Barb Altman Recovering From Depression, Anxiety, And Psychosis
What is the anxiety of psychosis?
Psychosis, generally speaking, is a type of loss of reality testing; properly speaking, it is a disorder of or a problem with thinking. This shift in thinking can be one of the most difficult anxieties for a patient to confront because of the overwhelming sense of loss. The psychotic process can be transient or long-term. Transient causes of psychosis include substance abuse, an acute delirium from a medication, or a medical condition such as an infection or a new onset tumor. It can also be in the context of a worsening mood disorder, such as depression or bipolar illness. At times, anxiety can, in and of itself, become psychotic as seen in extreme obsessive-compulsive disorders or eating disorders. Finally, there is the psychosis of more primary disorders of thought such as schizophrenia or schizoaffective disorder. The experience is commonly described as feeling a shattering loss of control, an overwhelming sense of despair, or an extreme futility. Much of this anxiety can be soothed, either by receiving medication or seeking the structural intervention of hospitalization.
What if I can’t stop thinking about the way I look?
Body dysmorphia is a feeling that something with one’s body is not right. This process focuses on a feeling of one’s nose being too large or too short, one being too fat or too skinny, one’s legs not feeling the right length or right width, or, perhaps, feeling that one’s penis is not large enough or that one’s breasts are too small. These self-perceptions can, when contrasted with the overvalued ideals of our culture, drive much of America’s obsession with cosmetic surgery. The problem, of course, is that the real issue is not the body itself, but the mind’s perception of the body. This symptom-viewing something about one’s body as defective-serves as a reservoir to house other feelings of defectiveness that one has about oneself or one’s sense of security in the world. For example, the woman who sees fat and her own perceived fat as disgusting often feels, consciously or unconsciously, that she is disgusting.
Patients with body dysmorphia harbor the illusion that if they can only fix their perceived defect, then they will feel fixed in their personality. But once the nose is repaired in a surgical intervention, patients with body dysmorphia often discover a new defective feature of their body on which to focus. This pattern of obsession keeps the experience of criticism alive; it reinforces the patient’s negative self-worth. In a most common scenario,
a woman looking at herself in a mirror simplycannot tell if she is skinny or fat. Her need to use a scale to measure her weight parallels her kind of emotional numbness. As she cannot tell whether she is skinny or fat, she also cannot tell whether she is happy, sad, anxious, blue, or excited. This obsession provides an externalized avenue through which to contain, to think about, and to connect with feelings of badness and defectiveness about oneself. Hence, the abusive cycle repeats itself.
Terms:
Dysmorphia – the idea that one’s body (or parts of one’s body) looks much worse or deformed than it actually is.
Obsession – a repetitive, intrusive thought that is difficult for one to get rid of, despite knowledge that the thought is unreasonable.
Does anxiety connect the mind and the body?
Commonly known as somatization, the body and brain work together in an integral way to illustrate a complicated interface between the mind and the body. Anxiety often is at the root of this interface. We know that, neurobiologically, the anxiety system is linked to the rest of the brain through other central parts called the hypothalamus and the pituitary gland. These regions, when anxious, fire multiple kinds of hormones, including cortisol, epinephrine, and norepinephrine within the body. These hormones travel down the vagus nerve and hit all of the major organ systems, including the head (headache); the voice (the raised-pitch voice); the jaw (TMJ, teeth grinding); the lungs (shortness of breath); the heart (palpitations); the gut (diarrhea, constipation, and nausea and/or vomiting); the back (pain); the limbs (trembling); or the peripheral nervous system (sweating and shaking).When some people are feeling anxious, their brains convert this emotional sensation into the physical experiences of nausea, aches, pains, numbness, contractions of the uterus, or hives of the skin. This transaction serves as one of the body’s ways to display its anxiety. It is very difficult for patients to believe that the original problem itself might be anxiety, since they actually experience physical distress.
After ruling out the major causes of any kind of medical problem and an appropriate referral to a psychiatrist, careful history can reveal links between the mind and the body and allow one to address the mental component involved in the physical display of these symptoms. Physical discomfort can represent an unusual way of remembering a past bodily or emotional experience. For example, a man who had asthma as a young boy could find himself with an asthmatic attack on the anniversary of the death of his mother-a way to remember and memorialize her death through shortness of breath, which might be a more emotionally acceptable version of crying. In classic examples of conversion disorder, a patient might experience paralysis of his right arm at a time he wants to punch his boss; or an entire group of Laotian women who witnessed the massacre of their families might develop blindness for the rest of their lives, despite normal functioning of the nerves and retinas of their visual systems.
Term:
TMJ -Temporomandibular joint. The joint that connects the jaw to the skull
