Anxiety: Normal Worry or Serious Symptom?

As the world begins to make sense of the tragedy of the bombing in Boston last week--and the equally harrowing pursuit and capture of one of the alleged perpetrators--we might expect that our anxiety levels and feelings of being unsafe in our surroundings would start to ebb as the days go on. But for some people, that relief won't come quite so easily. They may find they are still hypervigilant, still metaphorically (or actually!) looking over their shoulders for the next disaster to approach. They may still suffer insomnia, eating and sleeping disruptions, and obsessive thinking that is hard to rein in. They may avoid all news reports of the bombing or be consumed by the need to know every detail of the investigation, the rationale of the criminals behind the act. And the individuals cotinuing to suffer with these kinds of distress are not simply post-traumatic stress disorder survivors who are being retriggered by reports of violence. Even people who've never before reported experiencing anxiety symptoms or trauma history are being challenged by worry, fear, obsessions about their safety and concerns abOut the future. Perhaps it's the media saturation we now live with, or a heightened knowledge about safety issues and concerns, but whatever the genesis, we need to be able to recognize when anxiety is growing beyond our control and know how to seek help. If you experience three or more of the following symptoms for more than a few weeks, consider contacting your physician for a referral for counseling:

1. Restlessness, irritability or agitation
2. Inability to control your worrying
3. Fatigue
4. Difficulty concentrating
5. Muscle tension
6. Sleep or eating disruption
7. Worrying about several different topics/life areas

Counseling can assess whether therapy alone can help to alleviate your symptoms, or whether an assessment to evaluate for medication is called for. Data supports that cognitive behavioral therapy (CBT) is highly effective in helping people manage their anxiety. The world is likely to continue to run at a rapid pace, and we are probably not going to be able to avoid exposure to tragedies and struggles. But empowering ourselves to pursue help when we need it can be the first important step in feeling more in control, and safer, in our own lives.

Faith Over Fear

As I watch the coverage of the tragedy that has occured at the Boston Marathon, I find my faith in the benevolence of the Universe shaken and doubting. I regularly teach my clients about the power of positive thinking, of having faith in the face of fearful circumstances. I encourage clients to believe that the world is a safe place overall, and that people are, more often than not, wired for good. I usually struggle with the idea of evil: perhaps idealistic and naive, but my sheltered, suburban life has allowed me to believe that evil is an "idea", a concept more than a reality. And then these tragedies happen. Is evil real? Are we at it's mercy, whenever it desires to strike? Is our belief in a loving, protective Higher Power a fallacy? Or are these tragedies reminders that faith is easy to have when we feel safest, but it is exactly when we face our most fearful times, when we are riddled with doubt and questioning, that we most need to rely on our faith. I wish i could say I am able to take strength from my faith, that I can lean back into the arms of Universal Love and trust that peace will reign in the end. But I'm unsure, at best, of how I feel and what I believe. I'm hoping to learn from all of you how you have faced tragedy and learned again to trust, to believe, and to hope.

Positive transitions = Vulnerability

When we think about the developmental milestones that mark our lives--weddings, births, graduations, first jobs--we often think about the positive feelings, achievements and sense of empowerment we expect to accompany these tasks. But just as often, people experience an equal amount of vulnerability and emotional risks. I've had clients who are nearing the end of their college careers, and find themselves struggling with anxiety, fear, and depressive symptoms they believed were long in the past. Clients who change jobs to positions with more status, power or pay are confused by the sense of doubt and stress that accompany this change. And most of us know of the perils of post-partum depression, when new mothers may struggle with sadness, anxiety and a fear of not being up to the tasks of parenting. However, while new mothers are in the midst of tumultuous hormone changes that affect their mood and sense of efficacy, I've worked with men who experience similar challenges when they add children to their lives. The myths associated with these celebrated events are part of the problem. We feel ashamed, "broken" or wrong for having negative feelings alongside a joyous event. We feel confused and doubtful about our ability to navigate even positive life events with ease. Sometimes, we feel cheated by sadness, grief, anxiety or anger that prevents us from being present to joy. But all change brings stress, because it's a shifting of the status quo to a state that is a bit unknown. And even positive stress (eustress) taxes our emotional, mental and physical capacities. We would do better to expect a range of emotions to accompany exciting life changes, rather than assuming we will only feel happy, joyous or grateful. Being gentle and compassionate with ourselves during times of transition helps to lessen the strain and ensures we notice and attend to our feelings. When change is looming, we need to increase our self-care: get plenty of rest, healthy food and exercise, and stay hydrated. We might benefit from taking extraneous responsibilities off our plates. The next PTA meeting, Pinewood Derby or church rummage sale may have to run, this one tine, without us. And when we experience unpleasant emotions side by side with positive life events, we can try our best to be tender with those feelings, for they are there to teach us something. Perhaps the fear about a new job is a reflection of our perfectionistic streak as much as it is a fear of failure. That anxiety can clue us in to be conscious of our self-expectations, and to accept that, in some cases, doing "good enough" is better or healthier than doing "perfect" work. Sadness at leaving a beloved college campus and dear friends reflects the depth and meaning we've built into those relationships. Failing to acknowledge our full range of feelings can create unconscious self-sabotaging or worsening of symptoms. We respect ourselves most when we don't expect positive life milestones to come without some less-than-positive feelings. It's by embracing all our emotions that we reap the richness of all life offers us.