“The Dance Between Stress, Depression &

Anxiety”LifeServices EAP’s July, 2016

“First Tuesdays @ 12 Noon” LIVE Webcast

Your Presenter: Margie Roop, LPCC-S; CEAP; SAP

– LifeServices’ Regional Director, Ohio region– Supervisory Clinical Counselor, Certified EAP; Substance

Abuse Professional under U.S. Department of Transportation rules.

– 21 Years in EAP field; 37 years in the mental health/substance abuse fields.

– Live in Barberton, OH, near Akron. – Married 30 years, one son, age 25, two dogs. – I love to swim, run, travel, sing, read, & go to thrift shops!– “I know what I know from the over 1,000 persons I’ve met

within the EAP counseling setting & the hundreds of workplace settings I’ve visited.”

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The Dance Between Stress, Depression & Anxiety…..

According to the Anxiety & Depression Association of America (ADAA):

– Anxiety disorders are the most common mental illness in the U.S. affecting 40 million adults over the age of 18 (or 18% of the U.S. population).

– Anxiety disorders are largely treatable, yet only 1/3 of those suffering receive treatment.

– People with anxiety disorders are 3-5x more likely to go to the doctor & 6x more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders.

Anxiety & Depressive Disorders

– It’s not uncommon for someone with an anxiety disorder to also suffer from depression & vice versa.

– Nearly half of those diagnosed with depression are also diagnosed with an anxiety disorder.

– List of Anxiety & Depressive Disorders: Generalized Anxiety Disorder (GAD); Panic Disorder; Social Anxiety Disorder; Specific Phobias; Obsessive-Compulsive Disorder; Agoraphobia; Separation Anxiety; Post-Traumatic Stress Disorder; Major Depressive Disorder; Persistent Depressive Disorder (PDD: formerly dysthymia).

– Major Depressive Disorder-The major cause of disability for persons ages 15-44.3! More prevalent for women; median age of onset: 32.5 years of age.

Anxiety & Depression Association of America (ADAA)

– Anxiety disorders cost the U.S. more than $42 billion a year, almost 1/3 of the country’s $148 billion total mental health bill.*

– More than $22.84 billion of those costs are associated with repeated use of health care services; people with anxiety disorders seek relief for symptoms that mimic physical illnesses.

– *Economic Burden of Anxiety Disorders”, study commissioned by the ADAA (Journal of Clinical Psychiatry, 60 (7), July, 1999).

The Connection Between Stress, Depression &

Anxiety– What exactly IS happening here?

– I know I’m stressed, I sometimes feel depressed, & I certainly feel anxious at any given time…?!

– Is there a connection between the three?

– If I experience symptoms of one condition, will I automatically get the other?

– How can I stop it (them) in its (their) tracks?

Symptoms of Anxiety

– Excessive worry-more than six months

– Sleep problems

– Irrational fears-flying, driving, crowds, crossing bridges-if overwhelming & out of proportion=phobia

– Muscle tension-clenching jaw, balling fists, flexing muscles throughout body

– Chronic indigestion-IBS

Symptoms of Anxiety

– Stage fright-could become social anxiety

– Self-consciousness-1:1 contact eating/drinking in front of even small number of people

– Panic-gripping fear/helplessness; impending danger, panic or doom; increased heart rate, tingling/numbing of extremities

– Flashbacks-reliving disturbing events/ trauma; possible PTSD

– Perfectionism-constantly judging self, anticipatory anxiety.

Causes of Anxiety

Medical: Possible mental condition-panic disorder which exhibits as

heart palpitations &/or dizziness, which can also be brought on by:

Physical condition-overactive thyroid, abnormal heart rhythms, mitral valve

prolapse, medication side effect, lack of oxygen

Effects of Drugs-amphetamines; caffeine

Combination of all above!

Generalized Anxiety Disorder

Phobias

Stress Disorders

Causes of Anxiety-External Factors– Stress at work

– Stress from school

– Stress in personal relationships

– Financial stress

– Stress from emotional trauma-death of a loved one

Your doctor has the difficult task of….

– Determining which symptoms came from which causes!

– For example, Web MD reports in a study of people with chest pain-a sign of heart disease-43% were found to have panic disorder not a heart-related condition!

Symptoms of Depression

Causes of Depression

StressAccording to the American Institute of Stress:

– 44% of Americans feel more stressed than they did five years ago.

– 1 in 5 Americans experience “extreme stress”: shaking, heart palpitations, depression.

– Work stress causes 10% of strokes.

– 60% increase in work productivity over the past 20+ years, plus stagnant wages=WORKING HARDER FOR LESS…

– Stress is the basic cause of 60% of all human illness & disease!

Symptoms of Stress

Do you see the precursors to anxiety here?

Do you see the precursors to depression here?

What do YOU think is contributing to these symptoms?

Want to be proactive so you do not descend into an anxiety

disorder?

Causes of Stress

Hmmm, are they causes of or are they the result of stress?

Are we contributing to our own stress?

What do we have control over?

What do we NOT have control over?

Much the same, right?

We’re all in it together!

We’re not so different from the rest of people in the U.S.

Again, are the causes the also the effects of stress?

Are personal choices involved?

Risk Factors for Anxiety Disorders

– Pre-existing mental health condition

– Episodes of depression in youth

– Being a woman

– Being in an unhappy marriage

– Divorce or death of a spouse

– Personal or family history of substance abuse &/or addiction

– Experiencing a traumatic event

– Stressful life experiences

– Low socioeconomic status

– Presence of a chronic medical condition or illness

– Certain medications

Stress & Our Bodies

– Stress impacts our entire being!

–Contributes to poor mental and physical health

– We become more susceptible to illnesses

–We have less ability to fight off illnesses

What a lot of Americans do!

Or, drink alcohol, gamble, do drugs, watch porn, play tons of video

games, eat other junk foods, etc..

All has the some effect=short-term endorphine response=back to

feeling low=needing the “boost” once more, & on & on...

The cycle continues.

The Role of Cortisol*

– Stress starts in our hypothalamus pituitary adrenal (HPA) axis; a series of interactions between endocrine glands in the brain & the kidneys occurs. This controls how your body responds to stress.

– When your brain detects a stressful situation, the HPA axis is instantly activated & releases the hormone cortisol which primes the body for “fight or flight.”

– High levels of cortisol over a long period of time have notable effects on the brain: chronic stress increases activity among neural connections in the amygdala: the brain’s fear center-which results in heightened levels of cortisol.

– This increase can cause electrical signals in the hippocampus-the center for learning, memories, & stress control-to deteriorate inhibiting activity in the HPA axis & weakening a person’s ability to control stress.

* “Stress & The Brain High Cortisol Levels Can Damage Brain Structure, Cognitive Function”, Medical Daily “Pulse”, 11-11-15, Lizette Borroll.

Too much of this hormone pursing

through your brain will cause lots of

trouble!

Excessive Cortisol

– Will also cause the brain to shrink, resulting in loss of synaptic connections between neurons & the shrinking of the prefrontal cortex, a part of the brain that regulates behaviors like concentration, decision-making, judgement, & social interactions.

– Can also cause the hippocampus to produce less brain cells which could make it harder for you to learn & remember things.

– Can also set the stage for more serious mental health problems like depression & Alzheimer’s disease.

Stress & the Brain

Houston, we have a problem!!

Take control of your stress before it takes control over you!

– There are many ways to reverse what cortisol does to the brain:

– Exercising & meditating help a person become aware of & focus on their surroundings.

– Decreasing stress levels will increase the size of the hippocampus & improve memory.

Some helpful articles

– “Relaxation Techniques”– “Creating a Calm Environment at Work (or

home!)”

Mindfulness Exercises

– Ways of paying attention to the present moment using techniques like meditation, breathing, & yoga. Training helps people to become more aware of their thoughts, feelings, & body sensations so that instead of being overwhelmed by them, they’re better able to manage them.

Answers for Causes

Not feeling in control of one’s life…then, take control!

– Write down what IS within your control?! Share & discuss with a trusted partner or friend.

– Attend the EAP to discuss & plan for problem resolution.– Immerse yourself in projective activities: drawing, journaling,

painting, dancing, singing, speaking, exercising, cooking, building, sewing, volunteering, etc…SEE that YOU are the cause of your creation or contribution; moves the locus of control out & away from within (which can contribute to internal conflict) to where you can change, alter, resize, re-design, manipulate, or otherwise mold into what is pleasing to YOU!

– These are all endorphine-releasing activities!

What else are you in control of…?Those with whom you associate: marriage/partner, children, co-

workers, friends!

– Are they: addicts; physically, mentally, abusive?

– Are they negative? “Nay-sayers”? Negativity is poison!

– Do they work in cooperation with you? Financially, care of the home, family, future? Are they an asset or a liability?

– Do they then RESPECT you & your loved ones; your possessions?

– Bottom-line: if it walks like a duck, looks like a duck, smells like a duck, & feels like a duck….it’s…a….well, time to do something about it!.

Your thoughts, feelings & behaviors– Are YOU an alcoholic? Drug addict? Abuser of alcohol?

– Do you abuse others: physically or mentally?

– Are you addicted to: shopping, spending $, the internet, porn, food, collecting, etc…?

– Are you self-loathing? Involve self in negative self-talk?

– How do you perceive the world; other people? As basically good or bad?

– Do you set boundaries with others?

– Are you financially responsible?

– Do you take care of your body? Mind? Spirituality? Nutrition? Intellect?

– Do you respect yourself, your possessions, your job?

– Do you respect & manage your time?

Internal Conflict (may be from core beliefs)?

–Feeling worthless

–Hopelessness

–Guilt

–Persistent sad, empty feeling

–Anxious

–Irritability

–Thoughts of death or suicide

Get help & gain control!

– Suicidal? Call 911, &/or call LifeServices EAP 24/7 to discuss &/or go to the nearest emergency room for evaluation.

– If at work, pick up the phone to call LifeServices EAP or tell your supervisor to call for you.

– If not suicidal, call us to set up a counseling appointment.

– Counseling is projective by nature; it takes the “stuff” (issues) from inside of you to the outside with a qualified, objective, professional who can assist in YOUR taking control over the issues, NOT THE OTHER WAY AROUND!

Serenity Prayer

– “God grant me the serenity to accept the things I cannot change; courage to change the things I can, and the wisdom to know the difference.”

Counseling

–EAP: Short-term counseling: The goal: gain resolution to one’s problems within the short-term venue of the EAP: life transitions such as separation/divorce, stress, changes in finances, work, relationships, school, etc…

–Cognitive Behavioral Therapy (CBT): Short-term, goal-oriented, psychotherapy treatment, takes a hands-on practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, & so, change the way they feel. Often utilized within the EAP.

–Longer-term counseling or treatment: A more prolonged timeframe within which to apply treatment/methodologies to resolve more deep-seeded problems such as: severe depression or anxiety, addictions, phobias, childhood abuses, family of origin issues which still impact healthy life functioning, etc…

Cognitive Behavioral Therapy (CBT)We all possess “core beliefs” about: ourselves, others & the future, i.e., “Men can never be trusted.”

–Thoughts: We go about our days creating, dealing with, responding to numerous thoughts emanating from those core beliefs, i.e., “I’m not saying anything in this group (composed of mostly males).”

–Feelings: “I feel anxious around men.”

–Behavior: says nothing in groups composed of mostly men, so may come across to others as: aloof, suspicious, not knowledgeable, unengaged, or frightened.

–Possible outcome: confronted by boss (no matter male or female) about her non-participatory behaviors in the group, or, may not receive expected raise/promotion, change in title, etc…

Genetics & Medication

Inherited predisposition?

– History of anxiety &/or depression in your family?

– Were they treated with: counseling &/or medication?

– Were they compliant?

– Were there other environmental factors over which they did not exert control?

Medications

– Anti-depressants: non-addictive.

– Work on altering the neurotransmitters: serotonin, norepinephrine, dopamine

– Takes 2-4 weeks before the full effect is evident.

– 60-80% of people, after several months, have significant improvement in their symptoms.

A look at Serotonin

–Neurotransmitter associated with feelings of well-being & happiness.

–Produced in lower quantities in people with depression.

–Medications such as SSRIs-assist the serotonin in getting reabsorbed for optimal connectivity between brain cells which helps with mood regulation; people can find relief from feelings of hopelessness, extreme sadness & lack of interest

–There are many other categories of anti-depressants designed to assist in other “symptoms” caused by dysregulation of these three neurotransmitters.

Other medications…– For anxiety, primarily:

– Some anti-depressant drugs have anti-anxiety effects & can be beneficial.

– Benzodiazepine drugs, such as diazepam (Valium), are in this classification.

– Medications must be used with caution as there is a tendency to increase the dose over time (addiction) & over-sedation can be a problem.

LifeServices EAP

– Contact us at 1-800-822-4847 24/7 to talk!– Set up an appointment to talk in person with one

of our EAP counselors.– Visit our website for resources:

www.lifeserviceseap.com

www.slideshare.netLook up Margie Roop

Article: “Behaviors to Never Ignore in the Workplace”PowerPoints: – “Anger: Who’s Most at Risk?”– “Identifying Stressed-out Employees & How to

Intervene”– “Bullying in the Workplace”– “Dealing with Difficult Customers & We’re All the

Customer”– “Hostile or Respectful Workplace?”– “Communicating with Difficult People”– “Reasonable Suspicion”– “Identifying & Responding to Unsafe Behaviors”– “Stress & the Economy”

Look up Margie Roop on LinkedIn OR www.linkedin.com/in/lifeserviceseap.com

– “Creating a Calm Environment at Work”– “Relaxation Techniques”– “Having Fun in the Workplace”– “Tips for Relaxing”– “Dealing with Holiday Stress”– “I’m not Santa Clause, I’m Just the Manager:

Helping your Employees During the Holidays”– “Ho-Ho-Ho, Help Me; it’s the Holidays!”

Contact LifeServices EAP: 1-800-822-4847

Today! Help is here!– Contact Margie Roop:

mroop@lifeserviceseap.com: with questions or for more resources.

– Look me up on: www.slideshare.net & on www.linkedin.com.

– I will email you the link for today’s recording tomorrow!

– Need a Certificate of Attendance? No problem!

Questions?

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Thank-you so much for attending this webcast! Go out and do great things!