Depression

Anxiety

Anger

We all feel anxious from time to time. Anxiety is a normal response that occurs when something makes us uncertain, or when we’re unsure of how a situation will go. For example, if we have money problems, or a loved one becomes ill, we could become quite anxious about it. The same applies when we have to go through an interview for a job, address a group of people, or go on a first date with someone. Being anxious under these circumstances is entirely normal.

There is even benefit to feeling a little nervous. It makes us more alert and sharpens our senses, which helps us perform better.

Sometimes, people just aren’t able to shrug it off. They may remain so anxious that it keeps them awake. They go on worrying for days and develop several other symptoms. Sometimes their worries extend to include more and more things to worry about, and they’re left physically and psychologically exhausted.

Anxiety can increase to the point that it significantly interferes with our daily lives. When we and others start noticing that we’re so anxious that we just don’t function as well as we used to, chances are that we need help.

Anxiety disorders are the most common group of disorders. Approximately 14% of people struggle with it. The second and third most frequently occurring mental health issues are mood disorders and substance use disorders, respectively.

At its core, anxiety is a state of feeling on-edge. It’s an ongoing state of readiness to respond. It’s like an athlete waiting forever for the starting gun to go off. When our anxiety increases sufficiently, or persists for long enough, additional symptoms usually emerge.

For example, our ability to think, remember, and reason becomes affected. When we’re anxious enough, we can’t think straight, we struggle to remember things, and we make bad decisions. This is because anxiety disorders make us preoccupied. We think about our worries, concerns, and fears all the time, leaving little time to think about anything else.

Anxiety is also particularly likely to show up as physical symptoms. This includes increased heart rate and palpitations, shortness of breath and rapid breathing, increased perspiration, cold or sweaty hands or feet, dry mouth, nausea, muscle tension, trembling, dizziness, chest pain, headaches, ‘butterflies’ in the stomach, and restlessness.

Like all other mental health issues, anxiety negatively affects how we function in relationships. Anxiety often leads to things like oversensitivity, not being able handle frustration, irritability, anger, and even aggression.

Finally, anxiety messes up our sleep. Because we feel so on-edge, or remain preoccupied with whatever it is that is making us worry or feel threatened, we can’t fall asleep, and if we do, we typically wake up in the middle of the night, and then struggle to fall asleep again.

Just as we’re all anxious from time to time, we all have moments of unhappiness.

Feeling irritated, or down and sad sometimes, is normal. These bad feelings usually fade as we get over unpleasant circumstances or events. When feelings of irritation or sadness continue for long enough, or if they are intense enough, we could be suffering from depression.

One of the indicators that we are dealing with depression, rather than just common unhappiness, is when it interferes with our daily lives. When we and others begin to notice that we just don’t function as well as we used to, chances are that we have depression, and need help.

Depression is often not recognised. The World Health Organization did a study involving 14 nations in 1988, and found that approximately one out of ten people suffer depression. In addition, it was found that almost half of these cases had not been diagnostically recognised during visits to primary health care providers!

In addition to feeling sad or irritable, depression is typically accompanied by other symptoms. Mental Health professionals often check for the so called Neurovegetative signs of depression, as part of the diagnostic process. They include the following:

Sleeping problems. This is a very common indication that depression, rather than just ‘the blues’, is present. People with depression either struggle to fall or remain asleep, or sleep too much. The most common sleep disturbance involves waking up in the middle of the night, and having difficulty falling back asleep.

Interest and pleasure is reduced. People with depression lose interest in activities or events that they previously enjoyed doing. If you feel that this is true of you, or if other people have noticed that you have withdrawn from things that you liked doing, you may have more than ‘the blues’. This may also include a loss of interest in sex, or decreased sexual pleasure.

Guilt and Remorse. This is a really horrible symptom to have. People with depression often feel guilty, and spend a lot of time thinking about the mistakes they’ve made and blaming themselves for negative outcomes. Their self-esteem is low, and they think of themselves as helpless and powerless.

Energy loss. Tiredness or feeling drained is often found in depression. People with this symptom often report feeling fatigued by minimal activity, and that they just aren’t able to function as efficiently as before.

Cognitive problems. ‘Cognitive’ refers to our intellectual functions. People with depression often struggle to remember, make decisions, and concentrate.

Appetite and Weight changes. This refers to a significant increase or decrease in appetite, and resulting change in weight. A 5% change in weight over a month period usually indicates that this sign is present.

Psychomotor retardation and Psychomotor agitation. ‘Psychomotor’ refers to how your psychological state affects the way you move and express yourself behaviourally. Psychomotor retardation refers to slowed movement or speech. Psychomotor agitation is the opposite, - It refers to being fidgety, twitching, grimaces, rapid speech, and struggling to sit still and relax.

Suicide thoughts. This is a big signal that depression is present. When we have thoughts of suicide, whether or not we have made a specific plan to actually do it, it really is time to speak to someone.

To summarize: At the centre of depression is that horrible experience of feeling sad and miserable, a sense that things are hopeless, and feeling powerless. These feelings, when accompanied by the Neurovegetative signs, suggests the presence of depression. If you think you have any of them, it’s probably time to speak to a professional. Remember, the only person that can confirm or disconfirm a diagnosis of depression is a clinician who has been trained to do so.

Just like sadness or anxiety, anger is often normal, and a reasonable emotional response in reaction to circumstances or events. Everybody feels angry from time to time, just as everybody feels anxious or depressed on occasion.

Anger, must be distinguished from Hostility and Aggression. In summary, Anger refers to feelings, Hostility to thought, and Aggression to behaviour.

Anger is a strong, emotionally unpleasant reaction that usually occurs when we feel threatened. It is typically accompanied by physical sensations such as a pounding heart, muscle tension, increased blood pressure, rapid breathing, perspiration, and an increase in body temperature.

Hostility is the ‘thought’, or ‘cognitive’ component. It’s essentially the negative evaluations we make of people, situations, and things. It’s related to thoughts of bitterness, disgust, contempt, resentment, cynicism, negative judgements, dislike, and antagonism.

Angry feelings and hostile thoughts are likely to exist at the same time. When they increase sufficiently, aggressive behaviour often follows, which more often than not is met with disapproval by society. Because society usually disapproves of aggression, and we recognize that we’ve crossed the line, it usually leaves us feeling even worse.

In addition to aggressive behaviour, Anger may also lead to bad judgement calls. Hot-headed decisions and anger go hand in hand. Of course, Anger also often damages important relationships.

Aggression, which is deliberate behaviour intended to physically or emotionally harm others, can take many forms.

The most common form that aggression takes is physical aggression, which includes throwing, breaking, or slamming things, or physical attacks.

It can also occur in how we communicate with others, or how we relate to them. It includes insults, put downs, gossiping, spreading rumours, criticism, threatening, yelling, screaming, swearing, and blackmailing. Subtler forms of this lie in stern looks, ignoring or excluding someone, avoidance of eye-contact, exaggerated gestures, and stand-over tactics.

Aggression often occurs through financial intimidation or domination. This involves depriving someone of the right to earn money, look after themselves financially, by confiscating money they earn, and generally frustrating or sabotaging their attempts to look after themselves materially.

Aggression may take the form of ‘Cyberbullying’. This involves aggressive and intimidating text messages, accessing private digital information, and using social media to harm others.

Another related term is ‘Violence’. Violence refers to extreme forms of physical aggression, and includes acts such as murder, rape and physical assault. Aggression therefore is a broader term than violence. All violence is aggressive, but not all aggression is violent.