Anxiety

From Maesk Counseling in Fort Lauderdale - Nervousness

This is no way, shape or form a political post. This was posted today by Preet Bharara, former US District Attorney in NY.

I am re-posting this here because it is a brilliant essay on the great equalizer - nervousness - which bonds us in the human condition. Enjoy the read!

Dear Reader,


Early Monday evening I was sitting in the back seat of an immaculate Cadillac sedan, storm clouds overhead, crossing Manhattan at 53rd Street in the middle of rush hour. I was headed to the Ed Sullivan Theater, at a creeping pace. That’s where the Beatles on February 9, 1964, made their American debut. Countless other artists, from Eminem to the Rolling Stones, have played there. These days the theater is home to The Late Show with Stephen Colbert. I was on my way to that storied site because, for the first time, I was appearing as a guest on Colbert’s show to talk about current events and my book.

I had been invited to be on before but had never accepted. One time was right after I was fired by the President, an invitation I declined because it seemed that my first television interview post-termination should not be on a late-night comedy program.

As I sat in the car, now inching along at 53rd and Fifth, the network’s driver looked in his rear-view mirror and spoke to me for the first time. “Nervous?”

“Yes, I am,” I said.

He appeared startled, and I was not clear if he was surprised that I was nervous or surprised that I had admitted it. Probably a bit of both. Then he said, “Didn’t you used to prosecute mobsters?”

I smiled and said, “Yes, I did.” And that had not made me nervous. So was Stephen Colbert more scary than the Gambino crime family? In a way, yes, though it may sound preposterous to say so. Prosecuting mobsters had been my job; it was second nature; it was eminently in my domain and wheelhouse. Appearing on a late-night talk show was not.

But what on earth was I nervous about? Was Stephen Colbert going to stump me with a question about Constitutional law? No. The Mueller report? No. Was he going to render me speechless or tongue-tied over a question about my book? No. Was TV scary? No. I have done many, many television interviews. One of my actual jobs is Senior Legal Analyst for CNN.

And yet, there I was, nervous. And a bit uneasy. I’ve been a fan and admirer of Colbert for years, dating back to his bits on The Daily Show with Jon Stewart. Maybe that was a part of it, but more than that, with Colbert, there just seemed a special pressure to be witty and clever. Also pithy. The interview would be just a few minutes. And the whole thing is a bit unpredictable, with a boisterous live audience.

It turns out that even a seasoned prosecutor and podcast host can worry about appearing tedious or lawyerly or dull. About flubbing a question in front of a late-night audience with a particular expectation and sensibility. Up until the moment that Colbert came to shake my hand and welcome me backstage and even as I strolled out onto the stage, I had a case of the nerves. If I could confess that to my driver, I can confess it to you.

I am not sure how well the interview turned out, and I am not fishing for compliments or approval. My family thought it went great, for what it’s worth. What I do know is the following:

  • Once I was in my seat, you wouldn’t have guessed there was a single butterfly in my stomach that day. My gaze and voice and body language were all steady. I may even have looked relaxed, though I was far from it.

  • Everyone gets nervous, especially the first time doing something new. Everyone. If you meet people who claim otherwise, they are lying to you.

  • It is important to be able to control your nerves and conceal your sweaty palms to get the job done, whatever that job may be.

Why am I telling you all this? To me all of this seems so very obvious, but it is apparently not. My driver was surprised. But I was surprised, quite frankly, at his surprise. And so I think it’s important for people to know that, in this respect, all human beings are the same. Or at least most human beings. The ones I know, no matter how accomplished, don’t have ice water in their veins. Before my first press conference as U.S. Attorney I thought I would throw up. Same for my first opening statement. Same for my first deposition. Same for my first speech in high school. And so on.

Next week, 20 Democratic hopefuls will take center stage over two nights, in the first primary debates of the 2020 election. They are all impressive and accomplished people in their own ways. They all have the audacity to seek to be leader of the free world, commander-in-chief, holder of the nuclear codes. Many are excellent debaters and orators.

And I am willing to bet every single one of them will be nervous on debate night. How many would admit it, if asked? Would they view it as a mark of weakness? And over the next months in the campaign, how many will ever deign to admit error, offer apology, concede a gap in knowledge.

That is one thing I will be watching for – proof of life, evidence of humanity and also humility. We have had enough arrogant and unapologetic self-love at the apex of power lately.

My Best,

Preet

From Maesk Counseling in Fort Lauderdale - Anxious Depression

From Psychcentral:

Experiencing Anxious Depression

By LaRae LaBouff 
 

Depression is a part of bipolar disorder. It is, in fact, one of the poles. The question of experiencing depression is not “if” but “when.” Depression on its own is a horrible experience, but sometimes other problems pile on. More than half of people with bipolar disorder also have some form of anxiety disorder. These can include generalized anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive compulsive disorder and social anxiety. When anxiety occurs during a depressive episode of bipolar disorder it is called depression “with anxious distress.” Distress is exactly the term to describe how it feels.

When I experience anxiety, I communicate how I am feeling by comparing my mood to a pot of water. When I am feeling fine, the water is ambient temperature. The more anxiety I feel, the hotter the water becomes. Lately I’ve been sitting at a simmer with occasional panic attacks that put me into a rolling boil. This is in addition to the depressive symptoms I feel like depressed mood, loss of interest, weight gain, fatigue and feelings of hopelessness. It’s a debilitating combination.

In order to be qualified as an episode with anxious distress, you have to experience at least two of the following: 

  • Feeling keyed up or tense.
  • Feeling unusually restless. 
  • Difficulty concentrating because of worry. 
  • Fear that something awful may happen. 
  • Feeling that you might lose control yourself.

If you experience two of these symptoms, the anxious distress is considered mild. Three symptoms is moderate and four or more is moderate to severe. If physical restlessness is involved, it’s considered severe.

Having bipolar disorder with anxiety can lead to extra complications with the disorder. People who have episodes with anxious distress typically have longer episodes, don’t respond to treatment as well and have a higher suicide risk. 

Experiencing severe anxiety mingled with depression is incredibly distressing.  On the one hand my brain is telling me that all I can do is to go to bed and not do anything. On the other hand my anxiety is telling me how horrible I am for ignoring other responsibilities. The two sensations fight each other and leave me frozen, not knowing what part of my brain I should listen to. The anxiety is usually louder than the depression, but that doesn’t mean I succeed at getting out of bed. It just means I end up having a panic attack while I’m there.

I’m continuing to talk to my therapist and psychiatrist about my situation. My therapist gave me a list of ways to combat distress and my psychiatrist gave me additional medication to manage the anxiety acutely. In the meantime, I hope this is a short phase and that I will reach a level of normality soon.

From Maesk Counseling in Fort Lauderdale - Ten Gifts to Give Yourself This Year

Well, it's that time of year...a time for friends, holiday parties, good cheer and yes...sometimes more stress and anxiety.  It's important to remember that while it's important to give, it's also even more important to take care of ourselves.  Here are a few ways to do just that:

  1. Turn off the TV news for the holiday season.  Instead, light candles and put on music.
  2. Notice even the smallest of your daily accomplishments instead of what you DIDN’T get done. Keep a “success list!” 
  3. Remember that we get what we focus on in life. Focusing on good points in yourself and others will bring MORE of them.
  4. Take a “senses walk” for 20 minutes, 4 times a week. Notice the breath in your lungs, the smell of the air, the change of the seasons. Outdoor light and exercise both stimulate serotonin production, lifting mood.
  5. Take a few minutes daily to “hibernate.” Close your door, remove your shoes, dim the lights, and focus on what makes you happy.
  6. Breathe in to the slow count of four. Hold it four slow counts. Release in four slow counts. Repeat until you feel the muscles relax all over!
  7. Stay aware of your thoughts. 
  8. Don’t take on another person’s bad mood. Guard yourself, removing yourself from their company if necessary.
  9. Find freedom by letting go of criticizing and complaining about yourself or someone else.
  10.  If you need to make changes, act NOW. Don’t put off health or happiness! 

Maesk Group Counseling hopes you have a very happy Holiday Season!

From Maesk Group Counseling in Fort Lauderdale - Simple Ways to De-Stress:

It contributes to illness. It’s the major factor in back pain. In fact, it makes ANY pain worse. And it’s not always caused by bad things-it can be related to celebrations, new jobs, holidays, new babies, and many other things we would never wish away.

Yes, I’m talking about stress, or as defined by Webster’s, “a strain or pressure on the body or mind.” It’s almost always presented as a reason people finally get professional help for life issues, and I diagnose and treat it daily in my psychotherapy practice.  Stress management has become very important for most people.

The body and mind perceive any change as potential danger, and they react with heightened awareness, muscle tension, and increased cortisol production (cortisol is that nasty hormone that can increase blood pressure and blood sugar, and suppress immune response). It is essential to our overall health to learn to reduce stress responses in our body and mind. The following are some ways to do so:

Breathing

Under constant stress, our breathing becomes shallow and strained. A simple exercise is to sit back in your chair for a minute or two, close your eyes, and just focus on your breath. Breathe in deeply through your nose to the count of four, using the ticking of a clock if you have one. Hold your breath for four counts, and then SLOWLY let the air out for six beats. This deliberate focus and attention will both calm and distract your mind temporarily. 

Guided Imagery

This is an article all by itself, but basically guided imagery involves taking time to mentally “visit” your favorite relaxing memory-be it the beach, the woods, whatever brings a smile to your face- and mentally placing yourself there using all five senses. This also works with visualizing a beloved child’s face or your pet. A few minutes of visualization a day can actually increase immune response and is simple to do.

Tense/Relax (Progressive Muscle Relaxation) 

Starting at the top of your head, tense and relax the muscles of your face, neck, hands, shoulders, etc, all the way to your toes. Hold the tension to a count of four, and then let it go, moving on to the next muscle group. This puts a focus on muscles that may have been tight without your awareness.

Journaling

The benefit of scribbling down thoughts and feelings is well researched. You don’t need to watch spelling, grammar or anything else, as no one will see it. You don’t even have to “keep” a journal-just the act of writing in itself is beneficial, even if you shred it immediately after! Try completing these sentences to start:

It really bugged me today when….

If I could wave a magic wand I would change…

Then just keep writing without thought or censure.

Doing Nothing

A totally foreign concept to our goal oriented society, isn’t it? But sitting completely still in silence for a few minutes a day is a wonderful way to de-stress. As we let the mind daydream, rest and wander, we often find new solutions to our stressors. This concept is summarized by the beautiful quote: “Sitting quietly, doing nothing, spring comes, and the grass grows by itself” (Zen saying).

If these simple measures don’t ease your stress symptoms, the next step is to seek help. Maesk Group Counseling can help you resolve underlying issues contributing to the problem.  Feel free to call today to set up an appointment!

From Maesk Group Counseling in Fort Lauderdale: Emotional Support Animals

(IF YOU ARE LOOKING TO SCHEDULE AN EMOTIONAL SUPPORT ANIMAL EVALUATION, CLICK HERE)

Many people are not aware that in addition to service animals, there are "Emotional Support Animals."  According to Wikipedia, the definition is "a companion animal which provides therapeutic benefit, such as alleviating or mitigating some symptoms of the disability, to an individual with a mental or psychiatric disability."

An Emotional Support Animal can help with a variety of psychological issues, most commonly anxiety disorders.  They can provide a source of comfort and grounding.  Most typically, though not always, Emotional Support Animals are dogs or cats.

Maesk Group Counseling can provide current patients who qualify with an Emotional Support Animal certification letter.  This will allow you to take your pet on an aircraft, for example.  Keep in mind that air carriers may ask for documentation, therefore it is imperative that you have the letter with you when you travel.   With this documentation, airlines MUST allow you to keep your pet with you in the cabin.

If you would like more information, please click here or feel free to contact Maesk Group Counseling.