Saturday, September 29, 2012

Social Anxiety....Does It Happen to You?

Social Anxiety
Social Anxiety (Photo credit: HckySo)
Anxiety in and around social situations can be characterized as Social Phobia, Social Anxiety Disorder, Performance Anxiety and in some cases Generalized Anxiety depending on the level of stress it produces.  According to the DSM IV-TR, Social Phobia is a "marked and persistent fear of social or performance situations in which embarrassment may occur".  In these situations, an immediate sense of anxiety comes up and may lead into a panic attack.  Adults seem to understand that their response to these situations is unreasonable, however children may not.  Many times, the person with Social Phobia will avoid situations that cause them the anxiety, or if they can't get out of the situation it is endured with much dread.  Individuals should only be diagnosed with Social Phobia if the fear and avoidance significantly interferes with their daily life. 

English: An anxious person
English: An anxious person (Photo credit: Wikipedia)

Social Phobia most often begins in the mid-teens, "sometimes emergying out of a childhood history of social inhibition or shyness", according to the DSM-IV-TR.  How long it lasts is dependent on the individual, what interventions they may use and may come and go with the stresses and demands of life.  Most commonly, it is a life long circumstance. 

Social Anxiety can also create other conditions that interfere with personal self worth and value.  If a child has been in situations where chronic rejection by their peers has been a source of anxiety, their view of themselves can become damaged.  This creates great anxiety as they are injected into social situations or performance situations.  In dysfunctional families where parents have not mirrored acceptance and approval, low self-esteem develops and accompanies the child into social situations outside the home where they wonder if they are good enough or will be approved of or accepted.
English: Robert Plutchik's Wheel of Emotions
English: Robert Plutchik's Wheel of Emotions (Photo credit: Wikipedia)
Generalized Anxiety is more pervasive,  characterized when a person has anxiety most all the time, regardless of the specific situations they find themselves in.  Social Phobia is very much targeted to social situations and performance situations.  It is worth noting children with Separation Anxiety are usually comfortable in their own homes with people they know, where children with Social Phobia display anxiety even when the social situations they fear occur at home.

For most of us, Social Anxiety can be tied to a lack of social skills that are easily learned and implemented with practice.  For example, how many of you have felt a twinge of fear when you go into a situation where you don't know the other people there?  How do you feel when going to a high school reunion, especially the 10th reunion?  If you have ever been a part of a sales team or an MLM organization, how do you feel when asked to make "cold calls"?  All these situations can make us question our worth.  We ask ourselves, "what will I say, what do I say after I say hello, how do I get people to talk to me, what if I end up alone in the corner...that would be embarrassing, what if I do something stupid?"  These are very common fears to individuals who suffer from Social Anxiety.  Low self esteem can be a part of these concerns, but for those who just don't have good social skills, a few good conversation starters in the social tool bag can alleviate a lot of stress.

Here is a list of a few questions that you can learn.  When social situations come your way, all you need to do is decide which of these questions would be appropriate to the situation and you are on your way:

Conversation starters with someone you don't know:
  • How was your day?
  • What do you do for a living? followed by What do you like about your job?
  • Do you have a family?
  • Where do you live? followed by What do you like best about that area?
  • That's a beautiful (necklace, pair of shoes, tie, dress, suit etc.).  Where did you get it?
It is always best to ask "open-ended" questions.  These are questions which don't require a yes or no answer.  Yes and no answers bring conversations to a brisk halt and then require you to ask another question in order to get the conversation going again.  That can be one of your sources of stress.  It is also good to know that in natural conversation, the conversation will lag after about seven sentences so knowing that, you can be prepared with another question.

Remember, you are not interrogating the other person, but simply looking for things to talk about and trying to get to know them better.  Leave room for the other person to respond. When they do, listen to what they are saying.  In their conversation you will find other things to talk about.  Conversations are like ripples in a pond.  The more you converse, the more you learn about each other, and the more fodder for conversation you have to choose from. 

Here are other common questions that you can ask, once the conversation gets going:
  • Where did you grow up?
  • Do you have any brothers or sisters?
  • What do you like to do to relax?
  • Do you like sports?
  • Who is your favorite athlete?
  • Do you like to travel?
  • What was your worst vacation experience?
  • What is your favorite food?
  • What is your favorite TV show?
  • Where do you see yourself in 5 years?
  • What is the best piece of advice you've received?
  • Do you own a pet?
  • Do you prefer cats or dogs?  Why?
  • Do you like to live in the city or the country?
  • Tell me about your first car.
  • If you could have any super power, what would it be?
 In closing, it would be good to note some common mistakes that people make in conversations:
  1. Don't be rude.  Good manners are a must no matter what social situation we might find ourselves in.  Please, thank you and excuse me, go a long way in keeping a person interested in social exchanges with you.
  2. Listen.  Actually listen to what the other person is saying.  Sometimes it is tempting to think about how we are going to respond, but that often distracts us from what the person is saying.  Listening to the other person makes them feel valued in the conversation.
  3. Be sure not to monopolize the conversation.  Conversations are two-way streets. 
  4. Keep competition out of the conversation.  When you first meet someone, this is not the time to let them know you are an expert on their lives or their favorite topics.  Conversations can lead to friendships and virtually no one wants to be in a relationship with a know-it-all.
  5. Stand a comfortable distance from the person so as not to invade their personal space.  Strangers standing to close to us results in anxiety so it is always good to notice the adjustments that others are making in their physical presence when we are conversing with them. 
  6. Face the person you are having a conversation with and look them in the eye, most of the time.  Sometimes people are uncomfortable with eye contact, so look away from time to time when you are speaking, but always come back to looking at the person when they are speaking.  It shows them that you are interested in what they are saying.
  7. Don't be negative or engage in gossip about someone else.  Negativity can shut down a conversation very quickly.  Keep your conversation upbeat, positive and if possible, humorous. 
  8. Humor - the rule of thumb is if people don't laugh, its probably not funny.  Negative or self-depricating humor is often a turn off and makes others uncomfortable.
  9. Let other people have their opinions.  When getting to know another person, it is not the time to correct their beliefs or perceptions.
  10. Talk with people, not at them.  If people feel they are just your audience, they will leave the conversation quickly. 
  11. Include facial expressions and acknowledgments in your conversation.  Smile at the person when they are talking.  Use "ah-ha", "interesting", "I didn't know that" or just simply nod your head in agreement.  These types of acknowledgments let the other person know you are engaged in the conversation and listening to what they are saying.
  12. Don't interrupt or cut the person you are speaking with off.  We all get excited when we are speaking with someone who shares our views or that we strongly agree with or disagree with.  However, interrupting is an invalidating behavior and says to the other person that we only care about what we are saying rather than what they are saying. 
Knowing these simple social skills as well as having a few good questions on hand to keep the conversation going will soon allow you to be a whiz in social situations.  In order to perfect your skills, practice on family and friends.  Sometimes it helps to let them know that you are trying to add a few new tools to your social tool belt.  That way if you seem different, they will be in on what you are trying to achieve.  However, that is up to you.  The goal is to have fun!

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Saturday, September 22, 2012

De-Stress By Getting Practical

Day 77 - NaNoWriMo Day 16
Day 77 - NaNoWriMo Day 16 (Photo credit: Sashala)
Although a certain amount of stress in our lives can be helpful, chronic stress is detrimental to our health and our emotional well being.  As stress builds, once it reaches a certain level it can turn into anxiety disorders, which as I mentioned last week, are the number one mental health issue in our population. 

I thought that this week I might bring up some easy and practical things that can de-stress our daily lives.  Besides being busy, and looking to reduce the major stress producing activities from the daily routine, there are other, simple things that can be done.

  1. Get up 15 minutes earlier in the morning.  Having an extra 15 minutes can take the rush out of getting ready and set the tone of your day to a more calm pace.  Going a bit further, getting things ready the night before can also give us more time in the morning.  If the family eats breakfast together, setting the table the night before could shave a few minutes off the daily routine.  Making lunch and setting out your clothes the night before can also be a de-stressor.
  2. Make duplicates of all your keys.  If you happen to need a spare set, you can rest assured that with a quick phone call, you can be back in your car or in your home within minutes.  If you want to set a spare set of keys outside there are key safes that can be mounted to your door frame or you can bury a spare set of keys somewhere in your garden.  Although tempting, it isn't the safest thing to put spare keys somewhere on the outside of your car or in a "rock" in the garden.  Most criminals know all the places to look.
  3. Do NOTHING, which after being done, leads you to tell a lie.  Having to keep track of things you have said which are not true creates an undue amount of stress.  It is much easier to remember the truth.
  4. If you have clothes that don't fit, either get new ones or have them fixed.  There are few things that create stress over long periods of time than wearing clothing or shoes that don't fit right.
  5. Take stock of anything in your life that might be a consistent aggrivation.  Windshield wipers, stacks of laundry that need to be done, doors that catch and don't work smoothly, appliances that don't work right etc.  Get these things fixed or purchase new ones!
  6. Plan ahead - don't wait until you are down to your last egg, your last drop of shampoo, or your last gallon of gas before you replenish your supply.  Doing that creates stress. 
  7. Live in the moment.  When you are doing a task, think about what you are doing rather than doing the task and then thinking about the next thing.  If you are wholly present with the people you are with, that not only is a more calming strategy, it also improves relationships.
  8. Take time every day for yourself.  Make sure you have lunch, rather than working through.  Take some time to have peace and quiet, pray or spend time doing things that you enjoy.
  9. Every day, perform a random act of kindness.
  10. Take a bath.  The warm water can be a source of relaxation.
  11. When feeling stressed, most people tend to breathe in short, shallow breathes.  When you breathe like this, stale air is not expelled, oxidation of the tissues is incomplete and muscle tension frequently results.  Check your breathing throughout the day and before, during and after high-pressure situations.  If you find your stomach muscles are knotted and your breathing is shallow, relax all your muscles and take several, deep, slow breaths.
  12. Say NO.  If you don't have time or if you are uninterested in a project, just say no.
  13. Schedule a realistic day.  Avoid the tendency to schedule back-to-back appointments; allow time between appointments for a breathing spell. 
  14. Schedule unpleasant tasks for early in the day.  Get them done and the rest of the day will be more peaceful.
  15. Ask for help when you need it, delegate when you can.  As my mother used to say, many hands make light work.
  16. Stop being late!  Allow 15 minutes of extra time to get to your appointments.  You will find it will be less stressful and it is very considerate of the person you have scheduled the appointment with.
  17. Practice good self care.  Take vacations...if you can get away once a quarter that would be optimum.  Do something different on your weekends than what you normally do during the week.  The change of pace helps prevent burnout.  Preserve at least one day of rest during the week.  Your body needs the down time to recover.
  18. Don't take your iPad to bed.  Computer screens are stimulating, stimulation makes for problems in getting and staying asleep.  Lack of sleep creates stress.
  19. Take stock of any stimulants you are ingesting and eliminate or restrict them. 
  20. If you are worrying about something, take steps to solve the problem.  Being in a chronic state of worry adds to the stress load.  If you are procrastinating about something, get it done.  Procrastination is stressful.
If you will take some time to assess where the stress is coming from in your life and take steps to make some simple changes, you may find yourself in a better place. 
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Saturday, September 15, 2012

Anxiety and You

Anxiety disorders are now the most common mental health problem in the US. They affect 18% of the population according to the Anxiety and Depression Association of America.  Any of us who know more than a half dozen people can attest to that.  18% of the population means roughly 1 out of every 5 people is an anxiety sufferer.
These disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events. Many people have never suffered from anxiety until they go through a severe loss, a traumatic event or something big that is out of their control.  In my opinion, anxiety comes from the conscious understanding that we are not as safe, in control or invincible as we thought we were.  These experiences are different for each person, but the idea of being unsafe for one reason or another is difficult for most people to live with.
Being very treatable, the difficulty is finding where the anxiety is coming from.  We often look for life events or individual circumstances to give us a clue.  However, understanding anxiety, it is hard to determine which comes first, the chicken or the egg; life events or brain chemistry. Life events can have a significant effect on emotions, which in turn can change brain chemistry after long periods of time. Chronic life events like abuse, thoughts of low self worth or low self esteem can also have an effect on how we think.   Emotions are constructed from brain chemistry and when certain brain chemicals show up in significant amounts in the system, the body will adapt by creating more receptor sites for that chemistry. It is the same adaptation that happens with substance addiction. When looking at it from that context, we can say that we become "addicted" to our brain chemistry; addicted to anger, anxiety, depression etc.

Our brain chemistry, or neurotransmitter function significantly affects us over all. For example, low levels of Dopamine can result in feeling more cravings. Low levels of Norepinephrine can result in a lack of energy, lack of focus and lack of motivation. Anxiety can be the result of high levels of the same neurotransmitter, or high levels of Glutamate, PEA, GABA, Glycine or Taurine. Severe anxiety can also be the result of low levels of Taurine so you can see how changes in our brain chemistry can affect us negatively. When our chemistry is out of balance, it will then be difficult to be positive or calm. It can also affect our sleep, which then can affect short term memory, concentration and even can be a factor in weight gain.

Some of our neuro-transmitters stimulate and some calm the brain and the body, so it is understandable that a good balance between them will be beneficial in maintaining stability in our emotional life.

Often, clients tell me that it is just easier to ignore the emotions that remind them of difficult times in their lives. These emotions are unpleasant and often disrupt the feeling of "normal" that is more desirable. Although this may be a good short term strategy, emotions don't go away. That chemistry remains in the body and can be a source of disease and discontent in our lives. Dr. A.F Beddoe states that 80% of all disease begins with unresolved emotion.
Scripture says quite a bit about how to deal with our bodies when it comes to anxiety and stress.  Just to mention a few verses:  Ephesians 4:26 says, "In your anger do not sin": Do not let the sun go down while you are still angry,".  Could it be that in the context of health, this means in some form we are sinning against ourselves?  Anger let go without resolution can cause long term damage to our mental health and our physical bodies.   
Philippians 4:8 comes at it from the opposite perspective, "Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable--if anything is excellent or praiseworthy--think about such things."  Developing these kinds of thoughts in our lives on a consistent basis has the effect of keeping us in good mental health.  If we cultivate thoughts that have peace and calm as a basis, we will also be peaceful and calm.  This attitude can help keep our neural net in good shape.  Gratefulness and thankfulness are also positive attitudes to cultivate in our lives.  They

Dealing with our emotional life daily is helpful as a wellness strategy. Getting enough rest, working through traumatic experiences, prac-ticing prayer or meditation, practicing forgiveness and developing an attitude of gratefulness all help stabilize our emotional life. Although medications have their place in treatment for anxiety, more natural approaches are recommended to start. Good emotional hygiene is something to practice daily.

Natural Remedies for Anxiety

One of the most effective treatments for anxiety is deep breathing or square breathing techniques. Although it sounds too simple to be true, breathing in a deep, slow measured way does affect our heart rhythm which then sends a message to the brain and the rest of the body to slow down; become more relaxed.

Square breathing is accomplished by breathing in, holding, breathing out, and holding to a count of 3, 4 or 5 depending on how deeply you can breathe at the time. If that is too difficult, just breathing in slowly and deeply, then breathing out slowly over a period of 5+ minutes will help as well. Shallow and rapid breathing exaserbates the anxiety and will lead into a panic attack.

Another technique is to think of something calming. As part of a prescribed treatment, counselors help their clients to develop a memory or a picture in their minds that is very calming and relaxing. When faced with anxiety, this "mini mental vacation" can distract enough to be able to help the person calm down and remain in a relaxed state.

Meditation and/or prayer can also be a most effective way for the person to experience a sense of peace and calm. Practicing this for 15-20 minutes a day will help the mind and body to become more familiar with the state of calm that is desired. This practice can enhance the production of neuro-transmitters that are beneficial to the calm state and over time, bring us back into balance.

EMDR therapy is a trauma therapy which can help a person process through the traumatic memory and resolve the brain chemistry which gets triggered and dumped into the system, causing an anxiety reaction. It works in conjunction with the body's own processing system, rapid eye movement. Simply put, REM sleep is when we process through our day. Our emotions and things that are disturbing to us are brought up and resolved during this stage of sleep.

If traumatic events cannot be processed, the chemistry remains intact and becomes triggered through events, sensations, people, circumstances or any reminder of the event. EMDR allows that chemistry to process and thus takes the emotional charge off the memories that are disturbing to us.

EMDR also helps to change belief systems. Many of us have limiting beliefs that we just can't seem to get beyond. This therapy has proven beneficial when individuals are trying to improve their outlook on life or just change some long held beliefs that seem to hold them hostage.

Milk peptides have been found to be a very effective deterent to anxiety conditions. The study was conducted for 30 consecutive days showing reduced stress reactivity. This was assessed by monitoring a subject's
blood pressure response to a mental stress test. Results similar to the study have been seen at LWCC. Additionally, milk peptides do not compress the range of emotion as some drugs can.

Other articles of interest:

Making a Case for Peace
Being Calm Has Its Advantages
Emotions, DNA and Physical Well Being

Related Websites

Living Well Counseling and Consulting
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