Sometimes, anxiety feels a lot like riding too fast on a spinning carousel at an amusement park. It takes hold of a particular thought or fear and spins on it nonstop. It’s frustrating and exhausting, and it can feel out of our control.

The temptation in that situation is to do one of two things to feel better: (1) distract ourselves from the thoughts or (2) indulge them. Distraction maneuvers include watching television, calling a friend, taking a pill, or checking Facebook. Indulging behaviors might look like making endless lists and notes about anxious thoughts, researching whatever the issue is for hours, or calling people to talk through the same problems over and over.

The tough truth is that we can’t run from what’s bothering us, and we can’t necessarily “solve” it, either. If our minds are telling us to be very worried about a work meeting tomorrow, the answer is not to spend hours thinking about that meeting. This gives us the illusion of control—“If I can imagine every possible issue that could arise during the meeting, I’ll be able to handle whatever happens”—while keeping us tired out and high-strung. Trying to solve an irrational fear through rational thought is, as it sounds, impossible.

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Instead, we have to do something that feels pretty counterintuitive: To keep anxiety at bay, we should sit with it. This means choosing actions that address the anxiety itself rather than dealing with the subject we think we’re anxious about. “Sitting with the feelings” sounds a lot harder; who wants to lean into feeling scared and worried? But we’ve already tried distraction and indulgence, so we know those are temporary fixes without any long-term gain. Once the fear about the work meeting is soothed, another problem will be waiting to frighten us, and we’ll have to start working feverishly again to calm that thought.

There are many ways to attack anxiety more productively. The tools below are described in their simplest form. If you see one that appeals to you, a professional, a book, or even a website could help you flesh them out and practice them. Other ideas can be tried here and now, on your own.

To keep anxiety at bay, we should sit with it. This means choosing actions that address the anxiety itself rather than dealing with the subject we think we’re anxious about.

1. Words

When your mind is spinning, there’s a story that you’ve created. First, try to figure out the words the anxiety is using to scare you. Perhaps they’re “don’t bother asking that girl on a date, she’ll never say yes.” Or “if you drive on the freeway, you will be in danger.” Write down this message in the clearest words possible, then see if there’s any deeper message underneath it. If you’re afraid to ask someone out, could there be a fear underneath that such as “no one ever likes me”? Does anxiety about driving also include the larger worry that “the world is unsafe”? When we uncover the core message, we can sometimes see that it’s exaggerated and devastating. It’s a huge generalization.

Next, try to find a replacement thought that is more balanced, more realistic. It doesn’t have to be something magical like “everyone always loves me!” or “no one ever gets into car accidents!” These will be difficult to focus on because they’re hard to trust. A more reasoned statement might be “I can handle rejection” or “some women have wanted to date me in the past.” When you come up with a thought that feels more positive and easy to believe in, consciously stop yourself whenever the anxious thought arises, push it away, and replace it with the new thought. Over and over, practice the new words to create a new thought process.

2. Images

If you’re drawn more to pictures than to words, visualizations are a wonderful and powerful way to calm your spinning mind. Try to discern how your anxiety looks to you. Maybe it’s a field of pulsating red, or a spiky ball. Close your eyes and take a deep breath. Imagine holding your anxiety in your hands. Feel its texture, its weight, its temperature. Then imagine chilling this anxiety with a breeze of fresh, cool air. See it shrinking in your hand. It becomes as small as a medicine ball, then a kickball, then a handball. Soon, it’s as tiny as a ball bearing. Continue to hold and shrink the anxiety whenever it occurs.

Another way to calm anxiety with images is through creative visualization. There are many such resources available online as audio, video, or written scripts. These stories walk you through a calming experience, simultaneously helping your body relax and moving your mind away from the distressing thoughts and into a more peaceful, controlled state. Practicing these mini-meditations trains your mind to focus less on outside subjects, which we have little control over, and more on our inner selves, which we have complete control over (although this often doesn’t feel true). One lovely visualization can be found here.

3. Physical Feelings

Finally, relaxation and anxiety management can be found by changing how your body is functioning. Sometimes, anxiety starts in the body instead of as a thought. The sympathetic nervous system gets triggered, we feel a thumping heartbeat, quicker breathing, and twitchy muscles, and then the mind looks for something to blame it on. What am I so upset about? Suddenly we’re searching for a cause and choosing targets that may or may not be relevant or significant. It must be my relationship. And then we’re off on the cycle of repetitive thoughts that feel unmanageable.

Anxious thoughts and an anxious response in our bodies are almost always linked, and they need to be dealt with on both levels. First, taking deep breaths and slowing our body movements can help bring some oxygen and blood flow back to the brain, making it easier to think logically. Experts suggest breathing in to a count of four and out to a count of five, both through the nose. The slower out-breath mimics breathing patterns while we sleep, and can help trick the brain into thinking we’re relaxed before we actually are.

These techniques represent just the beginning of ways to address anxiety directly, without trying to run from it. The good news is, once you find a way (or two or three) of gaining control of your spinning thoughts, there can be a powerful sense of mastery and relief. The carousel does not have to rule your mind and body. Rather than pretending it doesn’t exist, you can slow the ride, dismount from the horse, and get a good night’s sleep.

When people think of eye movement desensitization and reprocessing (EMDR) therapy, they generally think about a treatment for trauma, which is partially accurate. Treating trauma is what EMDR therapy was developed for and continues to do. But since its development and introduction over 25 years ago, it has become more than an intervention and is now a comprehensive psychotherapy, one that is exceptionally effective in addressing multiple issues and challenges.

A common misconception is that a person has to be struggling with mental health or major life challenges to benefit from EMDR. On the contrary, one of the most interesting and innovative uses of EMDR has been in performance enhancement in addition to its ability to decrease fear, stress, or anxiety related to performance.

How EMDR Works

In short, EMDR therapy accesses and links the multiple facets of memory (image, cognition, emotion, and sensation) and uses bilateral stimulation/dual-attention stimulus (eye movements or tactile or auditory stimulation) in order to decrease disturbance associated with specific incidents in a person’s life. It taps into the brain’s natural ability to heal and helps it file away memory appropriately so that when the memory is recalled, there is no disturbance associated with the memory.

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Other Ways EMDR Can Help

EMDR has several wonderful applications. In addition to decreasing disturbance associated with trauma, it is effective in decreasing anxiety and targeting irrational or negative thinking, both of which may get in the way of performance. In addition, it can help a person to gain confidence in his or her ability to perform a task or reach a goal. EMDR works to achieve this by installing positive beliefs, and by having a person imagine doing the thing he or she is nervous to do or wants to improve in while doing bilateral stimulation. This has the effect of simultaneously decreasing the fear, anxiety, or stress associated with the task and boosting confidence.

It seems that EMDR helps the brain to think in a healthier, more adaptive way by removing blocks (such as negative self-beliefs) and helping the person to tap into his or her strengths.

An Example of EMDR in Practice

Sometimes EMDR is hard to conceptualize without a specific example. Here is a hypothetical one.

Alice wants to implement healthy habits into her life, so she has set a goal of exercising three times per week. However, she is self-conscious when she thinks of going to the gym. She worries about other gym members and trainers judging her.

She visits an EMDR therapist to help her reduce her anxiety and to boost her confidence in going to the gym. The therapist completes a thorough history and teaches her stabilization and calming skills to utilize between sessions and (if needed) during the desensitization phase. Once fully prepared for the next phase of EMDR therapy, Alice and her therapist assess and desensitize any past experiences that feel related to the current experience.

Once there is no longer any disturbance associated with past experiences, they then assess and target the current situations that are triggering for Alice. Specifically, Alice targets the image of the gym, the belief “I am not safe,” emotions (fear and insecurity), and body sensations associated with this target. They use bilateral stimulation and work through the target until no disturbance remains, Alice is able to fully believe the thought “I can keep myself safe,” and she no longer has any negative body sensations associated with the target.

Alice and her therapist then move to the next phase of EMDR therapy, during which future situations are targeted. During this phase, Alice plays a movie in her head, imagining herself packing her gym bag, getting in her car, driving to the gym, going into the gym, completing her workout successfully, and leaving the gym feeling a sense of accomplishment. Alice finds that when thinking about this scenario, she has some anxiety and another negative belief: “I am going to fail.”

Alice plays the movie through several times, all while the therapist provides bilateral stimulation. If Alice finds she gets stuck, she lets the therapist know and the therapist helps her to work through the sticking points. She finds that each time she plays the movie in her mind, she is less anxious and more confident in her ability to go through the actions she is imagining. She eventually finds that she no longer believes she will fail and, while playing the movie the last few times, instead holds the belief “I am strong and capable.”

The next time Alice goes through the actions of preparing for and going to the gym, she has far less anxiety and much more confidence.

Of course, every case and person is different, but this is a simple example of how EMDR may be helpful in not only addressing past and present issues related to performance, but also in enhancing future performance and decreasing anxiety related to potentially triggering situations. The number of sessions will vary from person to person, but it has been my experience as a therapist that EMDR is both efficient and effective. Contact a therapist trained in EMDR if you think it might be beneficial for you.

About a year ago, I was working as an art therapist in private practice and I had a 12-year-old client struggling with anxiety and figuring out who she was in the world. I asked her to create a self-portrait—a great exercise for a girl trying to define herself. At one point I realized I had never made a self-portrait, at least not since grade school. So I went out, bought a canvas, took a “selfie,” and began my own personal process answering, “who am I?”

I began with a light sketch, trying to see myself from the observer view. Then I started painting, layering first in basic colors to assign shadow and light areas. I have a lot of experience painting, but painting a person is definitely challenging. Faces have complex layers of subtle shadows and highlights. I worked layer after layer. Too dark. Too light. Too dark again …

One night I came home and looked at the painting in process and wondered, “Have I gone too far? I just keep layering and layering, will it ever be finished? This painting is getting overworked.” I paused, contemplating this chosen word. That’s exactly what I had created: “overworked Michelle”. Working three jobs and always doing a lot, I was overworked and my self-portrait reflected this state.

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This is the beauty of art therapy: even though you’re not trying to do it, your self comes through in the art you create. There I was, “overworked Michelle,” in painting as in life. I didn’t like how she looked … and I didn’t like how it felt to be overworked Michelle, either. At that point, I stopped working on the painting and bought a new, blank canvas of the same size. “Who would I be if I wasn’t overworked Michelle?”

I challenged myself to make the Michelle I wanted to be, my ideal state of being. To avoid overworking the painting again I limited my work time to two sittings. In the beginning, I did not sketch anything, but started with paint on canvas, finding a portrait through color and strokes. Without a photo to reference I was free to make the face, body, and shading however I wanted. The result was a representation of how it feels to be me on the inside.

A few nights previously I had had a powerful dream about a mountain lion and when the hole in the chest appeared in my painting, I knew I wanted a cougar coming from the darkness. But how would I paint a cougar in such a short amount of time? Actually, I had already cut one out of a magazine and it was just hanging on my bulletin board nearby. Should I put collage in my painting?! I’d never done that before!

I found freedom in creating this painting. All rules went out the window. I could be whoever I wanted to be! This is the truth of life. We create imaginary confines around ourselves that don’t actually exist. With the focus of actually creating the me I wanted to be, I found myself soft and open, vulnerable and dangerous, with strong roots hanging down, looking for soil.

Art is a powerful medium. It reminds us that we are creators, born to make what we want out of life. Art is an opportunity to ask yourself, who do you really want to be? I practiced what I wanted in this painting, and then my life followed suit. I am no longer “overworked Michelle.” Now I have one job, and it is my passion—the place where I share my heart with others and practice vulnerability and openness. I take care of myself first, every day. I don’t feel overworked, because I love what I do. I continue to draw and paint what I want out of life because, in the very near future, it could all come true.

Michelle Lynn Baker is an art therapist and owner of MBodied Art Studio in Westminster, CO. She teaches art classes to children and adults and runs therapeutic art groups for parents and children. Michelle enjoys the spectrum of art as therapy from learning to healing.

“I wanted a perfect ending. Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end. Life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next. Delicious ambiguity.” —Gilda Radner

You’ve shown up for work only to be told that your position has been eliminated, and now you find yourself jobless and afraid. You find out that your spouse has been having an affair, and suddenly you are in a panic about what the future holds and how your life will change. You have a health condition and begin to live in a space where nothing seems certain. In moments like these, anxiety takes up residence in our minds: What will the future look like? Can I handle what is coming down the road? Will I be OK?

We’ve all been there at one time of another: stuck in uncertainty. It’s a scary place to be, and can leave you feeling out of control, hopeless, and helpless.

Although each of us differs in how much of life’s ambiguity we can tolerate, there are some situations that challenge even the most risk tolerant among us. Humans love a sense of order and predictability; chaos and the random nature of life can be very scary.

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When you are living with uncertainty and feel like some of your power in life has been taken from your hands, how do you cope? How do you manage to live in that ambiguous place without falling apart or dissolving into stress and worry?

This is a challenge I’ve faced as a person living in the shadow of cancer. As a cancer survivor, living with the knowledge that your cancer could come back and ultimately end your life is a significant challenge. Finding a way to manage and live with that uncertainty is necessary in order to lead a fulfilling and whole life, as it is with all uncertainty we face.

Here are some tips on how to find peace in an uncertain time:

1. Recognize That Total Certainty Is an Illusion

This is where we take a turn for the philosophical. In learning to live with uncertainty, it took me some time to recognize that the life I had been living pre-cancer was not necessarily any more secure than the life I am living post-cancer. In considering the temporary nature of all things and in acknowledging that change can come at any moment, we can see that total certainty in life is but an illusion.

As much as we would like to deny it, we are always in a state of uncertainty. We take for granted that things will remain relatively constant and have a hard time accepting that huge changes can befall us with nary a warning. As distressing as it is to consider, the truth is that your life can change on a dime.

Driving home from work today, you could be hit by another car and find yourself permanently paralyzed. You could find out that your newborn has a significant medical or mental health issue that will impact your family for the rest of your lives. You could arrive home to find that your house has been gutted by fire and you have no place to live. Alternately, a sudden windfall of cash could land in your lap from the estate of Great Aunt Agnes, or you could get a call from the employer of your dreams, asking you to join the team.

We like to believe we have total control over what lies before us, and, in truth, we do maintain a huge amount of control in the trajectory of our lives. But we don’t control all of it. It’s helpful to remember this during hard times. Just because you now recognize the uncertainty in your life because it is bolded, highlighted, and in flashing neon lights doesn’t mean uncertainty wasn’t there before. It just means it wasn’t as in-your-face as it is now.

Knowing that this is the case makes it much easier to accept that uncertainty is not necessarily an indication that things are going all wrong—uncertainty is the natural state of things. Once you recognize this truth, it’s easier to loosen from the grip of anxiety around the unknown.

2. Practice Meditation

A growing body of research shows that meditation can be of tremendous benefit to people coping with anxiety and depression. I will frequently draw in a mindfulness piece when working with people in therapy, and often this includes meditation.

The real benefit of mindfulness meditation is that it allows you to create some distance between you and your automatic thoughts and emotional reactions. Putting even a 15-minute practice into place in the morning will provide a space for your mind to calm and your anxiety to be reduced.

3. Utilize Exercise

I recently attended a workshop focused on releasing stress and trauma held in the body. The woman leading the workshop noted that, in the wild, animals often shake as a way to reduce tension. She pointed out that after an antelope runs from a lion and survives, it will spend some time shaking as a way to discharge the physical tension and release the energy brought on by the fight-or-flight response. Many animals release tension this way, but humans don’t have such a built-in response for discharging the stress we carry. Exercise can function for us in much the same way that the need to tremble functions for a dog.

Running, walking, aerobics, yoga, and weight training are all great for discharging physical and emotional energy that we carry with us during the day. Getting proper physical exercise can also help with getting good sleep, which is essential in thinking clearly and being our optimal selves.

4. Take Action Where You Can

Frequently when we are living with uncertainty, we feel as though our power to control the direction of our lives has been taken from us. This can feel very unsettling, to say the least.

While it’s important to acknowledge that uncertainty is a natural part of life, it’s also important to take action on those parts of your life that you have control over. Sometimes, the only thing we have control over is how we choose to react to the challenges we face. How you choose to face uncertainty is all up to you. Consider how you’d like to move forward with this in mind.

5. Get Support

When difficulties befall you, it’s easy to feel alone. The reality is that each of us experiences suffering. It’s a part of the human condition. The feelings you are feeling have been felt by millions of others. People all over the world, in your town, in your neighborhood, are dealing with uncertainty, too.

Reaching out to others for support can be helpful. Find that friend who has faced some really hard times, who has been through the wringer and kept going. Talk to them about what you are coping with. Some people prefer to seek out a therapist in this circumstance; therapy can be grounding during uncertain times. No matter whom it is, find someone who can help you reconnect with yourself when you start floating into anxiety about what the future holds.

Learning to live with uncertainty is one of the great challenges of life. It’s not an easy task, but learning to tolerate ambiguity is an essential skill for living a satisfying life. It will carry you through many challenging times, and you’ll find yourself living with more appreciation of the moment, which is really all we ever have anyway. Uncertainty can be a great teacher; allow it to be yours!

“If I am killed, I can die but once; but to live in constant dread of it is to die over and over again.” —Abraham Lincoln

“Something did happen to me somewhere that robbed me of confidence and courage and left me with a fear of discovery and change and a positive dread of everything unknown that may occur.” ―Joseph Heller

I recently came across the above quote by Joseph Heller and it hit me right to my very depths. I remember as a child actively learning to—in essence—feel constant dread, as I taught myself to avoid disappointment and failure by always anticipating the worst. That way, when it came to be, I wouldn’t be devastated—just fatalistically accepting. It gave me a sense of control when I felt none. In so doing, I—like Joseph Heller—set into motion a lifelong habit of dreading just about everything. In fact, it has so pervaded my thinking that I have often observed myself dreading a fun or enjoyable event, just because it is my habit to do so.

The above description might not be exactly true for you (I hope it is not!), but it is a common state for many people in our culture. Most of us were not taught to deal with adversity in a healthy way, so we learned or taught ourselves how to avoid pain. As for me, as I’ve gotten older, gone through several rounds of psychotherapy, and explored many different spiritual traditions for help with dread, I have learned to work with the feelings. I’ve also helped many people deal with these same kinds of feelings. So what has worked?

I think the great Sufi poet Rumi expressed it best in his poem, The Guest House (excerpt):

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The dark thought, the shame, the malice, meet them at the door laughing, and invite them in.

Be grateful for whoever comes, because each has been sent as a guide from beyond.

Most of us spend a lot of our time fighting this sense of dread, feeling powerless to combat it and completely at its whim. We push it away, only to find it resurfaces at just the wrong time! Once you recognize this cycle, you can simply accept this dread that is so often present instead of fighting it off. When it arrives, allow it to be there without beating yourself up. Take some deep, yogic breaths to quiet your mind a bit, and then ask yourself some questions:

• Are there any data to support this feeling of dread? Is there really anything to be afraid of in this particular circumstance?
• Even if you can clearly identify the fear, ask yourself, “What’s the worst-case scenario? Would I be OK if that happened? Would it change who I am, or would it just be a challenge?” Most of the time, when I answer these questions honestly, I realize that my fear has been exaggerated in my mind. I realize that I am capable of handling whatever happens, and that I am just afraid of what I don’t know or perhaps of pain or rejection. Once I have softened my “rigid” response, I feel less dread and can tolerate whatever still lingers (and by the way, it often does not miraculously disappear!).
• Ask yourself, “Is anything happening to me right now?” Usually the answer is no; the dread is arising from some anticipated event in the future. You can then take a few breaths and remind yourself that your monkey mind is hijacking the moment instead of allowing you to be present in this moment. I often bring my attention to sensations in my body or to something beautiful in my immediate environment that grounds me in the reality of that moment. And I quickly realize “I have nothing to fear but fear itself.”

The more I have practiced this, the more I have been able to “work with” the dread and not allow it to disable me from living fully. There are days when I have to go through the above steps many times, and yet others where I am fully engaged moment-to-moment and don’t have the “time” to dread.

Next time you can’t get out of dread, try teaching yourself that you can: once you loosen your attachment to those feelings, they have way less power over you than you might think.

If you are what is commonly referred to as a “neurotypical” spouse of a person who is diagnosed as being on the autism spectrum, you are probably accustomed to anxiety. I don’t mean to imply that you enjoy it, but I suspect you are accustomed to walking the line between your initial reaction to a conversation, for example, and the way you may come to sort it out afterward.

It usually falls to the neurotypical spouse to make these distinctions, because he or she is the person who has the capability of doing so. This derives from the differences between the brains of the partners.

You may know that Asperger’s (AS)/high-functioning autism (HFA) is a structural, neurological condition and not a mental illness. This is of great significance because there is always risk of shame around a psychiatric diagnosis. If it is clear to you and to your partner that this is not a mental illness, you will be able to manage it more readily. Secondly, you may realize that if you attribute intent to something your AS/HFA spouse said or did based on your assumptions about what you might have said or done in similar circumstances, you are winding down the wrong path.

This error of attribution, natural as it may feel at the time, is one of the sources of the anxiety you experience, but there is seldom intent to inflict pain in your life on the part of your AS/HFA spouse. There is a difference in the way your brains process information, and you are the one most capable of seeing and understanding these differences; you are neurotypical. But your spouse is not setting out to confound you, regardless of how frustrating conversational and situational conflicts may feel to you.

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Educating yourself about AS/HFA is an excellent place to start. You can learn about the neurological differences. You can learn about the difficulties your spouse has faced his/her entire life in trying to figure out social protocols and nonverbal cues for meaning in interpersonal communication. You can begin to understand that there is nothing wrong with you, and that your expectations have been normal and natural; they simply haven’t been met because your spouse is unable to meet them. You can also learn means of expressing your thoughts that are less likely to cause confusion.

For example, if you bear in mind that nearly 70% of interpersonal communication is nonverbal, and that your AS/HFA spouse is very literal in his/her approach to communication, you can quickly see the limits. And even that is compromised by nonliteral forms of speech, such as metaphor, analogy, or figure of speech, all of which can be extremely difficult to discern and comprehend for a person on the autism spectrum.

Tony Attwood is an Australia-based clinical psychologist who has made the study of AS/HFA his life’s work. I recommend his works for anyone setting out on the path of understanding this diagnosis.

Now I’d like to return to the first point regarding your anxiety. It is important to acknowledge your anxiety and frustration so that you don’t fall into the trap of assigning blame where there is none, neither on your spouse’s part nor on your own. Understanding AS/HFA from a clinical standpoint is an excellent first step.

The second step I recommend is couples counseling with a psychotherapist who understands both the world of the individual with AS/HFA and the world of the spouse. Be mindful of this as you speak with potential counselors, because you don’t want to find yourself in a situation in which one side or the other is advocated and the remaining partner is expected to do all the adapting.

Finally, I would like to point out that in my clinical experience, nearly every individual I have met with AS/FHA experiences constant anxiety often coupled with depression, due to the complex demands of coping with a world that seems as inscrutable to them as the world of the person with AS/HFA may seem to be to you.

A final word of counsel: be kind to each other. Remember that bridges can be built between you and your spouse with the help of a talented counselor who understands what lies on both sides.

Although epilepsy is one of the most common causes of seizures, it’s not the only cause. Extreme emotional states can give rise to seizures. Psychogenic nonepileptic seizures (PNES) are seizures brought on by emotional states, occurring in between 2 and 33 per 100,000 people. According to one study, as many as 20% of people diagnosed with epilepsy might have PNES instead.

New research published in Epilepsy and Behavior aims to discern the differences between the two types of seizures, and researchers were able to correctly differentiate PNES from epilepsy in 83% of cases. They also found a clear connection between anxiety and seizures.

How Anxiety Triggers Seizures

Epilepsy is caused by rapid and chaotic discharge of electrical signals in the brain, but people experiencing psychogenic nonepileptic seizures don’t show this pattern. People with depression, anxiety, and similar mental health concerns can experience PNES, but doctors aren’t sure why. Strangely, a large percentage of people with PNES have epilepsy, making it even more challenging to distinguish psychologically induced seizures from those brought on by epilepsy. 

Differences between Psychogenic Nonepileptic Seizures (PNES) and Epilepsy

Differentiating between PNES and epilepsy can help people experiencing seizures get faster, more effective treatment. To evaluate differences between the two types of seizures, researchers administered questionnaires to evaluate whether and how frequently participants avoided circumstances that made them feel anxious. The group of participants included 30 people with PNES, 25 with epilepsy, and 31 with no history of seizures. Researchers found that PNES was more common among people who regularly experienced anxiety and who took steps to avoid sources of anxiety.

[fat_widget_left]Researchers also found that people who reported more somatic symptoms were more likely to experience seizures. Somatic symptoms are physical symptoms, such as headaches or vomiting, that don’t have an underlying medical cause. The study’s authors note that their research highlights the need for effective interventions among people struggling with anxiety. Because people who experience PNES tend to avoid anxiety, researchers point to the need for treatments that can help people with PNES reduce avoidance behaviors while more effectively managing anxiety.

References: 

1. Mellers, J. D. (2005). The approach to patients with “non-epileptic seizures”. Postgraduate Medical Journal, 81(958), 498-504.
2. New research links anxiety to seizures. (2014, August 1). Retrieved from http://www.lincoln.ac.uk/news/2014/08/932.asp
3. The Truth about Psychogenic Nonepileptic Seizures. (n.d.). Retrieved from http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures

Twisted lips, contorted mouth; you know the look of someone who is biting the inside of their cheeks when they are stressed. Why do people do that? Most of us understand it as a bad habit similar to nail biting because on the surface, it would seem like a benign repetitive behavior. However, under further consideration, the behavior may be a byproduct of an obsessive and compulsive reaction to stress and anxiety.

The medical term for the behavior is chronic cheek bite keratosis, which is a body-focused repetitive behavior (BFRB) comparable to hair pulling, nail biting, and frequent blinking. It is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under obsessive-compulsive and related disorders, and is complementary with anxiety-related types of problems. Body-focused repetitive behaviors, such as cheek biting, most often begin in late childhood and can last throughout adulthood.

Since we often cannot escape the stress of daily life and the resultant anxiety associated with it, behaviors such as this manifest as a subconscious solution to ease emotional overload. While not an ideal choice, it does serve a purpose to those who use it as a coping method. Other times, it is common for boredom and inactivity to trigger the behavior. Cheek biting is self-injurious yet compulsive in nature since it feels almost normal and necessary in the mind of the biter. The compulsive nature is what makes it difficult to stop.

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Since this behavior usually happens mindlessly, damage to the mouth tissue can occur. It is not uncommon for the biter to bite too deep and injure the mouth. Often, cheek biters have a favorite area to bite and repetitively break the skin in the same place inside the mouth. What’s worse is that when the cheek skin has been chewed and is raw, the skin feels broken and jagged, creating an additional compulsion to smooth out the affected area by biting again. This endless cycle can create physical complications only a dentist or oral surgeon can see.

Biting the soft skin inside the cheek over and over again can lead to oral trauma such as mouth sores and ulcers, but is reversible with avoidance of cheek biting, according to the Oral Cancer Foundation.

Whether it is an anxiety-related problem, an obsessive-compulsive issue, or just a bad habit, it is clear that the behavior is not ideal and potentially harmful. However, stopping the biting is a challenge because the biter is not immediately aware of when it is happening and why it is being used as an answer to stress and anxiety. The first line of defense is to lower the affected person’s stress level and provide alternative and healthy anxiety solutions. Stress and anxiety can be lowered multiple ways, most effectively by exercising regularly and eating healthy. After that, removing stressful situations and triggers should be evaluated. Additionally, treatment including mindfulness training and meditation is almost always useful. Learning to be aware and present in each moment allows the person to be in control of behaviors. While easier said than done, mindfulness and meditation are empirically proven to improve mental health.

Often, body-focused repetitive behaviors such as cheek biting respond well to talk therapy that includes techniques drawn from cognitive behavioral therapy and its subcategories dialectical behavior therapy, habit reversal therapy, and acceptance and commitment therapy. Although no one approach works for everyone, an eclectic sampling may work well. These therapies are based on the idea that obsessions and compulsions, like body-focused repetitive behaviors, help people experience stress, anxiety, and emotions without reacting negatively to them in the form of a behavior. The goal is to experience life without needing a compulsive outlet, like cheek biting, to handle what comes.

Robert’s palms were sweating and his heart was pounding. His big presentation was scheduled in less than an hour and he was starting to panic. What if he forgot his lines? What if he made a complete fool out of himself? His job was on the line and his anxiety was building.

Jenny was also apprehensive. She’d been trying to muster the courage to ask her boss for a raise for several weeks now, but every time she thought about doing so, she became too nervous to say anything.

We have all experienced anxiety at one time or another, although some people tend to struggle with nervousness more than others. Some of the common symptoms of anxiety are feelings of fear or panic, repetitive thoughts about the situation, difficulties sleeping, muscle tension, increased heart rate, shortness of breath, restlessness, nausea, and cold or sweaty palms and feet.

Part of our discomfort stems from our fear of being criticized, ridiculed, or rejected. We all have a basic need for love, acceptance, and validation, and tend to avoid situations that will jeopardize our relationships with others in any way. This is especially true if we have grown up in dysfunctional families, where these primary needs were not met and we were taught instead to behave in certain ways to please others and discount our own needs and emotions.

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We also frequently tend to play over and over in our minds the worst-case scenario, which only leads us to feel even more anxious about the situation. Rather than visualizing the outcome that we are hoping for, we make ourselves sick with our inner horror stories.

So how do we go about coping with anxiety in a healthier way? The following are some helpful techniques to begin to get our fears under control:

1. Take 10 deep breaths, focusing on the sensation of expansion in your chest and abdomen that occurs while inhaling and the release while exhaling.
2. Take some time the day before a stressful event to become physically active. Working out or going for a long walk are ways to decrease your stress levels. Doing so will also help you get a better night’s sleep.
3. Before bedtime, journal about your feelings of anxiety and the obsessive thoughts you have been having. Putting your emotions down on paper can often get them off your chest and prevent you from ruminating about them throughout the night.
4. Whenever you start to imagine the worst-case scenario, try to picture what you would like to happen instead. For example, if you are worried about an upcoming speech that you have to give, imagine remembering your words with ease and receiving a standing ovation afterward.
5. Lower your stress levels by doing relaxation techniques and/or listening to calming music. Help your physical body to relax by lying down or getting into a comfortable position, then progressively focus on contracting each of your muscles then releasing them. Start with your toes and feet and slowly work your way up to your face and scalp.
6. Try to gain some perspective about your fears by thinking about other times in your life that you may have dealt with a similarly difficult or stressful situation. How did you cope at that time? What are some of the strengths that you used then and can call on again?
7. If you are feeling anxious about talking to your boss (or another authority figure) about a specific problem, consider trying to role-play the conversation with a friend or therapist first. Practicing what you will say can help you feel more comfortable when the time comes to actually have that conversation.
8. Use mindfulness to tune into the emotions that you are feeling and allow yourself to feel them fully. Much of the time, we avoid the direct experience of our emotions, especially those that are uncomfortable, such as fear and anxiety. This tends to intensify the uncomfortable feelings rather than diminish them. To experience them, try to tune into the actual physical location in your body where the tension or fear is stored. Do you feel a knot in the pit of your stomach? Are your neck and shoulders tensed up? Allow yourself to fully experience the physical sensations and you will often find that they shift as you accept and honor them.

If you have tried some or all of these techniques and are still experiencing a considerable amount of anxiety, you may want to consider working with an empathic therapist. Although a certain amount of anxiety is a normal part of life, when stress becomes overwhelming and starts to interfere with our ability to function on a day-by-day basis, help is likely needed. Working with a compassionate therapist can assist you with facing some of your fears in a safe setting and bring you back in touch with your innate sense of peace and joy.

Most of us experience anxiety at different times in life; it’s when it takes over our quality of life that that it becomes a problem. But what is anxiety, and do you experience it?

There two different types of anxiety: external and internal.

External anxiety comes from outside events that produce an internal reaction inside us. Examples include sitting in traffic jams and worrying about being late, or perhaps an argument with a spouse.

Internal anxiety is when a person internally generates anxiety with an internal thought.

Thinking, “What if my boyfriend doesn’t like what I said and he leaves me, and then I’m all alone and I can’t take care of myself and I break down?”

We think the worst, and then our thoughts become a generator of this biochemical reaction in our bodies. A moment of anxiety automatically sends an alarm system to our brains. In this case, the anxiety is all in the mind, and it manifests into a physical reaction. When this happens, we start to question the physical symptoms.

The fuzzy, anxious feeling won’t hurt you. It’s only an adrenaline response. But when you focus on the fear, you may create more cortisol and adrenaline, which will create more body symptoms and more confusion. When adrenaline hits the lymbic system of the brain, we feel intense terror. The thinking part of our brain reacts, and we start to question how we feel and we want to fix it.

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Start by making a list of situations that make you uncomfortable and you find yourself wanting to avoid. Here are some possible examples:

• shopping in stores
• bridges
• standing in lines
• socializing with people
• talking in front of an audience
• being alone

Now write down the body sensations you could experience during an anxiety episode.

Here are more examples:

• racing heart
• feelings of confusion or bewilderment
• insomnia or sleeping too much
• feelings of fatigue and depression
• feelings of helplessness
• muscle tension
• headaches
• strange or scary thoughts

Now that you’ve thought about what makes you most anxious and how you react, don’t worry—you are not crazy, and you are not alone.

Anxiety can be caused by the following:

• obsessively anticipating
• thoughts that create body symptoms
• feeling fear of losing control
• projecting into the past and worrying about the future

The following is a six-part approach to helping manage anxiety:

1. Recognize that you are feeling anxious and accept feelings as a sign that something is bothering you.
2. Try to figure out what is really bothering you. Is it some kind of conflict you don’t want to deal with? Is it a scary thought? Is it a ridiculous expectation you have of yourself. Did you eat chocolate or drink caffeine last night?
3. Give yourself permission to feel anxious about whatever it is that is bothering you.
4. Use compassion and self-talk to move past anxiety. It will be ok. You can go about your business until it passes.
5. Get busy. Do something productive with all the energy.
6. Try to see a little humor in the way you feel and laugh at yourself a little. For example, if you don’t like confronting someone, say to yourself, “I don’t like confronting people. That is a normal, OK reaction to have.”

Being aware of what is causing your anxiety is the first step. Once you find out what is bothering you, you can use the six-part approach above to help cope with and diminish your symptoms. Remember, anxiety is often caused by a physical reaction to our thoughts. If one can stop and take time to recognize the thoughts and where they are coming from, one can then learn to do self-talk and understand that there are healthy ways to manage anxiety.

We’ve all heard that life’s problems don’t disappear because of a romantic relationships. But according to a new German study, love really might conquer all. Researchers found that positive romantic relationships can help stabilize people who tend toward neurosis. Neuroticism is dismissed by many in the mental health community; many mental health professionals see that it pathologizes personality traits, reducing mental health issues to an overall personality flaw. For the purposes of this article, we are recognizing neuroticism as a collection of traits including anxiety, insecurity, low self-esteem, and unhappiness.

The Study

Psychologists have long viewed neuroticism as a relatively stable personality trait. People who score high on measures of neuroticism tend to continue to score high months and even years later. But researchers wanted to see how a romantic relationship affected people who tended to be labeled neurotic. They followed 245 couples ranging in age from 18 to 30 for three months.

Using questionnaires, researchers identified some participants as having neurotic tendencies, then asked participants about their relationship satisfaction. Because people with neurotic tendencies often react negatively to everyday events, researchers also presented participants with various scenarios and asked them to evaluate how these scenarios might affect their relationships.

Researchers found that, as the duration of a romantic relationship increases, the negative reactions that people reported on questionnaires decreased. The researchers speculate that this may be because a romantic relationship increases the frequency of positive emotions, and that this process can help people with neurotic tendencies unlearn negative emotions.

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Will Romance Treat Anxiety?

The prospect that romance can treat anxiety and negativity is a promising one. However, researchers only looked at people in a romantic relationship. They did not evaluate whether the positive effects continued after the relationship ends, and this leaves open another avenue for potential future research.

It’s also important to note that rushing into a relationship is still not a good treatment for anxiety. The study only looked at people in relatively stable, healthy relationships. The results might look much different for people in abusive or unhappy couples, and the effects of such a relationship on an already anxious person could be even more pronounced.

We already know, for example, that a bad relationship can lead to physical illness, so people with neurotic tendencies shouldn’t pursue relationships solely to “cure” their anxiety. Ultimately, this study is part of a mounting body of research that shows that a healthy relationship yields healthy results.

References:

1. Hodgekiss, A. (2013, February 18). How a bad relationship can make you ill—by damaging your immune system. Retrieved from http://www.dailymail.co.uk/health/article-2280629/Being-anxious-relationship-make-ill–damaging-immune-system.html
2. Love makes you strong: Romantic relationships help neurotic people stabilize their personality. (2014, May 9). Retrieved from http://www.sciencedaily.com/releases/2014/05/140509074114.htm

It’s fairly common to see a child sheepishly hide behind a parent when greeting a new person, and some adults vividly remember the anxiety they experienced in childhood upon entering new environments. Recently published research, which tracked children over 15 years, argues that shyness isn’t just a personality quirk. It frequently indicates anxiety, and is often a precursor to high fearfulness in adulthood.

Childhood Shyness: The Study

Koraly Pérez-Edgar is a developmental psychologist who began studying children’s social interactions when she was a postdoctoral fellow. She found that children who displayed extreme shyness were more likely than other children to face anxiety as adults. A brief moment of trepidation meeting a new person wouldn’t rise to the level of such shyness, but a child who lurks anxiously in the background in an attempt to avoid other children is displaying severe inhibition.

Why Childhood Shyness Matters

Drawing upon previous research,Pérez-Edgar calls extreme shyness a form of behavioral inhibition. This inhibition involves more than just a case of nerves about trying something new. The personality trait appears as early as infancy, and involves an ongoing fear of new stimuli. Most babies might startle in response to a jack-in-the-box, then laugh as they realize the toy isn’t dangerous. Behaviorally inhibited babies are more likely to panic and cry.

[fat_widget_right]For children with behavioral inhibitions, meeting a new person is just one more frightening stimulus. These children aren’t just shy. They’re displaying a temperamental quality that is stable across the lifespan and a relatively accurate predictor of adult fearfulness.

Drawing Children Out of Their Shells

Behaviorally inhibited children tend to limit their own environments, giving them few opportunities to practice social interaction—a behavior that can make anxiety even worse. Consequently, Pérez-Edgar isn’t sure whether behavioral inhibition is an innate trait that appears early in childhood, or a learned disposition that shy children practice daily.

She wants to help shy children overcome their inhibitions, in the hope that doing so might reduce adult anxiety. In a new study, she and her colleagues are using behavioral therapy to help ease children’s anxieties. By drawing children’s attention to something other than the source of fear, researchers hope that they might train the brain not to fixate on sources of anxiety. If the approach works, it could work to undermine the connection between early shyness and adult anxiety.

References:

Inhibited children become anxious adults: Examining the causes and effects of early shyness. (2014, April 17). Retrieved from http://www.sciencedaily.com/releases/2014/04/140417155901.htm