Anxiety Disorders are the most common mental health issue in the United States. Anxiety disorders include a variety of conditions where excessive anxiety or fear cause significant distress or impairment in functioning at social, work, family, school or other domains of life. Anxiety disorders include: Generalized Anxiety Disorder, Panic Attacks or Panic Disorder, Social Anxiety, Agoraphobia (fear of leaving the home), Phobias, Separation Anxiety, and Selective Mutism. Some research suggests that here in Portland, Oregon people experience Anxiety Disorders and other mental health issues at the highest rates in the nation.
According to the National Institute of Mental Health (NIMH), nearly 1/3rd of the population (32%) will experience an anxiety disorder within their lifetime. 19 percent of U.S. adults will experience an anxiety in any given year. A larger percentage of young adults (ages 18-44) 22% will experience an anxiety disorder in any given year. A smaller percentage of the population, 8%, will experience an anxiety disorder which severely impair quality of life. Female identified persons tend to experience anxiety disorders at a higher rate than male-identified folk.
What is the Difference Between Regular Anxiety and an Anxiety Disorder?
Anxiety is a normal part of life. Anxiety is an activating emotion which helps us deal with a challenge, or fear in our future. Having a healthy concern about a situation can help you anticipate possible problems and discover better ways of handling them in advance. However, people with anxiety disorders experience frequent worry or fear that interferes with everyday life, relationships, work, or it causes an inordinate amount of distress compared to normative anxiety.
What Causes Anxiety Disorders?
There is no one specific reason or cause of anxiety disorders, usually it involves a combination of things; chemical changes in your brain, traumatic events, environmental stress, coping skills which no longer work, or even your genes. These disorders can run in families, research estimates that about 1/3rd of the risk of developing an anxiety disorder is genetic. This is why it is important to identify a disorder in order to help understand behavior family dynamics and help the next generation. Given the fact that nearly 1/3rd of the population will experience an anxiety disorder in their lifetime, this also indicates that an anxiety disorder may be a normal human reaction to unhealthy or overwhelming circumstances.
What Can Therapy Do for Anxiety Disorder?
Generally speaking, when your world becomes limited due to fear or anxiety it is time to seek treatment. Anxiety can impact your relationships, health, sleep, or work. It can even impact the ability to learn, pursue new things, or feel comfortable in your own skin. Therapy can help in learning tools to promote relaxation, reduce emotional vulnerability, increase resiliency, as well as changing unhelpful thinking, emotional, and behavioral patterns to more helpful ones that empower you to control anxiety and lead the life you want to live.
Do I Need Insurance to See a Therapist?
No. In fact, at Mindful Healing we accept clients on a sliding scale. We are currently accepting clients for our sliding scale rates.
If you live in Portland or the Portland area and want information or help with Anxiety Disorder,
Psychological trauma is a type of damage to the mindbody that happens as a result of either a singular distressing event – or a multitude of stressful events over time – that exceeds our ability to cope. This can include (but isn’t limited to): forced separation from one’s parents, physical, sexual, and emotional abuse, isolation, accidents, natural disasters, oppression, bullying, abandonment, or neglect. In fact, you can experience psychological trauma just by witnessing or learning about an event. In the case of secondary trauma, exposure to someone who has been traumatized becomes traumatic.
The Scars of Trauma
The basics of our stress response system is our fight-or-flight reaction. The mindbody can take this to extremes during traumatic events. When flight to safety isn’t possible, flight from the present can be the next step. In such cases the mind may detach from the body, turn inward, and withdraw from its connection to the present moment. If the fight instinct is activated it can project immense energy outward, expressed in tension, explosive emotions (like anger), thoughts, and behaviors in order to gain control.
When psychological trauma occurs the mind undergoes some fundamental changes in its assumptions of reality. The mind may learn lessons like: the world is unsafe, other people are threats, or that the self does not have the tools to cope with reality. The mind may rationalize that such traumatic events occur because the Self is evil, unloveable, incomplete, or deserving of trauma. These narratives shift people’s worldview and connection with the Self and as a result they become very sensitive to any sign of potential threats including: feeling trapped, close connections to others, isolation, or any physical, mental, or emotional reminders of the trauma.
As a whole psychological trauma disturbs thinking patterns, arousal, concentration, memory, sleep, appetite, attachment, and energy. Psychological trauma also makes the autonomic nervous system more sensitive to stressors, which makes it more difficult for people to regulate and self-soothe. Trauma can disrupt every phase of life. Below is a general list of acute stress symptoms, note that some people may only present with a few symptoms while others with many.
• Recurrent memories, thoughts, dreams, or nightmares that are about, or related in content to, the traumatic event(s)
• Flashbacks, feeling disconnected from body (some people describe it as though they are watching their life as it were a movie)
• The feeling that the world is fake/an illusion, or lack of awareness of surroundings.
• Attempts to avoid distressing thoughts, memories, emotions, or reminders about the event.
• Negative alterations of thoughts and mood. Inability to experience positive emotions
• Persistent negative beliefs or expectations about oneself or the world.
• Loss of interest or reduced participation in normal activities
• Feeling detached or estranged from others.
• Amnesia about the events
• Explosive anger, irritability, or sadness/crying outbursts with little or no provocation.
• Reckless or self-destructive behaviors. Substance use to self-medicate.
• Feeling keyed up, tense, the need to know everything going on, constant worry
• Exaggerated startle responses
• Problems with concentration, or memory
• Impairment in social, work, school, family or other realms of functioning.
Everyone Experiences Traumatic Events, Why Doesn’t Everyone Have the Symptoms?
Not everyone who experiences traumatic events will develop psychological trauma. Genetics, environment, experience, coping mechanisms, vulnerability factors, and resources all play a role as far as how susceptible to trauma a person is.
Risk Factors Include
• Social Isolation of Families
• Not getting developmental needs met
• Poverty, economic disadvantage
• Family disorganization, dissolution, or violence
• Emotionally, physically, or sexually abusive caretakers
• Parental stress, Family History of Abuse
• Community Violence
• Parents/Grandparents were Traumatized
• Previous Exposure to Traumatic Events
Protective Factors Include
• A supportive and nurturing home environment
• Dependable and stable family relationships
• Receiving healthy affection
• Higher Socioeconomic Status
• Economic Stability
• Adequate housing
• Caring adults inside and outside family who provide nurture and act as role models
• Access to health care and community support
As for the thousands of migrants currently being held in detention, they come from areas where they are at an economic disadvantage, victims of violence, and are having a lack of family continuity. This means that the migrants who come to the U.S. borders are at elevated risk of experiencing trauma, and that the current policies remove protective factors and increase the risk of psychological trauma.
Impact of Trauma on Attachment and Relationships
People who have unhealed psychological trauma tend to have problems with interpersonal relationships. One challenge is that trauma interferes with people from communicating emotions in a socially acceptable manner. Trauma itself can prevent people from experiencing humor or joy. Emotions like sadness, anger, guilt, or anxiety are often interpreted by the mindbody to be a threat (as they are associated bad experiences) and thus can set off even more explosive reactions or a dissociative (withdrawing) responses. This makes it very difficult for people with psychological trauma to interact with others.
People who have unhealed psychological trauma tend to have problems with attachment. Some people who have experienced trauma try to keep people at a distance, for fear of being too vulnerable. Romantic relationships and friendships involve a certain level of intimacy. If someone developed the narrative that other people are dangerous, becoming close to someone is a threatening proposition. Alternatively, if someone incorporated the idea that they are unloveable, becoming closer to people means that those people might find out how unloveable they are, which represents the threat of abandonment. Withdrawal, flight, irritability, betrayal, and anger are often great tools for keeping people at a distance,
Other trauma reactions are to pull people in close. People who experience neglect, isolation, or abandonment as a trauma might cling closely to those who they connect with, for fear of abandonment again. Anxiety, worry, excessive kindness and even self-harm are frequently tools used to try deepen connections. Unfortunately, such reactions usually push people away. Other people experience a confusing mix of both reactions where they both crave and fear closeness to others. This process is sometimes referred as disorganized attachment.
People who experience psychological trauma are more likely to enter into abusive relationships. They tend to have more problems with romantic relationships, friendships, and authority figures compared to other people. Given the trauma of loss of family, the abuse by jailers, and the horrors faced at home, the children being held in detention facilities here in the U.S. are more likely to develop all of these social problems.
The Impact of Trauma on Learning
Psychological trauma causes problems with thinking clearly, reasoning, and problem solving. The traumatized mind’s default is crisis mode. It has learned that the world is unsafe and needs to be aware of potential threats. It does this by identifying and criticizing problems of the past, analyzing potential threats in the present, or anticipating catastrophes of the future. As a result people who have experienced trauma have problems staying calm, regulating behavior, and learning new information.
All of this brain activity makes it incredibly difficult to concentrate, let alone navigate the rigors of education. Children who have a history of trauma demonstrate developmental delays, learning difficulties, and behavioral problems in school. Without an intervention they are less likely to achieve in the academic realm, and more likely to have problems achieving stable, high paying employment.
The children being held in detention already had a socioeconomic disadvantage when they arrived at the U.S. border. The current policy and environments these children and their parents are being held in makes it worse. Remember, some of the risk factors for developing psychological trauma include economic disadvantage and having parents who experienced trauma. The current policy of treating immigrants like prisoners is more likely to create psychological trauma not just for those being held, but also their future children. This type of policy manufactures inter-generational trauma.
Impact of Trauma on Mental Health
In short, psychological trauma is bad for mental health. The negative worldview, self-view, and hyper-arousal trauma creates leads to all sorts of mental health issues. People who have a history of psychological trauma are more prone to volatile, oppositional, and extreme behaviors. Emotionally they tend to be prone to defensiveness, aggression, spaciness, and difficulty regulating emotions. They are also more likely to demonstrate dangerous behaviors like self-harm, unsafe sex, recklessness, substance use, and suicide. There is plenty of data which demonstrates that childhood trauma alters brains development.
Children who experience trauma are more likely to develop the following types mental health disorders later in life: Schizophrenia (and other psychotic disorders), Post-Traumatic Stress Disorder, Depressive Disorders, Anxiety Disorders, Eating Disorders, Obsessive Compulsive Disorder, and Personality Disorders. As a clinician who has worked on healing with hundreds of people who navigate hallucinations, delusions, or personality disorders I have yet to meet a person experiencing such a disorder that was not exposed to childhood trauma.
Poor mental health does not just cause psychological suffering and problems with functioning, it is associated with increased risk of physical health issues as well. People with mental health issues are at increased risk for heart-disease, diabetes, and inflammatory conditions. People diagnosed with serious mental illness (schizophrenia spectrum, bipolar disorder, or severe depression) have a decreased life expectancy by 20 years.
Impact of Current Policies as a Whole
In this article we explored the nature of psychological trauma, its effects on the mindbody, and the long-term outcomes. The Trump administration’s current policies are traumatic acts that will cause lasting harm. Indefinite detention, keeping people in cages, and family separation, of migrants who are already fleeing violence will cause the development mental and physiological health problems. These policies are likely to cause economic and academic, and long-lasting inter-generational trauma. It is impossible to tell the totality of suffering this is creating now. Reuniting families, ending indefinite detention, and creating humane solutions that involve healing, nurturing, and hope is essential for our collective health in the present and the future.
Trigger Warning: If you’ve had a history of trauma, and are prone to flashbacks, intrusive thoughts, or are actively experiencing PTSD, this process may set off some of those experiences, which can reactivate feelings of the trauma. There are other mindfulness exercises that involve more grounding that may be a better fit for you, and you may want to skip this exercise.
Please read through all of the instructions before you begin.
Get in a comfortable position. This exercise can be done, sitting, laying, or standing if you wish.
Set a timer for 5 minutes.
Invite your eyes to rest.
Breathe in through the nose (if you can’t breathe through your nose the mouth makes an excellent substitute), out through the mouth, practicing diaphragmatic breathing. In order to practice diaphragmatic breathing,
Inhale deep into the belly, then the chest; invite your belly to expand and the ribcage to open as you inhale.
Exhale out through the mouth, at a pace that is comfortable for you, bringing the belly in towards your spine.
If you find it is difficult to breathe deep into the lungs you may consider resting your hands on top of your head, as this will open up the ribcage and make it easier to breathe deep.
Focus on the breath like a curious observer. Notice the coolness of the inhale, the warmth of the exhale. Notice how the chest rises and falls, and how the air flows through your windpipe.
As you go through this process, you may notice that your mindbody wanting to attend to different sensations, thoughts, or feelings. Perhaps you feel the urge to scratch an itch, or begin planning your to-do list is for tomorrow, or feel bored of this moment attending to the breath. Push nothing away and attach to nothing.
Any time you notice a thought or a feeling, label it and let it pass through your mind as though it were a log flowing down the river of your mind, and return your attention to the breath. You can tell yourself things like, “my mind is planning,” or “mind is judging,” or “body is feeling some anxiety.”
When the timer goes off, take a few moments to wiggle the fingers and toes, blink open the eyes, and then return to the room.
Go ahead now and take the time to complete the exercise, then return to reading.
Was it challenging for you to just breathe and sit still? Did you notice that even though all you’re supposed to be doing is breathing that your mindbody was having thoughts and feelings? I know my mind wandered to planning, criticism, and pondering. Did you notice any patterns? This exercise can be helpful to reduce anxiety, and understand the background content of our minds. It can also be a helpful reminder that we are more than our thoughts and feelings, and we do have some control over how we interact with them. Learning to regulate our interactions with our mindbody can go a long-way to improving our overall mindbody fitness.
DO I NEED INSURANCE TO SEE A THERAPIST?
No. In fact, at Mindful Healing Portland LLC., we accept clients on a sliding scale. We are currently accepting clients for our sliding scale rates.
Today we are going to explore the nature of mental health disorders. Mental health disorders are real, prevalent, and can impact anyone. 1 in 5 Americans will experience a diagnosable behavioral health condition this year. They cause emotional, physical, psychic, and relational suffering, and can severely impact life functioning. For the most part mental health disorders are not a disease. Rather, they are normal stress reactions, and expressions of variety within our species. The most common threads linking mental health disorders are stress, trauma, genetics, and access (or lack-there-of) to coping skills and resources.
A lot of times the normal emotions that get labeled as “negative” are often healthy responses to our environment. The sadness and fatigue we experience while we mourn the loss of a loved one, tell us to slow down, rest, and take time to understand our loss and make sense of our new environment. The energy of anxiety can propel us into problem-solving action like studying for that big test. The hypervigilance and wariness that trauma survivors experience help us keep on the lookout for danger, a key to survival while living in an unsafe and threatening environment. Many times it is when these healthy adaptations are present when they are no longer needed, or when they become maladaptive and impact the quality of our lives or impact our functioning, that we label them a mental health disorder.
It makes sense that most of us misconstrue and misunderstand mental health experiences. The majority of funding to provide treatment for mental wellness is paid for by health insurance here in the US. Insurance companies operate by the disease model of mental health. That is to say the way they classify mental health is that you either have a disease that is making you unhealthy, or you are healthy and no longer in need of treatment. Clinicians are expected to take notes that use language which indicates they are assessing and treating a disease. Such a model limits our view of mental health, having us merely focus on symptoms. Such a model does not provide credence to wellness factors like resilience, creativity, socializing, perspective taking, courage and other adaptive mental functions which contribute to health.
Another contributor to the misconception of mental health are the marketing and sales of psychopharmaceuticals. Major pharmaceutical companies medicalize normal human conditions such as sadness and worry. There is a multi-billion dollar market out there trying to convince people across the globe that experiencing human misery is a sickness that can be cured with medicine, and not only that, but long-term medicine. This isn’t to say that you should not pursue medicine. Internal and external stressors can cause our brain chemistry to get out of whack and cause needless suffering. Psychopharmaceuticals have helped millions cope, and if it helps you I am glad you’re taking them. What this is to suggest, is that misery is part of the human condition and the perspective of viewing mental health as a disease is problematic.
The problem is, is that the disease model doesn’t hold up under scrutiny. Mental health disorders are culturally dependent, while diseases are not. Cancer, the flu, HIV and other diseases look the same, no matter where you are in the world. Anthropologists have done many studies and have found that mental health disorder symptoms change depending on the geo-cultural location. Depression, anxiety, and schizophrenia, look different in the US than they do in Japan, Tanzania or India for example. Other studies have demonstrated that depending on the culture, traditional medicine folk are about equally effective in treating mental health disorders as mental health professionals.
Culture plays a significant role in our views of mental health as well. The DSM used to classify being gay as a disorder; today being gay, lesbian, pansexual, or bisexual are widely accepted (as they should be) as part of our normal sexual diversity. Emotional and cognitive responses like sexuality, height, and weight, also exist on a spectrum. Some of us are more emotionally sensitive than others, some of us are more expressive, some of us less. 20% of the population will experience a mental health issue this year. This suggests that these are pretty common stress responses. I have yet to work with a person who is experiencing a mental health issue who was living in a healthy environment, felt secure in their needs, had no experience of trauma, was well connected with their community, existed in healthy relationships, was engaging in meaningful activities, and in good health.
And that leads to another important question. Are mental health disorders unhealthy responses to healthy circumstances, or are they healthy responses to unhealthy circumstances. Nobody has ever proven that the collection of mental health disorders in the DSM or defined by the WHO are unhealthy responses to healthy circumstances. There is plenty of evidence to suggest that disorders PTSD, anxiety, and depression are normal stress responses to unhealthy circumstances like abuse, violence, neglect, or not being able to meet ones needs.
So what does this all mean for how we view mental health? Mental health disorders create suffering, have significant impacts on functioning, and are worthy of being treated as the serious and real conditions that they are. Perhaps this means we as a collective have to re-examine our definitions of wellness and how we as a society want to achieve our individual and collective wellness. Perhaps this means we need to re-examine and redefine how we provide resources to treat suffering. Maybe this means we should be a little more gentle and understanding with others and ourselves, knowing that if we’re not feeling well, behaving well, not thinking well, or not communicating well we are doing our best and probably responding to our internal and external environmental experiences. We are only human, after all.