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HOW BDD AFFECTS LIVES – SOCIAL AVOIDANCE, PROBLEMS AT WORK, AND SUICIDE: IAN’S EXPERIENCE: “I PULL MYSELF TOGETHER”

admin — Fri, 22 Apr 2011 14:40:48 +0000

While people with more severe BDD may, like Ian, be unable to function because of their symptoms, others, like Carl, function well despite their emotional pain. Carl was an intelligent man in his late thirties with a good sense of humor. He worked as a partner in a law firm, where he’d been very successful over the years. “I’ve been a fairly happy person, and I had a good life,” he told me. “But a year ago that all changed dramatically.

“I was looking in the mirror one morning, and out of the clear blue sky I noticed unusual thinning of my hair, and I panicked. I feared I was starting to go bald. I looked hideous. 1 panicked because I thought that within a year or two the whole front would be lost.”

Carl started reading about hair loss in dermatology textbooks and seeing dermatologists. “I even talked one of them into giving me minoxidil to make my hair grow, which didn’t do me any good. The other dermatologists I saw didn’t understand why I was using it. I think about my hair 24 hours a day—it’s on my mind all the time. It’s like a feeling of hunger that’s always there. When I comb my hair or look in the mirror, my focus on it becomes intense, and sometimes I have panic attacks.”

In reality, Carl had a full head of thick, curly blond hair. He realized his view was distorted. “I realize I look worse to myself than do to other people,” he acknowledged. “I know I’m distorting how I’ll look if I lose more hair. I’ll look worse to myself than to others. I’m distorting my perception, but I also believe it. I can’t help worrying about it. I’m very tuned in to other people’s hair and to changes in my own hair.

“I never really liked how I looked when I was younger. I always thought I was the ugly one in my family,” he told me. “Sometimes other kids called me ‘curly head.’ But I gradually got to like my looks, especially my hair. Now I feel I’ve lost the best part of my appearance.” Because of his concern, Carl felt depressed, and it was hard for him to concentrate at work. “It’s affected every aspect of my life;” he said. “I don’t have enthusiasm for things, and I’m depressed. It’s totally due to my hair.”

Nonetheless, Carl managed to function well. “I do my best to pull myself together for work,” he said. “In the morning I purposely comb my hair without my contacts in so I can’t see myself. I try not to look at my hair in my rearview mirror while I’m driving to work.” The distraction of work helped him think a little less about his hair. He had to put in some extra hours at the law firm to make up for decreased efficiency, but he performed his job adequately. “But,” he said, “I’m afraid that if I continue to lose my hair, I’ll be too embarrassed to be around clients.

“Socially, it’s caused me some problems,” he added. “It affects my relationships because I’m so wrapped up in my hair. It’s hard for me to empathize with other people’s problems. I feel unappealing because I assume people are looking at me the way I do, which I realize they’re not. I feel very self-conscious around women, but I force myself to go out. Even though I look terrible, I’m still asking women out on dates. I worry, though, that this will be an issue if I get into a serious relationship.”

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THE VERDICT ON DREAMS

admin — Sat, 18 Dec 2010 10:57:58 +0000

While theories abound as to the reasons for and the significance of dreaming, the verdict on dreams—whether they hold the key to our inner being, or whether they will prove to be mere electrical storms, like a sort of cerebral aurora borealis—lies in the future.

Our main concern here, however, is with their effect on sleep. As we have seen, dreams on the whole are a positive, if not actually beneficial, feature of sleep. Strictly speaking, the only dream-related sleep disorders recognized by the medical profession are the ones just discussed: nightmares and night terrors. Some people who have nightmares on a regular basis may develop fears and thus experience difficulty falling asleep. Others who have conditioned themselves to awaken at the first sign of a troubling dream may be said to have a problem in maintaining sleep.

By and large, however, these are conditioned responses that can be managed relatively easily in a healthy and positive way, either through self-awareness or through psychiatric counseling.

There is another approach that some people believe may one day prove to have merit, and that bears a brief mention here: dream control.

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THE VERDICT ON DREAMS While theories abound as to the reasons for and the significance of dreaming, the verdict on dreams—whether they hold the key to our inner being, or whether they will prove to be mere electrical storms, like a sort of cerebral aurora borealis—lies in the future.Our main concern here, however, is with their effect on sleep. As we have seen, dreams on the whole are a positive, if not actually beneficial, feature of sleep. Strictly speaking, the only dream-related sleep disorders recognized by the medical profession are the ones just discussed: nightmares and night terrors. Some people who have nightmares on a regular basis may develop fears and thus experience difficulty falling asleep. Others who have conditioned themselves to awaken at the first sign of a troubling dream may be said to have a problem in maintaining sleep.By and large, however, these are conditioned responses that can be managed relatively easily in a healthy and positive way, either through self-awareness or through psychiatric counseling.There is another approach that some people believe may one day prove to have merit, and that bears a brief mention here: dream control.*311\226\8*

HYPNOSIS AND SLEEP

admin — Fri, 08 May 2009 09:39:57 +0000

Highway hypnosis. Since hypnosis is not sleep, what is its relationship to sleep? When a person is driving a long distance on a highway, his eyes are focused only on the highway; he cannot look at anything beyond the highway for more than a few seconds. His eyes and his attention have to come back to the highway all the time. His awareness of the surroundings becomes narrower and narrower. This affects the content of his thoughts, which also become narrower. Although he is in a fully awake state, his awareness is submaximal and is continuously constricting to a narrower span. During this period of extremely limited awareness, it is as if he is in a trance state. He is dissociated from the awareness of his surroundings. Highway hypnosis is very dangerous. Eventually, if he does not pull over and stop driving, he will most likely fall asleep and lose control of the car.

After driving a period of time on a highway, a person goes into highway hypnosis, and very often highway hypnosis leads to sleep.

Hypnosis can lead to sleep. With the invention of the EEG machine, we now know that hypnosis does not equate with sleep. Schwartz, Bickford, and Rasmussen in 19SS reported that hypnosis and the awake state have identical EEG patterns. But typical sleep patterns on the EEG can be brought about in hypnotized individuals by means of appropriate suggestions. Hence, although hypnosis and sleep are two different states, given the appropriate suggestions of heaviness, tiredness, and sleepiness, one can pass from the hypnotic state to the sleeping state easily.

Dream state before sleep? David Foulkes, a US scientist, made a detailed study of the mental state of people falling asleep, and distinguished different phases. The first step is the loss of control over the flow of thought Thoughts begin to wander and go their own way. In the sleep laboratory, if the subject is awakened and questioned just before the appearance of a sleep pattern on the EEG, he reports that he has lost his orientation in time and space and is no longer aware of the reality of life around him. It is as if he is in a dream state resembling that of REM stage sleep, and sometimes it is impossible to tell them apart However, the EEG recording does not indicate any REM sleep and there is no rapid eye movement.

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PAIN AND DISTRESS: THE AGGRAVATION OF PAIN BY DISTRESS

admin — Wed, 29 Apr 2009 10:29:34 +0000

The little boy is playing. He falls and skins his knees, He screams. In an instant his whole being is overwhelmed with pain. For him there is only pain, his whole body, his whole world. Mother seizes him and holds him to her, kissing him on the cheeks. In a moment his distress is calmed and the pain passes, the sobbing dies down and he returns to his world of reality, and inquires about the thing he was playing with. Mother has quieted his distress, and the pain of his skinned knees does not disturb him unduly. Remember that this comes about by her kissing his cheeks rather than attending to the injured knees.

You may say that this is all very well for a child, but I am an adult, and I do not react like this. Perhaps so. But we adults react to pain with distress, only we do so slightly differently. We stop ourselves screaming; but the pain is still there. In a way we scream inwardly, and while this is happening, like the child, we feel consumed by the pain.

We can get some insight into this by comparing different cultural reaction to pain. The- Anglo-Saxon tradition is to present a stiff upper lip in the face of pain or disaster, on the other hand Southern Europeans have an accepted tradition of giving vent to their feelings. Such a woman in childbirth may scream when she experiences pain, and give full vent to her distress; her Anglo-Saxon counterpart may lie there silent, but tense and blanched, and in obvious distress. Both are suffering severe pain because the element of distress has got out of hand whether it is openly expressed or not. Another woman may be led to relax in her mind. Then there is no distress. And because there is no distress there is little discomfort.

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THE NATURE OF STRESS

admin — Thu, 23 Apr 2009 08:20:22 +0000

What is stress? Sky-rocketing interest rates. An unfaithful husband. Problems with the tax-man. Children on drugs. An impossible boss. An unwanted pregnancy. If you believe that such matters are stress, we are not on the same wavelength in understanding what stress is all about.

‘I know what stress is. I can feel it.’ No. You don’t feel stress. What you feel is some malfunction of your body due to the anxiety which has been caused by stress.

Well, what is stress?

As I see it, stress is the disharmony of brain function that arises when our brain is unable to integrate all the information it receives.

Looked at in a more homely way, stress is the disparity between the adverse circumstances of our life and our ability to cope with them.

There are always two sides to stress. On the one hand there are the problems, and on the other hand there is the coping.

If we have some practical problem and if it is of considerable magnitude, our coping will be so much the more difficult. If the impulses arriving at our brain reach such a level of intensity that our brain cannot sort them out and integrate them, our brain function becomes disorganized.

This produces the various bodily and mental malfunctions which we recognize as the symptoms of stress.

Often there is some major problem which initiates the bulk of the disturbing impulses to our brain. But the main problem always operates on a background of lesser problems which contribute their share of disturbing impulses, and so add to the effect of the major problem.

Of course, the magnitude and severity of the major problem will play an important part in determining whether it will generate sufficient nervous impulses to disturb the harmony of our brain function. But the magnitude of the problem by itself does not produce stress. There is always this other factor. Our coping.

Coping with the nervous impulses arising from a major problem occurs at two levels. There is the practical level. What can we do in terms of practical reality towards putting things right? Then there is the other level of coping. What can we do to make it easier for our brain to integrate the flood of messages it is receiving?

In many life situations, the major problem is an event which is quite outside our control. So for practical purposes, our main way of avoiding stress is learning ways of helping our brain integrate the flood of impulses coming to it.

We are living beings. Over countless generations we have evolved a whole host of compensatory mechanisms to help us if we come under strain from one source or another. In strenuous exercise our heart rate is increased and so is the rate and depth of our breathing. We have similar restorative mechanisms to help us if our brain is over-taxed by a flood of nervous impulses from our problems. Those few fortunate people among us who have unconsciously learned to call upon these inner resources enhance the coping power of their brain, and suffer little stress. In this way they come to experience a dimension of life that eludes most of us.

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MEDITATION FOR ANXIETY DISORDERS TREATMENT: BREATHING DURING MEDITATION

admin — Tue, 21 Apr 2009 06:42:22 +0000

As the meditation process unfolds, some people become anxious when they notice their breathing slowing down. Sometimes it feels as if you are hardly breathing at all. This can be disconcerting at first, especially for people who have this fear. There is nothing to worry about. The slowing down of our breathing indicates we are beginning to relax deeply. It is a positive sign that the meditation session is going well. If you are using a word or mantra technique to meditate don’t worry when the technique becomes distorted or disappears altogether in the course of your meditation. This is another indication of successful meditation.

Some people find they go to sleep during meditation. Although most meditation teachers advise their students to remain alert and not go to sleep, I feel somewhat differently about it in the case of anxiety disorders. Firstly, it is a good sign that the practice is going well. If we can let go and relax enough to sleep, then in the beginning this is all that matters. In this instance, meditation is being used as a relaxation technique. Many people with the disorder have difficulty in sleeping. If meditation means people are able to catch up on sleep, then the practice is successful. Most people who do go to sleep during meditation find they do so for about forty-five minutes, and on awakening they feel the benefits. Take it as it comes. In time we all reach the stage when we actually meditate instead of going to sleep.

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ANXIETY DISORDERS: FEAR OF DEATH

admin — Tue, 21 Apr 2009 06:40:32 +0000

Heart symptoms

The most common fear we have is that we will die from a heart attack. Besides having a rapid heartbeat, some people experience palpitations or ‘missed’ heartbeats. They are not dangerous, and will not hurt us in any way. The more we fear them, the more adrenalin is released, so the cycle continues.

Muscle tension

The fear of having a heart attack is compounded by the tightness or pain which may be experienced in the chest, arms and jaw. It can also be felt in our neck and throat. It doesn’t mean there is anything seriously wrong. Stress and tension cause our muscles to tighten. The tension will disappear once we have begun to let go of the fear and anxiety.

Throat constriction

Another symptom which causes a great deal of fear is the feeling of tightness or constriction in the throat, as it feels as if the air supply will be cut off. It won’t. The tightness is a sign of just how tense we are. When we reduce the tension this symptom will disappear.

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THERAPIES OF ANXIETY DISORDERS: OUR SILENCE

admin — Tue, 21 Apr 2009 06:38:44 +0000

Not only do we live in fear of the disorder, we live in fear of other people knowing we have it. Many of us live in silence in case our employer, friends and family find out. This silence is passed on from generation to generation. As we begin to understand our disorder, many of us realise that one of our parents or other family members also has the disorder. Sometimes, tragically, when our parents or other family members became aware that the disorder was beginning to develop in the next generation, they remained silent, just as many of us are now doing.

This silence needs to be broken. Anxiety disorders directly affect two million Australians, and indirectly affect families, friends, employers and the community as a whole. Together we have an enormous voice which can help to speed up the changes needed in the health care system.

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POWER OVER PANIC/SECONDARY CONDITIONS: THE ATTACKS

admin — Tue, 21 Apr 2009 06:28:38 +0000

Everyone who experiences spontaneous panic attack remembers their first attack: where they were, what they were doing and how they felt. There is no other experience with which to compare it. The panic attack usually appears to have little or nothing to do with any personal or environmental situation. Even if we are very distressed about a particular situation it can seem to us there is no direct relationship between the situation and the attack. Whereas in social phobia, obsessive compulsive disorder and post traumatic stress disorder, people may recognise the driving force behind their attack as it is usually specific to a particular situation.

Most people who experience a spontaneous attack will go straight to a doctor or the nearest hospital, sometimes by ambulance, as the attack feels as if it is actually a heart attack. We go through the standard clinical tests which show there is nothing physically wrong. Many of us are now diagnosed as suffering from a panic attack, although a large number of people are still only told they are suffering from stress or anxiety.

There is no relief in discovering that there is nothing physically wrong. The attack can be so severe and the physical reaction so extreme, it is difficult to believe there is not a physical cause. It is impossible not to feel frightened, especially if there appears to be little or no relationship between the panic attack and our current personal situation.

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