Ask The Therapist: “I have severe anxiety and overwhelming feeling of fear.”

n 2016, the number of people estimated to be suffering from mental health issues like depression and anxiety amounted to roughly 1.1 billion. Since then, numbers have likely continued to rise. Moreover, studies have also shown women especially on average are a) more likely to suffer from mental health issues, and b) less likely to talk about them. The taboo in Pakistan surrounding depression and anxiety disorders only serve to aggravate the individuals suffering even more. For the women who cannot seek out full time therapy, or simply need advice about their problems, we’ve enlisted the help of a trained counsellor. You sent us in your questions – here are the answers!

“I have severe anxiety and overwhelming feeling of fear.I start panicking and I take even small things so seriously that it starts to get on my nerves. I start to shiver and sweat. Every other day I see weird dreams and have sleeping issues. Due to some major financial and health issues in home all my life (and still there are), I have often been into kind of depression. Whatever I eat it just does not work. I am underweight like around 41 kgs. People make fun of me being so skinny.”

Haya’s Response:

Dear Anon,

The first step is to understand what anxiety is. Anxiety is an emotion the body and mind experience; it’s often a reaction to stressful, dangerous or unfamiliar situations. It’s a feeling of dread or distress you may feel before an event. Anxiety affects your sleep, concentration, ability to speak to others as well as your judgment. It may feel overwhelming. It can make you feel like you have no control over your feelings or a situation and when it starts interfering with your daily life, it needs to be treated.

Anxiety is a part of several different disorders, which include:

• Panic disorder: experiencing recurring panic attacks at unexpected times.
• Phobia: excessive fear of a specific object, situation, or activity
• Social anxiety disorder: extreme fear of being judged by others in social situations
• Obsessive-compulsive disorder (OCD): recurring irrational thoughts that lead you to perform specific, repeated behaviors
• Separation anxiety disorder: fear of being away from home or loved ones
• Illness anxiety disorder: anxiety about your health (formerly called hypochondria)
• Post-traumatic stress disorder (PTSD): anxiety following a traumatic event

Anxiety feels different for everyone. You could feel out of control, like there’s a disconnect between your mind and body. Or you could experience nightmares, panic attacks and painful thoughts or memories that you can’t control. You may have a general feeling of fear and worry or you may fear a specific place or event. Symptoms of general anxiety include:

• increased heart rate
• rapid breathing
• restlessness
• trouble concentrating
• difficulty falling asleep

More than you wanting to overcome your anxiety, you need to understand what is causing that anxiety. Most of the time, anxiety does not dissolve unless we understand, and eventually change, our situation. If it has to do with the future, which you have no control over, you’ll need to break it down into steps and let it go. Try to focus on the present, on what is around you and take things one day at a time.

Fearing the future will not change it, but it will rob you of your present and turn into a regretful past. If you continue to stay in victim-mode, your feelings and situation will not change. It’s only when you stop feeling like a victim and take ownership of changing your situation will things around you change.

But you can’t do this without one very key piece of the puzzle: self-awareness! Self-awareness and understanding yourself is primary, followed by actions and behavioural change. This may sound cliché but along with doing the above, you must believe that you can attain what you want to. Visualize yourself as the best possible version of yourself. Only then will you be able to reclaim yourself.

If you have difficulty in understanding how you feel, contact a CBT (Congntive Behavioural Therapist), who focuses on identifying, understanding, and changing thinking and behavior patterns related to anxiety. I know you don’t want to see someone, but this could be the missing piece to your frustration.

Once you start working on yourself, you will realize how empowered you are and what true growth feels like. You are not defined of other people’s opinions of you. Understanding who you are and why you feel the way you do will also help you in accepting and loving yourself.

Additionally, try making some life style changes such as changing your diet, finding a plan that your body needs and exercising. Exercising releases hormones called endorphins that will help elevate your mood. Along with that, try practicing mindfulness and meditation to ground yourself in the present. Practice focusing your thoughts in one direction and redirect them when they begin to wander. There are several free apps that can help you with this, such as Calm.

Good luck!