VARIABLES

When people are unable to control their emotions, their responses may be disruptive or inappropriate given the situation or setting.

Emotions that slip out of control (outbursts) can be temporary, however, when present for longer periods – can cause significant distress and problems.

Any emotion present in dominant excess will cause significant distress. If you experience emotional outbursts that are out of your control, it may be time to seek support.

Examples include:

• Feeling sudden irritability
• Fits of crying or laughter
• Feeling angry, but not knowing why
• Anger/aggression outbursts

Anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.

But if your feelings of anxiety are extreme, last for longer than six months, or are significantly interfering with your day to day life, you may suffer from an anxiety disorder. Over time, anxiety can be debilitating, as often times it leads to a formation of vicious circles in our behavior and experiences which lead to a progressive deepening of anxiety.

But…. there is good news. From all human emotions, anxiety is considered and shown to be the most adaptive and sensitive to change.

Several types of anxiety disorders exist:

• Agoraphobia: anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
• Anxiety disorder due to a medical condition:  includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
• Generalized anxiety disorder:  includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression
• Panic disorder:  involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
• Selective mutism: is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
• Separation anxiety disorder: a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
• Social anxiety disorder: involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
• Specific phobias: are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
• Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
• Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive. 

Depression is a mood disorder affecting more than 264 million people worldwide. It is characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities.  It can also disturb sleep and appetite; tiredness and poor concentration are common. The effects of depression can be long-lasting or recurrent and can dramatically affect a person’s ability to function and live a rewarding life.

Some examples of mood disorders:

• Major depressive disorder — prolonged and persistent periods of extreme sadness
• Bipolar disorder — also called manic depression or bipolar affective disorder, depression that includes alternating times of depression and mania
• Seasonal affective disorder (SAD) — a form of depression most often associated with fewer hours of daylight in the far northern and southern latitudes from late fall to early spring
• Cyclothymic disorder — a disorder that causes emotional ups and downs that are less extreme than bipolar disorder
• Premenstrual dysphoric disorder — mood changes and irritability that occur during the premenstrual phase of a woman’s cycle and go away with the onset of menses
• Persistent depressive disorder (dysthymia) — a long-term (chronic) form of depression
• Disruptive mood dysregulation disorder — a disorder of chronic, severe and persistent irritability in children that often includes frequent temper outbursts that are inconsistent with the child’s developmental age
• Depression related to medical illness — a persistent depressed mood and a significant loss of pleasure in most or all activities that’s directly related to the physical effects of another medical condition
• Depression induced by substance use or medication ― depression symptoms that develop during or soon after substance use or withdrawal or after exposure to a medication 

Personality is the way of thinking, feeling and behaving which makes us truly “unique”. Personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. 

When patterns of our behavior, emotions and relation to others yield continuous problems and distress over a long period of time, we speak of a personality disorder which can have long lasting implications.  

Several different types of personality disorder are recognized. They have been broadly grouped into one of three clusters – A, B or C – which are summarized below. 

• Cluster A personality disorders:  A person with a cluster A personality disorder tends to have difficulty relating to others and usually shows patterns of behavior most people would regard as odd and eccentric. Others may describe them as living in a fantasy world of their own. 
  An example is paranoid personality disorder, where the person is extremely distrustful and suspicious. 
• Cluster B personality disorders: A person with a cluster B personality disorder struggles to regulate their feelings and often swings between positive and negative views of others. This can lead to patterns of behavior others describe as dramatic, unpredictable and disturbing. 
  An example is borderline personality disorder, where the person is emotionally unstable, has impulses to self-harm, and has intense and unstable relationships with others. 
• Cluster C personality disorders: A person with a cluster C personality disorder struggles with persistent and overwhelming feelings of fear and anxiety. They may show patterns of behavior most people would regard as antisocial and withdrawn. 
  An example is avoidant personality disorder, where the person appears painfully shy, socially inhibited, feels inadequate and is extremely sensitive to rejection. The person may want to be close to others, but lacks confidence to form a close relationship.  

Relationships are an integral component of happiness and well-being. We live on this planet together, and that influences the need to foster meaningful connections within our community.

Family dynamics, acquaintances, friendships and romantic relationships are all ways in which we, as humans, relate to one another. 

However… Relationships can be complicated. Sometimes, they can even feel impossible.

If you reckognize one of the scenarios below, therapy may be able to help.

• Hard time keeping friends or maintaining healthy relationships?
• Have your relationships changed? Do they feel more strained, or have they always felt that way?
• Are you struggling with your role within your family — whether as a parent, caregiver, partner, sibling or child?
• Do you sometimes feel explosive anger toward others, or can’t stop yourself from arguing with them?
• Having trouble coping with the challenges of parenting, or dealing with defiant and aggressive behavior from your child
• Avoid starting new romantic relationships or ending ones you know are not healthy
• Have difficulties with coworkers and bosses
• Avoid certain social situations or isolate yourself from others
• Rely on drugs or alcohol to “help” in certain situations?

These difficulties are actually very common. But that doesn’t mean you have to continue living without healthy, nurturing relationships.

Therapy can help you develop the skills to create more satisfying connections with the people in your life.

With so many of us torn between juggling heavy workloads, managing relationships and family responsibilities, and squeezing in outside interests, it’s common to reply with to “how are you” with “busy”, “stressed” or the like. And that’s not balanced—or healthy.

In our rush to “get it all done” at the office and at home, it’s easy to forget that as our stress levels spike, our productivity plummets. Stress can zap our concentration, make us irritable or depressed, and harm our personal and professional relationships.

Over time, stress also weakens our immune systems, and makes us susceptible to a variety of ailments from colds to backaches to heart disease. 

While we all need a certain amount of stress to spur us on and help us perform at our best, the key to managing stress lies in that one magic word: balance. If pursuing this goal seems challenging, problematic or impossible, therapy may be able to help. 

Life happens. In Kipling’s words, the twin impostors of ‘triumph and disaster’, the best and worst the world can throw at us.

Life events are defined as discrete experiences that disrupt an individual’s usual activities, causing a substantial change and readjustment. Examples of life events include marriage, divorce, illness or injury, and changing or losing a job. 

Not all ‘life events’ are life-changing. At face value, many appear benign (leaving school, getting a job, moving in with a partner); whilst others seem inherently damaging (the death of someone close, a life-threatening illness, relationship break-up). Yet the extent to which a life event is ‘good’ or ‘bad’ is not necessarily intuitive.

If you are having trouble coping with or adjusting to a new (problematic) situation, therapy can help bring about new insights. 

Low self-esteem and lack of self -confidence are characterized by feelings of being unlovable, awkward, or incompetent as well as hypersensitive to signs of rejection, inadequacy, and rebuff. Associated with it are persistent (and often debilitating) fears of  making a mistake, displaying poor judgment, doing something embarrassing, exposing oneself to ridicule, behaving immorally or contemptibly.

Life, in all its variety, poses on ongoing threat to the self-esteem. But the bigger threat lies within us. As observers of our own behavior, thoughts, and feelings, we not only register these phenomena in consciousness but also pass judgment on them.

Thus, often times we are  our most severe critic, berating ourselves mercilessly when we find ourselves making an error in judgment, forgetting what we should remember, expressing ourselves awkwardly, breaking our most sacred promises to ourselves, losing our self-control, acting childishly—in short, behaving in ways that we regret and may deplore.

If the above-mentioned sounds familiar, then you likely are familiar with the critical, internal self-talk that accompanies it – or Internal Critical Voice. This self-defeating voice reinforces the already negative image we may nurture of ourselves.

When we perceive ourselves negatively, whether we label ourselves awkward, unlovable, obnoxious, shy, etc., it becomes more and more difficult to believe that others could possibly see us in a positive light. It also strengthens our conviction that others can see our pre-assumed shortcomings.  

The good news is that it is entirely possible to overcome low self-esteem! Therapy can help to relieve you from the miseries of nurturing a negative self-image and lack of conviction in your own abilities.

A traumatic event is defined as one that poses a threat of serious injury or death to oneself or others, and elicits feelings of intense fear, helplessness, or horror. 

When having experienced and/or witnessed a traumatic event, you may feel (intense) anxiety, “on edge” as well a series of distressful phenomena such as: 

• Re-living the traumatic event through distressing, unwanted memories, vivid nightmares and/or flashbacks. This can also include feeling very upset or having intense physical reactions such as heart palpitations or hyperventilating when reminded, directly or indirectly of the traumatic event.
• Avoiding reminders of the traumatic event, including activities, places, people, thoughts or feelings that bring back memories of the trauma.
• Negative thoughts and feelings such as fear, anger, guilt, or feeling flat or numb a lot of the time. One may blame themselves or others for what happened during or after the traumatic event, feel cut-off from friends and family, or lose interest in day-to-day activities.
• Feeling wound-up. A feeling of internal unrest manifesting additionally through having trouble sleeping or concentrating, feeling angry or irritable, taking risks, being easily startled, and/or being constantly on the lookout for danger.

While the above mentioned experiences are essentially our minds defense mechanism for dealing with the traumatic event, sometimes this process freezes. This happens when the degree of distress interferes significantly with day to day life and does not reduce over the course of 2-3 weeks post trauma. At this point the condition is referred to as Post traumatic stress disorder, often leading to other problems like depressive moods and intense anxiety.

Not every traumatic event leads to PTSD. If you notice the distress and complaints remaining stable or increasing over time, it’s time to reach out for help.

Experiencing intense and or prolonged psychological distress and suffering may lead to thoughts about or relating to thinking about suicide. 

Suicidal ideation is one of the symptoms of both major depression and the depression found in bipolar disorder, but it may also occur in people with other mental illnesses or no mental illness at all. It is also a sign of great distress, suffering and requires action and support. 

Signs that may hint to active suicidal ideation include:

• Isolating yourself from your loved ones
• Feeling hopeless or trapped
• Talking about death or suicide
• Giving away possessions
• An increase in substance use or misuse
• Increased mood swings, anger, rage, and/or irritability
• Engaging in risk-taking behavior like using drugs or having unprotected sex
• Accessing the methodology and means for suicide, such as medication, drugs, or a firearm
• Feeling extremely anxious

These thoughts may be especially prevalent at times of heightened distress, and present a permanent solution to a temporary problem.

If you find yourself dealing with suicidal ideation, and are concerned you may lose control – know there is help for you and it is time to reach out for it. You are not alone.

These thoughts may naturally occur in people. Together we can weather the storm by setting up a safety net for handling periods of heigthend suicidal ideation.

Therapy can be vital in dealing with such thoughts and experiences as well as the underlying causes of distress. But first and foremost it is human contact that has a protective factor. If you feel you may lose control over your thoughts, seek company, do not be afraid to approach others.

If someone you know displays the above mentioned points, express your concern by simply asking. Experiencing suicidal ideation is terryfying and leaves people feeling isolated and detached. Hearing someone express interest and care in their suffering, can be worth the world at that moment.

A habit can entertain you when you are bored or soothe you when you need to calm down. We can distinguish “better” habits: like reading before sleep or washing hands regularly – from bad habits like overspending and smoking. But good habits can sometimes turn bad. Like when it becomes harder to fall asleep without reading or when washing your hands consumes growing amounts of time and sore skin.  When habits become increasingly problematic and difficult to stop, they may develop obsessions.

Obsessions are reocurring thoughts, feelings and images that result in mounting anxiety. Obsessive thoughts usually portray an overly catastrophic prediction of consequences, should a given habit (by now deeply engrained) not be executed. In the afore mentioned example: not being able to wash hands (or coming in contact with potential contaminant) may result in rising anxiety with obsessive thoughts of getting a deadly illness if the contaminant is not removed immediately. The anxiety can quickly be alleviated if the person decides to wash their hands and execute their habit. The execution of a habit (behavior), resulting in direct alleviation of anxiety is defined as a compulsion. A compulsion is behavior thats not fully conscious or free-willed, as failure to execute despite seeing the irrationality of it – will result in feeling greater anxiety.  

When  obsessions become associated with intense feelings of anxiety, making compulsions impossible to withstand, you may be suffering from an Obsessive Compulsive Disorder. 

Fortuantely, help is available and as much habits as obsessions with or without compulsions can be modulated in therapy. Freeing yourself of obsessions and compulsions can add significant quality to your life and -simply put- give you more time back from the same 24hours. 

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are serious, debilitating and sometimes fatal conditions that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include

• Anorexia Nervosa

People with this condition tend to overestimate the weight/mass of their bodies, thinking they are overweight – even when increasingly underweight. Often accompanies by frustration, guilt and depressive feelings, the individual engages in additional efforts to control one’s weight. Behaviors typically employed are frequent weight checking, severely restrict the amount of food consumed, often exercise excessively, and/or may force themselves to vomit or use laxatives to lose weight. If left untreated this condition poses serious health risks.

• Bulimia Nervosa

People with bulimia frequently eat unusually large amounts of food in a specific period of time. Each binge eating episode usually continues until the person becomes painfully full. During a binge, the person usually feels that they cannot stop eating or control how much they are eating. Binges can happen with any type of food but most commonly occur with foods the individual would normally avoid. Individuals with bulimia then attempt to purge to compensate for the calories consumed and relieve gut discomfort.

Common purging behaviors include forced vomiting, fasting, laxatives, diuretics, enemas, and excessive exercise.

• Binge-eating disorder

People with binge-eating disorder have diffuculty controlling their eating behavior. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. In addition to serious health risks, if left untended binge eaters can become a hazard to their own health as a consequence suffering physically as well as emotionally – with depression and anxiety, low self esteem and social isolation often associated. 

When a group of symptoms, such as stress, feeling sad or hopeless, and physical symptoms occur after you go through a stressful life event you may be experiencing adjustment distress.  The symptoms occur because you are having a hard time coping. Your reaction is stronger than expected for the type of event that occurred. Perhaps the challenged proved greater than anticipated or you encountered more obstacles on your path such as a move to a foreign country or changing jobs. Depending on your transition, your coping skills and many more factors these feelings may subside or grow persistent. If the latter is true you may be dealing with an adjustment disorder. You may feel on edge, unmotivated, fatigued, suffer concentration issues and more while increasingly feeling your knees bending under the challenges youre facing.  

In todays globalized society, the world is a much smaller place, and movement of peoples is a common occurence. However, people vary in their capacity and speed to adjust, and life is full of surprises, so not every transmission is smooth. If you feel this applies to you, therapy can help you build on your existing coping strategies and develop new insights in emotions associated with the change.