions are irreversible.

3. Psychological or emotional – Our psyche absorbs the impact of stress coming from the body and the mind – and from our spiritual being. Like a funnel the residues are accumulated here. Imagine a man staring at an artificial waterfall at a New York park. How many promising people are ruined by emotional problems? Jungian psychology explains that as we continue to repress our thoughts, our feelings, particularly those that are negative, the more we bury them deeper, storing them in our sub-conscious.

It means two things. First, we thought we have eliminated them. No, they come out in our dreams, they seep out into the unconscious in trickles that spoil many happy thoughts. Second, as we keep filling up the unconscious with more repressed thoughts, there comes a time that the tank so to speak, is likely to burst. There on a couch the potential victim, with the help of a psychiatrist, releases the pressure by withdrawing from the unconscious into the conscious chamber of the brain and flows out to his relief. Such rehabilitation requires rest and expurgation of the negative thoughts and experiences. It is only through this process that the psychiatric symptoms begin to cease.

4. Spiritual – The biblical Seventh Day is one for the spirit, a day of communication with our Creature, with Nature. It is a renewal of relationship between man and God, a re-invigoration of the soul. Emptiness can be easily felt, but quite often, it mingles with the kind of emptiness that is hard to fill. Our spiritual life suffers every time we act on something against our conscience. It becomes dull when we fail to do the things we should in accordance with our faith. I have heard of people complaining about the lack of “meaning in life.” For me, the answer lies not in our rationale thoughts, in our physical power or emotional or psychological makeup. In fact I believe that the lack of meaning is in the emptiness of the spirit. I recommend reading of A Search for Meaning by Victor Frankl, founder of logotherapy - a field of psychology which helped prisoners in German prison camps in World War II to survive.

As I continue to write this article at Room 3031 at the UST hospital (September 20, 2001) I glimpse upon a Newsweek story about 30,000 Japanese a year have been killing themselves. The title of the article is “Death by Conformity.” It is about an epidemic of young Japanese pulling back from the world."

Take the case of a 29-year old salaryman. He described how he secluded himself for three years after resigning from his company. “I didn’t even know if it was day or night,” he confessed.

Another case is about a “corporate warrior” who became a victim of economic slump affecting his company in the late 1998. He became “spiritually” weakened by an anxiety he couldn’t comprehend. This is how the report pictured the fiftyish company executive.

“At first he couldn’t sleep. Then he grew physically weak each time the train neared the station nearest his office. On several occasions he rode to the end of the line. At one point, speaking on condition that he not be identified, he went to buy a rope, then put it in the trunk of his car to be prepared for the day when he would hang himself. Fortunately the day didn’t come. A doctor helped him from overcoming his depression.”

Hikikomori Syndrome 

This malady is called in Japan hikikomori or social withdrawal, a debilitating syndrome, which affects as many as 1.2 million young people – 7 out of 10 of them are male.
Photo of a potential hikikomori victim (internet)

Symptoms include

• Agoraphobia - Fear of places and situations that might cause panic, helplessness, or embarrassment. It is common, there are200,000 to 3 million US cases per year• Paranoia -
Paranoia involves feelings of persecution and an exaggerated sense of self-importance. Paranoia occurs in many mental disorders and is rare as an isolated mental illness, persons with paranoia can usually work and function in everyday life, however, their lives may be limited and isolated.
• Aversion to sunlight
• Severe anxiety
• Antisocial
• Fear they are being watched
• Think they are ugly, they smell, etc.
• Loner
• Uncommunicative
• Sullen, sometimes even violent

“Getting out may be the only cure from the blues.” - Takemi Matsuda, “Time out Stay in” Newsweek August 20, 2001

“People who suffer from hikikomori are at the top of a mountain – and that mountain is all of Japan’s problems."

Hikikomori begins with adolescent trauma that causes the afflicted to “stop growing up.” It is a social phenomenon, not a specific mental-health disorder. A certain Tamaki Saito who runs an outpatient program at Sasaki Hospital in Chiba, blames the problem on Japan’s efficiency first value system, which promotes conformity among workers, and students. So with the company workers who are expected to render efficient performance as Japanese culture has built standards of performance in return to security and compensation.

Hope for the Flowers

Hope for the Flowers has helped people gain the courage to leave jobs, change their lives and explore their love for another human being.

Anyone who has read Trina Paulus’ illustrated book, Hope for the Flowers*, is certainly convinced that there is “nothing out there at the top.”

The story goes like this. Caterpillars scrambled up to the top, each outsmarting and climbing over one another, and forming a living pyramid. Each caterpillar wanted to be at the top.

Imagine a whole mass of living, dynamic bodies, writhing, shaking, in the like of the Tower of Babel. At the top each one thought must be beautiful. To be at the top is honor. The higher one goes the more the risk to slide and fall off to its death.

“But there is nothing up there.” The caterpillar, which had reached the top, said. But the others did not believe. A female caterpillar gave up and turned into a pupa hanging peacefully on a branch of a tree. Then one morning she metamorphosed into a beautiful butterfly. Meantime her colleague continued on to struggle to the top of the pyramid.

She fluttered her wings in the morning sunshine and whispered something to someone she had met earlier. And the latter withdrew from the crowd, and followed the same thing she did. Then one morning he too, metamorphosed into a beautiful butterfly, while his colleagues were still struggling in the pyramid.

And the two butterflies lived happily ever after.

People are like caterpillars. They are gregarious. They form columns and pyramids. They step on one another just to be at the top. Many are frustrated, many get injured or even killed. Irony is that there is nothing at the top but space far from heaven. ~

* Hope for the Flowers is an allegorical novel by Trina Paulus. It was first published in 1972 and reflects the idealism of the counterculture of the period.

Posted by Abe V. Rotor at 5:37 AM 


1 comment:
Graciel Pogi said...

I always feel anxious about the things that I do in school, because I am not really good at everything especially when talking about school stuffs. I am always anxious every recitation, report, even when asking something to professors. It is very distressing that until now, I cannot overcome those anxieties. I still lack self esteem, but I’m won’t stop trying until I overcome this.