CHAPTER 8: Bothersome Feelings, Emotions or Mental Health Concerns

Contents

CHAPTER 8: Bothersome Feelings, Emotions or Mental Health Concerns
- Anxiety and Depression
- Management of Anxiety and Depression

Approximately 5-20% of adults say that they feel anxious, depressed, irritable, sad, downhearted, or "blue" most of the time.

Bothersome Feelings, Emotions or Mental Health Concerns are not a weakness
Bothersome Feelings, Emotions or Mental Health Concerns are treatable
Bothersome Feelings, Emotions or Mental Health Concerns can come back, but treatment will work again

Anxiety and Depression

For some people anxiety may be tied to very specific social situations or concerns: the person may do things to avoid the upsetting situations or perhaps do some things again and again (compulsions) to make them feel that the concern is under their control. For other people the reason for the anxiety is not clear…they are just anxious or very worried without knowing why. Regardless of cause, when people are bothered by severe and frequent anxiety, they are likely to have many other problems. Often they will have troubles with their bowels, appetite, or breathing. Most often they will feel dizzy, weak and tired.

Depression also can be tied to a recent or upsetting change such as a death or loss. Often this type of situational depression is called grief and may not be persistent. People who suffer from pain or a serious illness are at high risk to become depressed. Persistent sadness or depression usually has the following signs that last more than 2-3 weeks:

An "empty" feeling; ongoing sadness and anxiety.
Tiredness, lack of energy.
Loss of interest or pleasure in ordinary activities that used to give pleasure.
Sleep problems, including very early morning waking. Sleeping more or less than usual.
Problems with eating and weight (gain or loss).
A lot of crying or frequent feeling like crying.
Difficulty concentrating, remembering, or making decisions.
Feelings that the future looks grim; feeling guilty, helpless, or worthless.
Irritability.
Thoughts of death or suicide; a suicide attempt.

Management of Anxiety and Depression

Most studies show that people can reduce bothersome feelings, emotions and other mental health concerns by having interests or hobbies, staying involved in activities that keep the mind and body active, and staying in touch with family and friends. Different exercises and even light may be helpful for all emotional concerns.

A simple relaxation approach requires that you turn on soft back-ground music. (Without news or advertisements!) Lay down in bed or a recliner, and let your jaw drop slightly, as though you were starting a small yawn. Keep your tongue quiet and resting on the bottom of your mouth. Let your lips get soft. Breathe slowly and evenly: inhale, exhale, rest. Allow yourself to stop forming words with your lips and thinking words. Think of pleasant pictures.
Other adults find anxiety and stress are reduced by regular exercise. (See Exercising and Eating Well)
Some people regularly feel "depressed" in the winter and fine in the summer. One hour of intense light exposure in the morning seems to improve this seasonal "depression". Those who have studied this problem feel that it is very similar to "jet lag" -- except that it lasts for months. Light seems to work by keeping our internal clock synchronized with actual time.

Another very helpful approach is to use "Problem Solving": (health professionals sometimes call this cognitive behavior therapy or CBT). The Problem Solving part of HowsYourHealth is very helpful.

However, there is a limit to what a person can do for anxiety or depression without the help of others. To get help a person with bothersome feelings, emotions and mental health concerns has to overcome any negative attitudes that stand in the way. Some believe that getting help is a sign of weakness. Relatives or friends mistakenly say that a depressed person can quickly "snap out of it" or that some people are too old to be helped.

Help comes in several forms: - Community support groups. Often other people who have become confident in controlling and managing their own emotional concerns can provide very valuable assistance to people like them. - Community mental health workers have various titles. But they all share professional skills and know contacts that can be very helpful. - Health care professionals such as doctors, nurses, social workers, or psychologists. Depending on regulations these professionals can often prescribe medications. All mental health workers and health professionals understand the value of counseling, medications or the combination of these two treatments.

Several short-term (6-20 weeks) "talk therapies" are useful. A licensed mental health therapist can assist people to recognize and to change unhelpful thinking patterns or improve relationships as a way to treat depression. A very effective form of "talk treatment" focuses on the emotional difficulties that are caused by problems dealing with everyday events. Persons bothered by emotional issues are asked to make a list of problems. One problem is chosen. Methods for solving it are considered. After one problem is solved another is chosen. After about six sessions (4 hours of time), many patients are greatly improved. (If this sounds similar to Problem Solving, it is.) However, it is Problem Solving led by an expert).
Anti-depressant medications can improve mood, sleep, appetite, and concentration. Some improvement is often seen in several weeks, but drug therapies often take at least 4 weeks before being fully effective. They may need to be continued for 6 months or longer after symptoms disappear. Your doctor must know about all prescribed and over-the-counter medications you already take. Remember to take the medication in the proper dose and on the right schedule.

Despite their benefits, particularly in people who are severely depressed, antidepressant drugs need to be used with great care.: Some are best if you are too sleepy (desipramine) or not sleeping ( trazodone or amitryptyline). Some like fluoxetine (Prozac) stay in the body a long time. Older persons should avoid amitriptyline, imipramine, and doxepin. About 3-10 persons out of 100 (3-10%) who take antidepression medicines may be so bothered by side effects of the medications that they have to stop them. If one type causes problems, another type may work for you.

For anxiety antidepressant medications may be helpful. Many anxious people find relief with buspirone and even kava extract. The use of some "sedatives and tranquilizers" (lorazepam, oxazepam, zolpoidem, etc.) that do not stay in the body a long time may be helpful, but often cause dependance.
Alcohol is never a safe or effective treatment for depression or anxiety.
Keep a diary of how you feel and your activities during any treatment. Keeping track of your progress is usually very helpful.

To reduce bothersome emotions, Go TO Problem Solving.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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