Is Seasonal Affective Disorder Different From Depression?

Fall season brings some wonderful treats–apples, cider donuts, colorful foliage, football as well as shorter days, longer nights, and the advent of winter. During this time some might crave more carbs, feel fatigue, and sleep more than usual. These symptoms can also mean seasonal affective disorder or SAD.

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SAD is both similar to and different from other forms of depression. Many patients experience marked seasonal changes in the winter months. Although SAD symptoms are similar to depression, people experiencing these symptoms respond better and quicker to treatment then the ones suffering from Major Depressive Disorder (MDD).

What are the symptoms of seasonal affective disorder?

People who suffer from SAD have many of the common signs of depression, including:

  • Sadness

  • Anxiety

  • Irritability

  • Loss of interest in usual activities

  • Withdrawal from social activities

  • Inability to concentrate

  • Extreme fatigue and lack of energy

  • A “leaden” sensation in the limbs

  • Increased need for sleep

  • Craving for carbohydrates, and weight gain.

Symptoms of summer SAD include:

  • Weight loss

  • Agitation and restlessness

  • Trouble sleeping

  • Decreased appetite

What causes seasonal affective disorder?

The exact cause of this condition is not known, but evidence strongly suggests that, for those who are vulnerable to it, SAD is set off by changes in the availability of sunlight. One theory is that with less exposure to sunlight, the internal biological clock that regulates mood, sleep, and hormones is shifted. Exposure to light may reset the biological clock.

Another theory is that brain chemicals (neurotransmitters, such as serotonin) that transmit information between nerves may be changed in people with SAD. It is believed that exposure to light can correct these imbalances.

Melatonin, a chemical known to affect sleep patterns, may also play a role in seasonal affective disorder. Some have suggested that the lack of sunlight stimulates the production of melatonin in some individuals. This may be a factor in the symptoms of sluggishness and sleepiness. The lack of daylight can suppress Melatonin, a hormone made in the pineal gland that regulates sleep-wake cycles, therefore people may experience more of the symptoms above.

How to treat SAD?

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Exposing oneself to extremely bright light of 10,000 lux for 20 to 30 minutes a day has proven effective in relieving the symptoms of SAD. You want to get a safe, reliable device that has been clinically tested and validated. Though the light is intense, you don’t look directly at it. It is great to read by it while it is on. Research indicates people with SAD respond in days to light therapy, where non-SAD patients need psychotherapy treatment for months and at times in conjunction with antidepressants before they see results.

Additional ways to help decrease SAD are: checking for vitamin D deficiency, eating fewer carbs, managing stress, getting enough exercise, and even considering an SSRI by a psychiatrist and then tapered off as spring approaches. SAD patients can respond well to talk therapy, it helps with understanding of the condition and learning healthy coping skills to manage the symptoms.

Why is Alcohol Abuse such a Problem among young Professionals?

I work mostly with young professional who are well accomplished yet some suffer from anxiety, some have symptoms of depression, and some of them struggle in silent from alcohol abuse. These young professionals report long hours of work going at frantic pace. In addition, a competitive environment and pressure to succeed can contribute to making the job of a professional extremely stressful.

Research shows that some professionals such as lawyer and doctors struggle with depression, anxiety disorders and substance use disorders at higher rates than other professions. Despite the well-known toll that working in a high-intensity, demanding field can take, lawyers or doctors are typically unwilling to admit when they were struggling.

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The stigma and fear associated with seeking help for mental health and substance use issues are especially problematic for most well accomplished professionals such as lawyers, doctors, real-estate brokers, occupational therapist, accountants etc...

There is the tremendous fear that if anyone finds out that you have a substance abuse problem, even if it’s successfully treated, it will somehow get you fired, get you into trouble with the disciplinary board, and have your peers whispering about you around the water cooler. The fear is that somehow it may be used against you.

Young professionals struggling with their mental health or substance abuse disorders do their best to keep the conditions hidden and suffered in silence. Only when alcohol and drug use got out of control and they get caught using on the job, displayed erratic behavior, incurred substance use-related arrests, or could no longer perform their legal duties, do they come to the attention of their employer or disciplinary boards. Then, the matter either becomes grounds for these professionals being fired or subject to disciplinary action. These attitudes are starting to change. Promoting wellness at work and helping the ones struggling with substance abuse, mental health or behavioral disorders is a necessity. Acknowledging that mental health disorders and substance abuse are health issues that can be successfully treated and overcome in many cases.

By focusing on treatment and not punishment, mental health programs can allow all types of professionals to regain control over their mental health symptoms and alcohol abuse.

Sejdaras Psy.D & Associates provides treatment for young professionals by matching clients with highly skilled therapists who are experienced with diagnosing and treating a wide range of substance abuse and mental health disorders. To encourage young professionals struggling with alcoholism, drug addiction and mental health disorders to proactively seek help, we provide totally confidential assessments, referrals and ongoing support to help remain substance free.

We need to change our culture and make it cool to seek help when it’s needed. If you need to go to rehab, it doesn’t mean you’re not a fierce trial lawyer, amazing doctor, great financial advisor, or a hard working health care provider; it means you’re a fierce professional who is also courageous and smart enough to engage in appropriate self care and self compassion.

Is it Anger or Anxiety? Practical ways to deal with anxiety-driven aggression.

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 Anxiety can be a masterful imposter. It can sway away from the more typical of daily worrying, feeling on edge, to feeling irritable or even aggression. If the aggressive behavior derives from anxiety it can be treated differently instead of suggesting Anger Management treatment or blaming self or others.  Of course, that doesn’t mean that people should be getting a free pass on their disruptive behavior but anyone who is able to understand and respond to the aggressive behavior as something driven by anxiety will help to find healthier, stronger, more effective ways to respond to self, others, or the world. Once someone suffering from anxiety has a more solid understanding of why they do what they do, they will be well on their way to finding a better response.

Anxiety or Aggression?

The physiological driver of anxiety is a brain under threat – but instead of flight, it can initiates fight. It doesn’t matter that there’s nothing at all there to worry about. When the brain thinks there’s trouble, it acts as though it’s true.

Anxiety happens when a part of the brain, the amygdala, senses trouble. When it senses threat, real or imagined, it surges the body with hormones (including cortisol, the stress hormone) and adrenaline to make the body strong, fast and powerful. This is the fight or flight response and it has been keeping us alive for thousands of years. It’s what strong, healthy brains are meant to do. 

An anxious brain is a strong, healthy brain that is a little overprotective. It is more likely to sense threat and hit the panic button ‘just in case’. When this happens often, it can create ‘anxiety about the anxiety’. One of the awful things about anxiety is the way it launches without warning, and often without need, sending an unsuspecting body unnecessarily into fight or flight.

For adults with anxiety, any situation that is new, unfamiliar, difficult or stressful counts as a potential threat. The fight or flight response happens automatically and instantaneously, sending neurochemicals surging through their bodies, priming them for fight or flight. The natural end to the fight or flight response is intense physical activity. If the threat was real, they’d be fighting for their lives or running for it. When there is no need to fight or flee, there is nothing to burn up the neurochemicals and they build up, causing the physical symptoms of anxiety

Take note of when anger or aggression is running high. Is there a pattern? Does it happen more when you feel highly anxious and less resourceful on how to deal with it in a healthy and constructive way?

It is important to be open to the possibility that beneath an aggressive behavior, is an anxious feeling that is looking for security and comfort. If anxiety is at play, dealing with aggression as shameful or “bad behavior” could inflame the situation. On the other hand, dealing with it as anxiety will provide the strategies and support needed learning vital skills. 

•    Understand where anxiety comes from.

The times you get really angry are probably confusing for you. Everyone gets angry for all sorts of different reasons. Your reason might be your brain is working hard to protect you. The amygdala, the part of the brain that provided fight/flight/freeze responses thinks there might be danger, it surges your body– oxygen, hormones, and adrenaline –to deal with the danger. This could be anything that your brain thinks might hurt you or make you feel uncomfortable – new people, new places, too much noise, having to do something that feels risky. Everybody has something that makes them feel anxious

The same part of the brain also deals with your emotions. When it thinks you might be in danger, it switches on. When it’s on, your emotions will be switched on too. Sometimes they will be switched on causing you to feel like you want to burst into tears or get really angry.

There are a few things you can do to train the brain to relax and be in control of the anxiety.

•    Breathe

We all struggle with that! Breathing strong breaths is like any new skill. The more you do it, the better you’ll get. Diaphragmatic breathing, or deep breathing, is breathing that is done by contracting the diaphragm, a muscle located horizontally between the thoracic cavity and abdominal cavity. Air enters the lungs and the chest rises and the belly expands during this type of breathing.

•   Name it to tame it. 

Big emotions live in the right side of the brain. The words that make sense of those emotions live in the left. Sometimes, there is a disconnect between the two. It can happen in all of us. When there is a disconnect, there are big feelings, but they feel overwhelming and they don’t make sense. 

Think of it like this. The left part of the brain is ‘this is what’s happening’. It is the literal understanding of the world – the concrete data, the facts. The right part of the brain is ‘this is how I feel about what’s happening’. It’s a more emotional, intuitive understanding of the world. If we only had our left brain, we would have great detail (‘this happened and then this happened’), but it would be a colder, more detached way of responding. If we only had our right brain we would have a sense of how we felt about an experience, and there would be plenty of emotion, but the more rational understanding would be missing. The detail of the world is important (‘this is what happened’) but so is the bigger picture (‘this is how I feel about it’). 

A powerful way to bring calm when in the midst of a big feeling is to name the feeling. When you are in the thick of a big, angry feeling, name the feeling you see. Hearing the words that fit with the feelings will help to strengthen the connection between the right and left sides of their brain. Be patient. It won’t happen straight away, but it will make a difference. This is a powerful part of developing their emotional intelligence.

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•    Mindfulness & Self Compassion

The research on the effectiveness of mindfulness could fill its own library. Mindfulness has been proven over and over to have enormous capacity to build a strong body, mind and spirit. Building the brain against anxiety is one of its wonders.

Anxiety happens when the brain spends too much time in the future. This is where it grabs on to the ‘what ifs’. Mindfulness strengthens it to stay in the present. The more you can strengthen this skill, the stronger you will be.

Mindfulness is about stepping back and seeing thoughts and feelings come and go, without judgement, but with a relaxed mind. It has been shown to strengthen the connection between the instinctive, emotional back of the brain (the heartland of the fight or flight response) and the pre-frontal cortex (the part of the brain that soothes it back to calm). 

 

And Lastly…

Show self-compassion, focus on increasing awareness & be kind to yourself. As Christopher Germer has said “Self-Compassion is simply giving the same kindness to ourselves that we would give to others.”

How Does Social Anxiety Affect Your Life ?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Although individuals diagnosed with social anxiety disorder commonly report extreme shyness in childhood, it is important to note that this disorder is not simply shyness that has been inappropriately medicated.

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Social anxiety disorder can cause tremendous suffering on the lives of individuals who deal with it. Symptoms may be so extreme that they disrupt daily life and
 can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships. People with social anxiety disorder are also at an increased risk for developing major depressive disorder and alcohol use disorders. 

Despite the availability of effective treatments, fewer than 5% of people of with social anxiety disorder seek treatment in the year following initial onset and more than a third of people report symptoms for 10 or more years before seeking help. The defining feature of social anxiety is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress. Many people with social anxiety disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience full-blown attacks when confronting a feared situation. Although they recognize that their fear is excessive and unreasonable, people with social anxiety disorder often feel powerless against their anxiety.

Social anxiety disorder can be overcome, although it takes both consistency and persistence.  A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people's brains (i.e., their brain associations or neural pathways) to literally change.  The brain is continually learning, and irrational thoughts and beliefs can change as a result of this cognitive process.  

A good therapy program will supply the necessary and specific strategies as well as indicate to people how and why they need to practice, work on, and begin to accept rational thoughts, beliefs, emotions, and perceptions.

Manage Anxiety Without Drugs

Anxiety is defined by the dual characteristics of physiologic hyperarousal and excessive emotional fear. Biofeedback has demonstrated value for hyperarousal reduction and offers a non-pharmacological approach to direct symptom reduction tailored to the individual’s psycho-physiological profile.

Heart Rate Variability (HRV) is one type of biofeedback. It uses finger or earlobe with sensors to measure the functioning of the heart by diaphragmatic breathing. Breathing activates Vagal nerve, which descends from the brain in the carotid sheath all the way to you diaphragm. The vagal nerve slows your heart rate. A stress response to anything such as a difficult conversation, traffic, or studying changes your heart rate independently of the breathing-related variation to irregular changes. In contrast, when we breathe even, natural, and smooth, you get smooth heart rate waves which are associated with health and peak performance.

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breath

Self-regulation is the primary goal of Biofeedback

When a person inhales, heart rate increases. When a person exhales, heart rate decreases. This is referred to as “heart rate variability.” Higher rate variability is associated with favorable holistic health. Clients are taught smooth diaphragmatic breathing, psychological mindfulness, and adaptive responsiveness.

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One of the main advantages of using biofeedback for anxiety is managing it without medication or its side effects. It eliminate health problems that are stress- related or that have psychosomatic components. Biofeedback teaches awareness, relaxation skills and ways to manage anxiety & recognize, reduce, and control stress responses by returning the body to a healthier physiological state.

Social Anxiety & Eating Disorders

Social Anxiety & Eating Disorders

Many individuals with eating disorders experience significant anxiety. There is a strong correlation between individuals who have pre-existing anxiety and/or depression to develop eating disorders. 

Individuals with eating disorders often report that their anxiety generally centers on fear of humiliation when in public or social situations.  They fear being judged in both body shape and size and for how and what they eat. Often, shame and self-criticism that eating disorder sufferers typically feel with respect to their own body, is projected on to other people who they infuse with the power to hurt them or make them not feel safe or valued.

Patients also feel the need to accommodate other people’s feelings at the expense of their own, not feeling that they fit in, not being able to assert their point of view, essentially not feeling comfortable in their own skin when in the company of other people.  Some patients report that these feelings and interpersonal issues are significantly reduced or disappear in the safe world and solitude with food. 

Exploring how anxiety can be focused around interpersonal and relational issues in addition to a general state of free floating (likely, biologically driven) anxiety can be extremely useful in understanding a person and assessing outcomes.

It is important for health care practitioners to help patients distinguish from where their anxiety originates and then how to treat it – what is driving the anxiety bus – free floating, indiscriminate anxiety or specifically targeted to interpersonal or psychological forces. 

If you’re someone who has some concerns regarding anxiety and eating disorders, discuss them with your provider to evaluate your symptoms and/or to get the help you need.

How to Deal with Anxiety and Relationship Problems

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There is a wealth of information about anxiety and how it impacts emotional, psychological, and physical health. Anxiety can cause the person to feel overwhelmed, panicked, and a general sense of unease. These symptoms can affect not only your well-being but it can take over many other areas of your life such as work, family members, friends, and your intimate relationship. Are you feeling stressed on your relationship or contemplating ending it? If so, anxiety may be playing a role on putting your relationship at risk.

 

1.     Anxiety destroys trust and connection

If you’re feeling overwhelmed, worried about your recent argument, or trying to “fix” things as soon as possible you might not have time to notice on what is happening in the now. The fear and worries can cause you to be less attuned to your needs and your partner’s needs. The inability to be present in the moment can muddle your insight and awareness on how to take care of yourself and the relationship. When we ruminate about problems in a state of chaos we feed the anxiety.

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Shift your focus on being instead of doing. It is difficult to listen to your thoughts & physical signs when you are not slowed down. Pause, think, and feel, instead of assuming and letting your anxious thoughts take over. Help yourself find the evidence before you jump into conclusions. Once you’re in a calmer place, you can start to share openly with your partner on what happens to you when you’re feeling worried. Be intentional about building trust and connection by reaching out to your partner: be vulnerable, help your partner understand what anxiety feels and looks like. Instead of attacking or withdrawing strive to deepen your connection with your partner.

 

2.     Anxiety fogs your brain

Asking someone to share what they are feeling in a state panic, is easier said than done. Anxious people find it extremely difficult to give themselves or partner attention or space that is needed. In the heightened state of anxiety, some might try to avoid it while others believe “fixing the problem” immediately.

Taking a short break can be beneficial for you and your relationship. Resisting your feelings can feed and intensify anxiety, therefore acknowledging them can ease some of the tension you might experience. Approach a conversation with partner with kindness, and discuss some of the thoughts or fears that drain your energy.

3. Anxiety is the enemy of self-compassion

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Because anxiety brings an overactive fear response, ruminating about it may leave you with very little time to practice self-care. Some anxiety is healthy for everyone. However, if your anxiety causes you to reject/avoid things that are beneficial for you, it can create more suffering for you and your relationship. Could it be that the anxiety is real but not true?

Quite your mind to hear your own wisdom. Anxiety rubs people of joy. Practicing being with your uncomfortable thoughts, pausing, and listening to your anxiety might be just what you need to remove those invisible chains your anxiety creates. The deepest gift we can give ourselves is the quality of non-doing presence. So…. notice your anxiety, and come back to it with a lot of kindness. Intentionally turn your attention to whatever opens your heart by looking for what you love and practice. Practice being present for yourself and your partner and then practice some more and remember- where attention goes energy flows.

How to Screen for Social Anxiety?

How to Screen for Social Anxiety?

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If you have noticed some anxiety or think you might suffer from social anxiety, but are on the fence contacting a health care professional you can use the questions below as a guidance to share the results with your provider when you're ready to get some help.

Are you bothered by the following?

An intense and persistent fear of a social situation in which people might judge you

Yes    No

Fear that you will be humiliated by your actions

Yes    No

Fear that people will notice that you are blushing, sweating, trembling, or showing other signs of anxiety

Yes    No

Knowing that your fear is excessive or unreasonable

Does a dreaded situation cause you to...?

Always feel anxious?

Yes    No

Experience a panic attack, during which you suddenly are overcome by intense fear or discomfort, including any of these symptoms:

Yes    No

Pounding heart

Yes    No

Sweating

Yes    No

Trembling or shaking

Yes    No

Chest pain

Yes    No

Nausea or abdominal discomfort

Yes    No

Feelings of unreality or being detached from yourself

Yes    No

Fear of losing control or “going crazy”

Yes    No

Fear of dying

Yes    No

Numbness or tingling sensations

Yes    No

Chills or hot flushes

Yes    No

Go to great lengths to avoid participating?

Yes    No

Social anxiety may also be connected to other diagnoses such as depression. In addition, substance abuse, in particular alcohol is used most of the time as a way to cope with social anxiety. The questions below can help distinguish between social anxiety, depression, and/or substance abuse.

Have you experienced changes in sleeping or eating habits?

Yes    No

More days than not do you feel sad or depressed?

Yes    No

Are you not interested in life?

Yes    No

Do you feel worthless or guilty?

Yes    No

During the last year, have the use of alcohol or drugs been helpful to cope with?

Yes    No

Has your use placed you in a dangerous situation, such as driving a car under the influence?

Yes    No

Have you gotten arrested?

Yes    No

Do you continue despite problems you might have because of the use? 

If you answer yest to most of these questions, it is highly recommended you reach out to a health care provider to get treatment for a more fulfilling life. 

 

Anxiety & Sleep Problems

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Is Anxiety Interfering With Your Sleep?

 

Over 18% of nation’s population experience anxiety disorders, and the majority of them have sleep –related problems. The lack of sleep can increase not only anxiety but other mood related issues such as depression, anger, irritability, and/or muscle pain. If anxiety or disrupted sleep crops up occasionally, these simple strategies may help you relax your body and mind so you can get the sleep that you need.

Sleep Hygiene

A healthy bedtime routine allows your body and mind to slow down. Take at least half an hour before bed to play quiet music, take a bath, or read a book. Deem the lights one hour before you go to sleep; Avoid electronics an hour or more before your sleep; Spend a few minutes before bed using diaphragmatic breathing to help relax.

Exercise

Regular exercisers fall asleep faster and sleep more soundly. In fact, even a single moderate-intensity workout can improve sleep among people with chronic anxiety. Here are some recommendations for the ones who don’t enjoy going to the gym: Stretch often, simple yoga exercises throughout the day will do the trick; Go for a walk; Be active at home by using an indoor trampoline

Steer clear of stressful activities before bed.

Leave the bill paying for earlier in the day, stay away from heated social media exchanges, and skip the evening news.

Put your to-dos on paper.

Instead of letting your brain swirl with all the things that you don’t want to forget to take care of, write them down so your brain can relax and let go.

It’s not always easy to tell if your symptoms are an indication of an anxiety disorder or just the normal amount of worry. Certain situations, especially the ones we don’t like, can cause our anxiety symptoms to spike. Moving, changes in relationships, financial troubles, and speaking in public can all trigger these spikes. If your anxiety has spiked out of control, or has become debilitating to you by interfering with your daily life, it might be time to seek professional help.

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What Are Social Anxiety Symptoms?

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Some might dread meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store, others might avoid only some of the scenarios above. Most people with social anxiety do not talk about it and might not understand why they feel fine in certain situations but not in others. Some might feel physical symptoms of anxiety in situations such as giving a speech, playing a sports game, or dancing or playing a musical instrument on stage.

Here are some of the symptoms of social anxiety when performing in front of others:

  • Extreme fear of other people judging them

  • Staying away from places where there are other people they might feel judged by

  • Blush, sweat, tremble, or feel a rapid heart rate

  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice

  • Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they wish they could

  • Be very self-conscious in front of other people and feel embarrassed and awkward

The defining feature of social anxiety disorder is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. Because people with social anxiety disorder may worry about acting or appearing visibly anxious, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress.

Although they recognize that their fear is excessive and unreasonable, they often feel powerless against their anxiety. The first step to effective treatment is to have a diagnosis made, usually by a mental health specialist. Without treatment, social anxiety disorder can prevent a person from reaching their full potential.