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Fatigue

Is it Just Worry or Generalized Anxiety Disorder?

In today's world we have a lot to be worried about; job loss, bill payments, rising grocery costs, keeping our children safe, and keeping up with everything on our plates all while maintaining a smile in public.  Some of us are chronic worriers and some not.  Generalized Anxiety Disorder is a condition of chronic worry.  It occurs when our worries never seem to subside.  An ongoing wave of anxious thoughts and behaviors invade our lives daily and we may struggle to let go of them.  My counseling intern, Jill Oulman, Unlicensed Psychotherapist, who will be completing her counseling degree in the next few months, wrote a few thoughts on Generalized Anxiety.  I thought that I would share them with you.  

Generalized Anxiety Disorder

By Jill Oulman

It can be easy to confuse Anxiety for Depression.  Both affect one’s ability to concentrate, both affect mood, often both anxiety and depression affect sleep, and with both disorders one can appear agitated or restless.  Because anxiety is a part of natural human existence, it can be something many individuals brush off as normal.  When it begins to affect their daily lives, they assume it must be something more severe than anxiety.  Many people assume they are depressed and seek help because they cannot deal with their feelings of hopelessness.

By properly assessing the condition as Generalized Anxiety Disorder, the therapist can work to teach the client tools to reduce anxiety and feel in control again.  Human beings are programmed with a fight-or-flight mechanism.  In an individual with Generalized Anxiety Disorder, that mechanism can be faulty and the body is not able to restore itself to a decreased state of adrenaline once that mechanism has been activated.  Often the feelings of anxiety are automatic and not controlled by the client.  Using relaxation techniques can be an effective management tool for the client to restore order to their day.  

When patients can be taught techniques to help themselves, it brings the focus of control from external to internal.  That may be the most important skill as often patients feel as though the source of their anxiety is beyond their control.  This lack of control is what worries them the most.  Enabling clients to have control over their treatment can be a first step in healing.  The therapist can allow the client to focus on controlling their environment instead of the other way around.

Many individuals live with anxiety but it can be

by Gretchen Flores

Pushing Past My Limits and Breaking My Own Rules


I set my alarm for 5:10 am so I could head out to Colorado Springs for a Continuing Education seminar.  I remember thinking that I was over scheduled this week and wondering how this was going to affect me.  I reassured myself it would be okay. 

I used to push myself past my limits regularly.  Somehow I would always find time to crash and recover but 11 years ago I learned the hard way that it is not a good idea to push yourself past your limits on a regular basis.  That was before I had kids when time to “recover” has become more and more difficult to find. 

I groggily got up at 5 am on this midweek day, and headed out to Colorado Springs for my seminar on Play Therapy Techniques.  I was excited about this seminar but was also acutely aware of how fatigued I was.  My son had had the flu on the weekend and I was up with him at night helping him and cleaning up throw up.  Then by Monday I had an upset tummy myself but chose to push through it since my clients are counting on me to be there for them and I knew I would be taking the next week off. 

Because of the scheduled time off, I had a full work week with long days.  I managed to make it through but felt the effects on my body as I slogged into the next day with the enthusiasm of a hippo wallowing in the mud.  Then by Friday I got home from work and my husband seemed cheerful and excited to emphasize that I had made it through the tough week.  Even with the flowers he brought me my happiness waned.  I was grouchy and couldn’t even stand the sound of my favorite music.  I turned off the radio.  I reminded him in a monotone voice that I still had a Toastmasters meeting the next day. 

I was supposed to do a speech after the main meeting for the nursing home residents in the “Speech-a-thon.”  Fortunately I came to my senses and chose not to do the speech-a-thon but went to the main meeting with my makeup on to cover over my dark circles, and a smile (faking it was one of my old coping skills).  I managed to win “best evaluator” and even did a Table Topics talk when you are given a topic on the spot to talk about without preparation time.  By the end of the meeting my muscles in my neck and back ached and my head hurt.  I knew I was well over my limit.  

What is a “limit” and why is it so important?  Learning what my limits are and respecting myself enough to honor them was one of the main components to my recovery from the severe burnout I experienced 11 years ago.  It is also one of the concepts I try to teach my clients when learning to manage stress and anxiety. 

A limit is an invisible line that exists between emotional, physical, and psychological well being and becoming anxious, irritable and stressed.  Once you have crossed the line it is important to pull yourself in quickly by slowing down, implementing self care, and getting rest. 

There was a time in my life I had no perception of a limit.  I had no awareness that one should exist and I lived past my limits all of the time.  I thought I was just driven and “hard working.”  My need to please others, to work hard, and be involved was tremendous.  I thought I was doing what I was supposed to do, and I had an insatiable need to do because I lacked the self esteem to understand that my worth was not linked to how well I did things.  I would push and push.  I pushed myself all of the time, and the funny thing is, when people find out you are a hard worker, something else happens...you get asked to do more things.  Then I found that the pressure also came from others that were expecting me to do for them.  I was programed to feel that nothing was ever good enough so I would strive and strive to perfect things. 

My burnout was actually a gift.  It was a gift that helped me to understand what a limit is and how to enforce it.  I learned that you can’t expect anyone else to enforce it for you.  You have to first respect yourself and your well being enough to be determined to honor your own limits.  I went over them this past week and the result was not pretty.  I don’t  even like being around myself when I am in that place.   Fortunately, last week was an exception and there were parts that were out of my control.   I’ll get back on track and be determined to take better care of myself this week.  That should be easy since I am on vacation.  What are your limits?  How can you honor your limits this week?  

I welcome your comments. 

by Gretchen Flores

Insomnia: Causes and Cures

2:15, 2:21, 2:47, 3:06… watching the clock during insomnia can be tormenting. When will I finally fall asleep? You wonder. Finally, you drift off into a deep dreamy sleep and what feels like moments later; BEEP, BEEP, BEEP! The alarm irritatingly reminds you that you can’t sleep in to make up for hours lost. Groggy and tired you drag yourself out of bed and reach for that extra strong cup of coffee.

Insomnia, a frustrating condition to have. As an insomnia sufferer myself I understand the struggle. There are things that do work and that can help you get a better night’s sleep. You might still have the occasional night of wakefulness but hopefully not as often.

 

What causes insomnia?

There are different causes for insomnia for different people. Some may have chronic worry and cannot seem to turn off the worry switch in their mind and so obsessive thoughts disturb peaceful sleep. Others just wake up unable to fall back asleep. Still others sleep fine once they fall asleep, but may take hours to relax enough to sleep. All, equally frustrating, may require different method’s to solve.

 

Possible Causes:


  • Worry

  • Too much caffeine

  • Too much ginseng or other stimulants

  • Not enough exercise

  • Sensitivity to sound and light

  • Depression or anxiety


 

What solves insomnia?

Again, different people may require a different solution. Sometimes you have to work through different methods to find what works for you through trial and error. Each attempt has to be given some time and commitment, as it might not be solved in an instant. Here are some ideas to try:

 

Possible Solutions:


  • Go to bed and wake up on a regular schedule (to train your body to be in a certain rhythm).

  • Have a relaxing bed-time routine. Read, watch an unexciting show, slow down, get off the phone, computer or other things that require you to think. Drink herbal tea and wind down.

  • Stop drinking coffee or other stimulants by early afternoon. Some say by noon. Find what works for you. If you need caffeine to get you through the afternoon then try a type of drink with less caffeine, such as tea.

  • If you cannot fall asleep after 20 minutes, get up and sit on the couch or other place until you feel drowsy again. Then go back to bed. (This trains your mind not to think too much while in bed).

  • Some research has shown that those who take calcium supplements sleep better. http://www.ehow.com/how_4536607_calcium-sleep-well-night.html

  • Melatonin, a natural sleep aide can help. You can buy Melatonin at the grocery store. Take it 20 minutes before bed.

  • The worry box. For the worriers, a worry box helps. Buy note cards and a plastic note card box. Write down the things you worry about on the note cards. You are allowed to pull out the note cards for 10 minutes a day to worry. When you close the box you are not allowed to worry anymore. Some keep them organized in categories, such as Family, Work, and Misc…

  • Drink a glass of milk before bed or during insomnia. Some research shows it doesn’t work. I will say that it works for me. It is supposed to release melatonin naturally and help you to fall asleep.

  • Use the time to pray. If I can’t sleep I like to feel that I am using the time for something useful. I feel prayer is very useful and so I pray when I can’t sleep. Of course as I get tired my prayers become unusual “lord thank you for… help me to… eat pizza and get a new tire on my house…” But, I figure God understands. ;)

  • If the cause of your insomnia is depression, then you may need an anti-depressant to help. Talk to your counselor or doctor about what might be best for you.

  • For short-term insomnia a little bit of Benadryl can help. This is not useful for long-term insomnia and can cause dehydration.

  • Sleep prescriptions can be habit forming and have side effects. Only try these if nothing else works. Also, you can probably cut the prescriptions in smaller doses because they are pretty powerful.

  • Getting on a regular cardio exercise program can also help. People who exercise regularly sleep better. http://www.sleephotline.com/Sleep/categories/Excercise-Sleep.html

  • Avoid long naps in the afternoon. If you absolutely need a nap. Set an alarm and make yourself get up after 10 to 20 minutes but no longer.

  • Sometimes sleep deprivation can cause insomnia. Strangely, if you are over tired then you can’t sleep. Why? Because your body releases strong hormones to keep you going such as Cortisol or Adrenaline. If you make yourself stay up late to get things done, you may sabotage sleep later. http://www.adrenalfatigue.org/adrenal-fatigue-related-health-conditions/sleep-disruptions.html

 

 

Caffiene meter: (taken off the box of one of my favorite teas; Good Earth). http://www.goodearth.com

Coffee: 100 milligrams (Give or take)

Black Tea: 50 milligrams

Green Tea: 30 milligrams

White Tea: 20 milligrams

Herbal Tea: 0 milligrams

(Per 8 oz.)

 

Don’t make me give up my coffee!

For those of you who shudder when you think of cutting back on coffee or soda, let me tell you that the relief of a good night’s sleep is worth it. My doctor recently told me to “eliminate” caffeine for health reasons. Horrified, I kept repeating the word “eliminate” with a big question mark. “Eliminate? Certainly I can just cut back.” “No” she said. I had to stop.

Guess where the first place this compliant and willing patient went after the appointment? You guessed it. Starbucks! I headed straight there and ordered a Grande of my favorite coffee. That was my last one, though, for several weeks. I did stop drinking coffee. It was really hard to do. I was really tired and a bit grumpy. I was amazingly spacey and forgetful too. I became aware of how dependant on Caffeine I was to get through daily life.

I started to become aware of one nice side effect to my caffeine reduction…Sleep! Yes, I slept better. I felt better, and I had more natural energy during the day. It was great. Yes, I do drink a cup of coffee in the morning now, but I no longer drink three cups in the morning and then a cup or two in the afternoon. Why? Because I want to sleep! I have switched to tea for my afternoon pick me up and I do have more energy. Give it a try…I dare you. You might find you feel more rested and happier. Go for it.

Other resources:

http://www.mayoclinic.com/health/sleep/HQ01387

Blessings to you and to all a good night’s sleep! Gretchen

by Gretchen Flores