Recovering from Tragedy Is a Process

When you are caught in the throes of tragedy, your emotions feel out-of-control. But there is an order to how we process the chaos that accompanies traumatic loss, whether it is the death of a loved one, a failed romantic relationship, job loss, a difficult medical diagnosis or any of the challenges we face as we move through life. Understanding the process we go through as we work through a traumatic experience can help us cope. There is comfort in understanding that our feelings and responses are normal.

When we suffer a tragedy, we grieve for what is lost. Death, divorce, job loss, relocation, illness — all involve significant change and loss. In order to accept the change and move forward, it is necessary to recognize and mourn what is lost, whether it is friendship, love, familiarity, ability, status, financial stability, etc. Psychiatrists have identified distinct five stages of grief that accompany loss. While these are most often applied to mourning the death of a loved one, we go through the same stages as we learn to accept and heal from any tragic loss.

• Denial and isolation. At first, we may deny feelings of loss or try to minimize the importance of the event. People may withdraw from family and friends through emotional discomfort or embarrassment.
• Anger. Anger can be directed outward or inward if the person feels her actions contributed to the tragedy. Feelings of “why me” are also common. 
• Bargaining. No one wants to accept traumatic loss. We may try to bargain with God, promising “I will do this if you remove this burden from my life.” Or be tempted to plead with an employer if we are laid off. Bargaining attempts to stave off the inevitable.
• Depression. As anger fades, numbness may overwhelm us. Pervasive sadness blocks feeling. We may feel hopeless. You may need the guidance of an experienced psychiatrist to help you move forward.
• Acceptance. As we work through loss, we learn to accept the new reality.

For more information on How to Recover from Tragedy, listen to Dr. Marks’ October 14 podcast.

Learning to Recognize Symptoms of Stress

The nagging headache starts at the office. You feel tired. You’re having trouble concentrating. Your productivity starts to suffer, and you begin to wonder if you’re coming down with the flu. By the time you get home you’re ready to tuck yourself into bed. The chills and fever never materialize but your symptoms don’t go away.

While persistent headaches, fatigue, frequent forgetfulness and decreased productivity can be signs of illness, stress is often the culprit. Stress can affect your body physically, can impair thoughts and emotions, and can impact behavior.

• Physically, excessive or long-term stress can cause headache, back pain, chest pain, high blood pressure, erratic heart beat, stomach and intestinal problems, and sleep problems. Persistent stress can decrease your immunity to disease and cause heart disease.
• Emotionally, persistent stress can cause anxiety, restlessness, excessive worry, irritability, sadness, anger, feelings of insecurity, inability to concentrate and forgetfulness. Left untreated, stress can lead to serious depression.
• Behavior changes associated with constant stress include overeating or undereating, problems managing and controlling anger, drug or alcohol abuse, increased smoking, social withdrawal, crying spells and relationship conflicts.

If you are experiencing any of these symptoms of excessive or chronic stress, it is important to seek medical help. Naturally, a trip to your primary care physician to rule out and address any physical illness that may be responsible for your symptoms is in order. However, if chronic stress is the source of your symptoms, you will have to go beyond your primary care physician to cure what ails you. 

Chronic stress can be treated and overcome and you can learn to live a happier, more balanced, relatively stress-free life. With the help and guidance of a psychiatrist experienced in stress management, you can learn to recognize your personal stressors and how they impact your life and health. Through cognitive-behavioral therapy, an experienced psychiatrist can help you learn to recognize and control your reaction to stress. With expert guidance, you can learn new techniques for responding to stressful situations and people. You don’t have to let control your life. With help, you can learn to control stress and regain control of your life.

Regaining Control of Our Anger

Has anger run amuck in America? We have always been a nation of strong opinions and diverse views, but it seems that the added stress of the economy is causing us to crack (read our Sept. 25 post). The problem with the nation’s rising anger is bedded more in emotion than reality.

Economic and government experts tell us that we will survive, that times will get better; and history tells us this is true. But so many of us have been struggling without jobs, without enough to pay our mortgages or support our families for so long, that, internally, emotionally, many of us have lost hope. We simply don’t believe that things will get better for “me.” And we’re angry about that. When events affect us personally, we’re unable to take the wider view. Constant stress turns our psyche brittle causing minor problems and small slights to elicit angry outbursts out of proportion to reality.

Poorly controlled anger fueled by anxiety and stress seems to be at the root of the pervasive rudeness that is sweeping across America. When fear and anxiety about the economy and its impact on our own lives becomes too great to handle, it either explodes outward as physical or verbal anger or is internalized as anxiety and depression. Anger needs an outlet, but unhealthy expressions of anger do not solve problems, they simply create additional problems.

There are always solutions to our problems, but there are many times, like today, when many of us may feel so overwhelmed by our problems that we cannot see those solutions. It is at times like this when many people need professional help and support from a board certified psychiatrist to cope with and find solutions to their problems. Under the direction of an experienced psychotherapist, psychodynamic therapy can help us uncover and understand the true sources of our anger and anxieties, the first step in changing destructive behavior patterns. Psychodynamic therapy is often used in concert with cognitive-behavioral therapy which can help individuals identify non-productive ways of coping with stress and anger and replace them with positive behaviors.

Are Americans Raging Out of Control?

“I’m mad as hell, and I’m not going to take it anymore,” rants mad anchorman Howard Beale in the 1970’s movie satire Network. Beale’s nightly television rants inflame a nation of angry, frustrated citizens who have reached maximum overload and are fed up — with everything. Sound familiar? According to an article in the September 28, 2009 issue of Time magazine, pollster Frank Luntz surveyed 6,400 Americans earlier this year asking whether they agreed with Beale’s sentiment. A resounding 72% — 3 out of 4 — said yes.

The rude, angry tone in America today is the new hot media topic. Fanned 24/7 by the flames of ranting TV and radio hosts like Glenn Beck  and Bill O’Reilly, Americans are spewing anger and distrust.

• U.S. Representative Joe Wilson of South Carolina shocked his colleagues and the nation when he yelled, “You Lie!” during President Obama’s nationally televised speech to Congress.
• Tennis diva Serena Williams unleashed a profanity-laced threat at a line judge during a U.S. Open semifinals match.
• Rapper Kanye West grabbed the microphone away from a startled Taylor Swift during her acceptance speech for best female video at the Video Music Awards to declare that the winner should have been Beyonce.

Rudeness is a daily occurrence in any social community. The examples of bad behavior cited above received so much press because these people are supposed to be among our nation’s role models. Those who monitor the nation’s psychological temperature are concerned about the pervading lack of respect being expressed today. A 2002 Public Agenda survey found that 79% of Americans consider lack of respect a “serious national problem.” 

Anger-fueled rudeness seems to be increasing along with a sense of personal entitlement. Fanned by the ravings of national pundits and the selfish examples set by national celebrities, frustrated by the slow economic recovery, angered by the excesses of Wall Street, worried about the growing national debt, and concerned about providing for themselves and their families, usually well-mannered people are starting to crack under the strain. Rabid behavior during Congressional town-hall meetings over health care reform is just one example of anger run amuck in America.

To be continued on Monday: Regaining Control of Our Anger

Fighting the Out-of-Work Blues

The starting bell in the employment race has always rung in the fall. September has traditionally been the best time to look for a new job. Children start a new school year, freeing parents from daytime childcare duties. Collegiates return to college campuses, leaving stores hunting for replacements. Corporations assess staffing needs as they ramp up new marketing programs. Whether looking for full- or part-time work, most job seekers found success during fall recruitment drives. But that was before the recession and double-digit unemployment.

Today, job searches are taking months instead of weeks. Layoffs have made competition fierce, forcing more and better qualified applicants into the job pool. As job searches lengthen and savings dwindle, anxiety and feelings of desperation set in. Some people frustrated with their inability to find a job that will support them or their family give up and sink into depression.

But the burden is felt not just by job seekers. When layoffs occur, those left on the job often suffer survivor guilt. Those still employed are forced to take on greater work loads, work longer hours and assume greater responsibility, further increasing stress and anxiety. For some, the stress becomes too great. According to the U.S. Labor Department, 251 people committed suicide on the job last year, an increase of 28% over the previous year and the highest number since reporting began.

Losing your job doesn’t have to be a career death knell or plunge you into a pit of despair. Traumatic experiences can be a catalyst for positive change. Psychiatric counseling that focuses on cognitive-behavioral therapy can help you find the silver lining in a layoff or difficult job search. Losing a job can be the impetus you need to abandon a career you don’t enjoy, start a business or go back to school. It can be an opportunity to explore new interests, discover what is most important to you and reinvent yourself in a new career. If you are struggling with a job layoff or searching for a new direction in your life, or if you are feeling depressed and anxious about your job, cognitive-behavioral therapy under the direction of an experienced psychiatrist like Dr. Tracey Marks can provide the support and skills you need to meet life’s challenges successfully.

Put the Chill on Heat Wave Anger

When the temperature rises, tempers flare. It doesn’t take long in 90-degree heat for small irritations to ignite into angry rants. The frequency and volume of childish squabbles escalates. Frustrated parents lose their cool and yell at their kids. Spousal bickering escalates to angry arguments. When it’s hot outside, everyone gets more than a little cranky. 

It’s hard to keep your emotional cool when your body feels like it’s frying. Sweat, dehydration and exhaustion overwhelm us physically when the mercury climbs into the high 80s and 90s. Heat can increase heart rate and elevate blood pressure. The physical toll chips away at our emotional defenses, eroding our ability to cope with life’s ordinary challenges. Fueled by the heat, people who are normally pleasant and patient can become unreasonable and irritable. They snap and they snarl at the slightest irritation, lashing out at the closest target — often a spouse or child.

Psychologists and criminal justice authorities have long known that heat waves cause a spike in crime rates. Heat tends to make people more argumentative. They’re more likely to react to irritants without thinking. Iowa State University professor of psychology Craig Anderson who has studied the phenomenon told the Selma Times-Journal online, “Being uncomfortable colors the way people see things. Minor insults may be perceived as major ones, inviting retaliation.”

When the mercury climbs, your best defense against an emotional meltdown is a good offense. Cool down your body to cool off your psyche. Here are a few tips guaranteed to dial down your discomfort level during the dog days of August and help you keep your cool in the heat:

• Turn on the air conditioning and augment airflow with fans. No A/C? Mist yourself with water and sit near a fan.
• Chill out at the local shopping mall (most have a play area), senior center, public library or take in a movie.
• Wear loose, light-weight, cotton clothing. Declare a swimsuit day at home.
• Take cool showers. Let the kids play in a cool tub.
• Spend the day at the pool or beach.
• Fill up the kiddie pool and turn on the sprinkler. Join the kids in a water fight.
• Stay hydrated and eat some salty snacks. Avoid alcohol which can increase heat stress.

Sense of Fatalism Encourages Risky Behavior in Teens

A surprising number of teens expect to die young. In a seven-year study of 20,000 teens in grades 7 through 12, 15% felt it was highly likely that they would die before they reached their 35th birthday. Published in the July issue of Pediatrics, the unexpected results have caused researchers at the University of Minnesota to wonder if it is a feeling of hopeless fatalism rather than a sense of invulnerability that leads teens to engage in risky behavior.

The magnitude of teen-aged pessimism took researchers by surprise. University of Minnesota researcher Dr. Iris Borowsky told the Associated Press, Adolescence is “a time of great opportunity and for such a large minority of youth to feel like they don’t have a long life ahead of them was surprising.”

Males (15%) were slightly more likely than females (13%) to think they would die young. Living in a more stable family situation appeared to decrease the feeling of risk. Only 10% of teens who lived with both biological parents felt at risk, while 18% of those who lived with only one or neither of their biological parents felt they would die early. Lack of financial stability significantly increased the feeling of risk. Twenty-four percent of teens with a parent receiving public aid believed they would die at an early age. Racially and ethnically, the breakdown of perceived risk of early death was highest for groups exposed to the greatest deprivation and violence:

• 30% Native American
• 26% Black
• 21% Hispanic
• 15% Asian/Pacific Islander
• 10% White

While fatalistic teens did not die more often than their more optimistic peers (only 94 of the 20,000 teens participating died during the seven-year study), they were more likely to engage in unsafe behavior, including drug and alcohol abuse, unprotected sex, attempted suicide, and getting into fights that resulted in serious injury. Teens who believed they would die young were seven times more likely to contract AIDS than their positive-thinking peers. The perception that life was hopeless appears to have encouraged greater risk taking.

Psychiatrists are looking at the study in hopes of developing better methods for identifying at risk teens. It is hoped that the detection of fatalistic attitudes and thinking will help the medical community identify and treat at risk teens before they engage in dangerous behavior.

Learning to Control Anger

Anger is one of our most basic survival instincts. We use anger to protect ourselves from threat and defend ourselves against attack. But losing control of our anger can be physically and psychologically destructive. There are three basic ways people deal with anger:

• Expressing angry feelings assertively but without aggression is the healthiest way to deal with anger. Passion is fine, but not force. Expressing our needs is crucial to our well-being at any time, but particularly when we’re angry. We become angry when we perceive that our needs are not being met in some way. The ability to clearly tell others what we need and how we are feeling is the first step toward getting our needs met. The process helps dissipate and resolve anger as we compromise with others and develop a plan to meet our needs. However, it’s important to be respectful of the needs and boundaries of others.
• Suppressing anger can take two forms.  The most direct form of suppression is when we deny ourselves a way to express and thereby release our anger. When anger is internalized, it can fester and grow, becoming destructive. Redirection is another way of suppressing anger. Rather than confront the source of our anger directly, we channel angry energy into a more constructive activity, such as brisk walking, jogging, sports, house cleaning, gardening, etc. While not addressing the source of our anger or resolving it, redirection provides a non-confrontational release for angry feelings. However, without expression and resolution, anger will return and can become pathological. Suppressed anger can lead to chronic high blood pressure, anxiety, depression, passive-aggressive behavior or a hostile attitude.
• Calming techniques help us calm down and allow our anger to subside. Self-help techniques like meditation, deep breathing, guided imagery and muscle relaxation can be used to help us regain control of our physical and emotional responses to anger, allowing us to let go of anger.

People who are unable to express their anger or unable to  develop effective methods of resolving anger or whose inability to control their anger is affecting their personal relationships may need help learning to control and manage their anger from a board-certified psychiatrist trained in cognitive-behavioral therapy.

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