Living a Happy, Anxious Life

Paul, over at AnxietyGuru, asks the question, “Can You Live A Happy Anxious Life?”

It’s an interesting question, and I had to sit down for awhile and think about what my answer would be.

Paul posits:

Relative happiness is the kind you get when you buy something, say shoes or a motorcycle or whatever. It is temporary and subject to the whims of external change. Whereas inner happiness is yours no matter what, like all those fabulous bits of information you learned in school that you can’t use anywhere else, but yours they are.

I’m talking about inner peace and happiness. Now, admittedly you can be a Buddhist monk and never get there, but you can if you try. The fact that you can try should be, I hope, a signal that you can do more to be happy than you’re doing right now.

Dictionary.com has the following entry under happy:

1.         delighted, pleased, or glad, as over a particular thing: to be happy to see a person.

2.         characterized by or indicative of pleasure, contentment, or joy: a happy mood; a happy frame of mind.

3.         favored by fortune; fortunate or lucky: a happy, fruitful land.

4.         apt or felicitous, as actions, utterances, or ideas.

5.         obsessed by or quick to use the item indicated (usually used in combination): a trigger-happy gangster. Everybody is gadget-happy these days.

Anxiety, by the very nature of its presence, makes it difficult to achieve #3, since we anxious folk are generally skeptical of fortune or luck. But if we use #2 as our guiding light, which is what I think Paul was doing, then the answer is a resounding yes.

One of the very best things I learned in my treatment was to acknowledge and embrace the reality that things happen that are out of my control, and all of those years of pre-planning and proactive worrying didn’t change that a bit. It certainly gave me the illusion that nothing would go wrong, or if it did, I would be able to rapidly respond to the crisis. But it burned up energy and time for no good reason.

The downside of that – well, there were scores of downsides, but this is one of them – was that I was never in the moment during those times, because my mind and my emotions were perpetually skewed toward scanning the horizon for the next bad thing.

Once I began to let myself be present in the moment and feel the emotion that was appropriate for that snapshot in time, it became much easier to feel happy in an enjoyable way, not in the “if I let myself feel joy or peace, it will be crushing when it ends, because it always does” manner of my high anxiety years.

So when I stop to think about the things that make me happy, it’s much easier now to have clarity around what that means. I find great joy in time spent with my family, and I now allow this sense of calm, contentment, and happiness to wash over me like a waterfall, soaking me for as long as possible. Will this moment end, and will I eventually dry off again? Of course. But for that moment, that hour, that day, I’m drenched and soggy, which feels so much better than before.

I would call out these instances, these events, as reminders of my happiness, not happiness itself. I’m not engaged in some zero-sum game anymore, where I need to track and measure my level of joy, peace, and tranquility. I’m just me, a pretty happy guy, who often gets reminded of my happiness by people, places, and things. Other times, things don’t go as well, and rather than dwell on that, I seek out those very same people, places, and things that I know will keep me going until the dark cloud of anxiety passes over me.

Anxiety and Insomnia – Thanks, Mom

US News and World Report has posted an abstract that details the findings of researchers in the U.S. that there might be a genetic link between anxiety, depression and insomnia.

As a result, researchers advise that adolescents who suffer from anxiety and depression should also be screened for insomnia. That seems like an excellent idea.

I’ve often wondered if my occasional (but more frequent as I get older) insomnia and my anxiety are somehow connected, and if so, if my lack of sleep problems in my youth were in any way a signal of impending emotional struggles that didn’t start until later in life.

From the article:

The researchers’ analysis of data from 749 monozygotic twin pairs and 687 dizygotic twin pairs, aged 8 to 17, and their parents revealed that 19.5 percent of the children had insomnia.

The results indicate that, as has been seen in previous studies of insomnia in adults, diagnosable insomnia in children aged 8 to 16 years is moderately likely to be inherited, according to a news release about the study. The shared genetic effects between insomnia, depression and anxiety suggest that these disorders are linked.

Since genetics plays such a key role in so many disorders, it’s not surprising that insomnia might fall into that category, and 19.5% doesn’t seem to be outside of expectations. It’s also not shocking that there’s a link between insomnia and anxiety, but I wonder if this might not qualify as a “which came first – the chicken or the egg?” scenario. Are the teens more prone to anxiety and depression because they are so worn down due to insomnia, or is one of the symptoms of anxiety the inability to exhibit normal sleep patterngens? Or both?

Not much detail in the online article, but it’s an interesting topic nonetheless.

Insomnia and Anxiety May Be Genetically Linked, via US News and World Report

Napping and Anxiety

There’s an old saying that “if you snooze, you lose.” When it comes to anxiety and depression, that might not necessarily be true.

A study conducted on children between the ages of 4-5 (what, 4 1/4, 4 7/8 – that’s how kids count it) found that kids who stopped daytime napping between these ages had parent-reported higher incidence of anxiety, depression, and hyperactivity than kids who continued to take happy naps.

Reported during SLEEP 2009, an annual meeting of sleep professionals (sure wish I qualified for that), the results shed some new light on the benefits of daytime napping. The connection between poor sleep patterns and anxiety or depression are well-documented, but many believed that children could make up for the lack of daytime napping via nighttime sleep.

The quoted study demonstrated the potential for napping to be significantly more beneficial to children’s daytime functioning compared to nighttime sleep only. Any parent can provide anecdotal evidence that kids who nap tend to be less moody and more easily entertained than children who don’t nap.

Not mentioned in the article was any connection or bias on the part of parents whose children stay awake all day. If the study relied on parental reporting of the child’s anxiety or depression, I could easily see a situation where a parents’ own emotional state could impact on the reporting, as parents of kids who don’t nap can be every bit as frazzled as the children.

The article further points out that there’s still no data to suggest an optimal age to stop napping. I’d like to recommend that we never stop napping. In fact, if I had a cot in my office, and support from management, I’d nap every day. But that’s just me.

Napping, hyperactivity, anxiety and depression linked in preschoolers, via Anxiety Insights

Internet Psychotherapy Proving Effective

You know, there might just be one good thing that comes out of Internet webcams after all!

Anxiety Insights links to an Australian study that demonstrates online therapy can be just as effective as face-to-face sessions. What’s interesting is that patients only required an average of 111 minutes of clinician contact over an eight-week period, which is far less than most patients spend in office therapy sessions over the same timeframe.

The online program centers around treatment for depression, and 34% of patients felt they were no longer depressed after the two-month program, while 82% reported being either very or mostly satisfied with the treatment regimen at completion.

This bodes well for those who avoid seeking treatment due to social stigma, transportation, and provider availability issues, and since most of the program involves email contact and homework lessons, high-speed Internet connectivity isn’t a requirement – sorry to disappoint you webcam fiends.

Technology is opening new treatment vectors all the time, and the online experience can help with one of the sticky aspects of conditions like depression, which is the tendency to withdraw and avoid contact. Online therapy is a good middle step between no treatment and office visits.

On-line psychotherapy as effective as face-to-face therapy, via Anxiety Insights

No Holding Back the Tears

Wednesday night was “graduation” night at my son’s Montessori school, where parents, grandparents, friends, and family pack into the gym and celebrate educational milestones such as moving from kindergarten to lower elementary, lower elementary to upper, becoming big-kids-on-campus by heading to middle school, and finally, the 8th graders departing as they head out for their high school experience.

It’s nice that they celebrate important transitions such as these, and it really builds a sense of community and continuity. The mere fact that an eight year old wants to go sit in the gym for an hour for this demonstrates how much the kids benefit from the event.

Treating the Children of Anxious Parents

Researchers at the Johns Hopkins Children’s Center have found that when one or both parents has an anxiety disorder, therapy involving a family-based program was effecting in reducing anxiety symptoms among the kids and subsequently the risk of these children developing their own anxiety issues later in life.

Newswise has the details of the study, which although small in sample size (40 kids between the ages of 7-12), seems promising. From the study:

Within a year, 30 percent of the children in the no-intervention group had developed an anxiety disorder, compared to none of the children who participated in the family-based therapy. Parents along with researchers who evaluated the children and their parents independently reported a 40-percent drop in anxiety symptoms in the year following the prevention program. There was no reduction of anxiety symptoms among children on the waiting list.

That seems like a statistically significant percentage to me. Not just the children benefit from the therapy, either. Parents were able to develop coping mechanisms and modify their behaviors in several areas, such as “overprotection, excessive criticism and excessive expression of fear and anxiety in front of the children.”

Hopkins is now hoping to expand the study to 100 families. For more information, email CAPS@jhmi.edu .

When Adult Patients Have Anxiety Disorder, Their Children Need Help Too , via Newswise

Nature-nurture debate continues

It’s long been held that for folks suffering from emotional and behavioral conditions such as panic, anxiety, OCD, and so on, the genesis of their disorder could be traced to heredity, or via shaping by their environment, or both. Certain people were deemed to be more genetically vulnerable than others.

Anxiety Insights reports that new studies in the area of gene-by-environment interaction (GXE) surrounding the so-called “genetic vulnerability to adversity” is causing scientists to take another look.

The new thinking is that those with the “vulnerability” gene are not only more likely to be adversely impacted by negative experiences, but also more prone to benefit from positive environments, and they are noted as being more “malleable or plastic”, not just vulnerable.

Long story short – it’s not just vulnerability, it’s that these kinds of folks are more affected by all environmental conditions, both negative and positive.

“Our analysis of many published findings suggests that one potential solution to the nature-nurture controversy is to appreciate the role played by environmental experience and the role played by heredity in shaping who we are may actually differ across people,” said Prof Belsky.

Is it just me, or does it seem like this concept isn’t really breaking any new ground?

If there is a breakthrough here, it would be using this information to expand genetic research and gnome mapping to be able to someday identify the specific hereditary factors at work, which would allow a more tailored therapy approach based on the unique DNA of each individual.

From the article: “This could mirror the trend we are now seeing towards personalized medicine, where an understanding of the genetic make-up of an individual determines the type of drugs used to treat the patient based on their DNA,” said Prof Belsky.

Reframing the Nature-Nurture Debate , via Anxiety Insights

CNN Discovers Mindfulness

You know that eastern practices are becoming more mainstream when CNN starts reporting on them. Heck, I would expect Glenn Beck to begin railing against yoga and meditation now, as both exercises clearly discriminate against the mindless hordes.

All political humor aside, the mere fact that the concept of mindfulness is catching on in these odd and confusing times shows that perhaps the philosophy of quick fixes and pharmaceutical intervention is becoming antiquated as the populace discovers that much like Dorothy in the Wizard of Oz, they had the power all along.

I’ve written about mindfulness here, here, and here, and the longer I practice, the more beneficial it becomes. Certainly, attaining a mindful state isn’t something that happens quickly, or easily. Thoughts and feelings intrude incessantly at the beginning, and it can be difficult to push the head full of busy out of the way and refocus.

But the mere act of recognizing a lack of focus and the presence of intruding chatter and chaos is itself therapeutic, as it helps to frame the amount of noise with which we’re normally dealing and provides a sense of empowerment and calm when we begin to have success at reducing the bedlam to white noise.

The CNN article discusses various “mindfulness” techniques as solutions for stress-busting, but that’s become a sort of catch-all, a default description for anything that helps someone to slow down and feel better. Breathing exercises, stretching, yoga – all are part of plucking yourself out of the rat race and pushing the reboot button to reset your level of tension and anxiety.

Think of your muscles, mind, and body as a rubber band. Visualize that rubber band being stretched when you’re stressed and tense, and then watch it as it grows slack, returning to its natural state. Over time, this rubber band continues to stretch, growing tense, but often fails to fully return to its original loose form due to the underlying tension that never quite goes completely away.

Therefore, our rubber bands end up being partially stretched at all times, so when we do relax, we don’t do it in the manner that we did before – we only return part of the way to a non-stretched condition.

Practicing mindfulness and stress-reduction helps us take that rubber band and relax it the rest of the way, so that it’s both easier to notice the disparity between the stressed and non-stressed self, but also to fully grow limp from an emotional, physical, and spiritual perspective.

I’ve actually seen great benefit to proactive mindfulness – doing a bit of deep breathing and mind-clearing prior to entering meetings or situations that are typically stressful, so that I’m much more relaxed at the beginning and my stress thermometer is starting from a much lower reading.

Mindfulness – catch it!

Mindfulness training busts stress , via CNN

Fear On / Off Switch?

This would be very good news for those of us who have issues with having fear, panic, and anxiety responses that don’t work as well as they should.

Researchers at Harvard Medical School’s affiliate McLean Hospital have identified a protein in the brain that serves as a trigger for how we respond to fear, real or imagined. This finding increases the chances that scientists may be able to develop medications that could help regulate this faulty fear switch in people suffering from certain types of anxiety disorders.

In the study, the researchers looked at the neurons in the amygdala of mice lacking the TRPC5 gene and discovered that they did not fire as well as those in the brains of normal mice. At the same time, neurons in the same region of the brain of the mice missing the TRPC5 gene were not as sensitive to the neuropeptide cholecystokinine, commonly released in the brain during situations of innate fear or anxiety…

Let’s hope that this research continues and that we see some pharmaceutical trials of new medications as a result.

Researchers identify a fear on-off switch , via Anxiety Insights

Does Serotonin Help Moods?

In the treatment of depression, SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective norepinephine reuptake inhibitors) have become mainstrays in pharmaceutical treatment for many patients. Scientists are now asking two questions – do they work, and do they work the way everyone assumes they work?

Anxiety Insights has an interesting look at some research being performed at universities in Oxford and Belfast that questions the common belief that low serotonin levels are behind depression, and instead posit that serotonin therapies affect emotional processing.

In a recent randomized double-blind study, 42 healthy men and women who did not is have depression were given antidepressants (SSRIs or SNRIs), or a placebo for seven days. After a few days of treatment with SSRIs, they became more positive in their emotional outlook based on performance on tasks of emotional processing. These positive biases in emotional processing were independent of their reported mood.

“The drugs work quickly to change how people experience the world emotionally. We believe this is due to the effect of the drugs on emotional processing, rather than directly altering mood. Remembering and experiencing events in a more positive light helps to lift a person out of their depression,” he said. This mechanism of the action of antidepressants is compatible with cognitive behavior therapy suggesting that this dual approach will be helpful for people with depression.

Add to this research into genetic indicators that may shed some light into which patients might benefit from treatment and which might be prone to certain side effects, like weight gain, and it’s clear that while much is known about serotonin, there are many mysteries yet to be solved.

Rethinking Serotonin , via Anxiety Insights