four days in a London Clinic, being treated for anxiety and exhaustion.
Susan Boyle, reality-TV star, spent
Her brother, Gerry Boyle, in an interview with the BBC, denied that his sister had mental health problems and said that she tends to get a 'wee bit anxious', and that it was just part of her character.
Considering that this 47-year-old unemployed church volunteer has shot to stardom in a matter of weeks, it's not surprising. Mr Boyle said his advice to Susan had been to "take a couple of days off" so she could "come back down to earth".
The rest of us might not have stardom to cope with, but stress, tension and anxiety form part of every person's life.
Dr Jan van Leeuwen, clinical and counselling psychologist, says that the only way through this sort of thing is to address it immediately and deliberately, otherwise they might overwhelm and immobilise us. So Boyle did exactly the right thing.
"Stress forms the cornerstone of all forms of dis-ease," says Van Leeuwen. "Therefore it is necessary to know about the effects of anxiety, stress and tension and how we can cope with it. In this case I am talking about stress as dis-ease and not as a disease. It is a symptom of a disease when the thyroid gland is malfunctioning for instance. Then obviously you should get treatment for the thyroid gland that is malfunctioning and that will relieve the stress.
"Anxiety, stress and tension are terms that are often used as synonyms. According to the dictionary, anxiety refers to a state of being anxious about eminent danger; being excessively concerned about the future. Anxiety, however, is usually not linked to a specific person, situation or experience which is feared. It is a vague, undefined, tense feeling of dread that one experiences and which is difficult to control.
"Stress refers to an effort or demand upon physical or mental energy. Stress produces the same feelings as anxiety but it is usually linked to a specific significant other person, situation or experience that one fears. Examples would include an examination, assignment or a superior person. Tension on the other hand refers to mental strain or excitement; a strained state or relationship. If the symptoms are experienced acutely, it is referred to as a panic attack.
"All these definitions have in common the fact that individuals experience excessive uneasiness and that they worry as a result of perceived (excessive or dangerous) demands that are made on them on an interpersonal level. The anxiety, worry or tenseness could result in the impairment of social, occupational, physical and other important areas of functioning. One could also say that individuals experience an excessive sensitivity for other's opinions, attitudes and demands."
Experiencing anxiety, stress or tension can lead to symptoms such as:
- Getting tired very easily
- Muscle tension
- Palpitations - a pounding heart or an accelerated heart rate
- Sweating (cold sweat) or hot flushes
- Shortness of breath, a feeling of being choked or a smothering sensation with pain in the chest
- Nausea or abdominal distress
- Feeling numb or experiencing tingling sensations in certain parts of the body
- Experiencing a dry mouth and the urge to swallow repeatedly
- Impotence or an excessive need for sex
- Feeling dizzy, unsteady, lightheaded or faint
- Feeling depressed and downhearted at times
- Feeling detached from oneself
- Fear of losing control or going crazy
- Fear of dying
- Intense apprehension, fearfulness, or terror, often associated with feelings of impending doom
- Difficulty concentrating on a specific task or experiencing the mind going blank (clouding of consciousness)
- Forgetfulness, resulting from preoccupation with the problem
- Restlessness, feeling keyed up or on edge
- Trembling or shaking
- Withdrawal from interpersonal interaction
- Excessive smoking, sleeping and/or drinking
- Sleep disturbances (finding it difficult to fall asleep or experiencing nightmares, sleeping excessively or restless sleep - waking up tired)
- Not feeling hungry, or eating excessively
- Slow psychomotor co-ordination
"Very often," says Van Leeuwen, "a person who experiences stress is inclined to shy away from interpersonal contact and is thus inclined to bottle up feelings instead of sharing them with others. This bottling up of feelings and the corresponding tension could lead to psychosomatic symptoms as well as disturbed sleep, sexual and eating patterns. Your need for sex might be diminished or you could experience an excessive need for it to comfort you. You also might not feel hungry.
"In an attempt to overcome anxiety or tension, you might resort to excessive smoking, sleeping and drinking. When stress is prevalent, depression is underlying or dormant. Once you give up handling and competing with the problems creating the stress, depression sets in. What can we do about it if we experience stress and anxiety or underlying depression?"
How to cope with stress
Peter discovered that he was in debt. This realization made it impossible for him to sleep. He became very anxious and depressed and wanted to commit suicide. He complained about it to a good friend. The friend listened patiently as Peter told him of all his problems, but when he replied, he made no mention of the debts. This surprised Peter very much.
Instead of discussing the debts, the friend talked about what Peter owned, about his money, and about the friends who were ready to help him. Suddenly the disturbed Peter saw his problems in a new light. He stopped wasting his energy on problems and debts and concentrated on the abilities he actually had. He then discovered that he had enough power and resources to solve his problem.
"This story teaches us that a healthy person is not one who is free of problems, but one who deals with them," says Van Leeuwen. "One day's happiness can make a person forget his/her misfortune, and one day's misfortune can make a person forget his/her past happiness.
Your subjective perception could be different:
"As I have mentioned, anxiety or stress implies an over-sensitivity to other's opinions, attitudes and demands. It is the meaning that you attach to significant other people's opinions, attitudes and demands that brings about the tension.
"This being the case, then surely communication between the concerned parties should alleviate the matter. It sounds easy enough but we all have reservations about communicating about matters of a personal nature. We always think: 'What will he think of me if I told him this problem that I experience', or ' She would think I am stupid to have such a problem,' or 'Why can't I just cope with problems like anybody else?' or 'I am sure I am the only one with such a problem, nobody will understand me.'
"Most emotional problems are related to the perceptions and expectations we have of significant other people. The questions above confirm this view. One could thus also say that in one's (subjective) definition of the problem lies the solution to it as well." Van Leeuwen gives the following check-list:
To be able to perceive and handle problems effectively, one must also be as physically fit as possible. Tiredness can negatively influence the perception of, definition of and possible solution of a problem. The problem may then be perceived as overwhelming and insoluble.
Your definition of the problem could be different:
The solution to a problem lies in its meaning, perception and definition. If you define a problem as overwhelming, it will appear insoluble. Furthermore, if you think about a problem on your own, you will only have one point of view.
In the example earlier, Peter's friend introduced a different perspective and by implication a (different) solution to the problem. When a person is gets ill in the west, they say he must have a rest. He is visited by a few people and visits are socially controlled. In the east, when a person gets ill, his bed is placed in the living room.
The sick person is the centre of attention and he is visited by many family members and friends. If visitors stayed away, it would be seen as uncivil and as a lack of sympathy. In this way relationships are confirmed. In the West relationships very often become severed when a person becomes ill and the sick person is "forgotten" at his/her office until he/she returns. He/she does not experience being missed by colleagues and friends.
Begin to communicate about the problem:
So, if you find it difficult to talk to someone about your problems or negative experiences, find a psychologist or a good friend and start to practise talking to him/her first. Maybe that will give you enough courage to talk to others as well. By sharing a problem and feeling understood, the impact of a problem is alleviated.
There is a saying: "Nature is explained but people are understood." There is no need for you to ever explain your behaviour if you feel you have done the best you can. We only need to understand each other.
Take a tranquilliser for stress situations:
Very often people ask whether or not it may be simpler to take a tranquilliser to alleviate the anxiety or tension. There are times when tranquillisers may come in handy on a short term basis.
For example when a loved one dies and you find it difficult to cope with the emotional impact of the event or if you are the bridegroom who has to make a speech at your wedding and you suffer from stage fright, tranquillisers could help you cope with a temporary tense situation. (The bridegroom might however pay for it in another way later on that evening - much to his embarrassment! Tranquillisers and sex do not really work together.)
Feeling tense could be compared to the waves of the sea. You are not equally tense at all times, just as the intensity of the waves differ at different times. The tenseness builds up to a peak and then calms down a bit, similar to high tide when the sea is much more active. The waves come and go.
The tranquilliser succeeds in cutting out peak emotional experiences so that you do not experience it as so overwhelming. The 'wave' of emotion can thus not develop fully under the influence of a tranquilliser and in this way you are protected for as long as you take the tranquilliser.
Learn to ride the wave of emotion:
But can you carry on taking the medication for ever? Would it not be better to learn how to surf, so that you can ride the waves of emotion when they come? For this reason it is important to talk to as many people as possible about your experiences, especially to experts. If you bottle feelings up, you are 'freezing' the emotional wave and the body is kept in a state of readiness, like a horse that is ready to race. The adrenalin is still pumping and the heart rate is still high to keep you in that state of readiness.
Also many of the corresponding symptoms that were mentioned earlier, still prevail. Obviously the body cannot be kept in a state of readiness indefinitely and something must give in. Usually it is the heart which works the hardest and is the most vulnerable. So, does it pay to bottle up (and freeze emotions)? Definitely not.
- (Dr Jan van Leeuwen, Clinical and Counselling Psychologist, updated by Health24, June 2009)
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