Post-traumatic stress disorder was in the news recently. There appears to be a correlation between concussions and PTSD especially if the injury involved a loss of consciousness. My heart goes out to these soldiers.

Both of my grandfathers were in WWI but it was only my dad’s father that I believe had PTSD. It made sense as he saw much more combat than my mom’s father (pictured here) who was in a cooking outfit. I don’t think it’s a coincidence that there’s not any photos of my other grandfather in uniform. The war must not have held any good memories for him.

This got me to thinking . . . what happens when physical trauma or a threat to safety (staying alive) is replaced by sustained stress over time? Could it have the same effect? Instead of flashbacks of a violent encounter, maybe black dogs relive their emotional trauma. Maybe a lot of small traumas can add can add up to a big one over time.

Like depression, the PTSD diagnosis requires that one or more of the following be present for at least a month and that they must seriously interfere with leading a normal life (these are from www.medterms.com):

• Reliving the event through upsetting thoughts, nightmares or flashbacks, or having very strong mental and physical reactions if something reminds the person of the event.

• Avoiding activities, thoughts, feelings or conversations that remind the person of the event; feeling numb to one’s surroundings; or being unable to remember details of the event.

• Having a loss of interest in important activities, feeling all alone, being unable to have normal emotions or feeling that there is nothing to look forward to in the future may also be experienced.

• Feeling that one can never relax and must be on guard all the time to protect oneself, trouble sleeping, feeling irritable, overreacting when startled, angry outbursts or trouble concentrating.

Sound familiar?

In addition to sadness, black dogs often bring with them an awful lot of anxiety too. My black dog & the anxiety it brought, didn’t show up over night but gradually over the years. When I look back over my life I see a lot of things that aren’t really that unusual - school, relationships, marriage, births, deaths, lawsuits, employment, unemployment, more death, etc. Just ‘life’. In and of themselves they aren’t necessarily overwhelming but over time they built on each other like a slowly expanding sinkhole that sucked the life out of me.

The good and sad events in life each created their own kind of stress. That ‘good’ things are stressful too is something that’s often overlooked. When you have a black dog - a marriage, birth, job promotion or other ‘positive’ life events don’t necessarily feel good. Whether positive or negative all of these events bring an increase to our anxiety level.

Can’t afford to pay the rent? Lack of money is the same stress whether it’s for your mortgage or your daughter’s wedding. New baby? There’s more money and even more responsibility and worries. The black dog makes sure you see the down side to any event.

We learn to do things like driving a car, playing a sport or musical instrument by repeatedly doing that action until it becomes second nature. When we first learn to drive, we’re unsure of ourselves & our ability, so physical & mental tension is high. The more we drive, the more confident we become and our tension recedes as the action (driving) becomes second nature. Turning the engine on, putting it in gear, accelerating and braking have now become automatic in the sense that we no longer have to devote so much energy into each action. We’re still using our brain but much more efficiently now. The neural pathways are like the hard drive in our computer with a new & improved software installed. Unfortunately this operant conditioning plays an important role with learning many unhelpful things too . . . like anxiety, depression and other emotions. Sometimes driving an anxious & depressed car becomes second nature to us.

The Amygdala is a little almond shaped gland in our brain that acts as thermostat for our anxiety. With an appropriate level of anxiety, it switches ‘ON’ and signals us with the ‘fight or flight’ response to danger. Our heart beats faster, our pupils dilate, we become hyper-vigilant, etc. all with the purpose of helping us survive.

But what happens during repeated activation of it during times of stress? My grandfather went through a terrible war and came home to raise a family, then the depression hit, his wife died & he had to raise my dad alone and then he lost his job. The death of a loved one, family estrangement, financial problems, your soul-mate leaves you, etc. - can reset it to an abnormal level of anxiety. It ‘relearns’ and becomes more sensitive in its response to stimuli. It gets stuck in the ‘on’ position and the ‘fight or flight’ response kicks in more often and at inappropriate times.

The catalyst (a problem at work, finances, relationships, etc.) leads to an anxious response (a rapid heart beat) –> your subconscious becomes attached to this response (something must be wrong, my heart is pounding!) –> you become frightened (I’m having a heart attack!). Your anxiety escalates and creates more anxiety and body/mind sensations (more adrenalin, your body flushes, you feel shaky and on edge) and on and on it goes. Your computer now has a new depressive/anxious software.

To break out of this vicious cycle we need to reprogram our computer with newer, more positive software. Something that breaks the downward spiral of negative, anxious thought and feelings that only stimulate your anxiety response and replace it with a relaxation response.

When you’re anxious your heart beats faster, breathing is shallow & rapid and your mind races. So one of the first steps you may want to do is slow your breathing down and deepen it through diaphragmatic breathing. As your breathing slows and you become calmer, your heart will slow down too.

1. Relax your stomach and breath in slowly through your nose.
2. Breath in slowly and focus on your belly rising
3. Breath out slowly while focusing on your belly falling
4. Repeat for several minutes if possible until you feel calmer.
5. Repeat several times throughout the day until it becomes more natural.

You’ll want to keep practicing this type of breathing until it becomes second nature. It’s a good way to breath all the time. The more natural it is for you to do, the easier it will be to fall back on when you feel anxious. You don’t want to wait until you’re drowning to learn to swim. Set aside time to practice your breathing.

Don’t be surprised when your thoughts distract you from practicing the calming breath. It’s the nature of the mind for thoughts to continually pop up and distract us. The more you focus on your anxious thoughts, the more likely your anxiety will continue to grow and you may unwittingly reinforce an anxiety response.

When you’re practicing the calming breath and your mind continues to race, try observing your thoughts as though you are an objective outsider. Let go of any judgments that arise and attach themselves to these thoughts. Just practice seeing these thoughts as though they’re bubbles coming to the surface of the water of your mind. They make their way to the surface where they float for a second or two and then pop into nothing. They have no substance. When you notice you’ve become involved in your thoughts, use that awareness as a prompt to refocus on your breathing. If strong emotions arise in connection to these thoughts - acknowledge them and see them as bubbles too. They come and they go. With practice you can learn to let go and just be with your breath.

Thoughts, emotions and body sensations will continue to vie for your attention but if you continue to refocus on your breath they will eventually loose their hold. You will have re-framed the relationship with your thought & feelings. You will have a new software installed. Relaxation 2.1

For more information on anxiety and panic, here’s some good links:

Anatomy of Fear

Anxieties.com

Emotion, Memory and the Brain

Trauma Tamer

When Fear Takes Control

Retraining the Amygdala

Choosing Behavior - This article rings true for me, especially the part on ‘avoidance of pain’ and ‘inhibition of action’.

This entry was posted on Monday, February 4th, 2008 at 7:46 pm and is filed under anxiety.