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Archive for the ‘Anti Depressants-Sleeping Aid’ Category

Dec
15

POWER OVER PANIC/IN SEARCH OF SELF: THE BIRTH OF THE NEW

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It is unknown and unfamiliar. The dawning sense of self is like living with a person we don’t know, living with a person whose values and needs are different. Having to welcome such a stranger into our life on such an intimate level is naturally frightening, even though the stranger is ourself.

This is one of the most confusing aspects of the working-through process. As we learn to face the attacks, the anxiety and the fear we may also have to learn to face the fear of change and the fear of the new emerging self. The carefully constructed defences of a lifetime have been torn down. Rebuilding on more solid foundations means we have to push past the new fears.

When the new fears emerge we will have already broken through many barriers and overcome many of the fears associated with the disorder. We will be able to push past these new fears also, but it must be done gently and intuitively.

The essence of who we are, the essence of our self, is intact. It has always been there and will always be there. Now we have a chance to get to know our self. Now we have the chance to develop and integrate it into our life.

The process is hard, but each step we take means we learn more about the process. In the beginning it is difficult; there is fear, there is anger, there is frustration. ‘Why do I have to go through this, why can’t I just be normal like everyone else?’ What is ‘normal’ anyway? Use the anger, the fear and frustration to push past these new fears. With each step we gain new awareness, new knowledge and increased strength.”The process becomes easier and more tolerable. This is life, this is growth, a continual evolution. Now we can work with it by letting go and flowing with it, not by trying to control it.

*104/94/8*

Dec
15

POWER OVER PANIC/IN SEARCH OF SELF: DESTRUCTION TO CONSTRUCTION

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The seemingly inherent negativity of the disorder can actually be the most positive experience of our life. How many other people are given such an opportunity! The disorder has done so much of the hard work for us. It has stripped away the image of who we thought we should be, and has returned us to the basis of who we could be.

Life isn’t just about growing up, having a career, getting married, having children and so on. These are things we do during life, but they are not life. Life is continual evolution and development.

Our need to be in control of ourselves and our environment is our unconscious effort to try to stop this change. Although there are many external changes in our life, we fight to control any internal changes and development of ourselves. We need to be in control to keep the image we have, and the image other people have, of ourselves. We haven’t been able to let our image change in case it meant we did not meet the expectations of other people. We are now paying dearly for this.

Our continual suppression of self means we have blocked the ongoing development of our self. Although we have always wanted to be able to express and develop our self, we have never been willing to take the risk. How many times have we ignored the call to self, or not heard its almost silent whisperings? This time it is not whispering. It is shouting.

Anxiety disorders are destructive. They tear away the very fabric of our whole being. They destroy our way of life. The attacks and the anxiety terrify us sometimes to the extent that normal everyday living is non-existent. Yet we do not recognise in this destruction an equally positive force. The destruction can be a positive turning point in becoming our real self.

*101/94/8*

Dec
15

ANXIETY DISORDERS/WORKING THROUGH THE RECOVERY: MAKING ALLOWANCES

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Making allowances is not giving in; it is working with the disorder. Doing nothing is giving in. In the early stages of recovery, making allowances helps us to reduce the amount of pressure we feel. Making allowances indefinitely means we are not putting ourselves under enough pressure!

Another example of an allowance is breaking down the time we know we will have to spend in any given situation. It may be a business meeting, it may be an evening with friends, it may be doing the shopping. It could be anything.

If we know something will take two hours, work with the first hour first. Don’t even think about the second hour. If it is too difficult and our anxiety level doesn’t settle down, we can leave after the first hour. Usually by the second hour we are not even aware the first hour is over, because we have become involved with what we are doing, and not with the anxiety and attacks.

In the beginning there may be times when we feel we will have to leave a situation. If it becomes too difficult to manage, then leave, not with a sense of failure, but accepting that this time it was too difficult. A sense of failure defeats us, not only in the short term but also in the long term. Accept it and let go of the worrying. There will be other times when we will be able to do it as long as we keep practising.

We become ultra-sensitive to ourselves, and tend to think other people’s reactions towards us are as intensified as our own. In fact, a situation which we consider devastating is either unnoticed by other people or is quickly forgotten by them. Don’t add unnecessary stress by worrying about what people have thought or will think. It is not important. Recovery is.

*92/94/8*

Dec
15

WHAT ABOUT COMBINING ST JOHN’S WORT WITH ALCOHOL?

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Alcohol itself often complicates the treatment of depression. Although depressed people often report a pleasant buzz after using alcohol, in my experience they often pay for this buzz heavily in the days that follow. This delayed effect is often difficult to discern. If your mood is bad to start with and it feels worse on certain days, there are any number of good reasons to explain the mood worsening. The two or three drinks you had last night or the night before are by now a distant memory and hardly seem to be likely culprits. But careful observation in many patients has shown that once the alcohol is stopped, mood control is often much smoother and better. Now, if you enjoy having several drinks of an evening I hardly expect these mild observations of mine to persuade you to stop doing so, but it’s worth thinking about it. If you’re keeping the mood log I mentioned above, you might note when you drink (including the number and type of drinks you have) and see whether you can detect an impact of the drinks on your mood over the ensuing days.

Quite apart from the potential problem of drinking alcohol if you happen to suffer from depression is the question of whether you can safely drink alcohol if you are on St John’s Wort. The answer is that there is no known negative interaction between St John’s Wort and alcohol. Even so, I always suggest that my patients go easy on the alcohol if they are on any anti-depressant (no more than one or two lagers or glasses of wine or one glass of spirits is what I usually recommend). After all, if these drugs are all working on the brain, it would be strange if they did not affect each other’s actions in one way or another.

*91/75/2*

Dec
15

ANXIETY DISORDERS/WORKING THROUGH THE RECOVERY: DAVID’S CASE

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David had been making little progress with his recovery and was becoming disillusioned with the recovery program. He was having difficulty in finding any time to himself to concentrate on his recovery. There were so many other things which needed to be done first. He had volunteered to take on extra duties at work because of staff shortages. That meant he wasn’t getting home until 7.00 p.m. Working late meant he spent less time with his children, so he did his best to make up for it on weekends. This interfered with the work he did for two service clubs in his area, but he tried to juggle his time. This in turn was complicated by the fact that his neighbours and friends were always dropping by with various requests for favours or help. On top of all this he had to stop and take time out when the anxiety and the attacks became too much. Having to find time to work on his recovery was the final straw. David was feeling quite resentful because he thought there should be some sort of recovery program which took all these demands on his time into account.

To complete our list, write down how many times we have taken time out to meditate or practise some other form of relaxation. Then estimate how much time we have put into working with our thinking. That usually gives us the complete answer.

Illness can also lower our threshold. Many people react to the additional symptoms with further anxiety and panic. We need to realise that if we are unwell, we would have these new symptoms even if we did not have the disorder. Don’t add to them. Let go of the anxiety-producing thoughts.

Remember, we mustn’t spend time and energy continually worrying about the setback and thinking we’ll never get over the disorder. We will with practice and patience.

*88/94/8*

Dec
15

POWER OVER PANIC/TAKING BACK THE POWER: COURAGE

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Some people will say they would never have the courage to let an attack or the anxiety happen, and that it is only natural to fight against it. I agree it is natural to want to fight against it, but fighting it by resisting it only makes it worse. We are all very strong people and we need to recognise this. Whether we use our strength and courage to take back the power by letting it happen, or whether we use it to hold onto our pervasive need to be in control, is a matter of choice. Choosing to use our strength and courage by letting the attack and the anxiety happen, will ultimately teach us why there is nothing to fear. Then we will have a choice in how we react to the attacks and anxiety in the future.

What did you think when you read that you need to let the attack and the symptoms of anxiety happen? Did you think ‘I can’t do that. What will happen? How can I let it happen?’ How did you respond physically? Did you feel anxious? You probably did. Most people do when they first hear this. Did the anxiety or the negative thoughts come first? It was the thoughts which came first and the symptoms which followed. Very subtle but very true.

The first time we let an attack happen there may be an increase in the intensity of the attack. This happens because we are thinking ‘what if. Go with this onrush of fear. Let this happen also. When we are able to give up the fight and give in to an attack without resisting it, it will disappear so fast it will scare us further. ‘Where is it? Where did it go?’ ‘It’ will only return if we don’t let go of our fearful thinking.

When we fight the attack it can last for over an hour. When we totally give in to it and let it happen it can disappear within thirty seconds because it is not being fuelled by our fear-provoking thoughts.

*82/94/8*

Dec
15

POWER OVER PANIC: CONTROLLING THINKING

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What if?’. How many times during the course of the disorder have we all said this in one form or another: ‘what if I have an attack?’,'what if something happens?’,'what if I make a fool of myself?’ How many times has the anxiety stopped us from doing what we have wanted to do? How many times have we spent days, weeks or months worrying about ‘what if? What if this is perpetuating the disorder? It is.

Thinking about it

We give our thoughts the power and our thoughts destroy our lives. Everyone is always telling us ‘it is mind over matter’, or ‘you are always thinking about it’ and ‘you should just stop thinking about it’. This is exactly what we have to do. We have to stop thinking about it. We have to get to the point where it is mind over matter—we don’t really mind because it doesn’t really matter. In other words, we don’t mind if we do have an attack because it doesn’t really matter.

It is difficult for most people who haven’t experienced a panic attack and/or anxiety to understand why we can’t stop thinking about it and why we can’t ‘pull ourselves together’. If it were that simple we wouldn’t have the disorder. It is no use trying to ‘think positive’, because it is extremely hard to be positive when we are living with unremitting symptoms of anxiety and ongoing attacks.

Even though we are told repeatedly that nothing is going to happen to us, it is difficult to believe when we are constantly betrayed by the attacks and anxiety. We think the next attack is going to be ‘the one’ in which our fears will be realised. We can’t just ‘not think about it’ when we live and breathe it every day. This is the problem—we live and breathe it—because we constantly think it!

*75/94/8*

Dec
15

MEDITATION FOR ANXIETY DISORDERS TREATMENT: CASE HISTORIES

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Sandra

It was Sandra’s first meditation lesson. She was feeling apprehensive. She glanced around the room and wondered if other people were feeling the same way. She closed her eyes and began to practise the meditation technique she had chosen. At first she felt self-conscious and wanted to laugh out loud. She couldn’t understand how this would help her with her anxiety and attacks. Gradually Sandra became aware of a gentle heaviness slowly moving through her body. A wave of fear went through her, but she allowed it to pass without resisting it. She felt herself drifting into deeper and deeper levels of relaxation. The voice of Sandra’s instructor, ending the meditation session, broke into the silent depths of her meditation. Slowly Sandra opened her eyes. She had done it! She was able to meditate.

Philip

Deciding to find time to meditate can be a problem for many people, of whom Philip was one. Philip had been practising meditation on and off for several months. He had become aware that he always had a bad day if he didn’t meditate the night before, but wished there was an easier way to control his anxiety. He ‘didn’t have time’ and it was such an effort to try to make time. He felt he would just have to put up with the anxiety until a ‘real’ cure was found.

Joanne

Some people experience symptoms similar to those of panic attacks in meditation. Joanne did, while she was in the deeper stages of meditation. Instead of reacting with fear, Joanne was able to let them happen and they went as quickly as they came. This gave Joanne the courage to let them happen during the day, when she wasn’t meditating. Again, they went as quickly as they came. Joanne had found the key to her recovery.

*73/9/48*

Dec
15

SEVERE DEPRESSION NEEDS URGENT MEDICAL ATTENTION

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The voice on my answering machine says, T am calling to cancel my appointment for tomorrow. I am just too upset to come in and talk about it.’ This is the paradox of severe depression. It is a downward spiral. You feel so bad you have no wish to seek assistance nor any hope that it will help. You become more isolated and depressed. Work and relationships suffer, compounding the problem, and so it goes. You can be helped but you have to get to the doctor if this is to happen. And sometimes, if you can’t manage to do so yourself, a loved one or friend must take you there. Often this takes relatively little work on the friend’s part, but what a difference it can make!

Someone rings me to ask me to ask to see his friend, who is very depressed and needs help immediately. I am closed to new referrals, I say, but something in the friend’s voice changes my mind. If someone has a friend who cares so much for him, somehow that makes me care more too. I become involved, recruited to be a member of the team and help the friend out of his depression. Two months later the friend is completely well (on Lustral, incidentally, not St John’s Wort. It was too acute and serious to warrant my trying the herbal anti-depressant, though, in future, as we learn more about the herb it may become a first-line treatment even for more serious depression). Serious depression can cost a person his or her life. It can wreak havoc with relationships and jobs. It is a medical emergency – and it is treatable. So it is clearly a reason to seek out medical help without delay. And if you have a friend or loved one who is severely depressed, do go the extra mile or two to connect him or her with a good doctor. It is really worth the trouble and effort to do so.

*61/75/2*

Dec
15

A PRACTICAL GUIDE TO USING ST JOHN’S WORT: MONITORING YOUR PROGRESS

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How can you monitor your progress on St John’s Wort? The answer to this might seem obvious. Surely the medication either works or it doesn’t. What is there to monitor, you might ask. Well, it is not always so clear-cut when a problem is relatively subtle to start with or when the response is modest or partial. I always find it useful to keep an eye on what are known as the target symptoms – those presenting problems that are part of the reason why someone is seeking help in the first place. We measure whether an anti-depressant is working or not by focusing on changes in the target symptoms. In the case of someone with mild symptoms of depression or stress, such target symptoms might be lack of one’s usual enjoyment or enthusiasm for life, decreased energy, anxiety or sleep difficulties. It is worth listing these target symptoms and observing each week whether you can observe any improvement in them.

I have been impressed with the highly variable time course of response to St John’s Wort. Some people report feeling better within days of beginning the herbal remedy, whereas for others the response is far slower and more subtle. A proper trial takes at least five to six weeks. If you are still feeling down in the dumps or overstressed at that point, I suggest that you take some further step, such as consulting a GP or therapist. If you are feeling better and are not suffering any significant side-effects, you may wish to stay on the St John’s Wort regimen for a further three months before thinking of tapering it and determining whether you can maintain the gains without any further help from the herbal remedy. If you experience unacceptable side-effects, feel free to lower the dosage and see whether you still feel better. You can always raise it again later if you need to.

*47/75/2*