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June 28, 2018 By Samar Hafeez 7 Comments

Reduce Anxiety, Sleep Sound

anxiety1

Anxiety and Fear are a part of life. You may feel anxious before you take a test or walk a dark street. This kind of anxiety is useful as it can make you more alert, careful and productive, however, it usually ends soon after you are out of the situation that caused it. But, for millions of people, the anxiety does not go away and gets worse over time. This can make one, more restless, clumsy and unproductive thereby causing dysfunction in daily activities, and ultimately begins to take over lives.

Anxiety has plagued millions around the world from time immemorial. Anxiety is defined as a feeling of excessive worry, nervousness or unease about something. In this people are always preoccupied with ‘what- if’ thinking, what if something bad, dangerous or threatening could happen, what if anything bad happens to someone I love etc.

Symptoms of Anxiety:

Physical symptoms include:

  • Muscle tension, Muscle Twitching
  • Chronic indigestion, constipation, Diarrhoea
  • Increased or heavy breathing
  • Hyperventilation/Palpitations
  • Nausea
  • Cold chills, Hot flash, Frequent urination, sudden weight loss, headaches

Emotional symptoms include:

  • Feeling of dread, feeling tense and jumpy
  • Irritability
  • Restlessness
  • Sleep problems
  • Panicky most of the time

Cognitive symptoms:

  • Poor concentration Negative thoughts and Apprehension
  • Confusion
  • Poor communication, attention and memory skills

Now let’s move on to discuss how Anxiety may cause sleep problems

Many of us toss and turn and watch the clock when we can’t sleep for a night or two. But for some, a restless night is routine.

The growing cases of sleep disorders due to anxiety are not to be ignored. Indian women outnumber men when it comes to disturbed sleep due to anxiety.

Anxiety and sleep have a bidirectional relationship, meaning high amounts of anxiety tends to disrupt sleep and disruptions in sleep tend to increase anxiety.

In case of Anxiety, it begins in anticipation of an event. When you reflect on a stressful event at night, the emotional centres of brain namely Amygdala and Insular cortex get activated. This stimulates a chain of events that raise both your adrenaline and blood sugar levels. This sudden source of energy then keeps you alert, tense and restless. Ultimately disrupting your sleep.

Sleep on other hand is an integral part of emotional regulation. A lack of it leaves your emotions unstable and in disarray. You are more prone to falling sick often, show irritability and lack of patience and discontent often.

What your Anxiety at night may look like

An individual usually experiences either racing or stagnant/fixed anxious thoughts. These thoughts build on each other or spiral around making it harder and harder to fall asleep.

Some people describe this feeling as being stuck in their head.

Due to the consistent rise in adrenaline and cortisol (stress hormone) levels more and more physical symptoms may result.

Reduce Anxiety

  1. Melt Anxiety with mindfulness meditation: Focusing on your breath and physical sensations can help you stay in the present moment. This can help you recognize what your thoughts may be, allowing them to pass without reaction or judgement.
  2. Rationalize and not Awfulize: Accept the what if thinking as a projection that connects horrifying thoughts and images to anxiety. Think that a what if disaster does not validate or guarantee a disaster, Awfulizing things real or imagined situations as horrible, Awful or terrible will only make symptoms worse
  3. The shift from passive to active perspective: Talk to yourself in a realistic self- assuring way
  4. Relax your body Relax your mind: Practice Diaphragmatic breathing these exercises are simple to learn and can have relatively quick effects. This technique involves breathing in a way that your belly expands as you breathe in and contracts as you breathe out. Psychologist Jon Carlson describes belly breathing as a technique that can send calming signals to the brain and promote a feeling of relaxation and improved attention and awareness.
  5. Imagination and Relaxation: Rolodex of anxiety thoughts can be controlled by using Guided imagery, Guided imagery serves to redirect people’s attention away from what is stressing them and towards an alternative focus, this includes only visualizing pleasant and relaxing image like on a beach or on a serene hill or whatever may soothe a person. This practice is extremely portable, as it relies on nothing but one’s imagination and concentration abilities.
  6. Exercise: Regular exercise provides an outlet for frustrations and releases mood-enhancing endorphins/hormones
  7. Play music: Soft calming music can lower blood pressure and muscle agitation, usually found symptoms in people who get anxious often
  8. Direct anxiety elsewhere: Lend a hand to relative or neighbour or volunteer in your community services. Helping others will take your mind off your own anxieties and will help you count your blessings.

Sleep More Soundly

  1. Make good sleep a priority: Block out 7 hours for a full uninterrupted sleep
  2. Maintain regularity: Try to sleep and wake up on same time daily even on weekends, this helps circadian rhythm your ‘biological clock’ to tick properly.
  3. Avoid stimulants: Say no-no to alcohol, coffee, chocolate or nicotine post sunset
  4. Keep it cool: sleep in a dark room which is slightly cold, this helps the temperature in the brain to fall and help fall asleep quicker, the cool room takes your brain and body in the right temperature direction to get good sleep.
  5. Dark- deprived society: We need darkness in the evening to allow the release of a hormone called Melatonin(sleep hormone) It helps the healthy time of our sleep. In this modern era, we are severely deprived of darkness. So try to dim lights down in your home an hour before bed. Stay away from LED screens as they emit blue light that actually puts break on melatonin and fools brain into thinking it’s still daytime, even though night time.
  6. Do not stay in bed awake: If you haven’t fallen asleep within 30 mins of getting into bed or have woken up and finding difficult to fall back asleep, the advise is to get up go to another room and in dim light just read a book, no screens, no email checking, NO FOOD. And only when you feel sleepy should you return to bed and that way your brain can actually re-learn the association between bed being a place of sleep, rather than a place to stay awake.
  7. Avoid big meals before bedtime and avoid working out 2 hours before bedtime.
  8. Try magnesium-rich foods/supplements like fish or fish oil, almonds, bananas, pumpkin seeds, warm milk, cherries, mushrooms and dark green leafy veggies in dinner. Magnesium relaxes muscles and easesanxiety1 anxiety which contributes to insomnia
  9. Chamomile magic: Try having a cup of chamomile tea 30 mints before bed chamomile is regarded as a mild tranquillizer and sleep inducer, It relaxes nerves and muscles and help fall sleep quicker.

The power of sleep has always been known to be significant but now there’s more and more evidence demonstrating just how important it is for those who experience anxiety. By using above mentioned techniques you can hope for relief from anxiety and eventually will sleep your anxiety away!

 

 

 

 

 

 

 

 

 

October 11, 2017 By Dr Ashwin Nanda Leave a Comment

The Bipolar Journey

bipolar (1) (1)

In 2013, the celebrity world across the world was shocked when they heard that Catherine Zeta-Jones of Mask of Zorro, ‘Chicago’ and ‘Ocean’s Twelve’ fame declared she was suffering from ‘Bipolar II disorder’ and had checked into a hospital for treatment. There were a lot of discussions in media related to Bipolar Disorder- a kind of mood disorder which even the elite cannot escape away from if it grips them.

Similarly, I had a patient named Jalaj (name changed) who was detected with bipolar mood disorder. He got to know of his condition in a fairly unpleasant way. It began with him having trouble in his married life due to his unexplained aggression. Initially, his parents and wife were apprehensive to consult a psychiatrist because they considered seeking help for mental health a taboo. They thought he was stressed due to the financial burden. But, eventually, when his behaviour got worse, they consulted a psychiatrist who after diagnosing declared him to be ‘Bipolar’. His family, wife and friends stood by him in his trying times and he recovered in 6 months without medication. Unfortunately, most of us consider taking anti-depressants to be a sign of mental weakness.

When fights and Jalaj’s behaviour went out of control, it was on the insistence of his wife that the family consulted a shrink for professional help. On taking Jalaj’s history, the psychiatrist found that he had suffered a bout of depression 4 years ago also which was his first episode. He was 20 years old then.

Bipolar mood disorder typically starts in early adult life, between 18 to 22 years of age. Jalaj’s first episode of depression was also for no obvious reason. His wife Dimple reported that during the two years of their married life she did feel he had a lot of mood fluctuations. These mood fluctuations are called cyclothymic mood changes in medical terminology. The person swings between a mildly good and mildly low mood throughout the day and entire life. When his father came to know of his son’s diagnosis he confirmed that Jalaj’s grandfather was also bipolar. He used to have the bout of depression every 3 years and recover from it in 6 months. Bipolar Disorder is strongly hereditary and runs in families.

Let’s understand what is Bipolar?

A person afflicted with bipolar mood disorder goes from mild depression into moderate and then severe depression followed by a return to normal state for few months and then goes into mild mania and then hypomania in a cyclical and periodic manner throughout adult life. The word BIPOLAR means having two extremes which are poles apart. The medical reason is that the neurotransmitters serotonin, dopamine and norepinephrine fluctuate for no explainable reason. Hence it’s a chemical imbalance.

5% of world population is estimated to be bipolar. Impulsiveness is another hallmark feature of a bipolar. They hardly think before doing most things. When in an excessive happy mode, a bipolar tends to go on a buying spree. A bipolar person is also prone to aggression, alcohol, smoking and drug addiction, hypersexuality or promiscuous behaviour in mania phase.

Bipolar image 2 (2) (1)

Treatment

Treatment for Bipolar is psychiatric counselling and regular medication to control mood swings. Jalaj was counselled by a psychiatrist who made him understand that if he doesn’t take medication he will be jeopardizing his family life and career. Bipolars need daily and regular medication to function normally. The medicines called mood stabilizers prevent the mood fluctuations and prevent mania and depression.

Jalaj takes medication as prescribed and follows up with the shrink once every 3 months. Thankfully he is leading a happy married life again and Dimple also understands what he goes through and is able to counsel him. Daily meditation also helps Jalaj deal with his mood fluctuations. 8 hrs of sound sleep is essential on a daily basis for him so that he does not lose his sanity.

It is critical that bipolars’ take treatment because there are chances of attempting suicide during a major depressive phase. Many bipolar utilize the hypomania phase to be more creative and productive and achieve professional stardom. In a way, they turn it into a gift. Bipolar can be well controlled and one can lead a healthy life. On a lighter note, a bipolar person has a happening life with lots of ups and downs.

 

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