Author: Desi Karalis

If we want things to change we have to do things differently. Face our fears. Change our habits. Shift things around. We might find ourselves standing in a doorway, not sure where to go next. But at least we are there, and ready to go.

It’s like trying on a new hat or coat. We like the look of it, and slip it on one sleeve at a time. It might not be what we are used to wearing, and might feel strange. We might even look strange. But after a while it feels more comfortable, our new look. People make comments, our family and friends who know us best. Or do they? Some like it, and others don’t. Sometimes we pay attention to those who don’t like it, and take our hat off, or the coat that’s not our usual style. It felt a bit uncomfortable anyway, drew too much attention, too many sideways glances.

But sometimes we just refuse. We like our new hat, and love how the new coat makes us feel. After all, isn’t that what we’re after? The feel of it? Feeling fresh, new and different, we look at life a bit differently too. Just as life looks at us. Oh, she’s changed, what does she want now? More peace, more fun, more adventure, more freedom? All of that, and more.

When we change, we signal that things will be different from now on. We will do things we’ve never done and take chances we never took before. We will discover things we’ve never known, not just about the world but also about ourselves. Things we never knew we could feel or do, a life that we now see in a different way, just from doing things a bit differently.

Life is change after all. Nothing stays the same, even when we try to make it so. Sometimes change comes suddenly, and life kicks us hard, forcing us to change. If we were having a hard time this might be a good thing. If we are lucky, we can let the waves of change crash and wash over us until they are no more. If we are having a good time however, we might lament that things are now different, and let the grief and loss that change brings stay with us. Or we can learn to accept it and move on, knowing that change will bring new winds, new experiences, a chance to change direction and to do things differently.

So put on the new hat, try on the new coat, it might just be what you’re looking for.

The subject is heartbreaking – according to the most recent Australian Bureau of Statistics[1] the leading cause of death for people aged 15-44 in 2014 was intentional self-harm.  Tragically, men are three times more likely to die by suicide than women, but the number of women aged 15-24 who suicided in 2014 rose by 50% compared to a 2% rise for men during the same period.

That’s 12 people out of every 100,000, 12 people who most likely have families and friends who are left bewildered and devastated – left asking how could this have happened, what could they have done differently and, for some, asking what did they do wrong?

So why do some people suicide?

‘Untreated depression is the number one cause for suicide. Untreated mental illness (including depression, bipolar disorder, schizophrenia, and others) is the cause for the vast majority of suicides’[2].  Many people are of the view that suicide is a selfish act – what they may not know is that by the time someone decides to suicide it is most often out of desperation, with thoughts that it is their only option in the face of mental, emotional and/or physical suffering that is extremely debilitating and devastating to their quality of life.

Depression is often caused by a combination of difficult life events and personal factors[3], with severe consequences for the person’s state of mind. How they think and feel can become distorted – for example, often people who suicide think it is the best thing for their families and friends, and their only option. People who feel suicidal often feel lonely, isolated, hopeless and helpless. Those with little family or community support and no, or ineffective, treatment are most at risk. It is also important to understand the role that nutrition, sleep and exercise plays, not only in our physical health but in our emotional and mental wellbeing as well.

What can WE DO to prevent such a loss to our families and communities?

There are a number of protective factors (skills, strengths or resources)[4] that reduce the likelihood of people attempting or completing suicide: we can all help by becoming aware of and watching out for the signs and symptoms of mental health issues or suicidal thinking within our families, friendships and workplaces; help people stay connected to their communities; realise our significance to those within our family and friendship groups; support others by helping them change difficult or debilitating personal and environmental factors that impact on their emotional and mental wellbeing; understand the various treatments that are available – biological, psychological, social – and support people to get help.

NOTE: In Australia 24 hour 7 Day a week crisis support is available at Lifeline 13 11 14, Beyond Blue 1300 22 4636, Rural and Remote Distance Consultation and Emergency Triage and Liaison Service 13 14 65.  For longer term support we recommend counselling to assist with positive changes in thinking and wellbeing, as well as providing effective strategies addressing personal, environmental and other factors causing distress and affecting emotional and mental health.    

[1] Causes of Death, 2014, Australian Bureau of Statistics, (http://www.abs.gov.au), cited 9^th June 2016

[2] Kevin Caruso, (http://www.suicide.org/suicide-causes.html) cited 13^th June 2016

[3] What causes depression, (www.beyondblue.org.au), cited 13^th June 2016

[4] Western Michigan University, (https://wmich.edu/suicideprevention/basics/protective), cited 13^th June 2016

 

We all get stressed, and it’s often a beneficial response in our everyday life helping us accomplish our goals. But sometimes our stress levels climb and can go on for prolonged periods of time, which can adversely affect our nervous system and contribute to anxiety. Learning to keep our stress at manageable levels is important for everyone’s mental and physical health.

High levels of stress releases cortisol (the stress hormone) in the body. Cortisol impacts a wide range of bodily functions, and can suppress our immune system, affect our thinking, and cause other physical and psychological health problems.

1. Check your physical health

Sometimes physical health conditions impact our mental and emotional health and make us susceptible to feeling more stressed and overwhelmed – have you recently had a thorough physical check by your local doctor?

2. Nutrition and appetite

If your appetite is affected, try and have some healthy snacks and lots of water regularly throughout the day to give your body fuel to fight the effects of stress. Light foods such as salads, fruit and nuts are good for this and not too heavy on your stomach.

3. Sleep is important

Get enough good quality sleep to help with workloads and stressful situations. Sleep hygiene is important for this.

4. Talk to someone you trust

Looking at ways to reduce the stress at work where possible would be good to aim for. Can you talk to a manager or colleague about the stressors at work and what you might be able to put in place to help reduce them? For example some time management tips eg by prioritising workloads we can get important work done and stop us from getting sidetracked by less important time wasting tasks.

5. Simple breathing techniques are very helpful

See my post about simple but effective breathing techniques. You can also connect with a therapist in your area who can help you with these and more strategies.  Practising regular (daily) breathing and relaxation exercises will calm your body’s nervous system and reduce the stress hormone cortisol.

6. Regular exercise

I know, I know you’ve heard it all before but it really does help!  Regular physical exercise will help you eliminate stress from your body and help lift your mood. Even a half hour of brisk walking 3-4 times a week will help – you need to get your heart rate up to get the best results, so walking fast will do the trick. Cortisol levels (the stress hormone) are reduced and your body releases feel-good endorphins and the feel good hormones seratonin and dopamine. This then helps you cope with stress and anxiety, physically, mentally and emotionally.

1. Check your breathing and reduce anxiety

When we get anxious we tend to over-breathe which upsets the balance of oxygen and carbon dioxide in the body. This is because our fight/flight response is triggered by our fear, so our body gets us ready to run or stay and fight. Even though breathing is fairly automatic, we can get it under our control. The rate of breathing when we are calm is about 10-14 breathes a minute.

NORMAL BREATHING RATES

Use the guide below to help you work out if your resting breathing rate (the rate at which you breathe when you are not exercising) or that of your child’s, is inducing relaxation, or stress and anxiety.

• Newborns to 6 months old: 30-60 breaths per minute
• 6 – 12 months: 24-30 breaths per minute
• 1-5 years: 20-30 breaths per minute
• 6-12 years: 12-20 breaths per minute
• Adults: 10-12 breaths per minute

PRACTICE DIAPHRAGMATIC BREATHING TO CALM YOUR BODY AND MIND

To allay the effects of over-breathing and hyperventilation, practice this simple breathing technique every day. With daily practice you will soon be able to automatically use it to calm yourself when feeling anxious, and prevent the anxiety from spiraling out of control.

1. Place one hand on your belly just below your ribs, and another hand on your chest.
2. Notice if the hand on your chest is rising or if the hand on your belly is rising with each breath you take. If the hand on your chest is rising then you are shallow breathing, which can cause over-breathing. Focus on breathing down to the hand resting on your belly.
3. Keep breathing down into the space beneath the hand on your belly so you can feel this hand rising on the ‘in’ breath.
4. Breathe in through your nose and out through your mouth, and practice slowing down your breathing.
5. In the beginning it can help to use the counting methods below until you have ‘slow breathing’ down pat.

BREATHING TIPS – THE 3-1-4 METHOD

Breathe in to the count of 3 – then hold for 1 – then breathe out for the count of 4. The idea is to count longer on the ‘out’ breath than the ‘in’ breath as over-breathing is caused by breathing in too much oxygen.

BREATHING TIPS – THE 4-2-6 METHOD

As you get practiced at the 3-1-4 method, try slowing your breath down even more by using the 4-2-6 method. Breathe in to the count of 4 – then hold for 2 – then breath out for the count of 6. This counting method will help your body relax even faster by balancing your oxygen and carbon dioxide levels more quickly.

DAILY PRACTICE MAKES PERFECT

Find somewhere where you can relax undisturbed. By practicing at least once, and even twice a day, you will be able to reduce your general anxiety levels. Daily practice also means that you will be able to reduce your anxiety in situations that cause you stress and anxiety, and prevent it from escalating.

2. Relaxation techniques

There are many relaxation techniques you can use to reduce the tension in your body – when you reduce the tension in your muscles, your nervous system can stop being on alert and relax.

Yoga and stretching is a good way to relax tension in your body and release stress. Listening to guided meditation tracks, listening to relaxing music, and the latest trend – coloring in books for adults – are all great ways to relax and be present in the moment. But you do have to schedule these activities into your day. Spend short and regular times throughout the day – 5-10 minutes here and there, to release muscle tension, and free your mind from worry.

3. Psychological therapy

Many therapies aim to address high levels of worry, anxiety and stress.  Gateway Therapy, developed by counsellor Daryl Iannella, is a very effective way of working on anxiety on a deep level to effect changes quickly.  Darryl has been training other therapists to use the Gateway techniques, and we will soon be providing a link on this website to a video presentation of how to use the Gateway techniques.

Another very effective treatment is Exposure Therapy.  Exposure Therapy can be used in conjunction with all of the techniques here, and with other therapies as well. It can be used as a stand alone therapy and is very effective used this way.

Acceptance and Commitment Therapy (ACT) teaches you defusion techniques to distance yourself from your thoughts so you can be in charge of what goes on in your head, and less reactive to the many thoughts and sensations we think and feel every minute. ACT also helps you look at your values and take committed action in accordance with your values. it is funny how separated we can become from our values and we forget about them – but in the act of re-connecting with them, we find our inspiration for how we want to live again.

Cognitive Behavioural therapy (CBT) has also been used effectively to reduce anxiety and increase calm. CBT works on changing thoughts and behaviours and adopting more helpful ones that will lead to a reduction in anxiety symptoms.

Mindfulness techniques have been used in Eastern traditions for thousands of years and help enormously in reducing anxiety. Becoming present in the moment, and increasing self awareness are very effective ways of reducing anxiety symptoms.

See a counsellor or psychologist and ask them about using some or all of the approaches above to re-train your brain and body and improve your wellbeing and quality of life. You may need to look around for a therapist that will be able to give you what you need – ask people, ask your doctor who they can recommend.  A good therapist will have you doing homework activities and addressing all areas of your life, not just having a nice chat with nothing changing. So list some questions and ask if they are experienced and successful with helping people with anxiety.

4. Nutrition, Sleep and Exercise

If your body isn’t in a healthy place your brain and your mind will not be able to tolerate the ups and downs of life as easily as someone who is fit, eats well, sleeps longer hours and takes the time to practice relaxation and stress reduction activities.

ONE: Physical health – sleep, nutrition and movement

Check for any physical health concerns that could be affecting your levels of anxiety.  The other things that affect our levels of stress and anxiety are the quality of sleep, nutrition and exercise we get. Increase your sleep quantity (if you are not getting enough – at least 8 hours a night) and your sleep quality; ensure you are having regular healthy food; and try and fit in regular exercise at least 4 times a week for half an hour to get your heart rate up. This could be getting out for a brisk walk or at home doing star jumps, running on the spot, using the skipping rope or exercise bike.  And get some sunshine and fresh air regularly.

TWO: Breathing to calm yourself

We breathe in oxygen for our body to use and breathe out carbon dioxide.  Our body needs the right balance of each so that it can run efficiently.  When we begin to feel anxious we often start shallow breathing into our chest instead of our belly, causing the flight/fight response to quicken.  Often when we are anxious we can overbreathe (or hyperventilate), which means that we take in too much oxygen, upsetting the balance of oxygen and carbon dioxide in our body.  Our body then tries to bring these back into balance, and reacts with chemical changes – these symptoms then produce dizzyness, confusion, lightheadness, increase in heart rate, blurred vision, numbness and tingling in our hands and feet, cold or clammy hands, and muscle stiffness.

Taking slow even breaths can re-balance these gases, which alleviates anxiety and calms the body.  What we want to do is promote relaxation, and by practicing diaphragmatic breathing, we can induce the relaxation response instead. Check out our other post on how to control your breathing and calm your body’s responses to reduce your anxiety.

THREE: Learn How to Tolerate Your Emotions and Distress

Learning how to tolerate our distress and uncomfortable thoughts and emotions will go a long way to stop us from reacting to them with anxiety and fear. There are many ways you can do this but I’ve found one of the best ways is using distress tolerance worksheets that can be found on the internet, or seeing a counsellor to support you to do this well. You will be amazed at the difference it makes, just knowing you can cope with them and they won’t last. 

FOUR: Stop Avoiding and Start Approaching

Anxiety is characterised by avoiding those situations that we think make us anxious. Learning exposure strategies that help us take things one step at a time builds confidence that we can do things that normally make us anxious.

FIVE: Acceptance

When we practice acceptance rather than resistance we tend to relax more – this helps to alleviate our anxiety. By understanding and accepting what is going on with our body, we can stay more relaxed, realising we are having a normal response which we don’t need to fear.  Acceptance and Committment Therapy helps people do just that. Practicing acceptance, mindfulness (not focused on the future or the past but being present in this moment), and committed action.

SIX: Realise your brain is tricking you

Panic attacks might feel like a heart attack or that you are going crazy but they won’t hurt you. Obviously you need to have a medical check to make sure what you are experiencing is not heart related.  With Panic Attack, the body responds in much the same way, rapid heart beat, tightening of the chest etc. It is useful to remind yourself that you are not dying or going crazy, that it will pass and that your brain is only playing tricks on you.

SEVEN: Question your thinking

Your thoughts aren’t facts but we tend to believe everything they tell us about ourselves and the world.  If we change our relationship with them we can gain more control over how they affect us and choose to only listen to those that are helpful, realistic and encouraging. Cognitive Behaviour Therapy and Acceptance and Commitment Therapy teaches you how to do this.

EIGHT: Mindfulness

Focus on what you are doing now and bring yourself back to the present – keeps your head out of the past and future, which are often a source of stress and anxiety for us.

NINE: Stay connected with family, friends, community

If you are isolated join a group – your local community centre is a good place to start – you can enrol in a hobby such as gardening, book reading groups or something else you really enjoy.

TEN:  And last but not least – Laugh often and well

A good video or movie, or hanging out with so me funny people are all good for the soul.