A Fresh Look at Anxiety and Depression
I have been excited to do this post for a very long time. Anxiety and depression are the #1 presenting concerns that bring my clients to therapy. I have been noticing that a lot of people present with these problems, but often understand little about it beyond the label.
Of course, diagnoses can be very beneficial in helping people receive support and treatment. It can also put a name to what you are experiencing, and maybe provide some relief in knowing that thousands of others are going through the same struggle! So, an important note. I do not intend for this post to undermine the importance of therapy, consulting with a physician, or (in some cases) medication.
I like to provide a different perspective on anxiety and depression that delves deeper than these labels. In fact, I hope that this post helps you view these issues with greater compassion and understanding, especially for yourself if these are things you have struggled with. While unpleasant, disruptive, and at times debilitating, these concerns can be re-framed as adaptive responses of your nervous system. We will know we truly succeeded if you start to view them that way!
So let's break this down. May I present, for your consideration, the "Window of Tolerance." This term was originally coined by Dr. Dan Siegel; a very accomplished psychiatrist and educator from the United States.
The Window of Tolerance
The Window of Tolerance is, emotionally speaking, the place you want to be. It is where we feel present, emotionally regulated, and able to cope with whatever is going on. You can absolutely have bad days, stressful days, and difficult moments while remaining within the Window. The Window simply represents your ability to cope. When something feels like it is beyond your ability to cope with, this is a sign you have exited the window.
An important note about the Window of Tolerance. It can grow or shrink in size, depending on factors such as coping skills, resilience and trauma. Trauma tends to shrink the Window, while coping and support can expand it.
A different word for "Anxiety"
If you've ever experienced anxiety, you may identify with some of the common symptoms- racing thoughts, increased heart rate, tension, panic, dizziness, trouble sleeping, digestion issues....
Those symptoms can also be viewed as a "survival" reaction created by your nervous system. Ever heard of fight, flight, freeze? The first two- fight and flight- are also what we call hyperarousal.
The sympathetic nervous system (SNS) has a super important job: to keep you alive. I like to use the example of a grizzly bear because I truly believe it is the most accurate manifestation of terror on legs. If I were to be approached by a bear while out for a stroll in the forest, I would most certainly experience an immediate increase in heart rate, tension, prickly sensations up the back of my neck, ringing ears, and an overwhelming urge to get the #%$& out of there. That's my SNS trying to keep me alive. Thanks, buddy.
So let's say it isn't a bear. Let's say it's rush hour traffic. An upcoming deadline. An argument with your partner. A sudden and unexpected change in plans. Your boss yelling at you. While these may not be "life threatening" threats, the SNS isn't that fancy. When it comes to anxiety, it can treat every threat with the same degree of urgency. (By the way, this is really annoying to another area of the brain, which I refer to as the "logic brain" who clearly understands that the body is overreacting but can't do anything about it).
So this is what it looks like to when can't self soothe and exit the Window of Tolerance in an upward direction. Next I'll talk about what it looks like when we shut down and exit the Window in a downward direction.
Another word for "Depression"
Have you ever noticed how exhausting it is to be stressed out all the time? Throw in tension, disrupted sleep, and maybe some negative coping skills and eventually the body becomes so tired that it forces you to take a break. We call this burnout or hypoarousal. This is activated by a different part of your nervous system called the parasympathetic nervous system (PSNS).
A common pattern I hear about is experiencing hyperarousal during the day, maybe while at work, and crashing down into hypoarousal in the evening. For some people this might look like zoning out in front of the TV, tears, falling behind on tasks, or feeling empty and numb. They eventually fall into a disrupted, poor sleep, and wake up feeling tired but anxious for the stresses of the upcoming day. And so the cycle repeats itself.
Of course, this isn't the pattern for everyone. Some of us cycle much more slowly, and are able to sustain high levels of stress for long periods of time. Alternately, others can spend a long period of time in hypoarousal. And some don't experience much of this cycling at all. Your nervous system will be telling it's own unique story based on previous stressors and what you are currently dealing with. The body has a powerful way of telling us what it is feeling. I hope this will help you gain a clearer understanding of what it may be trying to communicate.
Here is a little graphic I created for all those visual learners out there!
Stay tuned for tips below on how to get yourself back into that valuable Window.
So, no doubt the questions to follow are "how do I get back into the window when I've exited?" Here are some ideas. Please note that not all of these tips may be helpful to your unique self, but I hope it will give you some ideas. I suggest trying one or two things at a time- not the whole package!
How to Come Down from Hyperarousal
If hyperarousal feels "up," then we need to find ways of bringing us back down. Think of things that feel soothing, comforting or relaxing. Here are some ideas that can work for both adults and children.
Putting ice on your face (click on this link to learn more)
Take a warm bath
Consider wrapping up in a blanket or making a blanket fort (especially helpful for kids)
Try a guided meditation or a breathing exercise
Ground yourself in time and space by looking around the room, moving, touching things, and pressing your feet into the floor
Try some mindfulness exercises
How to Come Up from Hypoarousal
Get some movement/exercise
Listen to"happy music"
Have a dance party
Talk to someone
Look for things that make you feel sparky*
*When I say "sparky" I mean things that give you life. Things that typically make you excited, happy or joyful. Petting a dog, watching a comedy, being creative, cleaning out a closet. This will be unique to you as a person. Think back to your childhood- what did you have the most fun with? Go swimming my friend. Play lego. Blow bubbles in your milk.