Monday, April 28, 2014

Worry, Anxiety, and Uncertainty

I've been told I overthink things.

To some degree this is little more than a loveable quirk (at least I hope it's loveable). I often take things I've observed, and try to dissect them as much as I can, often to the point of absurdity.

Recently, for example, I noticed that I had been reading more works of nonfiction than fiction. I was fascinated with this, and brought it up to my friends. I asked "When did this happen? Why did it occur? Do fiction books just not interest me as much anymore? Was I ever really that into fiction books?" For my friends, the reaction was mostly a combination of bemusement and exhaustion. It wasn't the first time I'd overanalyzed something as simple as me changing my preference of literature.

Unfortunately, my tendency to overthink isn't limited just to little things like that. I overthink everything. I dissect them, analyze them, ruminate over them. Often I overthink the things I fear might happen, or the things I don't know. And then I overthink them more. And more. And more.

Other words for it are anxiety, and in extreme cases obsession. It can be found in OCD, ADHD, and GAD, among doubtless many other conditions. The point is the same: there are thoughts, and I cannot let them go.

Let me give an example. For as long as I can remember, I've been afraid of brain damage. I fear it happening to me, and I fear the effects it could have on my personality, my beliefs, and my relationships with other people. I fear the philosophical possibility that if I suffer brain damage, that I cease to be myself.

I'm sure many other people have these fears from time to time. The difference for me is the immediacy and intensity with which I feel them, so that I feel not that brain damage might happen, but that it will. Several weeks ago, I spent an entire afternoon caught up in these fears of brain damage. I researched philosophical theories of the relationship between the mind and brain, theories of personality and the self. In my fear I bought a book how to live with brain trauma. I began feeling psychosomatic sensations in my head, minor throbbings and lightheadedness, and became paranoid that these were the precursor of an aneurysm, or an unnoticed concussion. All of this culminated in a point where I had checked myself into the school mental health counseling services, and broke down in despair over what brain damage might do to me.

I have not had brain damage. There was no reason for me to assume I had that likelihood in the near future. My family had shown no previous risk for strokes or the like, and I was not engaged in any high-risk activities that would put me at risk for brain damage. Even if I did suffer brain damage, there was no reason to believe it would affect me in the horrid, personality-effacing ways that I feared it would. All of that didn't make a difference to me. It could happen, there was nothing to prevent it from happening, and therefore my mind interpreted that it would, in the worst possible way.

That's an extreme example, but the same phenomenon occurs again and again in my life. These questions include, but are not limited to:
  • Is there a God? (And other philosophical questions)
  • Does someone I care about really love me?
  • Do I really love the people I think I care about?
  • Do I have some early stage of cancer right now but don't know it yet? 
  • Is this future event going to turn out the way I want it to, or  fear it will?
A common thread throughout is that all of these questions are things there are no easily knowable answers to. Take love for example. I want to think I love other people, but how do I know truly? Is there some test I can take to verify that the emotion I feel is love? What if I'm only convincing myself I'm feeling love? What if there's no such thing as love? I don't know, so I try to dissect every feeling, every thought, analyze it and reduce it, and ask myself "is this love? Am I feeling love?"

Unfortunately for me, there is no answer to this, or at least none that our society currently knows. Philosophers have been debating love for thousands of years, and if I were to take a guess, I'd say they'll be debating it for thousands of years more. We can put our stock in one view of love or another, but in the end there's no way we can guarantee that we have the right idea.

And that's where the anxiety comes in. Anxiety is about trying to get certainty in things we can't be certain about. We want to know about our future, about our relationships, about God, as clearly and certainly as we know the time of day. We want certainty, but we can't get it, so we become miserable thinking about the things we can't be certain about.

Often, when faced with this anxiety and uncertainty, our first response is to double down on our desire for certainty, often through checking behaviors. We try to do what we can to be as certain as we can be, even if what we can do doesn't actually leave us any more certain. A person afraid of catching disease may frequently wash his hands. A person who is insecure about their relationships may constantly apologize to other people for some wrongs they think they have done. Someone who is worried about whether there is or is not a God may spend a great deal of time reading philosophical works on the divine in search of an answer.

Unfortunately, all of these techniques are temporary solutions, and often can be more problematic in the long-term than they help in the short term. If someone feels they have to constantly wash their hands to prevent from catching disease, they build up the fear of the disease in their mind, and become increasingly anxious the longer they go without washing their hands. Someone who constantly apologizes for perceived wrongdoings in relationships may tire his loved ones through constant apologizing, ironically making the success of relationships less certain than if he did nothing at all. And with philosophy, well, men have been debating these things for thousands of years. We haven't gotten a certain answer yet, and continued readings of philosophy will only make that uncertainty all the more pronounced.

Yet for the anxious mind, what else can they do? When I have felt acute anxiety over something, I feel like the only thing I can do is, if I cannot be certain, to get as close to certainty as I can. Yet there's only so close one can get to certainty. No matter what I do, there will always be a gap between what I know and what I want to know, and there is no way to bridge that.

The only option, then, is to accept it.

When I first heard that suggestion, I bucked it as hard as I could. I couldn't imagine accepting the things I feared would happen, because in my mind that was as good as allowing them to happen, to admit defeat and give into the real possibly of my worst fears being realized.

But the possibility was always there. Most of the time, worrying about those fears doesn't prevent them from occurring, it just make the interim until/if they occur all the harder to bear. No matter what I do, no matter what I think, the things I worry about can still happen. I may get cancer. I may lose my loved ones. I may get brain damage and may through brain damage have my personality inexorably erased from existence.

But so far, none of those things have happened. So far, all that I have done is worry about them. And worry. And worry. My quality of life has been lowered over things that have not even happened yet, if they happen at all.

One may still be resistant about giving up their anxiety. One may argue that their anxiety has been useful, where by worrying about things they then do things to prevent the things they worry about from happening. And that may be the case for mild anxiety.

But for more severe cases. Cases like my own, I've found the exact opposite.

Often when I worry, I don't prevent the things I fear from happening; I make them all the more likely. By fearing bad outcomes to such a severe extent, I impair myself, and reduce my ability to function properly. When I've worried about a test or an assignment, I become paralyzed with fear, and avoid starting the project, or working on it as much as I should, because of how deeply I associate the project with the uncomfortable fear of failure. With friendships and other relationships, I become so worried about losing them that I no longer able to function normally in them, in the ways that started those relationships in the first place. I become visibly anxious and uncomfortable around them, and the other person does not want to be around someone like that, and so they begin to drift away. Which causes me to become more anxious. Which causes them to drift away.

Maybe for some of those cases, my anxiety didn't make things worse. Maybe in some of those cases, my anxiety had no effect on what was going to happen, or even delayed it. Maybe in some cases, my anxiety has actually prevented some of the things I worry about from coming to fruition. I can't think of any, and I seriously doubt there were more than a few, if any at all, but it's possible.

It's still not worth it.

I'm afraid of many things because I fear they will ruin my life. But anxiety has already done that for them. Anxiety has taken away my ability to enjoy the world from day to day, and has left me in constant fear of the future. Anxiety has made me paranoid and insecure, constantly worrying that I'm doing something wrong, or putting myself at risk. Anxiety has curled up inside of me like a parasite, and eaten me up from the inside.

And I want it to stop.

We can't always change the things we want to. We can't always know the things we want to. In those cases, all we can do is accept.

Accept all the things we do not know, and cannot be certain about. Accept that we will not get the answers to many of our questions for a very long time, if we ever will. Acknowledge that we are suffering greatly in our anxiety over the things which we do not know, and that worrying about them is unlikely to change the outcome of the things we worry about (they may even make the bad outcomes we worry about more likely!). The things we are afraid of may happen, and if/when they happen, they may be very hard to deal with. But we cause ourselves a great deal of misery now about something that hasn't happened yet, and may never happen.

Do we want to live in a world where we're constantly worrying over the things we don't know? How much better could our lives be if we could acknowledge the things we don't know, accept that the worst may happen, and still strive to live the best lives we can at this moment in time?

Jonathan Grayson, author of the book "Freedom from Obsessive Compulsive Disorder", from which I've drawn a great deal of material for this post, said in his book that "Living with uncertainty means choosing to cope with whatever may happen. There is no alternative." He is right. We have no other option, save to continue to suffer and agonize over the countless things we do not know, and that is no option at all. To get better, and to free ourselves from our anxiety and obsessions by no longer letting ourselves be in fear over them, is the only option we have. And we can begin the process now.

Monday, April 21, 2014


There are few things crueler in the world than feeling alone. All the pain and suffering in the world can be endured if we have others to share the load with. Alone, those burdens are frightening and all the more terrible.

I've felt alone. I've felt alone with other people around me. I've tried to talk, to communicate, but my ignorance and anxieties make me feel limited and distanced. I've felt alone in my depression, where the illness itself works to isolate and separate me from the rest of the world, and convince me that others do not love me. I've felt alone late at night, when there's no other voices to be heard but my own, and the things that it's saying are more than I can handle. Today I felt very alone for a very long time.

In my experience, loneliness is is accompanied by hopelessness.  Odd, considering we deal with problems by ourselves all the time, and most of the time we do them with no trouble. But when I think of myself as being by myself, the situation becomes much more difficult. The difference seems to be between being alone and feeling alone. It's the difference between not having others around us but still feeling their love and support, versus feeling like we're the only ones taking on the weight of the world.

We need to know we're not alone. We need to know that others are there to help us. We need to know that what we have struggled with others have struggled with. We need to know that out there, somewhere, is someone who cares about and values us as we would like to be valued.

But sometimes it's very hard to find that.

For those of us who have had traumatic experiences, who have had problematic childhoods, or who have dealt with the isolating experiences of mental illness, it can be very hard to feel like there's someone out there who can understand us. There are many solutions to this, and I would encourage everyone who feels this to look for what works for them.

But here is something that works for me:


Yesterday morning , as I was preparing for the day, I felt very depressed. I wouldn't call it despairing, but things felt empty. I wasn't sure why I was doing anything, what it was all going towards. The future felt narrower, and I felt smaller.

In the end, what got me out of this slump was not any philosophical tract on "revolt against the face of despair" or whatever. The feeling did not suddenly go away. No medicine removed it. Instead, I was inspired by an anecdote from Victor Frankl's Man's Search for Meaning, whereby Frankl, while suffering in a concentration camp, is able to inspire himself to continue on by thinking of his wife. The quote is wonderful, as is the whole book, and is included below:
We stumbled on in the darkness, over big stones and through large puddles, along the one road leading from the camp. The accompanying guards kept shouting at us and driving us with the butts of their rifles. Anyone with very sore feet supported himself on his neighbor's arm. Hardly a word was spoken; the icy wind did not encourage talk. Hiding his mouth behind his upturned collar, the man marching next to me whispered suddenly: "If our wives could see us now! I do hope they are better off in their camps and don't know what is happening to us." 
That brought thoughts of my own wife to mind. And as we stumbled on for miles, slipping on icy spots, supporting each other time and again, dragging one another up and onward, nothing was said, but we both knew: each of us was thinking of his wife. Occasionally I looked at the sky, where the stars were fading and the pink light of the morning was beginning to spread behind a dark bank of clouds. But my mind clung to my wife's image, imagining it with an uncanny acuteness. I heard her answering me, saw her smile, her frank and encouraging look. Real or not, her look was then more luminous than the sun which was beginning to rise.
Like Frankl, I thought of those I loved. I thought of my closest friends and loved ones, past and present. People who still cared for me and those who I knew no longer did but whom I still cared for nonetheless. I thought of their faces, of precious moments spent with them. I thought of wanting to make them happy, and I realized that the way to best make them happy was if I was happy, or at least as close to happy as I could be in the present moment. I could show my love for them by extending that love to myself, and willing myself to endure the suffering I was feeling now.

And that helped. The pain lessened somewhat, and what pain remained became easier to bear. It did not go away, but things became just a little bit easier, in part because I was able to take the pain and bear it in the context of something beyond myself I realized I was not alone. I was part of a larger world, filled with others who were affected, changed, by my presence and my actions. My pain became not simply something I was bearing for my own sake. It became something I bore for the sake of others as well. There's something very empowering in that.


That was just one technique. Sometimes it works, sometimes it doesn't. It's good to have multiple techniques at our disposal, as sometimes one does not help us but other does so.

But no matter what, we need to remember that we are not alone. Orson Welles once said that through friendships and relationships we give ourselves the illusion that we are not alone. But I think it is loneliness that is the illusion. True, each of us lives only in our own bodies. We can only ever see what it's like in our own heads, not the heads of others. And yet we do believe that others are around us (at least most of us do). We feel them and speak with them in our lives. And we care about people, and we believe they care about us, through the things they have done for us, the ways they've helped us get to where we are now. We can all think of people who have helped us. Fred Rogers made use of this to great extent in his acceptance speech for the Daytime Emmy Lifetime Achievement Award, and I encourage you to watch it:

"No man is an island", as John Donne said. We are part of something much greater than ourselves. Everywhere on this world there are people like us, who see through eyes as we do, hear the world as we do, and think as we do, though their thoughts may take them to different conclusions. Whatever we feel, we can know that there are others who have felt the same. When we hurt, there are others who have hurt the same ways as well. Each of us feels and thinks and experiences in our own unique ways, but though the details may be different for each of us, the core of them is the same.

Maybe we are alone. Maybe each of us is an island. Hell, maybe Hilary Putnam is right, and we're all just brains in a vat that believe we are making these connections. I choose to believe that we're not. I choose to believe that though we may feel very alone at times, and though we may not be as close to others as we'd like to be, we're never truly alone. There are always ways for us to connect, and feel that connection, though sometimes they might be very hard to find.

I'd like to end this post with the paragraph immediately following the quote from Victor Frank's Man's Search for Meaning above:
A thought transfixed me: for the first time in my life I saw that truth as it is set into song by so many poets, proclaimed as the final wisdom by so many thinkers. The truth - that love is the ultimate and highest goal to which man can aspire. Then I grasped the meaning of the greatest secret that human poetry and human thought and belief have to impart: The salvation of man is through love and in love. I understood how a man who has nothing left in this world still may know bliss, be it only for a brief moment, in the contemplation of his beloved. In a position of utter desolation, when man cannot express himself in positive action, which his only achievement may consist in enduring his sufferings in the right way - an honorable way - in such a position man can, though loving contemplation of the image he carries of his beloved, achieve fulfillment. For the first time in my life I was able to understand the meaning of the words, "The angels are lost in perpetual contemplation of an infinite glory."

Monday, April 14, 2014

The Courage To Be Vulnerable

Consider this article, which discusses how men, because of societal gender expectations of being stoic, strong alpha-males, often hide their mental health difficulties from others in an attempt to appear in control, and in doing so fail to reach out for the support that they need, and see their mental health deteriorate as a result:
One of the things I've found is that men have a difficult time talking about and getting help for their mental health or if they're feeling suicidal. There seems to be some societal pressure that says "You're not a true man if you don't have it all together, all the time."
I would argue this is true, but that it goes beyond men. I would argue that everyone feels that pressure to hide their mental illness from others, along with other perceived deficiencies in appearance, our health, or our character.

There are reasons for this. Mental illness stigma is very present in our society, and we fear we will be rejected or misunderstood by others we care about because of that stigma. More than that, it seems simply human nature to want present ourselves as the best possible version of ourselves. We are inclined to hide our own flaws and issues, partly because in doing so we believe we make others more affable towards us, and perhaps also because in hiding them from the public eye we are able to, in some degree, deny to ourselves that we have them.

Hiding one's personal struggles is not always a bad thing. In some situations, we do need to keep our problems, mental health or otherwise, hidden from other people. We feel little to no compunction to hide family stresses or financial difficulties at work, in a business meeting, or when we are giving a speech, if for no other reason than that we would expect the same of anyone else in such a situation. Too often, however, this is stretched to our friends and loved ones, and we feel we have to hide our struggles from them as well.

Time and again I have seen people, even those who have experienced mental illness in the past and gotten help for it, afraid to disclose their current struggles. I myself have been guilty of that sometimes--if I think that I have been generally improving, and then I have a bad depressive episode, there is a powerful fear that my recovery has stopped, or that I will go back to feeling worse. Never mind that I've had such feelings numerous times before--and that very often every depressive episode can feel like the worst one--I feel like I can't let anyone know, for fear of frightening them, or for fear of admitting to others and to myself that I wasn't doing as well as I thought I was, or that by simply talking about it, I will make myself worse by acknowledging it.

The result is that I keep my struggles balled up inside of me, trying to fix them myself so that no one else can see what I am struggling with. Sometimes I end up managing whatever problem I'm having and get better. Other times the problem continues to gnaw away at me until I have no choice but to make the problem becomes visible on its own--often in the form of a breakdown.

But when I do open myself up to others, very often I find the reaction is not a pushing away from me (though sometimes that is the case), but an understanding, an acceptance, and a willingness to help. I think something we forget about a lot of times when we are considering hiding our problems from others is that our loved ones do want to help us. They want us to feel good and be happy, and they want to contribute to that. While we might be worried about burdening them with our own problems, often times it can make them feel good because we've exposed our problems to them, and let them into our inner world so that they can help us.

Obviously, this does not apply to everyone. For people who have unhealthy relationships, relationships where the other person routinely demeans them and makes them feel bad about themselves, or otherwise constricts their ability to live a healthy life, telling such people risks causing more harm than good. The very foundations of those relationships aren't built upon a desire to help us in the first place. And of course, there is the recurring fear that even if we do reveal our problems to people who love us, that they will dismiss our problems and, though they do not intend to do so, nonetheless hurt us.

And unfortunately, they might. There are no guarantees. Some people may believe that we are overreacting, or being self-centered, or whatever the myriad of other reasons people give for why mental illness isn't mental illness, or why our problems don't matter. To some degree it's fear of thinking of someone they love as being one of those oft-maligned stereotypes they see in the media, as well as numerous other reasons I don't feel I have the understanding to talk about. They may turn away from us, or dismiss us, or even think less of us. We can't control that.

Nonetheless, very often letting others in to our own issues provides a way for us to get better. It allows others to understand how we are struggling, and understand how their own behavior affects us, and try to better accommodate us.  It allows others to give us advice, and opens us up to new perspectives which we may not have thought about, either because it was simply something we hadn't considered or because we were so distressed we didn't have the breathing room to consider other options. Sometimes just knowing that others know, and understand to some degree, is comforting and therapeutic on it's own, making us not feel so alone.

In the end though, we can't be certain how another person will react. And since most of us are used to hiding our problems inside ourselves for quite some time, it can be very difficult to open ourselves up, to show ourselves at our most vulnerable and able to be hurt, and ask that others help us.

Some may consider keeping one's internal problems wholly inside themselves a show of strength, but I would argue the opposite--hiding one's troubles is a sign of fear. Fear of appearing weak. Fear of having loved ones think poorly of you. Fear of thinking poorly of yourself.

A greater show of strength is one which emphasizes that we are not nearly as strong as we'd like to be--that we are flawed human beings, and we need other human beings to support us.

I am talking about the courage to be vulnerable.

I am talking about the courage to open oneself to other people, flaws and all, and risk being hurt by them. Not because you will be hurt, but because by doing so you allow them the opportunity to help you, and to connect with you in a deeper way. You show to yourself that you are willing to take a risk, in the hopes that you will get better.

It is not easy to say to another person, "I have a problem", but it is so crucial for us to do that. There are some battles we cannot always fight on our own, where we need the love and support of someone else to get us through it, and the only way they can give us that love and support is if they know what we are going through.rld

Monday, April 7, 2014

Healthy Body, Healthy Mind

Today I am depressed.

The cause is relatively easy to fix, fortunately, but in the time I have it, it's a real pain to manage. I did not get enough sleep last night. I elected to watch videos on youtube when I should have been going to bed, and as a result I went to bed later and woke up intermittently throughout the night. When I woke up, I struggled to go back to sleep. I became anxious about whether or not I would fall asleep, what would I do during the day if I couldn't fall asleep now, is thinking about this keeping me awake for longer, and so on. Once I had woken up, I should have gotten out of bed, had something to eat, and taken a Xanax to quell the anxiety, and I might have salvaged a bit more sleep than I did. Alas, I did not, and this is what I have to show for it.

The result was I became depressed. Obviously, I was tired. I felt reduced motivation to work, and what work I did do was filled with a low but present sense of dread. When I was left with idle thoughts, I felt empty and the future seemed bleak. At one point I had thoughts of suicide. They were ill-defined and fleeting, quickly rejected after a few seconds, but for a period of time, however short, they were there.

I eventually remembered to use the techniques I had learned for myself to allay the depression. I began by turning off the melancholy music I was listening to (not surprisingly, Copeland is a bad choice to listen to when you're already feeling down), reminded myself that the feelings I was experiencing were transient, and even started to count the windows on nearby buildings to distract myself, which oddly enough ended up being the most helpful technique.  I pushed through that part of the day, and for a period of time my depression lessened and enabled me to better get work done.

As I write this, I am still tired, and as a result, still feeling somewhat depressed. Hopefully I will get a good night's sleep tonight, and will have learned an important lesson for the future, but for right now, I just have to grit my teeth and slog through the rest of the day.

In the meantime, my experiences today seem like a good jumping-off point for discussing a part of recovery discussed less often than it should be, and that is general physical health and how it relates to our mental health.

As I said, I have little energy today, so in lieu of much more introduction to the subject, I will simply throw some articles at you.

"Nutrition can play a key role in the onset as well as severity and duration of depression

"People who exercise regularly have positive boosts in mood and lower rates of depression"

"Sleep Therapy Seen as an Aid for Depression"

On reflection, these results seem obvious. Of course being well-fed, healthy, and well-rested makes us feel better. What's surprising is how deeply such healthy habits can affect us. When I don't eat enough, I become anxious. When I exercise regularly, I'm left with a glow that stays with me throughout the day. When I don't get enough sleep, as has been seen today, I suffer for it.

A few weeks ago, for whatever reason, I hadn't eaten enough in my meals. I was participating in a class project that afternoon and was becoming increasingly distressed and depressed. I doubted my ability to perform the tasks required of me, and wanted to leave class early and retreat to my room. Acting on that feeling, I went to my teacher and told him how I was feeling, at the time hoping he would see how I was struggling and give me his permission to go home.

Instead, he suggested I eat a protein bar. I did, and almost instantly I felt better, and went at my tasks that afternoon with a vigor and excitement that just a few minutes earlier seemed so foreign to me. Was some of that placebo? Probably. But all of it?

It's important to realize that depression is not only an illness that affects the brain. It is an illness which affects the whole of our bodies. Yet at the same time, by bettering our bodies, we contribute to the bettering of our mental health as well. Medication, therapy, and social support can all be very helpful, and in some cases crucial, to our recovery. It's important we don't disregard how our overall health can affect us as well.