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TREATMENT OF STRESS BREAKDOWN: RELAXATION TECHNIQUES, BIOFEEDBACK

admin — Thu, 21 Apr 2011 11:24:03 +0000

Much of the literature available on stress symptoms today seems to be concerned with managing the anxiety from a too-busy lifestyle, and often contains advice about relaxation techniques, physical exercise and biofeedback techniques to deal with muscle tension.While I am in full agreement with people who point out how generally unfit and unhealthy we sedentary, city dwellers are, and how in need we are of more physical exercise, I do not agree with the notion that physical exercise, relaxation or biofeedback are of use in themselves as an answer to stage one stress breakdown.Take biofeedback, for example. It has been shown that human beings, given appropriate feedback or information on the state of a body function normally controlled automatically, can work out ways of voluntarily controlling that function. Patients, for example, are wired up to an instrument which will make a sound or switch on a light if muscle tension is high. The patient works out some way of visualizing some peaceful scene, or emotionally letting go, and learns the subjective feel of how to voluntarily lower the muscle tension.I believe that this technique is useful for those people who have become so used to feelings of muscle tension that they cannot operate at any lower level of activity. Such people, in my opinion, have basic problems with nervous system function and sometimes have what might be called minimal brain dysfunction.In these biofeedback experiments, the subject is learning how to control certain body reactions by using the reticular activating system’s capacity for inhibiting the activity of cortical brain cells. The imagery required in biofeedback, therefore, requires a normally functioning reticular activating system and a normal capacity for the cortical cells to respond. Therefore, in order for biofeedback to be of use, the person cannot be suffering from third stage stress symptoms.Thus biofeedback and relaxation techniques (particularly those using techniques of self-hypnosis) can only be of use for stage one symptoms. However, I feel that it is not of much use overloading the nervous system, and then working out methods of reducing the discomfort from the alarm system activated by that overload.I recognize that relaxation techniques are useful in treating the anxiety of stage one stress breakdown. But the relaxation techniques which to me appear to be useful for stage one stress symptoms seem to work because they force people under stress to take time out to stop doing what they were doing and concentrate on something totally different. The something totally different might be to spend time concentrating not on the report you are trying to write, but on certain aspects of your own body function.I really think that almost any relaxation technique will work so long as it imposes a forced rest. Likewise, the physical exercise that takes the executive away from the desk or the telephone will be effective because it does that, not necessarily because of the exercise aspect.
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SECOND STAGE OF STRESS BREAKDOWN: USING THE WILL-POWER TO IGNORE FEELINGS OF ANXIETY

admin — Sat, 15 Jan 2011 10:58:42 +0000

Looked at objectively, the use of will-power mechanisms to ignore a signal which is a warning of overload of the nervous system, would seem foolish, and expensive. It is. However, some people make a habit of doing just that. They have been trained to ignore body feelings of tension and anxiety, and to suppress open display of emotion.
Many different cultures set out deliberately to train young people to do this, placing great value on keeping a stiff upper hp. During World War II, the personality characteristic of being able to endure stressful circumstances, feeling fear and anxiety but not outwardly showing it, was considered a desirable quality for selecting people for aircraft crew. However, an undesirable side-effect of selecting unflappable people to fly aircraft and drop bombs in situations of great peril, was the selection of a number of people who had the potential to break down quite suddenly.
My understanding of the case histories of pilots and other air crew, who broke down under combat stress, is that these men habitually kept their emotions in check until they ran right out of inhibitory reserve and then, quite unexpectedly, they broke down. This is not to say that these people were any more or any less capable of carrying out their duties while under severe life-threatening stress than others who tended instead to express their anxiety and fear.
The airmen, who were able to suppress displays of emotion, gave their superiors no hint of warning before their breakdowns. On the other hand, those who displayed their feelings of anxiety readily tended to be grounded because their superiors felt they might break down and become unreliable and inefficient under further stress. For this reason, the men with stoic personalities were over- used and put at risk for sudden breakdown. On the other hand, the anxious worriers were not over-used and tended therefore to be less susceptible to breakdown under stress.

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

admin — Mon, 18 May 2009 08:27:04 +0000

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.

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SWITCHING FROM A CONVENTIONAL ANTI-DEPRESSANT TO ST JOHN’S WORT: JAKE’S STORY

admin — Wed, 29 Apr 2009 08:40:05 +0000

Jake is a 29 year-old freelance writer and health food shop owner, who is currently trying to write and sell screenplays. He has suffered from feelings of sadness, fatigue and anxiety off and on since the age of three when his parents got divorced. He remembers being sick a lot as a child and getting into many fights at school. He was the class clown and was often in trouble with teachers.

Jake’s depressions went undiagnosed until age 22, by which point he felt extremely sad and dejected. He had recently completed his university course but didn’t know what he wanted to do with his life. He was working as a fund-raiser for disadvantaged children, but was tired much of the time and had a hard time performing his tasks. When he consulted me that autumn, he had quit work and was home sleeping for most of the time.

Jake had previously been treated with Prozac, but it didn’t help his lack of energy, which was one of his main symptoms, and made him feel ‘spacey’. I then treated him with another SSRI in high dosages. Although the drug made him feel more energetic and less down-in-the-dumps, it also made him angry and irritable and he developed a nasty edge in his dealings with other people that was quite uncharacteristic for him. To combat these unwelcome effects, I added a second mood-regulating drug, lithium carbonate. In addition, he also received psychotherapy and light therapy. This combination of treatments was quite effective and by the new year Jake had enough energy to acquire two part-time jobs and felt about as good as he could remember ever feeling. He was bothered, however, by medication side-effects such as sleep disturbance and continued aggressive feelings despite the placating effects of lithium.

After several years on this combination, Jake stopped his medications because he wanted to see how he would do without them. He felt fine until he moved to a new city with his girlfriend. He had always had difficulties with transitions and he felt the old familiar fatigue and anxiety coming back to him and consulted a GP, who restarted Jake on anti-depressants. Once again, he began to feel unpleasantly edgy. At Jake’s request, the GP prescribed a different anti-depressant, Lustral, which helped his mood somewhat but decreased his sex drive a great deal. Not only was he less interested in sex, but also had difficulty with erections and orgasms. He began to avoid sex because it was uncomfortable for him not to be able to perform and affected his self-esteem.

Jake read about St John’s Wort in the popular press and coinci-dentally, I had just begun to treat his mother with the herbal extract with excellent results. Since he is interested in alternative medicines, he put himself on St John’s Wort, 300 mg three times a day, and gradually phased out the Lustral. His sex drive, mood and energy improved markedly following the introduction of St John’s Wort. The only side-effect was mild indigestion, which responded readily to antacids and was in any case short-lived.

Jake’s mood and energy levels are as good as they have ever been and he finally feels ‘like a normal person’. He is grateful to the herbal remedy for helping him so much, even though he recognizes that he has also worked very hard to feel better about himself and his life. This work has involved therapy and self-reflection, regular exercise and actively avoiding toxic influences and negative attitudes. He plans to move to Los Angeles where he is more likely to succeed as a screenwriter, and feels optimistic even though his chosen course is a difficult and risky one and he has recently broken up with his girlfriend, with whom he was deeply in love.

Although Jake shifted from Lustral to St John’s Wort on his own, it is certainly better to make such changes under a doctor’s supervision. But Jake had clearly learned some of the key principles of anti-depressant management during his years of psychiatric care and did a good job with juggling his own medications. He recalled, for example, that you should try not to stop an antidepressant abruptly if at all possible. To do so is to court withdrawal side-effects, such as dizziness, sleep disruption and flu-like symptoms, to name just a few. Also there can be a rapid decline back into depression again. So Jake was wise to taper his Lustral gradually. In addition, Jake recognized that finding the right antidepressant is only one aspect of the treatment of depression. He is combining the herbal remedy with other healthy activities, such as therapy, self-reflection, exercise and the avoidance of negative influences. His move to Los Angeles also promises to be a healthy choice for him as it is more likely to offer him the career opportunities he needs in order to feel professionally fulfilled.

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